Hippocratic Oath

For other uses, see Hippocratic Oath (disambiguation).

A 12th-century Byzantine manuscript of the Oath

The Hippocratic Oath is an oath historically taken by physicians and other healthcare professionals swearing to practice medicine honestly. It is widely believed to have been written by Hippocrates, often regarded as the father of western medicine, or by one of his students. The oath is written in Ionic Greek (late 5th century BC), and is usually included in the Hippocratic Corpus. Classical scholar Ludwig Edelstein proposed that the oath was written by Pythagoreans, a theory that has been questioned because of the lack of evidence for a school of Pythagorean medicine. Of historic and traditional value, the oath is considered a rite of passage for practitioners of medicine in many countries, although nowadays the modernized version of the text varies among them.

The Hippocratic Oath (horkos) is one of the most widely known of Greek medical texts. It requires a new physician to swear upon a number of healing gods that he will uphold a number of professional ethical standards.

Original

This is the original version of the Oath:

Ὄμνυμι Ἀπόλλωνα ἰητρὸν καὶ Ἀσκληπιὸν καὶ Ὑγείαν καὶ Πανάκειαν καὶ θεοὺς πάντας τε καὶ πάσας, ἵστορας ποιεύμενος, ἐπιτελέα ποιήσειν κατὰ δύναμιν καὶ κρίσιν ἐμὴν ὅρκον τόνδε καὶ συγγραφὴν τήνδε‧

ἡγήσεσθαι μὲν τὸν διδάξαντά με τὴν τέχνην ταύτην ἴσα γενέτῃσιν ἐμοῖς, καὶ βίου κοινώσεσθαι, καὶ χρεῶν χρηί̈ζοντι μετάδοσιν ποιήσεσθαι, καὶ γένος τὸ ἐξ αὐτοῦ ἀδελφοῖς ἴσον ἐπικρινεῖν ἄρρεσι, καὶ διδάξειν τὴν τέχνην ταύτην, ἢν χρηί̈ζωσι μανθάνειν, ἄνευ μισθοῦ καὶ συγγραφῆς, παραγγελίης τε καὶ ἀκροήσιος καὶ τῆς λοίπης ἁπάσης μαθήσιος μετάδοσιν ποιήσεσθαι υἱοῖς τε ἐμοῖς καὶ τοῖς τοῦ ἐμὲ διδάξαντος, καὶ μαθητῇσι συγγεγραμμένοις τε καὶ ὡρκισμένοις νόμῳ ἰητρικῷ, ἄλλῳ δὲ οὐδενί.

διαιτήμασί τε χρήσομαι ἐπ' ὠφελείῃ καμνόντων κατὰ δύναμιν καὶ κρίσιν ἐμήν, ἐπὶ δηλήσει δὲ καὶ ἀδικίῃ εἴρξειν.

οὐ δώσω δὲ οὐδὲ φάρμακον οὐδενὶ αἰτηθεὶς θανάσιμον, οὐδὲ ὑφηγήσομαι συμβουλίην τοιήνδε‧ ὁμοίως δὲ οὐδὲ γυναικὶ πεσσὸν φθόριον δώσω. ἁγνῶς δὲ καὶ ὁσίως διατηρήσω βίον τὸν ἐμὸν καὶ τέχνην τὴν ἐμήν.

οὐ τεμέω δὲ οὐδὲ μὴν λιθιῶντας, ἐκχωρήσω δὲ ἐργάτῃσι ἀνδράσι πρήξιος τῆσδε.

ἐς οἰκίας δὲ ὁκόσας ἂν ἐσίω, ἐσελεύσομαι ἐπ' ὠφελείῃ καμνόντων, ἐκτὸς ἐὼν πάσης ἀδικίης ἑκουσίης καὶ φθορίης, τῆς τε ἄλλης καὶ ἀφροδισίων ἔργων ἐπί τε γυναικείων σωμάτων καὶ ἀνδρῴων, ἐλευθέρων τε καὶ δούλων.

ἃ δ' ἂν ἐν θεραπείῃ ἢ ἴδω ἢ ἀκούσω, ἢ καὶ ἄνευ θεραπείης κατὰ βίον ἀνθρώπων, ἃ μὴ χρή ποτε ἐκλαλεῖσθαι ἔξω, σιγήσομαι, ἄρρητα ἡγεύμενος εἶναι τὰ τοιαῦτα.

ὅρκον μὲν οὖν μοι τόνδε ἐπιτελέα ποιέοντι, καὶ μὴ συγχέοντι, εἴη ἐπαύρασθαι καὶ βίου καὶ τέχνης δοξαζομένῳ παρὰ πᾶσιν ἀνθρώποις ἐς τὸν αἰεὶ χρόνον‧ παραβαίνοντι δὲ καὶ ἐπιορκέοντι, τἀναντία τούτων.

English translation

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; and that by my teaching, I will impart a knowledge of this art to my own sons, and to my teacher's sons, and to disciples bound by an indenture and oath according to the medical laws, and no others.

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 give no deadly medicine to any one if asked, nor suggest any such counsel; 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 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 humanity and in all times; but if I swerve from it or violate it, may the reverse be my life.

The original oath broken down

The original Hippocratic Oath can be broken up to cover twelve different areas to which a physician is swearing to; the areas are as follows:

• The first is a covenant with the deity Apollo, who is the god of healing. Most modern oaths have removed this portion; however, the original translation reads "I swear by Apollo the physician…".
• The second is the Covenant with Teachers, and this is done with the pledge of collegiality and financial support.
• Next is the Commitment to Students by the promise to teach those who swear the oath.
• After the Commitment to Students comes the Covenant with Patients, and this is the physicians pledge to use their best ability and judgment.
• The fifth area is Appropriate Means with the use of standard "dietary" care; this is using the established and accepted practices to treat their patients.
• Appropriate Ends is next and says that a doctor is to do what is best for the patient, rather than what is best for the physician.
• The seventh area is the Limits on Ends, which was originally in the oath but has been omitted by many medical schools. The Limit on Ends in the oath said that a doctor would not help a women have an abortion and that the physician would not administer a lethal drug if asked. Both of these have caused many ethical dilemmas in modern times, with abortion being legal in many states and with prisons using lethal drugs to execute prisoners.
• The next area is Limits on Means; this refers to the leaving of surgeries and specialty care to those who have been trained in that particular specialty.
• Next is Justice; upon taking the oath, the physician is swearing that they will avoid any voluntary act of impropriety or corruption.
• After Justice comes Chastity, which states that a physician will not have any sexual contact with their patients.
• The eleventh area covered is Confidentiality; this simply says that a doctor will not repeat anything that is seen or heard.
• The final area of the oath is Accountability, which is a prayer that the physician be favored by the gods if the oath is kept and punished if it is broken.

When the Oath was rewritten in 1964 by Louis Lasagna, Academic Dean of the School of Medicine at Tufts University, the prayer was omitted, and that version has been widely accepted and is still in use today by many medical schools.

Modern use and relevance

Engraving of Hippocrates by Peter Paul Rubens, 1638.

The oath has been modified multiple times. 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.

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 other people.

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. In a 1989 survey of 126 US medical schools, only three reported usage of the original oath, while thirty-three used the Declaration of Geneva, sixty-seven used a modified Hippocratic Oath, four used the Oath of Maimonides, one used a covenant, eight used another oath, one used an unknown oath, and two did not use any kind of oath. Seven medical schools did not reply to the survey. In France, it is common for new medical graduates to sign a written oath. The modern Hippocratic oath being nonobligatory is similar in scope to what the president, congressman, or other elected official takes when being sworn into office.

In the United States, the majority of osteopathic medical schools use the Osteopathic Oath as well as the Hippocratic Oath. The Osteopathic Oath was first used in 1938, and the current version has been in use since 1954.

In 1995, Sir Joseph Rotblat, in his acceptance speech for the Nobel Peace Prize, suggested a Hippocratic Oath for Scientists.

Lethal injection and the Hippocratic Oath

There has been a large debate on whether a doctor administering or facilitating in a lethal injection to a prisoner is breaking the Hippocratic Oath they took.

In 1991, Jose High was set to be executed in Georgia. The execution team could not gain access to Jose High's vein due to extreme drug use from his past. The execution team brought in a doctor who had critical care training and was an expert at finding deep veins in the human body. Once the doctor was hired for the sole reason of inserting an IV the doctor at that point become part of the execution team.

Up until this point, doctors would not take part in placing an IV or administering the drugs, they were only there to pronounce the death of the inmate. The execution happened without incident, however, a group of doctor's sued the Georgia State Medical Board for not disciplining the doctor , stating that he violated federal law and broke the Hippocratic Oath ( although the Hippocratic oath has no legal binding). In response to this the Georgia Legislature passed laws protecting doctors who took part in lethal injections from civil and criminal prosecution.

This provides some insight into the very fine line that deals with a doctor taking part in an execution in regards to if he/she is breaking their Hippocratic Oath. In this case, the state of Georgia believed the doctor was not breaking the Oath or the law and passed legislation that protected them.

Breaking the Hippocratic Oath

There is no direct punishment for breaking the Hippocratic oath in modern days. It can be said that malpractice is the same thing and it carries a wide range of punishments from legal action to civil penalties. In antiquity the punishment for breaking the Hippocratic oath could range from a penalty to losing the right to practice medicine.

See also

3

References

Notes

• The Hippocratic Oath – an article by The Hitchhiker's Guide to the Galaxy (h2g2).
• The Hippocratic Oath Today: Meaningless Relic or Invaluable Moral Guide? – a PBS NOVA online discussion with responses from doctors as well as 2 versions of the oath. pbs.org
• Lewis Richard Farnell, Greek Hero Cults and Ideas of Immortality, 1921.
• "Codes of Ethics: Some History" by Robert Baker, Union College in Perspectives on the Professions, Vol. 19, No. 1, Fall 1999, ethics.iit.edu

External links

• Hippocratic Oath, The Hitchhiker's Guide to the Galaxy (h2g2).
• Hippocratic Oath – Classical version, pbs.org
• Hippocratic Oath – Modern version, pbs.org
• Hippocratis jusiurandum – Image of a 1595 copy of the Hippocratic oath with side-by-side original Greek and Latin translation, bium.univ-paris5.fr
• Hippocrates | The Oath – National Institutes of Health page about the Hippocratic oath, nlm.nih.gov
• Tishchenko P. D. Resurrection of the Hippocratic Oath in Russia, zpu-journal.ru