The Hippocratic Oath is perhaps the most widely known of Greek medical texts. Written in the 5th Century B.C. by Hippocrates, it requires a new physician to swear upon a number of healing gods that he will uphold a number of professional ethical standards. It also strongly binds the student to his teacher and the greater community of physicians with responsibilities similar to that of a family member. Here’s the original oath:
- I swear by Apollo the physician, and Asclepius, and Hygieia and Panacea and all the gods and goddesses as my witnesses, that, according to my ability and judgement, I will keep this Oath and this contract:
- To hold him who taught me this art equally dear to me as my parents, to be a partner in life with him, and to fulfill his needs when required; to look upon his offspring as equals to my own siblings, and to teach them this art, if they shall wish to learn it, without fee or contract; and that by the set rules, lectures, and every other mode of instruction, I will impart a knowledge of the art to my own sons, and those of my teachers, and to students bound by this contract and having sworn this Oath to the law of medicine, but to no others.
- I will use those dietary regimens which will benefit my patients according to my greatest ability and judgment, and I will do no harm or injustice to them.
- I will not give a lethal drug to anyone if I am asked, nor will I advise such a plan; and similarly I will not give a woman a pessary to cause an abortion.
- In purity and according to divine law will I carry out my life and my art.
- I will not use the knife, even upon those suffering from stones, but I will leave this to those who are trained in this craft.
- Into whatever homes I go, I will enter them for the benefit of the sick, avoiding any voluntary act of impropriety or corruption, including the seduction of women or men, whether they are free men or slaves.
- Whatever I see or hear in the lives of my patients, whether in connection with my professional practice or not, which ought not to be spoken of outside, I will keep secret, as considering all such things to be private.
- So long as I maintain this Oath faithfully and without corruption, may it be granted to me to partake of life fully and the practice of my art, gaining the respect of all men for all time. However, should I transgress this Oath and violate it, may the opposite be my fate.
The Hippocratic Oath remained intact for about 1500 years before being rewritten to suit the values of different cultures influenced by Greek medicine. Contrary to popular belief, the Hippocratic Oath is not required by most modern medical schools, although some have adopted modern versions that suit many in the profession in the 21st century, deleting the phrase, “First, do no harm,” which is commonly attributed to it.
One of the most significant revisions was first drafted in 1948 by the World Medical Association. Called the Declaration of Geneva, it was “intended to be a self-conscious rewriting of the Hippocratic Oath, reaffirming Hippocratism in the face of the shame and tragedy of the German medical experience”. The Third Reich had, true to their genocidal ethic, of course deemed that there was such thing as a life not worth living, and this was seen in their medical experimentation on Jews throughout WWII.
The details of the Nazi Doctors’ Trial at Nuremberg and the revelations about what the Imperial Japanese Army had done at Unit 731 in China during the war clearly demonstrated to the World Medical Association the need for reform, and for a re-affirmed set of guidelines regarding both human rights and the rights of patients. Here’s the Declaration of Geneva, as currently published by the World Medical Association:
- I solemnly pledge to consecrate my life to the service of humanity;
- I will give to my teachers the respect and gratitude that is their due;
- I will practice my profession with conscience and dignity;
- The health of my patient will be my first consideration;
- I will respect the secrets that are confided in me, even after the patient has died;
- I will maintain by all the means in my power, the honor and the noble traditions of the medical profession;
- My colleagues will be my sisters and brothers;
- I will not permit considerations of age, disease or disability, creed, ethnic origin, gender, nationality, political affiliation, race, sexual orientation, social standing or any other factor to intervene between my duty and my patient;
- I will maintain the utmost respect for human life;
- I will not use my medical knowledge to violate human rights and civil liberties, even under threat;
- I make these promises solemnly, freely and upon my honor.
In the 1960s, the Hippocratic Oath was changed to “utmost respect for human life from its beginning”, making it a more secular concept, not to be taken in the presence of God or any gods, but before only man. Here’s the Modern Version, written in 1964 by Louis Lasagna, Academic Dean of the School of Medicine at Tufts University:
- 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.
Notice the “modern” version has deleted reference to abortion, and added reference to “taking a life” continuing “must not play at God.” While there is currently no legal obligation for medical students to swear an oath upon graduating, 98% of American medical students swear some form of oath, while only 50% of British medical students do.
The argument between what’s legal and what’s moral, what’s absolute and what’s not, continues. At the end of the day, this I know … there is a God and I’m not Him. But the dilemma we face are all those walking around who think they are God. What a mess!
Psalm 46:10 says, “Be still, and know that I am God; I will be exalted among the nations, I will be exalted in the earth.”
Tagged: patience, pro-life, world war II
