Children are always taught in school that medical profession is a noble one. But they are never told, about the cruelty this profession has faced since ancient times. the ancient rulers always blamed the physician for the poor patient outcome and also made regulations to regulate medical profession, and this was when the medical science was not even developed enough to deal with most diseases.
A great military commander, Hammurabi consolidated small states in the vicinity after ascending to the throne on the death of his father. Sometime around 1780-50 B.C., the Babylonian king Hammurabi promulgated the now famous Code of Hammurabi, covering both civil and criminal law.
Hammurabi’s Code of Laws was considered the first documented Code ever used by human civilization in Mesopotamia, the cradle of civilization, the land of Assyro-Babylonian culture. This era first saw the interface between medicine and law in the dawn of civilization.
Among the 282 laws in Hammurabi’s Code, nine (215-223) pertain to medical practice:
HAMMURABI’S CODE OF LAWS :
- If a physician performs eye surgery and saves the eye, he shall receive ten shekels in money.
- If the patient be a freed man, he receives five shekels.
- If he be the slave of some one, his owner shall give the physician two shekels.
- If a physician performs an operation and kills someone or cuts out his eye, the doctor’s hands shall be cut off.
- If a physician performs an operation on the slave of a freed man and kills him, the doctor shall replace the slave with another slave.
- If he had opened a tumor with the operating knife, and put out his eye, he shall pay half his value.
- If a physician heal the broken bone or diseased soft part of a man, the patient shall pay the physician five shekels in money.
- If he were a freed man he shall pay three shekels.
- If he were a slave his owner shall pay the physician two shekels.
As we can see, it did not take into account the earlier works or contribution of doctors to society. It also did not take into account the uncertainty of medical science and uncertainties of the outcome. The regulatory system was based on principle of revenge and punishments.
Deselection of providers: Hammurabi’s Codex specified the harshest form of deselection possible. If the physician erred through omission or commission, his fingers or hands were cut off, immediately stopping his practice. This severe punishment for negligence supposedly weeded out physicians incapable of delivering adequate care. In addition, it prevented these physicians from practicing in a different locality. Obviously, such a penalty discouraged a physician surplus.
Since ancient civilization, medical regulation has been always cruel to doctors. Hammurabi at the start of civilization believed that doctors needed to be punished in case there was poor prognosis. He failed to understand the complexity of human body and the limitations of medical profession.
Today our system is becoming somewhat similar, to those ancient regulations in terms of punishment and revenge. Differential payment system for health care also resembles the Code of Hammurabi in some respects.And this is despite the fact that now we are very well conversant with the workings of the human body and despite cognizance of the poor prognosis in certain disease states.
In an effort to institute managed healthcare, our society is in a way re-entering the realm of an ancient medical care system. Certain aggrieved health care consumers may welcome a move toward harsh penalties in the name of justice and simply for revenge but we need to keep in mind the poor outcomes in complex diseases, limitation of science and of course the idiosyncrasies of the human body.
Code of Hammurabi. (2017, December 18). In Wikipedia, The Free Encyclopedia. Retrieved 16:58, December 23, 2017, from https://en.wikipedia.org/w/index.php?title=Code_of_Hammurabi&oldid=816023447