There is growing chaos in the world. Barely surviving the Covid-19 pandemic, the world is currently facing new catastrophes, including the devastating consequences of climate change, the war in Ukraine, the oil crisis, and social and political unrest. These events have put a lot of stress on several healthcare systems. Consequently, medicine as a profession is faced with renewed challenges on an already fragile equilibrium.
Physicians are generally expected to navigate between three paradigms in executing their tasks. The first paradigm, Logos, is how facts, science, and evidence are used to serve the patient. The second paradigm, Pathos, refers to how emotional intelligence is used to care for others and establish personal connections. The third paradigm is Ethos which entails how certain ideals or belief systems are used to guide decisions. Often described as the rhetorical triangle, these three paradigms form the basis of how we (are expected to) communicate and interact with others and perform our tasks.
Ethics in medicine originated from the mythic traditions of the "physician-hero/physician-god," Asklepios (1500 BC and 500 AD), whose first followers included the ancient physicians Galen and Hippocrates. In Greek, Ethos refers to "custom" or "character" and describes the guiding beliefs or ideals that characterize communities, nations, or ideologies. As used by Aristotle however, Ethos refers to a person's character or personality, especially in its balance between passion and caution.
Over the centuries, Ethos has been refined to include the original tenets of medical ethics - benevolence, altruism, relief of suffering, integrity, fidelity, honesty, compassion, humility, confidentiality, social responsibility, and respect for autonomy. These principles have resulted in the articulation of a ‘universal truth’ of the human condition - "The predicament of illness, the vulnerability of the sick, and the unique nature of the physician-patient relationship that imposes ethical obligations on anyone who professes to be a healer."
It Is on this Ethos that the traditional recitation of the Hippocratic oath is stooled, which is meant to serve as a reminder of this universal truth. So, as we reexamine the Hippocratic oath, every physician need not forget the importance of good professional ethics.
Jamiu Busari, associate professor of medical education at FHML and dean Health Professions Education (HOH Academy Aruba)