First, Do No Harm? The Dark Side of Hippocratic Medicine
Kimbell Kornu, MD, PhD, Assistant Professor of Palliative Medicine and Health Care Ethics, Saint Louis University
Hippocratic ethics is often equated with traditional medical ethics, exemplified by “first, do no harm” and the Oath. Those that hold traditional Christian moral positions, such as the prohibition of physician-assisted suicide, often invoke the Hippocratic Oath as a way to safeguard the practice and ends of medicine without appealing to religious arguments. Yet, the modern sensibility often separates epistemology from ethics; but in Hippocrates’s case, epistemology is inseparable from ethics. The medical art (technē) that the Hippocratic Oath seeks to uphold has a dark, violent dimension against nature. To better understand the relationship between Hippocratic ethics and Hippocratic epistemology, I will examine specific texts within the Hippocratic corpus that elucidate the medical art and then trace their influence on the subsequent Greek medical tradition, particularly the advent of anatomical dissection as the foundation of Western medical knowledge. We find that the medical epistemology that grounds the medical art is startlingly similar to that of the early modern philosopher Francis Bacon’s violent mastery over nature to relieve the human condition. Such mastery of nature is an ethical stance that Gerald McKinney has called the Baconian project, which currently animates the ethos of modern medicine. This paper suggests that Hippocratic epistemology lies at the heart of Western medicine and already anticipates the Baconian project by 2000 years. Citing Hippocratic ethics in contemporary debates about medical ethics as well as in medical practice motivated by religious faith must take seriously the epistemological dark, violent side of Hippocratic epistemology that seeks to master nature. Otherwise, invoking the Hippocratic tradition can tacitly support violence against human nature rather trying to protect it.
Hippocratic ethics is often equated with traditional medical ethics, exemplified by “first, do no harm” and the Oath. Those that hold traditional Christian moral positions, such as the prohibition of physician-assisted suicide, often invoke the Hippocratic Oath as a way to safeguard the practice and ends of medicine without appealing to religious arguments. Yet, the modern sensibility often separates epistemology from ethics; but in Hippocrates’s case, epistemology is inseparable from ethics. The medical art (technē) that the Hippocratic Oath seeks to uphold has a dark, violent dimension against nature. To better understand the relationship between Hippocratic ethics and Hippocratic epistemology, I will examine specific texts within the Hippocratic corpus that elucidate the medical art and then trace their influence on the subsequent Greek medical tradition, particularly the advent of anatomical dissection as the foundation of Western medical knowledge. We find that the medical epistemology that grounds the medical art is startlingly similar to that of the early modern philosopher Francis Bacon’s violent mastery over nature to relieve the human condition. Such mastery of nature is an ethical stance that Gerald McKinney has called the Baconian project, which currently animates the ethos of modern medicine. This paper suggests that Hippocratic epistemology lies at the heart of Western medicine and already anticipates the Baconian project by 2000 years. Citing Hippocratic ethics in contemporary debates about medical ethics as well as in medical practice motivated by religious faith must take seriously the epistemological dark, violent side of Hippocratic epistemology that seeks to master nature. Otherwise, invoking the Hippocratic tradition can tacitly support violence against human nature rather trying to protect it.