Hippocratic Oath
Origin and History
The Hippocratic Oath is an ethical code attributed to the ancient Greek physician Hippocrates, adopted as a guide to conduct by the medical profession throughout the ages and still used in the graduation ceremonies of many medical schools. The original oath was written in Ionic Greek, between the fifth and third centuries BC. It is usually included in the Hippocratic Corpus, a collection of around seventy early medical works from ancient Greece, and attributed to Hippocrates and his students. Hippocrates, often referred to as the "Father of Medicine," is credited with establishing medicine as a profession distinct from philosophy and theurgy.
Content and Themes
The Hippocratic Oath addresses several key ethical issues and themes. It begins with an invocation to several Greek gods, asking for their witness and guidance. The oath-taker swears to uphold a number of professional ethical standards. These include the promise to respect the teacher who taught them the art of medicine and to treat their patients to the best of their ability. The oath also includes a prohibition against causing harm or injustice, often encapsulated in the phrase "first, do no harm" or "primum non nocere" in Latin, although this exact phrase is not found in the original Greek text.
The oath also includes specific ethical guidelines regarding the practice of medicine. For example, it prohibits the administration of deadly drugs, even if asked by the patient, and it forbids the use of the knife, which is often interpreted as a prohibition against surgery. It also includes a clause about maintaining patient confidentiality, a precursor to modern concepts of patient privacy and confidentiality in healthcare.
Interpretation and Modern Use
The Hippocratic Oath has been interpreted and adapted in various ways throughout history. The original oath, with its invocation to Greek gods and specific prohibitions, is not commonly used today. Instead, many medical schools use a modernized version, often referred to as the "Modern Hippocratic Oath," which was written in 1964 by Louis Lasagna, Academic Dean of the School of Medicine at Tufts University.
The modern version of the oath retains the spirit of the original, with its emphasis on ethical conduct, patient welfare, and professional responsibility. However, it omits the invocation to the gods, and it modifies some of the specific prohibitions to reflect modern medical practice. For example, it does not prohibit surgery, reflecting the fact that surgery is now a well-established and essential part of medical practice. It also includes a commitment to medical research and the advancement of healthcare, reflecting the importance of scientific progress in modern medicine.
Despite these changes, the core ethical principles of the Hippocratic Oath—respect for teachers and colleagues, commitment to patient welfare, and the promise to do no harm—remain central to the ethical conduct of physicians today.
Criticisms and Controversies
The Hippocratic Oath has been the subject of criticism and controversy. Some critics argue that the oath is outdated and irrelevant to modern medical practice. They point out that many of its specific prohibitions, such as the prohibition against surgery, are no longer applicable. Others argue that the oath's emphasis on the physician's duty to the patient can conflict with other ethical considerations, such as public health and resource allocation.
The use of the oath in medical graduation ceremonies has also been questioned. Some argue that the oath is a form of ritualistic indoctrination, and that it does not adequately prepare medical students for the ethical challenges they will face in practice. Others argue that the oath serves an important symbolic function, reinforcing the ethical responsibilities of the medical profession.
Despite these criticisms, the Hippocratic Oath remains a powerful symbol of medical ethics and professional responsibility. It continues to be used in many medical schools, and its core principles continue to guide the conduct of physicians around the world.