Hippocratic Oath

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For other uses, see Hippocratic Oath (disambiguation).
A twelfth-century Byzantine manuscript of the Oath, rendered in the form of a cross.

The Hippocratic Oath is widely believed to have been written by Hippocrates, the father of western medicine, in the 4th century BC, or by one of his students.[1] And is usually included in the Hippocratic Corpus. The oath is traditionally taken by physicians pertaining to the ethical practice of medicine. 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.

Contents

[edit] Oath text

[edit] Original

Wikisource
Greek Wikisource has original text related to this article:

Original, translated into English:[3]

“ I swear by Apollo, the healer, Asclepius, Hygieia, and Panacea, and I take to witness all the gods, all the goddesses, to keep according to my ability and my judgment, the following Oath and agreement:

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.

I will prescribe regimens for the good of my patients according to my ability and my judgment and never do harm to anyone.

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.

But I will preserve the purity of my life and my arts.

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.

 ”

[edit] Modern

Modern translation of the English:[4]

“ 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 the oath according to medical law, but to no one else.

I will apply dietic 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 if 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 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 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.

 ”

[edit] 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]

[edit] 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.
     

[edit] 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 correct, 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.

[edit] See also

[edit] References

  1. ^ Farnell, Lewis R. (2004-06-30). "Chapter 10". Greek Hero Cults and Ideas of Immortality. Kessinger Publishing. pp. 234-279. ISBN 978-1417921348.  p.269: "The famous Hippocratean oath may not be an authentic deliverance of the great master, but is an ancient formula current in his school."
  2. ^ Temkin, Owsei (2001-12-06). "On Second Thought". "On Second Thought" and Other Essays in the History of Medicine and Science. Johns Hopkins University. ISBN 978-0801867743. 
  3. ^ "The Hippocratic Oath". National Institute of Health. http://www.nlm.nih.gov/hmd/greek/greek_oath.html. Retrieved on 2009-02-02. 
  4. ^ Edelstein, Ludwig; Owsei Temkin, C. Lilian Temkin (1987). Owsei Temkin, C. Lilian Temkin. ed. Ancient Medicine. Johns Hopkins University Press. pp. 6. ISBN 0801834910. http://books.google.com/books?id=WuTllFJleCIC&source=gbs_navlinks_s. Retrieved on 2009-06-21. 
  5. ^ National Library of Medicine 2006
  6. ^ Roh, Jane (2006-01-17). "Supreme Court Backs Oregon Assisted Suicide Law". Fox News. http://www.foxnews.com/story/0,2933,181881,00.html. Retrieved on 2009-01-24. 
  7. ^ Woodward, Curt (2008-11-04). "Wash. voters approve assisted suicide initiative". Seattle Times. http://seattletimes.nwsource.com/html/localnews/2008352565_apwaassistedsuicide2ndldwritethru.html. Retrieved on 2009-01-24. 
  8. ^ "Montana Judge Endorses Right to Assisted Suicide". New York Times. 2008-12-06. http://www.nytimes.com/2008/12/07/health/07montana.html. Retrieved on 2009-01-24. 
  9. ^ Smartt, Ursula (2007-02-21). "Euthanasia and the law". BBC News. http://news.bbc.co.uk/2/hi/health/2600923.stm. Retrieved on 2009-01-24. 
  10. ^ Lasagna, Louis (1964, broadcast March 27, 2001 to April 10, 2001). "Hippocratic Oath—Modern Version". WGBH Educational Foundation for PBS and NOVA Online: Survivor M.D.. http://www.pbs.org/wgbh/nova/doctors/oath_modern.html. Retrieved on 2007-11-07. 
  11. ^ "Good Medical Practice: The duties of a doctor registered with the General Medical Council". General Medical Council. 2006. http://www.gmc-uk.org/guidance/good_medical_practice/duties_of_a_doctor.asp. Retrieved on 2007-11-05. 
  12. ^ "Good Medical Practice". General Medical Council. 2006. http://www.gmc-uk.org/guidance/good_medical_practice/index.asp. Retrieved on 2007-11-05. 

[edit] External links

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