Contents

• Caring About HIV Care
• The Oath of Hippocrates
• World Faces Possible Crisis in Untreatable TB
• Nairobi Prostitutes May Hold Key to Aids Vaccine

Caring About HIV Care
By Karen Wong & Iris Sun

~ An interview with Mr. David Coop, Coordinator of the Immunodeficiency Clinic at the Toronto General Hospital

Attitudes toward AIDS and HIV are improving, but ignorance and prejudice still surround the disease.  The people who make up the team at the immunodeficiency clinic of the Toronto General Hospital are dedicated to providing their specialized abilities, knowledge and heart.

“Our philosophy is really to provide a holistic care to people.  We don’t just look at the disease, but also the impact of the disease on the whole functioning (of the patients),” said Mr. Coop.

This specialized clinic is one of the two largest HIV clinics in Canada.  The clinic presently manages about 1200 active cases and approximately 250 patients visit each week.  The health-care team of the HIV clinic consists of professionals ranging from researchers, scientists and medical specialists to social workers and chaplains.  They work together in order to promote the patients’ health and well-being.

The major function of the clinic is to provide specialized consultations for patients with complicated cases referred by their family physicians.  The patients receive monitoring and medical treatment, and also gain advice with regards to psychological, social, functional and nutritional concerns.  In addition, the patients are exposed to innovative research studies, and new or experimental medications that are not available elsewhere (more than 40 research trials are presently in progress).

Mr. Coop confesses that his job as a clinic coordinator is both physically and psychologically demanding.  He regularly encounters patients struggling with anxiety and depression, but he still enjoys his work.

“The patients that I see here are by and large people who really make tremendous lifestyle changes and psychological adjustments…  I find patients are quite inspirational.”

Biggest Challenges Facing the Clinic:

1. There is no cure for AIDS yet.  The clinic aims to make HIV infection chronically manageable.  This means that patients may live long and qualitative lives provided they receive proper medication and therapy.
2. Preventing the virus from spreading out is a very important issue.  Therefore, it is necessary to develop a vaccine for the virus, especially for Third World countries.
3. The health-care funding of the clinic is being eroded.  It is critical for the clinic to continue to have its base of funding in order to maintain the resources necessary for a high quality of care.

 

 
 
 
 
 

According to Mr. Coop, the future of the HIV clinic will include a greater emphasis on outpatient care.  The complexities of the drug regiments (resistance, side-effects) necessitate frequent monitoring and support.  As well, HIV can be a latent infection for many years.  The tendency will be the use of viral loads, which involves the procedure of measuring the amount of the virus in the plasma.  This initiates preventive instead of reactive therapy with a patient who presently does not suffer from any symptoms or active disease.

The HIV clinic sustains one of the most dynamic clinical care units and make leading medical discoveries in the field.  The objectives of the immunodeficiency clinic and the broad patient population psychological resilience and foster positive challenges.  The environment also evokes team members’ compassion as they reflect on death and dying.  But hope is not lost; the contagious inspiration gives light and direction to the lives of the patients and the health care team.

Visit the HIV clinic web site at:
http://tthhivclinic.ca

The Oath of Hippocrates
By Karen Wong & Iris Sun

I SWEAR by Apollo the physician and Aesculapius, and Heath, and All-heal, and all the gods and goddesses, that, according to my ability and judgment,

I will keep this Oath and this stipulation—to reckon him who taught me this Art equally dear to me as my parent, to share my substance with him, and relieve his necessities if required; to look upon his offspring in the same footing as my own brothers, and to teach them this art, if they shall wish to learn it, without fee or stipulation; and that by precept, lecture, and every other mode of instruction,

I will impart a knowledge of the Art to my own sons, and those of my teachers, and to disciples bound by a stipulation and oath according to the law of medicine, but to none others.

I will follow that system of regimen which, according to my ability and judgement, I consider for the benefit of my patients, and abstain from whatever is deleterious and mischievous.

I will give no deadly medicine to any one if asked, nor suggest any such counsel; and in like manner I will not give to a woman a pessary to produce abortion.  With purity and with holiness I will pass my life and practice my Art.

I will not cut persons labouring under the stone, but will leave this to be done by men who are practitioners of this work.  Into whatever houses I enter, I will go into them for the benefit of the sick, and will abstain from every voluntary act of mischief and corruption; and, further, from the seduction of females or males, of freemen and slaves.  Whatever, in connection with my professional service, or not in connection with it, I see or hear, in the life of men, which ought not to be spoken of abroad,

I will not divulge, as reckoning that all such should be kept secret.  While I continue to keep this Oath unviolated, may it be granted to me to enjoy life and the practice of the art, respected by all men, in all times.  But should I trespass and violate this Oath, may the reverse be my lot.

WHO WAS HIPPOCRATES? 
Hippocrates was a Greek physician born on the island of Cos between 470 and 460 B.C.  His family claimed descent from the legendary Aosculapius, son of Apollo.  Hippocrates was acknowledged as the earliest author of the Greek medical writings.  The oath was only one of the few that are commonly recognized to be his accomplishments.

 The Hippocratic oath shows that the physicians of his period were infusing the medical tradition with regulations and a common professional model.  He believed that “life is short, and the Art long; the occasion fleeting; experience fallacious, and judgement difficult.  The physician must not only be prepared to do what is right himself, but also to make the patient, the attendants, and externals cooperate.”

“I will not cut persons labouring under the stone.”
According to Michael Harris, this is a reference to bladder stones.  Hippocrates was instructing physicians to not operate on patients suffering from stones in the urinary tract.  In the time of Hippocrates, bladder stones often caused fatality.

 There is a trend of increased administration of oaths to medical graduates.  However, the original features of the various oaths have been modified with time.  A study was conducted by Robert D.Orr, M.D. and Norman Pang, M.D. with regards to the use of the classical Hippocratic oath in 1993.  They analyzed the convention and the content of the oaths conducted in 157 medical schools in the United States and Canada.

It was investigated that only one school continued to use the ancient version of the Hippocratic oath, whereas 68 others used different adaptations of the traditional oath.  The following are percentages of the oaths used today that incorporate the specific content item which was a component in the original Hippocratic oath:
100% pledge to patients
43%  liable for actions
14% oppose euthanasia
11% request a diety
8% oppose abortion
3% oppose sexual contact with patients

 “By abandoning the transcendent and convenantal character of the Oath, those who drafted this reformulation of Hippocratism have turned the principles of medical ethics into one long composite motion to be debated year over year at representative medical assemblies.”  [Nigel M. deS. Cameron, The New Medicine, p. 88]

 What makes the Hippocratic oath controversial is the application of some of its ethical principles about medicine in today’s world.  Abortion and euthanasia are issues that many people are concerned with (with the Hippocratic oath is against them), and whether they should be practised or not is debatable.  Some people suggest discarding the oath and replacing it with a new one, while others are in favor of keeping the original version.  Although the World Medical Association has already revised the oath, many people question its validity.

Source:  http://www.sequel.net/~twilight
   http://webatomics.com/Classics/Hippocrates/hippoath.html

World Faces Possible Crisis in Untreatable TB
 

To be made available soon.

Nairobi Prostitutes May Hold Key to Aids Vaccine
 

To be made available soon.

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