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The Hippocratic Oath

By Yolly Eileen A. Gamutan R.N.


Hippocrates (460-377 BC), a Greek physician, is traditionally acknowledged as the “Father of Medicine”. The Hippocratic Oath was formulated in the 4th century BC, at the time when Hippocrates was establishing medicine as a science, raising it from its primitive state. Though the oath was not universally accepted by ancient physicians, medical practice began to conform to conditions envisaged by the document at the end of the ancient times.

The oath is the most enduring tradition in Western medicine and has been the guiding ethical code for physicians since ancient Greece. The oath became the nucleus of all medical ethics. It its most compelling portions, it emphasizes the profundity of the medical covenant, patient dignity, the confidentiality of the transaction, and the physician’s responsibility to guard against abuse or corruption of his knowledge and art.

The oath was modified during the 20th century, but its ethical strength remained. The modified version was written by Lasagna, which eventually became known as the Oath of Lasagna. In the 21st century, some medical schools began to adopt other forms of ethical oath, while some other schools abandoned the administration of any ethical oath. 1

In view of the universal degradation of morality in the society, the traditional administration of an ethical oath is beginning to lose moral force. According to a 1993 survey of 150 U.S. and Canadian medical schools, only 14 percent of modern oaths prohibit euthanasia, 11 percent pledge by a deity, 8 percent reject abortion, and 3 percent forbid sexual contact with patients, which were all maxims held sacred in the classical Hippocratic Oath. "The original oath is redolent of a covenant, a solemn and binding treaty," writes Dr. David Graham in JAMA, the Journal of the American Medical Association (12/13/00). "By contrast, many modern oaths have a bland, generalized air of 'best wishes' about them, being near-meaningless formalities devoid of any influence on how medicine is truly practiced." 2

Thus we see how the Hippocratic Oath has ceased to be a moral force or a guiding ideal for many physicians. Breaking away from the traditional medical covenant of respect for life, new segments of medical professionals have reversed the end for which the science of medicine was founded, which is to heal and save lives. In their hands, the science of medicine has become instrumental for ending lives by abortion, euthanasia, and assisted suicide. Lamentably, these break-away physicians have become instruments of death. As for them, no longer is the ethics of Hippocrates relevant since the abiding motto of Hippocrates had been: “First, do no harm”. As for these physicians, the Hippocratic medical covenant is as meaningless as the Mosaic covenant: “Thou shalt not kill.”

References:
1. Grolier International Encyclopedia.
2. The Hippocratic Oath Today: Meaningless Relic or Invaluable Moral Guide? http://www.pbs.org/wgbh/nova/doctors/oath_today.html


THE HIPPOCRATIC OATH (full text)

Traditional text

I swear by Apollo Physician and Asclepius and Hygieia and Panaceia and all the gods and goddesses, making them my witnesses, that I will fulfil 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 fulfil 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.

Translation from the Greek by Ludwig Edelstein. From The Hippocratic Oath: Text, Translation, and Interpretation, by Ludwig Edelstein. Baltimore: Johns Hopkins Press, 1943. http://www.pbs.org/wgbh/nova/doctors/oath_classical.html


Modern Text descriibed

Most of the schools that still retain the traditional oath use a modern version of the oath, as praying to Aesculapius and the other gods is no longer relevant, and no one swears anymore to split fees with his mentor. Also, it is no longer feasible to expect the doctor to teach in medical schools for free.... This version had been popular in the 1960's until the 1980's. When abortion and euthanasia became legal in many countries, the binding force of the oath ceased. So other forms of oath came to be. Needless to say, it is now impossible to unite the medical professionals under one ethical code of conduct. The medical body is badly split, just the way the Church is split... There are traditionalists, conservatives, and liberals.. But worse, there are total angels of death, like Dr. Jack Kevorkian, who operated his active euthanasia practice while USA still held euthanasia a crime. Then there are the Chinese doctors who inject poison in the skulls of undesired children, or deny them treatment, food and water until they die.
I just wonder why after the Nazi doctors were condemned as war criminals for their efforts at euthanasia, the same countries who decried such war crimes would VOTE for euthanasia.


Modern Text used in many Medical Schools

I swear to fulfill, to the best of my ability and judgment, this covenant:

I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.

I will apply, for the benefit of the sick, all measures which are required, avoiding those twin traps of overtreatment and therapeutic nihilism.

I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug.

I will not be ashamed to say "I know not," nor will I fail to call in my colleagues when the skills of another are needed for a patient's recovery.

I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.

I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.

I will prevent disease whenever I can, for prevention is preferable to cure.

I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.

If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.

Written in 1964 by Louis Lasagna, Academic Dean of the School of Medicine at Tufts University, and used in many medical schools today.
http://www.pbs.org/wgbh/nova/doctors/oath_modern.html


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