Doctors Aren’t Bound By The Hippocratic Oath

By Debra Kelly on Tuesday, February 4, 2014
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“While I continue to keep this Oath unviolated, may it be granted to me to enjoy life and the practice of the art, respected by all men, in all times! But should I trespass and violate this Oath, may the reverse be my lot!” —Hippocratic Oath

In A Nutshell

In fact, they usually don’t even swear by it. The Hippocratic oath is usually thought of as a centuries-old oath that all medical practitioners swear by, essentially prohibiting them from doing harm. And virtually no modern medical schools require it. (If they did require it and abide by it themselves, there would probably be no such thing as tuition.) Graduating doctors often recite a modern version of a Hippocratic oath that bears little resemblance to the original.

The Whole Bushel

According to a common belief, upon graduation from medical school, doctors swear to be bound by the Hippocratic oath. One of the most important tenets of the oath is, of course, to do no harm. Unfortunately, both of these ideas are completely false.

First, the straightforward one. Many medical schools don’t require any kind of oath-taking upon graduation, and those that do don’t make their recent graduates recite the ancient text of the Hippocratic oath. Many use the one written in 1964 by Louis Lasagna, Academic Dean of the School of Medicine at Tufts University. Included in this oath is a promise to respect the privacy of patients, not lose sight of the patient’s humanity in the face of disease, share all newly discovered knowledge and ask for help when it’s needed in diagnosing and treating a patient.

The original Hippocratic oath is a bit different than most might expect. The phrase that’s most commonly attributed to it, “First, do no harm,” isn’t even in it. (It is something he was known for saying, but it didn’t make it into the oath itself.)

What is, though, is a line that would put medical schools out of business. Doctors who swore to the Hippocratic oath also swore to pass along their knowledge free of charge to anyone who wanted to learn. That included a specific mention of the giving of lectures, rules, texts, and “every other mode of instruction,” all for free—as long as these future students would also swear to the oath.

Parts of the original Hippocratic oath are echoed in today’s modern oaths. They swore to respect a patient’s privacy and specifically not to tell anyone else what they had been told in confidence. Practicing physicians were still fairly new at the time the oath was written, and as such, they were viewed with some degree of suspicion. This passage was probably included in the hopes of alleviating some of that suspicion.

They also swore to honor the homes they went into, promising that they were there only to heal the sick and not to seduce other members of the family or take advantage of the ill.

The ancient oath also made its stance on several of today’s controversial subjects absolutely, unconditionally clear. Doctors promised not to administer poisons or other deadly drugs to an ill person, even if it was requested. This had a two-fold meaning; assisted suicide went against the oath, and so did the physician’s other common occupation—assassination. This was a time when physician-administered poisons weren’t uncommon, and many physicians wanted to distance themselves from the practice.

Also included in the original oath is a line forbidding the administration of a “destructive pessary,” which was a particular methods of inducing an abortion. Strangely, abortion was legal at the time the oath was written, but the destructive pessary (soaking wool and inserting it into the vagina) could cause a host of other problems for the woman in question. Some scholars have suggested that the oath was simply outlawing the method, not the practice.

Physicians who took the original oath were swearing in the names of gods that have fallen from the realms of practiced religion and into mythology. Apollo’s name was the first invoked, followed by his son, Asclepius and Asclepius’s daughters, Hygeia and Panacea. Modern oaths leave god—and gods—out of it entirely.

Show Me The Proof

BBC News: A guide to the Hippocratic Oath
Greek Medicine
PBS NOVA: The Hippocratic Oath Today