Hippocratic Oath

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The Hippocratic Oath is an oath traditionally taken by physicians, in which certain ethical guidelines are laid out.

Traditional text

I swear by Apollo the physician, by Æsculapius, Hygeia, and Panacea, and I take to witness all the gods, all the goddesses, to keep according to my ability and my judgement, 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 if they so desire without fee or written promise; to impart to my sons and the sons of the master who taught me and the disciples who have enrolled themselves and have agreed to the rules of the profession, but to these alone the precepts and the instruction. I will prescribe regimens for the good of my patients according to my ability and my judgement 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 art. 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."

Modern relevance

The Hippocratic Oath has aged fairly well, but several items have been eroded or dropped over the years in various societies. Following is a listing of the specific promises and a modern perspective:

  1. To support my teacher if necessary. Professional courtesy (not charging families of physicians for one's services) is perhaps the last trace of this item and has largely been abandoned.
     
  2. To teach medicine to the sons of my teacher. In the past, medical schools would give preferential consideration to the children of physicians. This too has largely disappeared.
     
  3. To practice and prescribe to the best of my ability for the good of my patients, and to try to avoid harming them. The beneficial intention is the timeless purpose of the physician and should never become obsolete.
     
  4. To never deliberately do harm to anyone for anyone else's interest. This item is still invoked in discussions of euthanasia. Physician organizations in the U.S. and most other countries have strongly denounced physician participation in legal executions.
     
  5. To never attempt to induce an abortion. The wide availability of abortions in much of the world suggests many physicians no longer feel bound by this.
     
  6. 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").
     
  7. 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 general practitioners, and therefore was left for specialists. It is interesting how early the value of specialization was recognized. 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.
     
  8. 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.
     
  9. To avoid sexual relationships or other inappropriate entanglements with patients and families. The value of avoiding inappropriate relationships has never been questioned.
     
  10. To keep confidential what I learn about my patients. Confidentiality continues to be valued and protected, but governments and third-party payors have occasionally encroached upon it in limited ways for well-intentioned purposes.

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, q.v.

See also: Hippocrates, Medical ethics

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