Hippocratic oath

A twelfth-century Byzantine manuscript of the Oath, rendered 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 western medicine, in the 4th century BC, or by one of his students.^[1] 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.^[2] The phrase "Above all, do no harm" is usually attributed to the oath. Although mostly of historical and traditional value, the oath is considered a rite of passage for practitioners of medicine, although nowadays the modernized version of the text varies among the countries.

Oath text

Original

Greek Wikisource has original text related to this article:

Ἱπποκράτειος ὅρκος

Original, translated into English:^[3]

Modern

Modern translation of the English:^[4]

Modern interpretations

The original text of the Hippocratic Oath is usually interpreted as one of the first statements of a moral of conduct to be used by physicians, assuming the respect for all human life, even unborn. Most Christian tradition interprets the original Hippocratic Oath as a condemnation of abortion and infanticide. According to Margaret Mead : "For the first time in our tradition there was a complete separation between killing and curing. Throughout the primitive world, the doctor and the sorcerer tended to be the same person. He with the power to kill had power to cure, including specially the undoing of his own killing activities. He who had the power to cure would necessarily also be able to kill... With the Greeks the distinction was made clear. One profession, the followers of Asclepius, were to be dedicated completely to life under all circumstances, regardless of rank, age or intellect – the life of a slave, the life of the Emperor, the life of a foreign man, the life of a defective child..." [1]

Modern relevance

Engraving of Hippocrates by Peter Paul Rubens, 1638.^[5]

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Derivations of the oath have been modified over the years in various countries. Most Medicine schools administer some form of oath. It has been suggested that a similar oath should be undertaken by scientists, a Hippocratic Oath for Scientists.

Modern challenged parts of the oath:

1. To teach medicine to the sons of my teacher. In the past, medical schools gave preferential consideration to the children of physicians.^{[citation needed]}
    
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. I will not give a lethal drug to anyone if I am asked, nor will I advise such a plan. Physician organizations in most countries have strongly denounced physician participation in legal executions. However, in a small number of cases, most notably the U.S. states of Oregon,^[6] Washington,^[7] Montana,^[8] and in the Kingdom of the Netherlands,^[9] a doctor can prescribe euthanasia with the patient's consent. In addition, abortion in many western countries is legal, rendering the forbiddance of abortive remedies irrelevant in some circles of medicine.
    
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. 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. The "stones" referred to are kidney stones or bladder stones, removal of which was judged too menial for physicians, and therefore was left for barbers (the forerunners of modern surgeons). Surgery was not recognized as a specialty at that time. This sentence is now interpreted as acknowledging that it is impossible for any single physician to maintain expertise in all areas. It 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.
    

Modern versions and alternatives

Louis Lasagna.

A widely used modern version of the traditional oath was penned by Dr. Louis Lasagna, former Dean of the Sackler School of Graduate Biomedical Sciences of Tufts University.^[10]

In the 1970s, many American medical schools chose to abandon the Hippocratic Oath as part of graduation ceremonies, usually substituting a version modified to something considered more politically and medically 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^[11] and Good Medical Practice^[12] statements.

See also

• Declaration of Helsinki
• Geneva conventions
• Hippocrates
• Hospital Corpsman Pledge
• Medical ethics
• Nightingale Pledge
• Nuremberg code
• The White Coat Ceremony
• Primum non nocere
• Oath of Asaph
• Oath of the Hindu physician
• Seventeen Rules of Enjuin
• Sun Simiao
• Physician's Oath
• Can sometimes be mistaken for the Hippocritic Oath (this is different)

References

• The Hippocratic Oath - a BBC article about the oath
• The Hippocratic Oath Today: Meaningless Relic or Invaluable Moral Guide? - a PBS NOVA Online discussion with responses from doctors as well as 2 versions of the oath
• Lewis Richard Farnell, Greek Hero Cults and Ideas of Immortality, 1921.
• "Codes of Ethics: Some History" by Robert Baker, Union College in Perspectives on the Professions, Vol. 19, No. 1, Fall 1999 [2]

External links

• BBC - Hippocratic Oath
• Hippocratic Oath - Classical version
• Hippocratic Oath - Modern version
• Hippocratis jusiurandum - Image of a 1595 copy of the Hippocratic oath with side-by-side original Greek and Latin translation
• Hippocrates | The Oath - National Institutes of Health page about the Hippocratic oath
• Tishchenko P. D. Resurrection of the Hippocratic Oath in Russia