Are medics bound by the Hippocratic Oath, or similar?

[Nanako]

In real life, being a doctor is a position that comes with a lot of responsibility. Many medical schools require trainees to take some sort of oath or ethical agreement, and in general being a doctor is a position that comes with expectations and rules in addition to those an ordinary citizen would be bound to.

Are any of those represented here?> Are medical staff bound to any additional rules, aside from the corporate regulations? http://aurorastation.org/wiki/index.php?title=Corporate_Regulations

What should be done in various ethical scenarios?

For example, if a patient in critical condition refuses treatment.

Or if a doctor is assaulted and unable to escape, are there additional obligations in how she's allowed to defend herself?

What if the captain orders an execution by lethal injection, and wants a doctor to carry out the sentance?

What if i'm ordered not to treat someone who would die without it? is that order valid?

How far is a doctor expected to go in putting themselves at risk, in order to retrieve wounded crewmen?

Is there an expectation that crewmen suffering SSD should be carried onto the shuttle by a doctor?

Is doctor-patient confidentiality a law?

Are there regulations about bedside manner? or operating without anaesthetic?

What applies here. Tell me as much as you can, please.

[Fire and Glory]

I don't actually know if the docs are actually meant to be bound by the Oath or not, there is different-but-similar book that contains a Doctor's Oath in a bookcase in the medical break room, or somewhere, but again, I don't know if all are bound.

Though I do know about some certain things that aren't bound by moral obligation.

Q:What if the captain orders an execution by lethal injection, and wants a doctor to carry out the sentance?

A:Executions can NOT be ordered by Captains or any Head or Staff, as that would be explicitly illegal rather then just against regulation, if a Captain is ordering anyone to execute a prisoner or such without proven authorization from CC, he is Exceeding Official Powers and a doctor does not need to listen to him.

Q:What if i'm ordered not to treat someone who would die without it? is that order valid?

A:Could or wouldn't die without it, most likely depends on context, if it was a prisoner beaten by an officer's harm baton so badly he broke bones when he was not giving hostile resistance, then preventing the docs from treating him, most likely falls under Mistreatment of Prisoners (as well as beating the guy in the first place usually) and the person refusing to let him be treated is breaking regulations, things are more tricky and grey when considering those who AREN'T prisoners, and I don't really have a good answer for that.

Q:How far is a doctor expected to go in putting themselves at risk, in order to retrieve wounded crewmen?

A:The actual doctors? None, they were hired to sit in medical and treat those who end up on their door step, although that's not going to stop them from running to every call, EMT's or paramedics however, are of course expected to retrieve them to a reasonable degree, but they're typically to get on the scene and give treatment after everything is told and done, so anything beyond getting out of medical and eventually giving treatment is up to the EMT, none are expected to run into fire-fights and pull out wounded or fend off space-carp, of course, that's not going to stop them from doing it.

Q:Is doctor-patient confidentiality a law?

A:Pretty much, there's a difference between regulation and law but a doctor randomly telling people about the confidential medical records of anyone falls under Neglect of Duty and would probably get them demoted or fired.

Q:Are there regulations about bedside manner? or operating without anaesthetic?

A:Not specifically, HOWEVER, giving, say, a new clone or such psychiatric trauma by being an abrasive asshole or operating without anesthetic without a good reason will end up going under Neglect of Duty and again, get you demoted out of medical pretty fast.

Not the answers you'd be looking for since you wanted to know about the ethical side of things but it should clear a few things up on what you should or shouldn't be doing.

I've purposely skipped over some questions because I didn't have answers for them.

A link to the regulations I've been quoting, http://aurorastation.org/wiki/index.php?title=Corporate_Regulations

[Guest]

No, the hippocratic oath is no longer enforced; NanoTrasen has a personal medical staff oath (found in the NT Medical Manuals) which is optional for medical staff you follow. And @FireandGlory, executions can't be ordered by anyone, they're completely illegal in Republic of Biesel.

[Fire and Glory]

And @FireandGlory, executions can't be ordered by anyone, they're completely illegal in Republic of Biesel.

Thought there was something about being able to execute if Central Command gives the go ahead, but okay.

[SierraKomodo]

And @FireandGlory, executions can't be ordered by anyone, they're completely illegal in Republic of Biesel.

Thought there was something about being able to execute if Central Command gives the go ahead, but okay.

 

It's along the lines of if CC authorizes/orders it, it's CC that's willing to bite the bullet for it.

[witchbells]

The Baystation wiki has a similar pledge called the Iaso Doctrine. While Aurora isn't purely based off bay lore, I've always referred to the doctrine when the situation came up. Not sure if it's in our canon, however.

For reference.

[Guest]

I was semi-wrong, Nursie was semi-right. From the IC NT Medical Diagnostics Manual: (it says at the top that all NT Medical Employees take this oath)

Now, as a new doctor, I solemnly promise that I will, to the best of my ability, serve humanity-caring for the sick, promoting good health, and alleviating pain and suffering.

I recognise that the practice of medicine is a privilege with which comes considerable responsibility and I will not abuse my position.

I will practise medicine with integrity, humility, honesty, and compassion-working with my fellow doctors and other colleagues to meet the needs of my patients.

I shall never intentionally do or administer anything to the overall harm of my patients.

I will not permit considerations of gender, race, religion, political affiliation, sexual orientation, nationality, or social standing to influence my duty of care.

I will oppose policies in breach of human rights and will not participate in them. I will strive to change laws that are contrary to my profession's ethics and will work towards a fairer distribution of health resources.

I will assist my patients to make informed decisions that coincide with their own values and beliefs and will uphold patient confidentiality.

I will recognise the limits of my knowledge and seek to maintain and increase my understanding and skills throughout my professional life.

I will acknowledge and try to remedy my own mistakes and honestly assess and respond to those of others.

I will seek to promote the advancement of medical knowledge through teaching and research.

I make this declaration solemnly, freely, and upon my honour.

[Nanako]

these replies are excellent, i greatly appreciate it <3 and thanks xander for posting it in full

[Nanako]

I was semi-wrong, Nursie was semi-right. From the IC NT Medical Diagnostics Manual: (it says at the top that all NT Medical Employees take this oath)

Now, as a new doctor, I solemnly promise that I will, to the best of my ability, serve humanity-caring for the sick, promoting good health, and alleviating pain and suffering.

I recognise that the practice of medicine is a privilege with which comes considerable responsibility and I will not abuse my position.

I will practise medicine with integrity, humility, honesty, and compassion-working with my fellow doctors and other colleagues to meet the needs of my patients.

I shall never intentionally do or administer anything to the overall harm of my patients.

I will not permit considerations of gender, race, religion, political affiliation, sexual orientation, nationality, or social standing to influence my duty of care.

I will oppose policies in breach of human rights and will not participate in them. I will strive to change laws that are contrary to my profession's ethics and will work towards a fairer distribution of health resources.

I will assist my patients to make informed decisions that coincide with their own values and beliefs and will uphold patient confidentiality.

I will recognise the limits of my knowledge and seek to maintain and increase my understanding and skills throughout my professional life.

I will acknowledge and try to remedy my own mistakes and honestly assess and respond to those of others.

I will seek to promote the advancement of medical knowledge through teaching and research.

I make this declaration solemnly, freely, and upon my honour.

 

Reading over this a couple more times, it actually seems quite empty. Most of these could just be summarised as "I will do my job", The only particularly ethical thing is the part about policies breaching human rights. It seems extremely odd that NT would have that in a pledge, they're known for abusing their workers

I notice particularly, that all of the obligations in it, are obligations specifically to my patients, not to people in general. There's no definition of what a patient is. So i can only assume a patient is defined as someone i'm told to treat, or who comes into medbay.

The rules for example, don't seem to stop a doctor from maliciously attacking others, or employing dangerous methods in self defene. There doesn't seem to be an obligation towards the care of everyone on the station, only those who qualify as my patients

I suppose i'm kind of disappointed in this, it's nowhere near as restrictive or demanding as i'd expected. I wonder if it would be alright to RP an additional medical oath (medical schools typically administer them) on top of this one

During a slow shift today, an antagonist attacked two tajarans in the hall. very ineptly. Nobody reported it, and the first i heard about it was when i wandered outside of medbay to find them slashing and strangling his battered, barely-alive body. I ended up having to assault my coworkers to get them to back off so i could rescue him, there was no time to call security, he was on the brink of death.

Even though he was an antagonist, and attempted to murder them, he was still a sentient being, and i felt compelled to save his life. The death penalty is not legal in biesel after all

It was an interesting time, i'm quite enjoying playing as a doctor with a rigid sense of morality and a strict "nobody dies on my watch" rule

[Dea Tacita]

Reading over this a couple more times, it actually seems quite empty. Most of these could just be summarised as "I will do my job", The only particularly ethical thing is the part about policies breaching human rights. It seems extremely odd that NT would have that in a pledge, they're known for abusing their workers

 

1. Wrong board, moving this to the lore questions thread as this is a question regarding lore.

2. The oath Xander quoted (afaik) is from baystation 12 and is not 100% ICly binding. It may or may not even exist in our lore. So until a member of the lore team confirms it, there's really no point in critiquing an oath that doesn't apply to us.

[Guest]

Reading over this a couple more times, it actually seems quite empty. Most of these could just be summarised as "I will do my job", The only particularly ethical thing is the part about policies breaching human rights. It seems extremely odd that NT would have that in a pledge, they're known for abusing their workers

 

1. Wrong board, moving this to the lore questions thread as this is a question regarding lore.

2. The oath Xander quoted (afaik) is from baystation 12 and is not 100% ICly binding. It may or may not even exist in our lore. So until a member of the lore team confirms it, there's really no point in critiquing an oath that doesn't apply to us.

 

I'm quoting something that exists expressly in our universe as a NT manual which is inside of Medical and the Library.

[Outboarduniform]

i find this quite interesting , as i've seen many a few doctors say fuck it with certain antags (vampires will always be pieces of shit lets be honest) , but does that give medical the right to just leave them at a scene , bleeding to death ? something to think about.

[SmokedFish]

Actually the Oath has been changed over time....I don't think any SS13 server lore speaks about abortion or lethal injections. Probably best if they do not.

I like to base my medic based on a few parameters, your questions are relavant to them :

Q:For example, if a patient in critical condition refuses treatment.

A: I never had that situation, I'd probably ask a head if available, if none available, person should be put under anesthethic, treated.

If they have a complaint for having their life saved, they can file it to NT. If they complain using their fists, then a security officer will be called.

Q:Or if a doctor is assaulted and unable to escape, are there additional obligations in how she's allowed to defend herself?

A:According to regulations, Doctors are allowed to defend themselves as any other crewmember would, and the assailant, punished accordingly.

Q:What if the captain orders an execution by lethal injection, and wants a doctor to carry out the sentance?

A:No. Because Corporate Regulations and Sol Law. Depending on your character,they might fall under pressure,perhaps bribed. If station is no longer under NT control as it happend once, they might again, fall under pressure depending on your character's personality.

Q:What if i'm ordered not to treat someone who would die without it? is that order valid?

A:Technically you are supposed to treat them. But if said person represents a threat to the station , like a someone with "access to blue space technology", that should again, be a matter to consider.

Q:How far is a doctor expected to go in putting themselves at risk, in order to retrieve wounded crewmen?

A: Paramedics are expected to do so in colaboration with security officers. Know how in real life when an accident occurs, Police and Ambulances arrive?In our case, Security,Engineers and medics, depending on situation.

Q:Is there an expectation that crewmen suffering SSD should be carried onto the shuttle by a doctor?

A: I was doing that usually depending on how "Nice" my doctor was.In principle, the crew heads/captain's duty is to make sure everyone gets to the shuttle, no matter their state.Least that's what i think. Usually I would grab everyone and take them to the shuttle, as I learned, Transfer shuttles do not need that necessary. In case of emergency shuttles, Medics, among other crew members like security SHOULD take SSD people to the shuttle, in principle, each department taking care of it's own members, under their head's guidance, or if appliable, SSD in their imediate vicinity.

Q:Is doctor-patient confidentiality a law?

A: Controversial here. Station Security should be put first. Again, according to your character's personality.

Q:Are there regulations about bedside manner? or operating without anaesthetic?

A: Haven't read any. Aparently not, but to be a good doctor, you must anesthethic your patient before surgery.

[SierraKomodo]

So as someone who's been playing a CMO and has had several medbay characters...

 

I like to base my medic based on a few parameters, your questions are relavant to them :

Q:For example, if a patient in critical condition refuses treatment.

A: I never had that situation, I'd probably ask a head if available, if none available, person should be put under anesthethic, treated.

If they have a complaint for having their life saved, they can file it to NT. If they complain using their fists, then a security officer will be called.

 

Seems to depend on the character, but mine follow the understanding that everyone has a right to refuse treatment. If they aren't cooperating, or are outright fighting the doctors trying to treat them, causes more harm then good so my CMO just sends them on their way with a note on their record saying 'Denied treatment' or 'Fought against treatment'.

 

Q:Or if a doctor is assaulted and unable to escape, are there additional obligations in how she's allowed to defend herself?

A:According to regulations, Doctors are allowed to defend themselves as any other crewmember would, and the assailant, punished accordingly.

 

I actually had an interesting situation similar to this with Ariana. It was code red, Ariana was given a gun (She has security experience) and told to keep an eye on a suspect that was cuffed to a chair. She was being a bit lenient, which resulted in said suspect unbuckling /and/ uncuffing themselves, and then making arun for her. Suspect then got shot until he dropped, Ariana then pulled out her medkit and treated what she could there. So, while again it's dependent on a character, a doctor can probably get away with more potentially lethal means as long as they treat it - Any good doctor always has a medkit on them anyway (You spawn with it).

 

Q:What if the captain orders an execution by lethal injection, and wants a doctor to carry out the sentance?

A:No. Because Corporate Regulations and Sol Law. Depending on your character,they might fall under pressure,perhaps bribed. If station is no longer under NT control as it happend once, they might again, fall under pressure depending on your character's personality.

 

What you said. Executions are illegal and, if it's going to occur, will require CC to order it. Even then, it's STILL illegal and 'I was just following orders' isn't the best defense in a murder charge.

 

Q:What if i'm ordered not to treat someone who would die without it? is that order valid?

A:Technically you are supposed to treat them. But if said person represents a threat to the station , like a someone with "access to blue space technology", that should again, be a matter to consider.

 

Refusing treatment to a patient would also be illegal, and medical treatment is actually addressed in the current corporate regs. I tend to consider refusing treatment of a lethal injury as the same as ordering an execution:

http://aurorastation.org/wiki/index.php?title=Guides/Regulations#Classification_Notes

G04 Medical reasons Medical personnel can be called, or the prisoner can be escorted to the Medbay. The timer continues to run during this time.

Prisoners are entitled to medical attention if sick or injured.

 

Q:How far is a doctor expected to go in putting themselves at risk, in order to retrieve wounded crewmen?

A: Paramedics are expected to do so in colaboration with security officers. Know how in real life when an accident occurs, Police and Ambulances arrive?In our case, Security,Engineers and medics, depending on situation.

 

I wouldn't say anyone's expected to put themselves in a position where they're going to die, but as mentioned an EMT would be more likely to have to enter a potentially dangerous situation to recover someone.

 

Q:Is doctor-patient confidentiality a law?

A: Controversial here. Station Security should be put first. Again, according to your character's personality.

 

After asking Jackboot, here's what he said:

 

[attachment=0]sadgds.PNG[/attachment]

 

Q:Are there regulations about bedside manner? or operating without anaesthetic?

A: Haven't read any. Aparently not, but to be a good doctor, you must anesthethic your patient before surgery.

 

Speaking of anesthetics, operating without them tends to be slapped with a neglect of duty charge - Especially if your patient starts screaming bloody murder on comms.

[Guest Marlon Phoenix]

The Hippocratic Oath and all other "human rights" things were all lumped under the Luna Convention of Galactic Law. The specifics are kept vague because I have no interest in writing out actual legal documents and treaties. It's good shorthand for anything like the hippocratic oath, geneva convention, and other human rights documents. ALl of this is covered under the Luna Convention, which applied all of this to galactic space on a galactic scale to make it all universal and singular. Even if enforcement is lax in some areas. Or ignored.

1. The obligation to respect Sentient Rights

5. The right to liberty and security

8. The right to respect for private life

9. The right to freedom of thought, conscience and religion

10. The right to freedom of expression

14. The right to prevention of discrimination

For example, if a patient in critical condition refuses treatment.

I actually couldn't find a lot of reliable information on how this is handled IRL. All the sources talk about treating the mentally ill. Apparently doctors have to juggle the civil liberties and safety of the patient by asking things like "is he a risk to himself/others?" and other questions. Use your best judgement.

Or if a doctor is assaulted and unable to escape, are there additional obligations in how she's allowed to defend herself?

I don't think a doctor would stop to think about legal and ethical questions when someone's actively shooting/stabbing them. The difference is that once the doctor is safe they ideally should make reasonable effort to get the assaulter medical care, even if they can't do it themselves.

What if the captain orders an execution by lethal injection, and wants a doctor to carry out the sentance?

You have every right to refuse to carry out the order. It's a violation of Galactic Law to execute anyone, and this is enforced by the Republic of Biesel. That doesn't mean it can't be ordered, but you shouldn't be compelled.

What if i'm ordered not to treat someone who would die without it? is that order valid?

Ideally you treat them anyway, but maybe keep them restrained. All sentients, under the idealistic laws of the Luna Convention, are entitled to medical treatment. Enemy combatants, collateral damage, political dissidents...

How far is a doctor expected to go in putting themselves at risk, in order to retrieve wounded crewmen?

As far as would keep them safe and is reasonable.

Is there an expectation that crewmen suffering SSD should be carried onto the shuttle by a doctor?

it'd be polite but there's no regulation demanding it

Is doctor-patient confidentiality a law?

Yes. Security would need a search warrant or the allowance of the Chief Medical Officer to get access to a medical record.

Are there regulations about bedside manner? or operating without anaesthetic?

Unreasonable harm or distress for a patient tend to be a bad thing. You need to operate with painkillers or anaesthetic of some kind. If you absolutely can't, do whatever you can do to keep the patient safe and not screaming in incoherent agony.

What applies here. Tell me as much as you can, please.

[Nanako]

Another issue that's been coming up recently, RE Anaesthetic.

I do always use anaesthetic by default if possible, but there's been a number of occasions of nonhuman crewmembers refusing it. Particularly Vaurca

I'm not quite clear on parts of their lore, but my understanding is that their carapace feels little or no pain. Certainly, vaurca players always RP that way with me. I've sometimes offered them the choice of anaesthetic too, mostly on the OOC basis that they can chat more and see whats happening during the surgeery.

Today an Unathi janitor refused sedation too, because "pain is a journey" and he wanted to chat with me during the surgery.

I'd like some thoughts on this, and particularly regulations about anaesthetic too.

Are patients allowed to refuse sedation?

Is it reasonable to not sedate (bound) vaurca patients on the basis that they don't feel pain and don't care?

[SierraKomodo]

Another issue that's been coming up recently, RE Anaesthetic.

I do always use anaesthetic by default if possible, but there's been a number of occasions of nonhuman crewmembers refusing it. Particularly Vaurca

I'm not quite clear on parts of their lore, but my understanding is that their carapace feels little or no pain. Certainly, vaurca players always RP that way with me. I've sometimes offered them the choice of anaesthetic too, mostly on the OOC basis that they can chat more and see whats happening during the surgeery.

Today an Unathi janitor refused sedation too, because "pain is a journey" and he wanted to chat with me during the surgery.

I'd like some thoughts on this, and particularly regulations about anaesthetic too.

Are patients allowed to refuse sedation?

Is it reasonable to not sedate (bound) vaurca patients on the basis that they don't feel pain and don't care?

 

I'd say for the purpose of NT covering their butts, anyone refusing anesthetic needs to sign a waiver. If they're not capable of signing a waiver prior to the surgery, they can't be considered fit to make that decision themselves and it'd be preffered you put them under anesthetic anyway.

[Guest Marlon Phoenix]

Today an Unathi janitor refused sedation too, because "pain is a journey" and he wanted to chat with me during the surgery.

I'd like some thoughts on this, and particularly regulations about anaesthetic too.

 

The only time that Unathi are feasible unable to get access to anaesthetic even on Moghes is if they're literally being given battlefield surgery in a makeshift tent, and even then the izweski have access to sophoric injectors. Or if they're in one of the dirt poor villages or towns scattered over the planet outside the nicer cities. even then the local shaman/doctor would try to grind some plants together or jerry-rig something. And no Unathi would want to willingly go through a surgery without any form of anasthetic and be in their right mind - hell, they could offer to go without it, but once the pain messages hit they should be reduced to a gibbering mess regardless. Let me know if you see Unathi doing this so I can just remind the players that pain-rp counts for Unathi too.

If a patient refuses sedatives you need to give them something. Painkillers, oxycodone, sophoric, or anaesthetic. You need to have one of these things in the patient before you do a surgery. At the very minimum feed him a bunch of painkillers. You should never do a surgery without some form of sedative or painkiller for the patient. Unless it's critically life threatening and there is literally no other choice, you simply refuse to do the surgery while insisting they get anasthetic/sedatives. Unless, again, it's life-threatening or you have no other choice. A broken ankle? Let him try to walk around. They'll come crawling back. A popped lung? Keep insisting and keep something handy.

Having them sign a waiver is a silly idea since, you know, they're on a surgery table and probably not able to properly sign a form. It's a common sense thing really; no one in their right mind willingly get operated on without painkillers. It's extremely silly!

Vaurca I'll have to poke about. If their bug-eyes feel no pain then it should be fine.