Hippocratic Oath

Little is actually known about the life of the Greek physician Hippocrates, thought to have been born on the island of Cos between 470 and 460 BCE. His father and grandfather were both physicians. Hippocrates left behind a series of writings that comprose the earliest known Greek medical texts. Few of these texts, however, have survived to the present, and doubt has been cast on the authenticity of many. Of those regarded as genuine, the most famous is the “Hippocratic Oath.”

In its original form, the oath begins with an affirmation of Apollo and the various other gods and goddesses. The apprentice physician then swears to support his teachers financially and in turn to teach their male children the medical art without fee or payment. He swears to keep medical knowledge secret from those who are not physicians and who have not themselves taken the oath. Following are a series of rules regarding conduct with patients: to work for their benefit, to keep them from harm and injustice, to perform no abortions, to give no deadly drug, to leave surgical procedures to those who are trained to perform them, to remain free of intentional mischief—including sexual relations—in whatever house he may visit in his capacity as a physician, and to keep his patients' confidentiality.

A reading of the oath could lead one to assume that the medical profession had an organized structure at the time of Hippocrates, with accepted rules of deportment and behavior. Some authorities, however, have concluded that Hippocrates was to some extent a rebel and that the oath was an attempt to codify a reformist code of medical ethics. Certainly, at the time of Hippocrates infanticide (and, by inference, abortion) as well as suicide were generally accepted in Greek society. The oath has undergone many revisions over the years, and many of its original precepts are regarded as outmoded. Certainly, few physicians today would consider it appropriate to swear by Apollo and the other Greek gods and goddesses, and the practice of medicine is no longer limited to males. In addition, the for-swearing of abortion is deleted from most modern versions of the oath, and the current controversy over such topics as physician-assisted suicide and euthanasia has made this passage problematic as well.

The Hippocratic Oath has waxed and waned in popularity, with many critics considering it more a series of “guild rules,” whose primary purpose is to protect and promote the interests of the medical profession in society, rather than a set of moral precepts guiding proper physician action toward patients. In February 2002, a Charter on Medical Professionalism was published simultaneously in the Lancet and Annals of Internal Medicine. The charter does not claim to be a direct revision of the oath. Nevertheless, it contains many of the same precepts, and addresses many of the same issues. Most medical students today are required to study both the original and modern versions of the Hippocratic Oath, and many medical schools have incorporated it, in one form or another, into graduation, and in some cases, into induction ceremonies.

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