In the fall of 1953, as a first-grader in Pittsburgh, I was part of a medical miracle. Every few weeks my classmates and I were lined up in the school gym for injections and blood tests given by researchers from the University of Pittsburgh. Like most kids I was afraid of the needles, but I could tell from the way the grown-ups were acting that this was something very important. I particularly remember a balding, white-coated man named Jonas Salk, who personally injected his experimental polio vaccine into my tensed-up arm. No kidding. By the next spring, he was a national hero&emdash;and, visiting our school for the last time, he signed my yearbook.
We've come to take such medical miracles as Salk's polio vaccine for granted. Immunizations, antibiotics, pacemakers, CAT scans, bypass surgery, and transplants&emdash;almost all unknown a century ago&emdash;have become commonplace. Public health measures and high-tech medicine have postponed our deaths many times over. As Dr. Tom Preston '55 points out in "The Future of Dying" (page 20), "Today the fatal condition ... is no longer a natural outcome of a life lived and completed under natural conditions as it was in the time of Hippocrates.... Nowadays we live long enough to succumb to the diseases of old age&emdash;heart disease, stroke, and cancer."
Of course we remember the Hippocratic Oath and its famous dictum "First, do no harm." But the fact is that Dr. Hippocrates couldn't do much good either. While we credit him with the idea that diseases have knowable natural causes, we also know that he believed illness was traceable to imbalances among the four so-called "humors"&emdash;blood, black bile, yellow bile, and phlegm.
In Hippocrates' time death was just another part of nature, something the physician could do almost nothing about. Now we know disease isn't just an imbalance of bile and phlegm, and medical science has given physicians great power to extend our lives&emdash;and indeed to extend our period of dying. In this issue Tom Preston argues that because of these changes, we need to rethink our approach to dying itself, perhaps even rejecting another Hippocratic dictum: "I will give no deadly medicine to anyone if asked, nor suggest any such counsel."
Swarthmoreans love a good debate&emdash;and so do Tom Preston and his twin brother, Ted '55. Tom the physician has taken the question of physician-assisted suicide to the Supreme Court. Ted the lawyer thinks the body politic&emdash;and the medical profession&emdash;should debate the question first, reaching some broad consensus before ideas are made law. We invite you to decide for yourself, Swarthmore-style, where the truth really lies.
- Jeffrey Lott