Hippocratic oath printable

Hippocratic oath printable DEFAULT

Hippocratic Oath

Oath of ethics taken by physicians

For other uses, see Hippocratic Oath (disambiguation).

Not to be confused with Hypocrisy.

The Greek physician Hippocrates(460–370 BC), to whom the oath is traditionally attributed

The Hippocratic Oath is an oath of ethics historically taken by physicians. It is one of the most widely known of Greek medical texts. In its original form, it requires a new physician to swear, by a number of healing gods, to uphold specific ethical standards. The oath is the earliest expression of medical ethics in the Western world, establishing several principles of medical ethics which remain of paramount significance today. These include the principles of medical confidentiality and non-maleficence. As the seminal articulation of certain principles that continue to guide and inform medical practice, the ancient text is of more than historic and symbolic value. Swearing a modified form of the oath remains a rite of passage for medical graduates in many countries, and is a requirement enshrined in legal statutes of various jurisdictions, such that violations of the oath may carry criminal or other liability beyond the oath's symbolic nature.

The original oath was written in Ionic Greek, between the fifth and third centuries BC.[1] Although it is traditionally attributed to the Greek doctor Hippocrates and it is usually included in the Hippocratic Corpus, most modern scholars do not regard it as having been written by Hippocrates himself.

Text of the oath[edit]

Earliest surviving copy[edit]

The oldest partial fragments of the oath date to circa AD 275. [2] The oldest extant version dates to roughly the 10th-11th century, held in the Vatican Library.[3] A commonly cited version, dated to 1595, appears in Koine Greek with a Latin translation.[4][5] In this translation, the author translates "πεσσὸν" to the Latin "fœtum."

The Hippocratic Oath, in Greek, from the 1923 Loeb edition, and then followed by the English translation:

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 χρηΐζοντι μετάδοσιν ποιήσεσθαι, καὶ γένος τὸ ἐξ αὐτοῦ ἀδελφοῖς ἴσον ἐπικρινεῖν ἄρρεσι, καὶ διδάξειν τὴν τέχνην ταύτην, ἢν χρηΐζωσι 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 ἐργάτῃσιν 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 ἐνθεραπείῃ 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.[6]

I swear by Apollo Healer, by Asclepius, by Hygieia, by Panacea, and by all the gods and goddesses, making them my witnesses, that I will carry out, according to my ability and judgment, this oath and this indenture.

To hold my teacher in this art equal to my own parents; to make him partner in my livelihood; when he is in need of money to share mine with him; to consider his family as my own brothers, and to teach them this art, if they want to learn it, without fee or indenture; to impart precept, oral instruction, and all other instruction to my own sons, the sons of my teacher, and to indentured pupils who have taken the Healer’s oath, but to nobody else.

I will use those dietary regimens which will benefit my patients according to my greatest ability and judgment, and I will do no harm or injustice to them.[7] Neither will I administer a poison to anybody when asked to do so, nor will I suggest such a course. Similarly I will not give to a woman a pessary to cause abortion. But I will keep pure and holy both my life and my art. I will not use the knife, not even, verily, on sufferers from stone, but I will give place to such as are craftsmen therein.

Into whatsoever houses I enter, I will enter to help the sick, and I will abstain from all intentional wrong-doing and harm, especially from abusing the bodies of man or woman, bond or free. And whatsoever I shall see or hear in the course of my profession, as well as outside my profession in my intercourse with men, if it be what should not be published abroad, I will never divulge, holding such things to be holy secrets.

Now if I carry out this oath, and break it not, may I gain for ever reputation among all men for my life and for my art; but if I break it and forswear myself, may the opposite befall me.[6] – Translation by W.H.S. Jones.

"First do no harm"[edit]

Main article: Primum non nocere

It is often said that the exact phrase "First do no harm" (Latin: Primum non nocere) is a part of the original Hippocratic oath. Although the phrase does not appear in the AD 245 version of the oath, similar intentions are vowed by, "I will abstain from all intentional wrong-doing and harm". The phrase primum non nocere is believed to date from the 17th century.

Another equivalent phrase is found in Epidemics, Book I, of the Hippocratic school: "Practice two things in your dealings with disease: either help or do not harm the patient".[8] The exact phrase is believed to have originated with the 19th-century English surgeon Thomas Inman.[9]

Context and interpretation[edit]

A 12th-century Greekmanuscript of the oath

The oath is arguably the best known text of the Hippocratic Corpus, although most modern scholars do not attribute it to Hippocrates himself, estimating it to have been written in the fourth or fifth century BC.[10] Alternatively, classical scholar Ludwig Edelstein proposed that the oath was written by the Pythagoreans, an idea that others questioned for lack of evidence for a school of Pythagorean medicine.[11] While Pythagorean philosophy displays a correlation to the Oath's values, the proposal of a direct relationship has been mostly discredited in more recent studies. [12]

Its general ethical principles are also found in other works of the Corpus: the Physician mentions the obligation to keep the 'holy things' of medicine within the medical community (i.e. not to divulge secrets); it also mentions the special position of the doctor with regard to his patients, especially women and girls.[13] However, several aspects of the oath contradict patterns of practice established elsewhere in the Corpus. Most notable is its ban on the use of the knife, even for small procedures such as lithotomy, even though other works in the Corpus provide guidance on performing surgical procedures.[14]

Providing poisonous drugs would certainly have been viewed as immoral by contemporary physicians if it resulted in murder. However, the absolute ban described in the oath also forbids euthanasia. Several accounts of ancient physicians willingly assisting suicides have survived.[15] Multiple explanations for the prohibition of euthanasia in the oath have been proposed: it is possible that not all physicians swore the oath, or that the oath was seeking to prevent widely held concerns that physicians could be employed as political assassins.[16]

The interpreted AD 275 fragment of the oath contains a prohibition of abortion that is in contradiction to original Hippocratic text On the Nature of the Child, which contains a description of an abortion, without any implication that it was morally wrong,[17] and descriptions of abortifacient medications are numerous in the ancient medical literature.[18] While many Christian versions of the Hippocratic Oath, particularly from the middle-ages, explicitly prohibited abortion, the prohibition is often omitted from many oaths taken in US medical schools today, though it remains controversial.[19]Scribonius Largus was adamant in AD 43 (the earliest surviving reference to the oath) that it preclude abortion.[20]

As with Scribonius Largus, there seemed to be no question to Soranus that the Hippocratic Oath prohibits abortion, although apparently not all doctors adhered to it strictly in his time. According to Soranus' 1st or 2nd century AD work Gynaecology, one party of medical practitioners banished all abortives as required by the Hippocratic Oath; the other party—to which he belonged—was willing to prescribe abortions, but only for the sake of the mother's health.[20][21]

The oath stands out among comparable ancient texts on medical ethics and professionalism through its heavily religious tone, a factor which makes attributing its authorship to Hippocrates particularly difficult. Phrases such as 'but I will keep pure and holy both my life and my art' suggest a deep, almost monastic devotion to the art of medicine. He who keeps to the oath is promised 'reputation among all men for my life and for my art'. This contrasts heavily with Galenic writings on professional ethics, which employ a far more pragmatic approach, where good practice is defined as effective practice, without reference to deities.[22]

The oath's importance among the medical community is nonetheless attested by its appearance on the tombstones of physicians, and by the fourth century AD it had come to stand for the medical profession.[23]

The oath continued to be in use in the Byzantine Christian world with its references to pagan deities replaced by a Christian preamble, as in the 12th-century manuscript pictured in the shape of a cross.[24]

Modern versions and relevance[edit]

The Hippocratic Oath has been eclipsed as a document of professional ethics by more extensive, regularly updated ethical codes issued by national medical associations, such as the AMA Code of Medical Ethics (first adopted in 1847), and the British General Medical Council's Good Medical Practice. These documents provide a comprehensive overview of the obligations and professional behaviour of a doctor to their patients and wider society. Doctors who violate these codes may be subjected to disciplinary proceedings, including the loss of their license to practice medicine. Nonetheless, the length of these documents has made their distillations into shorter oaths an attractive proposition. In light of this fact, several updates to the oath have been offered in modern times,[26][27] some facetious.[28]

The oath has been modified numerous times.

In the United States, the majority of osteopathic medical schools use the Osteopathic Oath in place of or in addition to the Hippocratic Oath. The Osteopathic Oath was first used in 1938, and the current version has been in use since 1954.[29]

One of the most significant revisions was first drafted in 1948 by the World Medical Association (WMA), called the Declaration of Geneva. "During the post World War II and immediately after its foundation, the WMA showed concern over the state of medical ethics in general and over the world. The WMA took up the responsibility for setting ethical guidelines for the world's physicians. It noted that in those years the custom of medical schools to administer an oath to its doctors upon graduation or receiving a license to practice medicine had fallen into disuse or become a mere formality".[30] In Nazi Germany, medical students did not take the Hippocratic Oath, although they knew the ethic of "nil nocere"—do no harm.[31][failed verification]

In the 1960s, the Hippocratic Oath was changed to require "utmost respect for human life from its beginning", making it a more secular obligation, not to be taken in the presence of any gods, but before only other people. 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 US medical schools:[32]

I swear to fulfill, to the best of my ability and judgment, this covenant:

I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.

I will apply, for the benefit of the sick, all measures [that] are required, avoiding those twin traps of overtreatment and therapeutic nihilism.

I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug.

I will not be ashamed to say "I know not", nor will I fail to call in my colleagues when the skills of another are needed for a patient's recovery.

I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.

I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.

I will prevent disease whenever I can, for prevention is preferable to cure.

I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.

If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.

In a 1989 survey of 126 US medical schools, only three of them reported use 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.[33]

As of 1993, only 14 per cent of medical oaths prohibited euthanasia, and only 8 per cent prohibited abortion.[34]

In a 2000 survey of US medical schools, all of the then extant medical schools administered some type of profession oath. Among schools of modern medicine, sixty-two of 122 used the Hippocratic Oath, or a modified version of it. The other sixty schools used the original or modified Declaration of Geneva, Oath of Maimonides, or an oath authored by students and or faculty. All nineteen osteopathic schools used the Osteopathic Oath.[35]

In France, it is common for new medical graduates to sign a written oath.[36][37]

In 1995, Sir Joseph Rotblat, in his acceptance speech for the Nobel Peace Prize, suggested a Hippocratic Oath for Scientists.[38]

In 2007 US citizen Rafiq Abdus Sabir was convicted for making a pledge to Al Qaeda thus agreeing to provide medical aid to wounded terrorists.[39]

Violation[edit]

There is no direct punishment for breaking the Hippocratic Oath, although an arguable equivalent in modern times is medical malpractice, which carries a wide range of punishments, from legal action to civil penalties.[40] In the United States, several major judicial decisions have made reference to the classical Hippocratic Oath, either upholding or dismissing its bounds for medical ethics: Roe v. Wade, Washington v. Harper, Compassion in Dying v. State of Washington (1996), and Thorburn v. Department of Corrections (1998).[41] In antiquity, the punishment for breaking the Hippocratic oath could range from a penalty to losing the right to practice medicine.[42]

See also[edit]

Ethical codes of conduct for physicians
Ethical principles for human experimentation
Ethical practices for engineers

References[edit]

  1. ^Edelstein, Ludwig (1943). The Hippocratic Oath: Text, Translation and Interpretation. p. 56. ISBN .
  2. ^Norman, Jeremy. "Perhaps the Earliest Surviving Text of the Hippocratic Oath". HistoryofInformation.com. Retrieved April 26, 2018.
  3. ^"Codices urbinates graeci Bibliothecae Vaticanae: Folio 64(Urb.gr.64)". Vatican Library: DigiVatLib. 900–1100. p. folio:116 microfilm: 121.
  4. ^North, Michael (2002). "Greek Medicine: "I Swear by Apollo Physician...": Green Medicine from the Gods to Galen". National Institute of Health; National Library of Medicine; History of Medicine Division.
  5. ^Wecheli, Andreae (1595). "Hippocrates. Τα ενρισκομενα Opera omnia". Frankfurt: National Institute of Health; National Library of Medicine; History of Medicine Division).
  6. ^ abHippocrates of Cos (1923). "The Oath". Loeb Classical Library. 147: 298–299. doi:10.4159/DLCL.hippocrates_cos-oath.1923. Retrieved 6 October 2015.
  7. ^"Greek Medicine - The Hippocratic Oath". www.nlm.nih.gov. National Library of Medicine - NIH. Retrieved 29 July 2020.
  8. ^Lloyd, Geoffrey, ed. (1983). Hippocratic Writings (2nd ed.). London: Penguin Books. pp. 94. ISBN .
  9. ^Sokol, Daniel K. (2013). "'First do no harm' revisited". BMJ. 347: f6426. doi:10.1136/bmj.f6426. PMID 24163087. S2CID 33952216. Retrieved 20 September 2014.
  10. ^Jouanna, Jacques (2001). Hippocrates. Baltimore, Md.: Johns Hopkins University Press. ISBN .
  11. ^Temkin, Owsei (2002). "On second thought" and other essays in the history of medicine and science. Baltimore, MD: Johns Hopkins University Press. ISBN .
  12. ^Askitopoulou, Helen; Vgontzas, Antoniοs N. (2018-07-01). "The relevance of the Hippocratic Oath to the ethical and moral values of contemporary medicine. Part I: The Hippocratic Oath from antiquity to modern times". European Spine Journal. 27 (7): 1481–1490. doi:10.1007/s00586-017-5348-4. ISSN 1432-0932. PMID 29080001. S2CID 10142596.
  13. ^Potter, Paul, ed. (1995). Hippocrates (Reprint ed.). Cambridge, Massachusetts: Harvard Univ. Press u.a. pp. 295–315. ISBN .
  14. ^Nutton, Vivian (2012). Ancient medicine (2nd ed.). Milton Park, Abingdon, Oxon: Routledge. p. 68. ISBN .
  15. ^Edelstein, Ludwig (1967). Ancient Medicine: Selected Papers of Ludwig Edelstein. Baltimore, Md.: Johns Hopkins Press. pp. 9–15. ISBN .
  16. ^Markel, Howard (2004). ""I Swear by Apollo" — On Taking the Hippocratic Oath"(PDF). The New England Journal of Medicine. Massachusetts Medical Society. 350 (20): 2026–9. doi:10.1056/NEJMp048092. PMID 15141039. Retrieved 1 March 2017.
  17. ^Lonie, Iain M. (1981). The Hippocratic treatises, "On generation," "On the nature of the child," "Diseases IV" a commentary. Berlin: De Gruyter. p. 7. ISBN .
  18. ^King, Helen (1998). Hippocrates' woman : reading the female body in ancient Greece. London: Routledge. pp. 132–156. ISBN .
  19. ^Markel, Howard (13 May 2004). ""I Swear by Apollo" — On Taking the Hippocratic Oath". New England Journal of Medicine. 350 (20): 2026–2029. doi:10.1056/NEJMp048092. PMID 15141039.
  20. ^ ab"Scribonius Largus"
  21. ^Soranus, Owsei Temkin (1956). Soranus' Gynecology. I.19.60: JHU Press. ISBN . Retrieved 6 October 2015.CS1 maint: location (link)
  22. ^Wear, Andrew; Geyer-Kordesch, Johanna; French, Roger Kenneth, eds. (1993). Doctors and Ethics: The Earlier Historical Setting of Professional Ethics. Amsterdam: Rodopi. pp. 10–37.
  23. ^von Staden, H (1996). "In a pure and holy way. Personal and professional conduct in the Hippocratic Oath". Journal of the History of Medicine and Allied Sciences. 51 (4): 404–437. doi:10.1093/jhmas/51.4.404. PMID 9019063.
  24. ^Nutton, Vivian (2012). Ancient medicine (2nd ed.). Milton Park, Abingdon, Oxon: Routledge. p. 415, note 87. ISBN .
  25. ^National Library of Medicine 2006 harvnb error: no target: CITEREFNational_Library_of_Medicine2006 (help)
  26. ^Buchholz B, et al. Prohibición de la litotomía y derivación a expertos en los juramentos médicos de la genealogía hipocrática. Actas Urologicas Espanolas. Volume 40, Issue 10, December 2016, Pages 640–645.
  27. ^Oswald, H.; Phelan, P. D.; Lanigan, A.; Hibbert, M.; Bowes, G.; Olinsky, A. (1994). "Outcome of childhood asthma in mid-adult life". BMJ (Clinical Research Ed.). 309 (6947): 95–96. doi:10.1136/bmj.309.6947.95. PMC 2540578. PMID 8038676.
  28. ^Schiedermayer, D. L. (1986). "The Hippocratic Oath — Corporate Version". New England Journal of Medicine. 314 (1): 62. doi:10.1056/NEJM198601023140122. PMID 3940324.
  29. ^"Osteopathic Oath". osteopathic.org. American Osteopathic Association. Retrieved 28 November 2014.
  30. ^World Medical Association, Inc. "WMA History". www.wma.net. World Medical Association, Inc. Archived from the original on 6 February 2015. Retrieved 1 November 2014.
  31. ^Baumslag, Naomi (2005). Murderous Medicine: Nazi Doctors, Human Experimentation, and Typhus. Praeger Publishers. pp. xxv. ISBN .
  32. ^"The Hippocratic Oath Today".
  33. ^Crawshaw, R (8 October 1994). "The Hippocratic oath. Is alive and well in North America". BMJ (Clinical Research Ed.). 309 (6959): 952–953. doi:10.1136/bmj.309.6959.952. PMC 2541124. PMID 7950672.
  34. ^Markel, Howard (2004). ""I Swear by Apollo" — On Taking the Hippocratic Oath"(PDF). The New England Journal of Medicine. Massachusetts Medical Society. 350 (20): 2026–9. doi:10.1056/NEJMp048092. PMID 15141039. Retrieved 1 March 2017.
  35. ^Kao, AC; Parsi, KP (September 2004). "Content analyses of oaths administered at U.S. medical schools in 2000". Academic Medicine. 79 (9): 882–7. doi:10.1097/00001888-200409000-00015. PMID 15326016.
  36. ^Sritharan, Kaji; Georgina Russell; Zoe Fritz; Davina Wong; Matthew Rollin; Jake Dunning; Bruce Wayne; Philip Morgan; Catherine Sheehan (December 2000). "Medical oaths and declarations". BMJ. 323 (7327): 1440–1. doi:10.1136/bmj.323.7327.1440. PMC 1121898. PMID 11751345.
  37. ^Crawshaw, R; Pennington, T H; Pennington, C I; Reiss, H; Loudon, I (October 1994). "Letters". BMJ. 309 (6959): 952–953. doi:10.1136/bmj.309.6959.952. PMC 2541124. PMID 7950672.
  38. ^"Nobel Prize winner calls for ethics oath". Physics World. 19 December 1997. Retrieved 2008-07-19.
  39. ^"Trial and Terror".
  40. ^Groner M.D., Johnathan (2008). "The Hippocratic Paradox: The Role of The Medical Profession In Capital Punishment In The United States". Fordham Urban Law.
  41. ^Hasday, Lisa (23 February 2013). "The Hippocratic Oath as Literary Text: A Dialogue". Yale Journal of Health Policy, Law, and Ethics. 2 (2): Article 4. Retrieved 6 October 2015.
  42. ^Nutton, Vivian (2004). Ancient Medicine. New York, NY: Routledge.

Further reading[edit]

  • Hulkower, Raphael (2010). "The History of the Hippocratic Oath: Outdated, Inauthentic, and Yet Still Relevant". The Einstein Journal of Biology and Medicine. 25/26: 41–44.
  • 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
  • Kass, Leon (2008). Toward a More Natural Science. Simon & Schuster. ISBN .
  • 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[edit]

Sours: https://en.wikipedia.org/wiki/Hippocratic_Oath

Cornell Chronicle

NEW YORK -- Revisiting a hallowed ritual for doctors, a committee within the Weill Cornell Medical College (WCMC) convened this spring to craft an updated Hippocratic Oath, one that responds to the state of modern medicine. Originally composed in ancient Greece, the oath expresses principles still fundamental to the practice of medicine today. Over the years, it has become an emotional rite of passage in medical school graduations across the world.

On June 1, the college's new oath was unveiled at Commencement ceremonies for the WCMC and Graduate School of Medical Sciences. After Antonio M. Gotto Jr., dean of WCMC, administered the oath to the graduates, he invited the medical faculty and other physicians present to stand and recommit themselves to the oath's principles by raising their right hands. (The oath is at the end of this story.)

"With this gesture," Gotto said, "we will join our new colleagues in affirming the values that guide both our work and our lives."

The original Hippocratic Oath has been revised many times to reflect changes in medical practice, historically by individuals or professional associations. The new Weill Cornell oath is unusual because it represents a single institution's effort. Comprising faculty from both Weill Cornell locations in New York City and Doha, Qatar, the 20-member Dean's Committee on the Hippocratic Oath included two senior associate deans, two associate deans, two student leaders and three department chairs. At Gotto's request, this representative committee was headed by Joseph J. Fins, chief of the Division of Medical Ethics and professor of medicine, public health and medicine in psychiatry.

The committee members took a scholarly, systematic and inclusive approach, enriching their knowledge with background reading and categorizing the key elements of earlier medical oaths, including the classical Hippocratic Oath; a well-known 1964 revision by Louis Lasagna; the Oath of Maimonides, a medieval Jewish philosopher; and an oath for Muslim physicians.

In addition to content, the committee examined the language of the oath. "We wanted to be respectful of the diversity of perspectives on faith and belief," explained Fins, "and to be mindful that there are a number of ways to express personal commitment." With this in mind, the members chose to replace phrases that have a religious connotation with more ecumenical expressions, such as changing "I swear" to the more secular "I vow."

The revised oath ends on a more positive note than the classical version, which threatens retribution for any doctor who transgresses the oath and swears falsely. Revised, it reads: "I now turn to my calling, promising to preserve its finest traditions, with the reward of a long experience in the joy of healing." It concludes: "I make this vow freely and upon my honor," again underscoring personal responsibility as a guidepost in one's profession.

The committee also considered the history of medicine, the enduring principles of medical practice, and the profound social and scientific changes affecting the profession today.

New emphases in the revised oath address doctors' responsibilities and duties to serve as advocates for their patients, champion social justice for the sick and forge strong bonds throughout the healing process.

The oath reaffirms a "sacred trust" between doctors and patients, reminding doctors to "use their power wisely." It also fosters trust and respect within the profession by including a pledge to help sustain colleagues in their service to humanity. In a culture preoccupied with wealth and power, the oath serves as an antidote to professional arrogance, obligating doctors to practice humility and self-awareness, accept their limitations and pursue lifelong learning to better care for the sick and prevent illness.

"It was so invigorating to have a group of colleagues together, talking about these important issues and thinking deeply about why we're here and what we're doing," Fins said. "It helped reconnect us as a group, and I hope it will encourage our broader college community to recommit to the values embodied in the oath."

The committee first met in February 2005 to discuss the core values of the oath in the context of 21st-century medicine.

"Our goal was to preserve the enduring precepts and obligations of doctoring, but also to make the oath reflective of some of the current challenges that the health-care system faces today, trying to balance the old with the new," Fins said. "We had to express the core principles in a more modern way; otherwise it becomes platitudinous."

 


Weill Cornell Medical College's Hippocratic Oath

I do solemnly vow, to that which I value and hold most dear:

That I will honor the Profession of Medicine, be just and generous to its members, and help sustain them in their service to humanity;

That just as I have learned from those who preceded me, so will I instruct those who follow me in the science and the art of medicine;

That I will recognize the limits of my knowledge and pursue lifelong learning to better care for the sick and to prevent illness;

That I will seek the counsel of others when they are more expert so as to fulfill my obligation to those who are entrusted to my care;

That I will not withdraw from my patients in their time of need;

That I will lead my life and practice my art with integrity and honor, using my power wisely;

That whatsoever I shall see or hear of the lives of my patients that is not fitting to be spoken, I will keep in confidence;

That into whatever house I shall enter, it shall be for the good of the sick;

That I will maintain this sacred trust, holding myself far aloof from wrong, from corrupting, from the tempting of others to vice;

That above all else I will serve the highest interests of my patients through the practice of my science and my art;

That I will be an advocate for patients in need and strive for justice in the care of the sick.

I now turn to my calling, promising to preserve its finest traditions, with the reward of a long experience in the joy of healing.

I make this vow freely and upon my honor.

Sours: https://news.cornell.edu/stories/2005/06/revised-hippocratic-oath-resonates-graduates
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The Hippocratic Oath

Greek Medicine
I swear by Apollo Physician... Greek Medicine from the Gods to Galen


Page showing the Hippocratic Oath in Greek on the left and in Latin on the right, from: Hippocrates. Ta euriskomena ... Opera omnia … (Frankfurt: The heirs of Andreas Wechel, 1595).  NLM Call number: WZ 240 H667 1595.

The Hippocratic Oath (Ορκος) is perhaps 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. It also strongly binds the student to his teacher and the greater community of physicians with responsibilities similar to that of a family member. In fact, the creation of the Oath may have marked the early stages of medical training to those outside the first families of Hippocratic medicine, the Asclepiads of Kos, by requiring strict loyalty.

Over the centuries, it has been rewritten often in order to suit the values of different cultures influenced by Greek medicine. Contrary to popular belief, the Hippocratic Oath is not required by most modern medical schools, although some have adopted modern versions that suit many in the profession in the 21st century. It also does not explicitly contain the phrase, "First, do no harm," which is commonly attributed to it.

Hippocratic Oath

I swear by Apollo the physician, and Asclepius, and Hygieia and Panacea and all the gods and goddesses as my witnesses, that, according to my ability and judgement, I will keep this Oath and this contract:

To hold him who taught me this art equally dear to me as my parents, to be a partner in life with him, and to fulfill his needs when required; to look upon his offspring as equals to my own siblings, and to teach them this art, if they shall wish to learn it, without fee or contract; and that by the set rules, lectures, and every other mode of instruction, I will impart a knowledge of the art to my own sons, and those of my teachers, and to students bound by this contract and having sworn this Oath to the law of medicine, but to no others.

I will use those dietary regimens which will benefit my patients according to my greatest ability and judgement, and I will do no harm or injustice to them.

I will not give a lethal drug to anyone if I am asked, nor will I advise such a plan; and similarly I will not give a woman a pessary to cause an abortion.

In purity and according to divine law will I carry out my life and my art.

I will not use the knife, even upon those suffering from stones, but I will leave this to those who are trained in this craft.

Into whatever homes I go, I will enter them for the benefit of the sick, avoiding any voluntary act of impropriety or corruption, including the seduction of women or men, whether they are free men or slaves.

Whatever I see or hear in the lives of my patients, whether in connection with my professional practice or not, which ought not to be spoken of outside, I will keep secret, as considering all such things to be private.

So long as I maintain this Oath faithfully and without corruption, may it be granted to me to partake of life fully and the practice of my art, gaining the respect of all men for all time. However, should I transgress this Oath and violate it, may the opposite be my fate.

Translated by Michael North, National Library of Medicine, 2002.

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Sours: https://www.nlm.nih.gov/hmd/greek/greek_oath.html
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