{"id":35784,"date":"2015-12-09T13:57:18","date_gmt":"2015-12-09T12:57:18","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=35784"},"modified":"2015-12-09T14:10:40","modified_gmt":"2015-12-09T13:10:40","slug":"is-the-good-samaritan-the-wrong-metaphor-to-use-for-doctors","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2015\/12\/09\/is-the-good-samaritan-the-wrong-metaphor-to-use-for-doctors\/","title":{"rendered":"William Cayley: Is the Good Samaritan the wrong metaphor to use for doctors?"},"content":{"rendered":"

\"bill_cayley_2\"<\/a>A story from the Christian New Testament has provided the literary namesake for countless medical facilities, as well as legal and ethical principles guiding care for those in need, but it may be the wrong illustration\u2014or at least, not an adequate one.<\/p>\n

The \u201cGood Samaritan\u201d story<\/a> is told in the book of Luke to answer the question \u201cwho is my neighbor?\u201d After a traveler is beaten, robbed, and left for dead, he is helped and cared for not by either of the two religious professionals who pass him by, rather he is given aid by a stranger from a socially suspect group of outsiders. The point of the story is that \u201cneighborliness\u201d has to do with actions (caring, compassion), not simply with social proximity, respectability, or status. The challenging implication is that such \u201cneighborliness\u201d is an inherent part of our responsibility to each other, simply by virtue of being human.<\/p>\n

Recently, however, while preparing a talk for our residents on responding in \u201cGood Samaritan\u201d situations to calls for medical assistance, I was prompted by some writings by Dr Ed Pellegrino<\/a> to re-think the adequacy of the \u201cGood Samaritan\u201d for addressing the role of the physician in rendering assistance. While \u201cneighborliness\u201d would imply a common human responsibility to those in need, Dr Pellgrino argues that helping the person in need is a fundamental commitment or obligation inherent in being a physician\u2014an obligation assumed on taking a professional oath (typically, some version of the Hippocratic Oath) when entering the profession of medicine. For example<\/a>:<\/p>\n

“At this moment, one enters a moral community whose defining purpose is to respond to and to advance the welfare of patients\u2014those who are ill, who are in need of help, healing, or relief of suffering, pain, or disability.”<\/p>\n

And<\/a>
\n“Without the Oath the doctor is a skilled technician or laborer whose knowledge fits him for an occupation but not a profession.”<\/p>\n

A similar sentiment is found in the World Medical Association<\/a> (WMA) International Code of Medical Ethics:
\n“A physician shall give emergency care as a humanitarian duty unless he\/she is assured that others are willing and able to give such care.”<\/p>\n

Periodically in the medical literature, one finds articles addressing the practical or legal considerations inherent in responding to a call for medical assistance. Typically, these address the problem from the perspective of \u201cshould I respond?\u201d or \u201cshould I be a Good Samaritan.\u201d<\/p>\n

I am beginning to think that this is the wrong perspective. Challenging as it is, the story of the Good Samaritan refers to a common human responsibility we each have to those who are our neighbors, whether we realize it or not. However, at least Dr Pellegrino and the WMA would both argue that for those who have committed to the medical profession, a commitment to respond has already been made a priori.<\/p>\n

All ethical humans face the challenge of whether or not we will emulate the model of the \u201cGood Samaritan\u201d and help neighbors in need (whether they be crowds of refugees or a homeless person on a park bench). For a physician, however, when the call comes \u201cIs there a doctor in the house,\u201d the question should not be \u201cShould I respond?\u201d but rather \u201cHow can I help?\u201d<\/p>\n

End note:\u00a0For those interested, the resources I\u2019ve found most helpful in preparing my educational session are:<\/p>\n