WILTIMS #101: The Catholic consult

The snow day yesterday delayed our return to classes, but things were in full swing today. Biochemistry has become nitro-centric with protein catabolism and the uric acid cycle. Meanwhile physiology has turned its gaze from the heart to the kidneys. Lastly, we started History of Medicine as taught by our well-spoken chancellor.

After classes had ended I attended a guest talk by an ethicist and physician, Dr. Barron Lerner, on the changes in medical ethics from the times of his father, who was also a physician, to his own contemporary views. The takeaway was that medicine used to be far more paternalistic, with doctors making decisions on behalf of patients without ever necessarily consulting the patients themselves.

One dramatic example made my classmates and me question whether our current legal and moral framework is truly the best. An ailing woman who was terminally ill and had expressed a desire to discontinue treatment suddenly coded (cardiac arrest). She had not signed a DNR (do not resuscitate) form so the hospital staff went to call the code team, as they are required to do by policy and law. The speaker's father yelled for them to stop, saying that this was wrong and that the moral thing to do was to let the woman die with dignity. The staff called the code anyway and when the team arrived, the speaker's father literally laid his body across her chest to prevent them from doing CPR, and the woman died. Today, such an action would likely result in a lawsuit and/or sanctioning by the hospital. But was it truly wrong? I don't know.

A less serious anecdote was told of an old woman who needed an invasive surgery but wouldn't consent to being operated upon. The speaker's father explained thoroughly explained the need and brought in several other preeminent physicians to do the same. Finally he asked if another doctor from another institution could come take a look. The woman assented but still adamantly refuse surgery. The other doctor was devoutly Catholic. After he recommended the surgery and the woman refused again, the doctor accepted this and then asked the woman if he could pray for her. She was taken aback but said yes. The doctor proceeded to take out his rosary and make a show of his elaborate desperate prayer. The woman had surgery the
following day.

TIL: Hippocratic medicine was founded on the principles of the four humors, which though not correct, was the first time disease was attributed to natural causes rather than deities and treatment to physical action by physicians as opposed to intervention by said deities. The Hippocratic age was also the origin of the technique of taking a history and physical, as well as keeping a medical record for empirical research about the efficacy of treatments.