Medicine is both a science and an art, guided by a moral compass and balancing patient autonomy and the physician’s desire to provide beneficence. An anchor in this discussion has historically been the Hippocratic Oath, which shapes a coherent worldview of health care. This worldview encompasses a profound respect for the life of each human being placed under the care of the physician. Differentiation between the provision of technology and the human art of caring is at the heart of the heated discussion over whether or not physicians can be forced by the state to participate in the destruction of the lives of their patients. Historically, the Hippocratic Oath has been the foundation of Western medical ethics, recently reaffirmed after the medical atrocities of the previous century. What are the essential elements of this Oath? What are the essential elements of the unique “Doctor-Patient” relationship? What does that relationship mean in an age of hospitalists, telemedicine and “cost centers” controlling reimbursement? Why is it critical that a physician have a coherent moral worldview and be allowed to practice the ethical implications of that world view? Several of these issues are now before the US Supreme Court: 1) The issue of “accommodation”, 2) the issue of whether or not a state can force pharmacists (and by extension other health care providers) to dispense medications capable of ending a human being’s life and prohibit the referral of such patients on grounds of conscience, and 3) the issue of whether or not the individual 50 states will maintain the power to regulate the provision of medicine; or will these powers be subjugated to federally mandated statist goals. We will also review the historical precedents where the role of physician as advocate for the patient was made subservient to other cultural demands such as the duty to the state or the duty to a political movement.