My ex boss, in Family Practice, is a hard core Catholic. We went head to head over religion, atheism, catholicism, politics and the list goes on. Most all the time it was good fun although we never really came to any agreements. The other night, in the ER, I saw a patient who I used to take care of in FP for 10 years. He has Hep C, endstage liver cirrhosis, portal hypertension, esophageal varices (which had bled twice), hyperammonemia and hepatic encephalopathy. He uses marijuana regularly. His visit to the ER was because of lower leg swelling. The workup led to nothing new and I sent him home. His mother pulled me aside and told me that my ex boss had told this patient to absolutely not smoke dope. I told her that at this point in his life he may smoke as much dope as he wants. I talked to my boss about the Hippocratic Oath—first do no harm and relieve pain and suffering—His response to me more than once, has been “suffering is part of life”. How can he reconcile this with the oath? If dope makes this patient comfortable, then is it not our responsibility to encourage that (in view of the fact that he is terminally ill). My ex’s “suffering” comment comes from his catholic/christian beliefs and, as I see it, directly contradicts his medical oath but he could never see this. This was a source of conflict for us both for years.
So after our visit in the ER I told the patients mother to ignore my ex’s advice and let him smoke dope if he wanted to. Doing “no harm“ by limiting what helps him is wrong; “relieving pain and suffering“ means marijuana if life is terminal. In my experience, I believe religion gets in the way of sound medical practice.