The Ever-Changing Oaths of Doctors

Is There Such a Thing As a Doctors Oath?

Thousands of medical students swear a doctors oath each year. They recite modern versions of the Hippocratic Oath, which keep original values in place and address advances in medicine and societal changes.

These modern oaths often include tenets such as preserving patient privacy, advocating interprofessional teamwork, and striving to erase unconscious biases. They also may foreswear euthanasia and abortion or commit to never revealing secrets about patients.

The Hippocratic Oath

Many of the pledges in the Hippocratic Oath still hold relevance in today’s world, despite 2,500 years of advancement in medicine and technology. However, not all medical schools use the same version of the Oath.

Many modern oaths, including the Declaration of Geneva adopted by the World Medical Association in 1948 and periodically updated, build upon Hippocrates’ principles and include promises not to commit medical fraud, not to withhold treatment from patients, and not to disclose confidential information.

The oath also includes a promise to promote health knowledge by sharing medical information with colleagues and students. This is a key point that has come under challenge in recent years as medical education has shifted from being a solo endeavor to a team-based, collaborative practice. It’s important for all healthcare providers, regardless of discipline, to share and be transparent about their expertise. This is one of the foundations of modern medicine. It is the best way to ensure patient safety and prevent errors.

Origins

Many doctors today take the Hippocratic Oath upon graduating from medical school. This is a ritual that dates back almost 2000 years and is often accompanied by an elaborate ceremony. The oath embodies principles such as beneficence, gratitude, confidentiality and humility.

It is important to note that the first principle of the oath, “primum non nocere,” does not actually appear in the original Hippocratic Oath. This phrase was added in a few centuries later, most likely during the translation of the Oath into Roman Latin by Cato and others in the first century B.C.

The oath also contains some seemingly strange rules for physicians, such as demanding free tuition for students and urging them to never use a knife or cut their patients. The oath also mentions Apollo and other Greek gods. Bioethicist Steven Miles suggests that these names were used to remind physicians of the high standards of medicine and the need to remember their own mortality.

Significance

Since the time of Hippocrates, the world has experienced huge scientific and social changes that have placed new demands on physicians. These demands include malpractice issues, government regulation, third-payer healthcare systems, and advances in technology and pharmaceutical companies that allow doctors to treat more patients than ever before. These changes have made some people feel that the Hippocratic Oath is irrelevant.

Many modern doctors have come to believe that the oath’s content no longer addresses their ethical concerns, such as abortion and physician-assisted suicide. They also complain that the oath does not help resolve some of the more pressing medical issues today, such as the growing demand for patient privacy and the need to treat patients with lethal new diseases like AIDS or Ebola.

Regardless of their beliefs, many medical students continue to take some form of the Hippocratic Oath or similar pledges. The debate over the significance of such an oath or pledge will probably continue as long as there are different cultures and views on the value of human life.

Variations

Despite the fact that 98% of American medical students swear some form of oath upon entering or graduating from school, most oaths do not have much in common. A survey of 105 different oaths found that no single element appeared in all oaths.

The oaths that do exist today usually start with a reference to patients as primary objects of care. In addition to putting the patient first, modern oaths often include pledges to respect the autonomy and dignity of all patients. Psychiatrists, for example, are required to inform authorities of any suspected cases of child abuse. Failure to do so could result in a fine or imprisonment.

The Hippocratic Oath prohibits abortion and euthanasia, but it does not address many modern issues such as vegetative states or the right to die with dignity. Furthermore, the original oath calls for free tuition for medical students, but that is an impossibility in this day and age when healthcare is largely public funded.

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