mythbusters: the hippocratic oath

This post is suitable for: nerds. No trigger warnings except maybe for yawning. Fun videos. Popcorn.

Many people think that doctors still swear the Hippocratic Oath. It is not compulsory but in fact many medical schools now hold a ceremony where graduating doctors do swear an updated version.

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It is about 2,500 years old.

It is not proven that Hippocrates actually wrote the oath.

Dunno bout you, but I thought first do no harm (primum nil nocere) was the first bit of the Hippocratic Oath. It ain’t, but it is in the Hippocratic Corpus (pdf download link – 70 medical texts).

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Although ancient, swearing the oath was not used as a rite of passage at medical schools until 1508, when the University of Wittenberg first administered it. By 1804, it had been incorporated into the graduation ceremony of the medical school in Montpellier, France. However, it was still not commonly administered, and by the early 20th century, not even 20% of U.S. medical schools included the oath as part of their commencement ceremonies.

Similarly, in 1964 a modern version of the Hippocratic Oath was penned by Professor Lasagna of the School of Medicine at Tufts University.

Professor Lasagna!!! Yup, that is the sole reason for the inclusion of the quote.

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So is it all irrelevant and old hat? Dr Howard Markel says not.

It is unlikely to become superannuated. It serves as a powerful reminder and declaration that we are all a part of something infinitely larger, older, and more important than a particular specialty or institution . . . . The need for physicians to make a formal warrant of diligent, moral, and ethical conduct in the service of their patients may be stronger than ever.

Especially in a world where doctors do clinical empathy courses (see my previous reblog).

Video:
Hippocratic Oath – reconstructed ancient Greek pronunciation
Hippocratic Oath – Grey’s Anatomy
Hippocratic Oath Rap – possibly the worst Caucasian rap ever
Hippocratic Oath Slam – Sheila Shaw, very cool indeed
Take Some Crime – this Hippocratic Oath song does no harm
Ali G – medical ethics

Full Texts:

Modern Version:
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.
—Written in 1964 by Louis Lasagna, Academic Dean of the School of Medicine at Tufts University, and used in many medical schools today.

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Classical version:
I SWEAR by Apollo the physician and AEsculapius, and Health, and All-heal, and all the gods and goddesses, that, according to my ability and judgment, I will keep this Oath and this stipulation — to reckon him who taught me this Art equally dear to me as my parents, to share my substance with him, and relieve his necessities if required; to look upon his offspring in the same footing as my own brothers, and to teach them this art, if they shall wish to learn it, without fee or stipulation; and that by precept, lecture, 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 disciples bound by a stipulation and oath according to the law of medicine, but to none others. I will follow that system of regimen which, according to my ability and judgement, I consider for the benefit of my patients, and abstain from whatever is deleterious and mischievous. I will give no deadly medicine to any one if asked, nor suggest any such counsel; and in like manner I will not give to a woman a pessary to produce abortion. With purity and with holiness I will pass my life and practice my Art. I will not cut persons labouring under the stone, but will leave this to be done by men who are practitioners of this work. Into whatever houses I enter, I will go into them for the benefit of the sick, and will abstain from every voluntary act of mischief and corruption; and, further, from the seduction of females or males, of freemen and slaves. Whatever, in connection with my professional service, or not in connection with it, I see or hear, in the life of men, which ought not to be spoken of abroad, I will not divulge, as reckoning that all such should be kept secret. 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.
Source: “Harvard Classics Volume 38″ Copyright 1910 by P.F. Collier and Son.

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Declaration of Geneva: (drawn up in response to Nazi medical actions)

AT THE TIME OF BEING ADMITTED AS A MEMBER OF THE MEDICAL PROFESSION:
I SOLEMNLY PLEDGE to consecrate my life to the service of humanity;
I WILL GIVE to my teachers the respect and gratitude that is their due;
I WILL PRACTISE my profession with conscience and dignity;
THE HEALTH OF MY PATIENT will be my first consideration;
I WILL RESPECT the secrets that are confided in me, even after the patient has died;
I WILL MAINTAIN by all the means in my power, the honour and the noble traditions of the medical profession;
MY COLLEAGUES will be my sisters and brothers;
I WILL NOT PERMIT considerations of age, disease or disability, creed, ethnic origin, gender, nationality, political affiliation, race, sexual orientation, social standing or any other factor to intervene between my duty and my patient;
I WILL MAINTAIN the utmost respect for human life;
I WILL NOT USE my medical knowledge to violate human rights and civil liberties, even under threat;
I MAKE THESE PROMISES solemnly, freely and upon my honour.
In 1948, the 2nd General Assembly of the World Medical Association adopted the Declaration of Geneva.

Hippocratic Linkdump:
A Guide to the Hippocratic Oath – witty, informative and well written. Yay!
Doctors Aren’t Bound by the Hippocratic Oath – ditto. Coolness.

Disclaimer: no hypocritical puns were used in the making of this post.

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