The Hippocratic Oath is an oath of ethics historically taken by physicians. It is one of the most widely known of Greek medical texts. In its original form, it requires a new physician to swear, by a number of healing gods, to uphold specific ethical standards. The oath is the earliest expression of medical ethics in the Western world, establishing several principles of medical ethics which remain of paramount significance today. These include the principles of medical confidentiality and non-maleficence. The original oath was written between the fifth and third centuries BC, is traditionally attributed to the Greek doctor Hippocrates, while modern scholars do not regard it as having been written by Hippocrates himself.
Hippocratic Oath: Classical VersionEdit
- I swear by... all the gods and goddesses, making them my witnesses, that I will fulfill according to my ability and judgment this oath...:
- To hold him who has taught me this art as equal to my parents and to live my life in partnership with him...
- To regard his offspring as equal to my brothers.. and to teach them this art — if they desire to learn it — without fee and covenant...
- 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.
- I will not give to a woman an abortive remedy. In purity and holiness I will guard my life and my art.
- 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 regard to the life of men...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...
- if I transgress it and swear falsely, may the opposite of all this be my lot.
- The Hippocratic Oath: Text, Translation, and Interpretation, by Ludwig Edelstein (translation from the Greek). (1943)
Hippocratic Oath, Modern VersionEdit
- 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 [that] 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
- 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...
- 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...
- 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.
- Louis Lasagna [Oath, Modern Version], Academic Dean of the School of Medicine at Tufts University (1964)
- In Germany during the Third Reich, medical students did not take the Hippocratic Oath, although they knew the ethic of "nil nocere" — do no harm.
- Naomi Baumslag, Murderous Medicine: Nazi Doctors, Human Experimentation, and Typhus. Praeger Publishers. pp. xxv. ISBN 9780275983123. (2005)
- In the current multifaceted philosophical and scientific context, a considerable number of scientists and philosophers, in the spirit of the Hippocratic Oath, see in medical science a service to human fragility aimed at the cure of disease, the relief of suffering and the equitable extension of necessary care to all people. At the same time, however, there are also persons in the world of philosophy and science who view advances in biomedical technology from an essentially eugenic perspective.
- Congregation for the Doctrine of the Faith, "Dignitas Personae: On Certain Bioethical Questions”, n.2, (20 June 2008).
- In the context of the urgent need to mobilize consciences in favour of life, people in the field of healthcare need to be reminded that "their responsibility today is greatly increased. Its deepest inspiration and strongest support lie in the intrinsic and undeniable ethical dimension of the health-care profession, something already recognized by the ancient and still relevant Hippocratic Oath, which requires every doctor to commit himself to absolute respect for human life and its sacredness".
- Congregation for the Doctrine of the Faith, "Dignitas Personae: On Certain Bioethical Questions”, “Third Part: New Problems Concerning Procreation”, “The use of human "biological material" of illicit origin”, n.35, (20 June 2008).
- The doctor's duty is to heal, not to harm and, in this admonition, Largus provides the earliest reference to the Hippocratic Oath, when he appeals to the provision that forbids a woman being given an abortive pessary. It is Hippocrates, "the founder of our profession" who "handed on to our discipline an oath by which it is sworn that no physician will either give or demonstrate to pregnant women any drug aborting a conceived child." Then "how much more abominable will those men judge it to do harm to a fully formed human being who consider it wicked to injure the uncertain hope of an unborn child" (trans. Hamilton).
Soranus, a Greek practicing in Rome in the early second century AD, refers to the Oath in the Gynecology. There, he sides with the opposing position of the controversy. Rather than prohibit all abortions, Soranus understands the Oath to prohibit only abortive suppositories and that abortion is permitted if the life of the mother is in danger.
"For one party banishes abortives, citing the testimony of Hippocrates who says: 'I will give to no one an abortive'; moreover, because it is the specific task of medicine to guard and preserve what has been engendered by nature. The other party prescribes abortions, but with discrimination, that is, they do not prescribe them when a person wishes to destroy the embryo because of adultery or out of consideration for youthful beauty; but only to prevent subsequent danger in parturition if the uterus is small and not capable of accommodating the complete development" (I.19.60).
- Encyclopedia Romana, "Scribonius Largus and the Oath of Hippocrates". penelope.uchicago.edu.
- The execution technique itself-which had been developed to simulate a medical procedure and was thought to be humane - came to be considered inhumane unless carried out by medical professionals, because of the risk that the inmate would suffer torture, in violation of the Eighth Amendment's prohibition against the infliction of "cruel and unusual punishment. ' As Tennessee Governor Phil Bredesen commented, "if the Vanderbilt anesthesiology department would come over and perform executions for us, there wouldn't be any issues.' On the other hand, medical professionals are ethically forbidden from participating in lethal injection because their participation risks irreparable harm not only to physician-patient relationships but to the medical profession and even society as a whole.' Thus, execution by lethal injection has created a "Hippocratic paradox" where it is unethical for physicians not to participate in lethal injection, but also unethical for physicians to participate.
- Solving the Hippocratic Paradox: From the state's point of view, the problem with the Hippocratic paradox is that capital punishment and lethal injection are still constitutionally acceptable, yet the Hippocratic paradox prevents executions from occurring. Thus, state lawyers have tried to develop methods to solve this dilemma... 1. Medical Coercion: The coercion method began in the early days of lethal injection... They may be offered cash payments and guarantees of anonymity. In some states, attendance at executions may be a requirement of the prison's medical staff...
- The medical profession has a long history of obligations not only to individual patients but to society as well. If physicians are truly dedicated to helping society's most vulnerable individuals, the time to show mercy is not in the death chamber. Rather, they should demonstrate compassion by helping to improve the deplorable medical care that exists in many prisons or the socioeconomic conditions that predispose people to end up in prison in the first place. Nevertheless, even though every prominent medical professional organization forbids participation in lethal injection, physicians make appearances in the death chamber for the vast majority of executions... The machinery of death requires medical professionals, yet the integrity of the profession depends on physicians making the choice to refuse participation. The legal system cannot resolve the Hippocratic paradox. Thus, in order to preserve its professional ethics, and its position as a morally protective force in society, the medical profession must work to abolish capital punishment. 214.
- While some scholars hold that the increasing importance of the Hippocratic Oath is linked to the rise of Christianity, this is disputed by others who believe that there are significant differences and tensions in the ethical precepts on which Hippocratic and Christian medicine were built. One obvious difference lies in the two traditions’ religious commitment. At different times, various modifications were thus introduced to make the Hippocratic Oath acceptable to Christians. One of the earliest of these dates from the tenth or eleventh century. It is entitled “From the Oath According to Hippocrates Insofar as a Christian May Swear it.” This oath no longer required Christian doctors to swear to Greek gods and goddesses; rather, those taking the oath addressed themselves to “God the Father of our Lord Jesus Christ” ( Jones 1924: 23).
- “A companion to bioethics”, edited by Helga Kushe and Peter Singer, Blackwell Publishing Company, (2009), p.5.
- It was not only Greek philosophers that he hated, but he was also suspicious of Greeks who practised medicine at Rome. He had heard, it would seem, of Hippocrates' reply when the Great King of Persia consulted him, with the promise of a fee of many talents, namely, that he would never put his skill at the service of Barbarians who were enemies of Greece. He said all Greek physicians had taken a similar oath, and urged his son to beware of them all"
- Plutarch, Life of Cato, XXIII.3-4; as quoted by Encyclopedia Romana, "Scribonius Largus and the Oath of Hippocrates". penelope.uchicago.edu.
- Already discussed was the modification to the Hippocratic oath, which, by the first century A.C.E., was interpreted to prohibit all abortions, not merely abortive pessaries. Whoever modified the oath, whenever he lived, was a pagan Greek, because this version of the oath is still taken to Apollo and other Hellenic pagan deities. Before Christianity and seemingly separate from the tradition of the Stoic philosophers, some minorities in the Greek communities came to regard sexual activity with more distrust and birth control as wrong.
- John M. Riddle, Contraception and Abortion from the Ancient World to the Renaissance, Harvard University Press, 1992, p.81
- Abortions were always available. The degree to which they may have limited population historically is not clearly known. Late-term abortions induced by drugs or by manipulation were often dangerous to the mother, and the Greco-Roman medical literature cautioned and sometimes counseled against it. The well-known line form the Hippocratic oath regarding abortions was, despite its fame, not generally followed by ancient physicians. For that matter, not only do we not know who swore to its principles, it is also not entirely obvious what the oath means. The oath did not prohibit one who swore to its tenets from administering an abortion. It prohibited the administration of an abortive suppository, or pessary. Following a statement that the physician will neither administer a poison nor advise its use, the next line reads: … It has been translated, “Similarly I will not give to a woman an abortive remedy” and “Neither will I give a woman means to procure an abortion.” Closer to the literal meaning, however, is “. . . give a suppository to cause an abortion.” Even the great medical historian W.H.S Jones, who correctly translated the passage and knew that only a pessary was specified, nonetheless interpreted its broader meaning to include a prohibition of abortion in any form.
- John M. Riddle, “Eve's Herbs: A History of Contraception and Abortion in the West”, Harvard University Press, 1997, p.7
- During the post World War II and immediately after its foundation, the WMA showed concern over the state of medical ethics in general and over the world. The WMA took up the responsibility for setting ethical guidelines for the world's physicians. It noted that in those years the custom of medical schools to administer an oath to its doctors upon graduation or receiving a license to practice medicine had fallen into disuse or become a mere formality.
- World Medical Association, Inc. "WMA History". World Medical Association, Inc. Archived from the original on 6 February 2015
“The Hippocratic Oath and the Ethics of Medicine” (2005)Edit
Miles, Steven (2005). “The Hippocratic Oath and the Ethics of Medicine”. Oxford University Press. ISBN 978-0-19-518820-2.
- The Hippocratic Oath is an ancient Greek document that is simply entitled “Oath”. Its age is debated; 400 BCE is a reasonable estimate of when it was written. That date is contemporaneous with the oldest of medical works written by generations of Greek physicians (see Appendix A). We do not know who composed it, and we do not know of any other document that appears to be by the same author. There is no evidence that Hippocrates wrote it, knew of it, or approved of it. There are no extant drafts or records of discussions of its terms. We do not know its stature in its own time or how widely or how long it was used. The “Oath may be the only survivor of dozens of such oaths.
This lack of context for the “Oath” greatly complicates any effort to understand its meaning. The “Oath” is neither a sacred scripture nor a legal code. It appeasrs to be designed for the swearing in of a person at the beginning of a medical apprenticeship.
- There are intense debates about the moral authority of the “Oath” in relation to the medical profession of its time. Scholars believe that few Greek physicians even knew of this aoth, though the same is probably true of most of the ancient Greek medical texts. Most scholars do not believe that it represented the mainstream views of physicians in Greece of 400 BCE. Ludwig Edelstein asserts that ancient Greek physicians commonly performed euthanasia, abortion, and surgery and that the “Oath” reflected the views of a sect of philosophers rather than the medical ethics of the day (see Chapter 3).
- Part of the problem in understanding the relationship between the Oath and medical ethics is that the record of this relationship is nearly blank. The “Oath” was rarely mentioned during the first 1500 years of its existence.
- [W]e may choose to accept parts of the “Oath” as speaking to contemporary issues without establishing a historical continuity between its message in its time and the parallel issue in our time. For example, many people see the “Oath’s” disavowal of giving a deadly drug as applicable to the modern debate about physician participation in capital punishment. This is a counterfeit historical foundation in that there is no evidence to support the idea that this passage envisioned or addressed physician participation in executions in ancient Greece. It entails projecting contemporary values and issues back onto ancient Greece and then hearing a historical ratification of those values and issues echoing back to us. The “Oath” has been used in this manner in the debates about medical euthanasia and abortion as well.