The Oath of Hippocrates

The Oath of Hippocrates is referenced a lot in popular culture (i.e. medical TV shows, books, magazines, etc.), but most people don’t know what it states. Here is what it really says (at least, the version I will be taking):

I swear by Apollo, the physician, and Aesculapius, and Health and All-Heal, and by God and By whatever I hold most sacred, that according to my ability and judgement, I will keep this Oath and this stipulation—I will look upon those who shall have taught me this Art even as one of my parents. I will share my substance with them, and I will supply their necessities if they be in need. I will regard their offspring in the same footing as my own brethren and I will teach them this Art by precept, by lecture and by every mode of teaching not only to my own children but to the children of those who have taught me, and to disciples bound by covenant and oath, according to the Law of Medicine, but to none other.

The regimen I adopt shall be for the benefit of my patients to my ability and judgement and I will abstain from whatever is deleterious and mischievous. I will seek to inform my patients fully about their illness and prognosis, and will always remember that the final decision regarding their own life rests with the patient. I will regard my patients always as fellow human beings and will do everything possible to preserve their dignity. With purity and with holiness I will pass my life and practice my Art. Whatsoever things I see or hear concerning the life of men in my attendance, on the sick or even apart therefrom, which ought not to be noised abroad, I will keep silence thereon, counting such things to be sacred secrets. While I continue to keep this Oath unviolated, may it be granted to me to enjoy life and the practice of the art, respect by all men, in all times. But should I trespass and violate this Oath, may the reverse be my lot.

There are a few noticeable lines:

1. “I swear by… God and By whatever I hold most sacred… With purity and with holiness I will pass my life and practice my Art.”

2. “I will teach them this Art by precept… according to the Law of Medicine, but to none other.”

To me, this immediately sets up a contradiction, but the wording escapes the conflict with a very fine distinction. The Oath states that physicians must teach their students according to the Law of Medicine and none other, but physicians must practice according to their own individual codes of ethics as well (e.g. purity and holiness). Hopefully, the profession would train physicians to share a common code of ethics, but this isn’t always the case, especially in the case of abortion and teenage pregnancy. Allegedly, New York Medical College, a Catholic medical school, doesn’t teach its medical students about abortion (this notion needs to be verified, but two students from NYMC have made this allegation). Is this a breach of the Oath of Hippocrates (by using a religious “Law” to infringe on teaching that should only be guided by the “Law of Medicine” which undoubtedly seeks the best health outcome for the patient)? Those who support this measure might view abortion, in all situations, as an improper practice for physicians or any moral being, but should this moral judgement typically based on a religious belief be integrated into the physician’s code of ethics in the case of teaching or should it be overrided by the need to teach medicine that can save lives or prevent suffering (leaving the decision to engage in abortion practices to the individual physician)?

3. “I will keep silence thereon, counting such things to be sacred secrets.”

Ancient HIPAA! This seems to be a fundamental principle in the practice of medicine, but one that a lot of people forget: physicians, nurses, physician-assistants, and other care providers talk about their patients all the time (sometimes abstractly, sometimes more identifiably). In many cases, they want to share their daily life experiences with their spouses, families, and friends (afterall, doctors aren’t spies or secret agents). On the other hand, patients seem to want privacy, so physicians should be respectful and only talk about patients in discrete manner in ways that won’t substantially affect the lives of the patients (in other arenas).

4. “I swear by Apollo…”

Awesome.

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