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The impact of Hippocratic Oath on medical practice is universally recognized. However, some physicians raise questions about its validity and few medical schools use it in graduation ceremonies. It is postulated that this oath does not harmonize with present bioethical concepts and that the principles of beneficence, lack of harm, autonomy and justice, elaborated by Anglo-Saxon philosophers, would do so. The Hippocratic Oath contains these principles and many others, such as gratitude, compassion, justice, honesty, humbleness, sanctity, integrity, confidentiality, fidelity to the bond, and respect for human life and dignity. These are ethical values that apply to modern dilemmas in medicine. As a whole, the oath expresses an ideal of medical behavior and a life project. It must be interpreted in the context of ancient Greek culture and history. Some uncertainties about its relevance are due to a lack of understanding of its exceptional content of values. Modified versions of the oath or original texts presumptuously pretend to replace a document that has lasted 2500 years and that meant a revolution, not only to medicine, but for all mankind. Students should have the opportunity to analyze its content and the way its values are related to concrete situations of present medical practice. Medical schools should shelter it without objections, as the expression of a reflexive compromise acquired by physicians during their studies and to be applied in medical practice.
The Hippocratic Oath, the Hippocratic tradition, and Hippocratic ethics are widely invoked in the popular medical culture as conveying a direction to medical practice and the medical profession. This study critically addresses these invocations of Hippocratic guideposts, noting that reliance on the Hippocratic ethos and the Oath requires establishing (1) what the Oath meant to its author, its original community of reception, and generally for ancient medicine (2) what relationships contemporary invocations of the Oath and the tradition have to the original meaning of the Oath and its original reception (3) what continuity exists and under what circumstances over the last two-and-a-half millenniums of medical-moral reflections (4) what continuity there is in the meaning of professionalism from the time of Hippocrates to the 21st century, and (5) what social factors in particular have transformed the medical profession in particular countries. This article argues that the resources for a better understanding of medical professionalism lie not in the Hippocratic Oath, tradition, or ethos in and of themselves. Rather, it must be found in a philosophy of medicine that explores the values internal to medicine, thus providing a medical-moral philosophy so as to be able to resist the deformation of medical professionalism by bioethics, biopolitics, and governmental regulation. The Oath, as well as Stephen H. Miles' recent monograph, The Hippocratic Oath and the Ethics of Medicine, are employed as heuristics, so as to throw into better light the extent to which the Hippocratic Oath, tradition, and ethics can provide guidance and direction, as well as to show the necessity of taking seriously the need for a substantive philosophy of medicine.
This study focuses on the ancient text of the Hippocratic Oath. Ancient authors refer to various oaths in the context of medical practice, but none of these closely resemble the Hippocratic Oath. The text of the Hippocratic Oath contains several contractual clauses, which clearly reflect a strictly structured community within an institutionalized professional framework. Comparison with the epigraphic and papyrological tradition suggests placing the text in the Hellenistic-Roman period. In particular, investigation of the oldest remaining ancient textual witness, the POxy XXXI 2547 of the third century A.D., reveals Christian influences in the use of language. This indicates a stage of development of the Hippocratic Oath in which the latter existed within a Christian context. The article concludes that, as early as the third century A.D., Christian influences played an equally significant role in the transmission of the Oath as pagan influences.
Medical oaths have consulted the source of all Medical Ethics through centuries. Since the 60s a new consensus on ethics was sought to apply to the new medical problems. The consensus was on the basic principles: beneficence, non-maleficence, justice and respect for the patient's autonomy with its two rules of confidentiality and veracity. The Hippocratic Oath specifies the principles of beneficence and non-maleficence and the rule of confidentiality. They are included in the texts used in different Medical Schools of the United States, Canada and the United Kingdom. The purpose of this analysis is to determine which of those ethical principles are included in the Argentinian Medical Oaths. At present, out of the ten Faculties of Medicine that use a formula, six choose the Declaration of Geneva and the rest use their own texts. No schools use the Hippocratic Oath. Neither of the five different Oaths include the four principles. The rule of confidentiality is the one most frequently mentioned followed by the principles of beneficence and justice. The principles of non-maleficence and of respect for the patient's autonomy, in general, and the rule of veracity, in particular, are not indicated. Revision of the Medical Oaths used in Argentina, is basically for the ethical revision suggested, in order to include all the ethical principles strongly agreed upon.
A few years ago, a Greek text of the Hippocratic Oath (textus receptus) with an interlinear translation into Latin was (re)discovered in a book printed in 1508 in Paris. Its spiritus rector is François Tissard. This paper examines the nature of both the Greek and Latin versions of the Oath text and the rationale of including them in a book which contains an eclectic assemblage of texts in Greek, Latin and Hebrew. The paper also discusses the intellectual background of Tissard and his publishing programme, set up by Gilles de Gourmont. It addresses the social, political, pedagogical and religious implications of publishing a bilingual version of the Hippocratic Oath in 1508 in Paris, i.e. for the first time in the history of printing, and attempts to accommodate this "editio princeps" (at least for the present) within the textual history of the Hippocratic Oath.
The Hippocratic Oath and 1980 Code of Ethics of the American Medical Association (AMA) are compared to evaluate the nature of the relationship between students and teachers of medicine and the ethical injunctions that guide practice and make up the essence of the Hippocratic Oath. Such injunctions include the need to take care that harm is not done, to maintain confidentiality, and to avoid acts leading to death. The AMA code is analyzed from the perspective of its injunctions to give competent and compassionate care, to follow the law, to be responsible for guarding patients against incompetent physicians, and to assure that patient care is based on principles of compassion and skill. The centrality of trust in the relationship between patient and doctor as a crucial value in defining a profession is emphasized.
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The Hippocratic Oath is twenty-five centuries old. Probably drawn-up by Hippocrates himself, it intervenes in a particular cultural, political and religious context: that of Greece at the time of Pericles. It guaranteed the Asclepiad doctors of the continuity of their knowledge within their community. Medicine was highly esteemed because of it. The Oath, more than any other work of the Hippocratic collection, has outlived the centuries. It still remains one of the symbols of the medical profession. Despite its age, it provides insight into some of the questions of medical ethics even today. Its topicality is, without doubt, due to the transcendent nature of the values it proclaimed.
Throughout the long centuries of medical activity, the Hippocratic Oath always had a distinguished place and role within the self definition of curative practice: it contains in a condensed form those ethical principles and moral norms that determine the doctors' behavior and their relationships with their patients and colleagues. The Hippocratic Oath is not the only oath but it is surely the best known and most famous one, that contains both timeless and age dependent norms. The ceremonial taking of the Oath is still a symbol of moral commitment for doctors. The millennia long adherence to the Oath perhaps suggests a timeless stature above all changes of society, but tracing its history, it becomes apparent that, though the text remained essentially the same, the interpretation is greatly influenced by the values and norms of the given age. Even so, the Oath's deontological, normative attribute has made it possible to fulfill its morally regulating role both of level of the profession and the individual, up to the middle of the 20. century. Today, however, classic, bipolar medicine has become complex and varied. Medicine and society have both undergone changes. Bioethics has appeared and become widely accepted. All this raises the question whether the Oath is still suitable for a modern statement of the moral identity of medical practitioners. Does it still have a compulsory force beyond keeping the tradition, and can its norms still be realized in practice? Both the study of texts used for the Oath in Hungarian universities, and the international proposal for modernization--together with the arguments that followed--indicate that if the traditional oath wishes to fulfill its function in the age of modern medicine, it has to adhere to the more up-to-date principles of bioethics, that better correlate with today's expectations.
For centuries the Hippocratic Oath was the example of medical etiquette and as such, determined the professional attitude of physicians in modern medicine. This essay includes a short biographical account of Hippocrates, throws some light on the origin of the oath, cites the text of the oath (in English) and gives an ethical interpretation of the oath. Analysis of the past very often offers creative guidance to the present and also to the future, and the Hippocratic oath is no exception.
The context in which Hippocrates practiced is presented as an explanation for the content of the oath. Today oath-taking invokes respect for high principles shared among a community of practitioners even though the specifics of Hippocrates' code may be outdated or even unknown to many health professionals. More recent oaths particular to dentistry are also presented.
It has been suggested that the Hippocratic oath is no longer relevant in the context of modern morals and current medical practice and that it continues to be administered simply out of blind adherence to tradition. Such judgments may be the result of too superficial an analysis of the oath. The substance of the oath is its ethical content, while the style is shaped by its cultural and historical roots and its literary form. This article carefully examines the Hippocratic oath in order to elucidate the ethical values it contains and consider whether or not these continue to have relevance for contemporary physicians.
The Hippocratic Oath is to be considered a code of conduct for all physicians and not a Pythagorean manifesto, in spite of the view of Edelstein. In fact, it can be shown that the prohibitions and requirements on which the Pythagorean hypothesis rests (the prohibition against helping suicide, inducing abortion, performing surgery, and having sex with patients or with members of their household and the rules of confidentiality and collegiality) do not necessarily link the Hippocratic Oath to the Pythagoreans. Edelstein affirms that only the Pythagoreans condemned suicide, whereas it can be shown that Plato, Aristotle, the Epicureans, and several authors in antiquity opposed it. Similarly, induced abortion was by no means universally accepted in antiquity. Soranus, for example, clearly states that many physicians opposed it in all cases. The passage of the oath concerning surgery can be shown to refer only to lithotomy (as others have underlined). As for sexual relations with patients or members of their household (male or female), the existence of laws against promiscuity (homo- or heterosexual), and other evidence, indicates that it was usually condemned. Finally, confidentiality and collegiality were virtues that the Pythagoreans were not alone in upholding. In addition, many of the principles upheld by the Oath are found in other documents unrelated to the Pythagoreans.
For the last number of years, when ethical problems were discussed in Germany in public, the hippocratic oath was quoted as the valid norm for medical ethics. Although no physician swears this oath in Germany, it is necessary to know its contents, its origin and its role in the history of medicine. And it is necessary to ask some questions: What are the ethical claims of the hippocratic oath? Does it really originate from Hippocrates? How and why did the hippocratic oath become the 'Magna Carta' of behaviour for physicians? Do specific medical ethics exist over time? Do specific medical ethics exist in general? And if it exists, can it be normative ethics? A short survey of the multiple dependences of medical situations shows that ethics in medicine must undertake a new beginning. It cannot be normative ethics, it cannot be situation ethics, it must be differential ethics. It has to respect rules and declarations, but it has also to compare the benefits and risks. In the center of such ethics stands the responsibility of the physician. To assume this responsibility, the physician needs knowledge, the ability to make decisions and a conscience.
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A passage with one of the most contradictory interpretations of the so-called Hippocratic Oath, which was presumably created between 500 and 300 before Christ, is the prohibition of lithotomy. The oldest handwritten traditions of the Hippocratic Oath are dating back to the 11th-12th century. However the section of the prohibition of lithotomy is missing in the oldest preserved tradition (Codex Urbinas gr. 64), which led to some authors interpretation of being added later on. Beyond all doubt the analysis of the texture of the Hippocratic Oath leads to the conclusion that the prohibition of bladder stone lithotomy must have been an integrative part of the oath from the very first beginning. The author could have been inspired by the following reasons to have a non oath related doctor let done the medical operation: the removal of a bladder stone by an operation, which was outfitted with many complications, was one of the most difficult surgical interventions in the antique. Celsus (1st century A. D.) mentioned "severe fever, urine fistula and deadly inflammations" after lithotomy. Since the operation was done perineally, presumably a negative sexual potency was feared. No doctor engaged to help and not to harm his patients was allowed to make this kind of operation, which was often followed by many complications. Nevertheless sometimes patients were "tantalised to death by suffering dreadful pain" through those bladder stone diseases. Consequently "practising men" (the term "surgeon" was created at a later date), those who had been specialised in that operation and had not been linked to the oath, were allowed to make this kind of dangerous operation. Due to a greater experience of those specialists (named as "Lithotomos" by Celsus ih the 1st century A. D.) the danger of this kind of operation was reduced. The prohibition of lithotomy could be interpreted as a commitment to realize the limits of ones own medical actions.
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