Hippocratic Paradox: A Mathematical Economic Analysis of Medical Decision-Making

This paper is the first mathematical economic analysis of the Hippocratic Paradox. The Hippocratic Oath and its derived four principles --- nonmaleficence, beneficence, respect for patient's autonomy, and justice --- are the moral foundations of medical decision-making. However, they are found self-contradictory in both theory and practice, which leads to hard cases confronted by the U.S. Supreme Court. This paper aims to resolve such paradoxes. It offers a topological approach to identify all possible contradictions in the form of cyclic rankings. This approach has achieved success in other areas of economics such as social choice (e.g., Arrow's and Sen's impossibility theorems) and voting theory and can provide new interpretations in medicine and partial resolutions. Our paper is the first mathematical economic analysis of the Hippocratic Paradox. It identifies the cause and source of conflicts in medical decision-making, which are commonly concerned across other disciplines including medicine, ethics/moral philosophy, and law. By tracing where all such possible conflicts come from, we predict paradoxical situations. And then by modifying the relative positions of problematic regions, that is, by remedying the extent of some principles, this study can help health professionals escape from fatal self-contradictions while making crucial decisions.