Hippocratic Oath

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A twelfth-century Byzantine manuscript of the Oath in the form of a cross.

The Hippocratic Oath is an oath traditionally taken by physicians pertaining to the ethical practice of medicine. It is widely believed that the oath was written by Hippocrates, the father of medicine, in the 4th century BC, or by one of his students. It is thus usually included in the Hippocratic Corpus. Classical scholar Ludwig Edelstein proposed that the oath was written by Pythagoreans, a theory that has been questioned due to the lack of evidence for a school of Pythagorean medicine. Although mostly of historical and traditional value, the oath is considered a rite of passage for practitioners of medicine, although it is not obligatory and no longer taken up by all physicians.

The Hippocratic Oath

Original, translated from Greek.

I swear by Apollo, Asclepius, Hygieia, and Panacea, and I take to witness all the gods, all the goddesses, to keep according to my ability and my judgment, the following Oath.

To consider dear to me, as my parents, him who taught me this art; to live in common with him and, if necessary, to share my goods with him; To look upon his children as my own brothers, to teach them this art.

I will prescribe regimens for the good of my patients according to my ability and my judgment and never do harm to anyone.

To please no one will I prescribe a deadly drug nor give advice which may cause his death.

Nor will I give a woman a pessary to procure abortion.

But I will preserve the purity of my life and my arts.

I will not cut for stone, even for patients in whom the disease is manifest; I will leave this operation to be performed by practitioners, specialists in this art.

In every house where I come I will enter only for the good of my patients, keeping myself far from all intentional ill-doing and all seduction and especially from the pleasures of love with women or with men, be they free or slaves.

All that may come to my knowledge in the exercise of my profession or in daily commerce with men, which ought not to be spread abroad, I will keep secret and will never reveal.

If I keep this oath faithfully, may I enjoy my life and practice my art, respected by all men and in all times; but if I swerve from it or violate it, may the reverse be my lot.

According to NOVA, the Oath is, as follows:

Hippocratic Oath -- Classical Version

I swear by Apollo Physician and Asclepius and Hygieia and Panaceia and all the gods and goddesses, making them my witnesses, that I will fulfill according to my ability and judgment this oath and this covenant:

To hold him who has taught me this art as equal to my parents and to live my life in partnership with him, and if he is in need of money to give him a share of mine, and to regard his offspring as equal to my brothers in male lineage and to teach them this art - if they desire to learn it - without fee and covenant; to give a share of precepts and oral instruction and all the other learning to my sons and to the sons of him who has instructed me and to pupils who have signed the covenant and have taken an oath according to the medical law, but no one else.

I will apply dietetic measures for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice.

I will neither give a deadly drug to anybody who asked for it, nor will I make a suggestion to this effect. Similarly I will not give to a woman an abortive remedy. In purity and holiness I will guard my life and my art.

I will not use the knife, not even on sufferers from stone, but will withdraw in favor of such men as are engaged in this work.

Whatever houses I may visit, I will come for the benefit of the sick, remaining free of all intentional injustice, of all mischief and in particular of sexual relations with both female and male persons, be they free or slaves.

What I may see or hear in the course of the treatment or even outside of the treatment in regard to the life of men, which on no account one must spread abroad, I will keep to myself, holding such things shameful to be spoken about.

If I fulfill this oath and do not violate it, may it be granted to me to enjoy life and art, being honored with fame among all men for all time to come; if I transgress it and swear falsely, may the opposite of all this be my lot.

Modern relevance

Engraving of Hippocrates by Peter Paul Rubens, 1638.[1]

Several parts of the oath have been removed or re-shaped over the years in various countries, schools, and societies as the social, religious, and political importance of medicine has changed. Most schools administer some form of oath, but the great majority no longer use the ancient version, which praised Greek deities, advocated teaching of men, and forbade general practitioners from surgery, abortion, and euthanasia. Also missing from the ancient Oath and from many modern versions are the complex ethical issues that face the modern physician.

Changed portions of the oath:

  1. To teach medicine to the sons of my teacher. In the past, medical schools would give preferential consideration to the children of physicians.
     
  2. To practice and prescribe to the best of my ability for the good of my patients, and to try to avoid harming them. This beneficial intention is the purpose of the physician. However, this item is still invoked in the modern discussions of euthanasia.
     
  3. Never to do deliberate harm to anyone for anyone else's interest. Physician organizations in most countries have strongly denounced physician participation in legal executions. However, in a small number of cases, most notably Oregon[2] and the Netherlands[3], a doctor can perform euthanasia, by both his and the patient's consent.
     
  4. To avoid violating the morals of my community. Many licensing agencies will revoke a physician's license for offending the morals of the community ("moral turpitude").
     
  5. To avoid attempting to do things that other specialists can do better. The "stones" referred to are kidney stones or bladder stones, removal of which was judged too difficult for physicians, and therefore was left for surgeons (specialists). The value of specialization was recognized in that time. The range of knowledge and skills needed for the range of human problems has always made it impossible for any single physician to maintain expertise in all areas. This also highlights the different historical origins of the surgeon and the physician.
     
  6. To keep the good of the patient as the highest priority. There may be other conflicting 'good purposes,' such as community welfare, conserving economic resources, supporting the criminal justice system, or simply making money for the physician or his employer that provide recurring challenges to physicians.
     
  7. To avoid sexual relationships or other inappropriate entanglements with patients and families. The value of avoiding conflicts of interest isn't often questioned.
     

Modern versions and alternatives

A widely used modern version of the traditional oath was penned by Dr. Louis Lasagna, former Dean of Tufts Medical School. [1]

In the 1970s, cultural and social forces induced many American medical schools to abandon the Hippocratic Oath as part of graduation ceremonies, usually substituting a version modified to something considered more politically up to date, or an alternate pledge like the Oath or Prayer of Maimonides.

The Hippocratic Oath has been updated by the Declaration of Geneva. In the United Kingdom, the General Medical Council provides clear modern guidance in the form of its 'Duties of a Doctor' and 'Good Medical Practice' statements.

See also

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Footnotes

  • Template:Ent cf. L.R. Farnell, Greek Hero Cults and Ideas of Immortality, Chapter 10, "The Cult of Asklepios" (pp.234-279), p.269: "The famous Hippocratean oath may not be an authentic deliverance of the great master, but is an ancient formula current in his school."
  • Template:Ent Owsei Temkin, "On Second Thought," in "On Second Thought" and Other Essays in the History of Medicine, Baltimore: Johns Hopkins University Press, 2002.

References

External links

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