Some thoughts about contemporary ethics in medicine – Appendix

The Hippocratic Oath

The Hippocratic Oath is the earliest and most impressive document in medical ethics. Hippocrates (c. 460-c. 377 B.C.) separated the practice of medicine from religion, superstition, and magic.

"I swear by Apollo the physician, by Æsculapius, by Hygeia, Panacea, and all the gods and goddesses, that, according to my best ability and judgment, I will keep this oath and 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 regard his offspring as on 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, oral teaching and every other mode of instruction, I will impart a knowledge of the art to my own sons and to those of my teachers, and to disciples bound by a stipulation and oath, according to the law of medicine, but to no others.

"I will follow that method of treatment, which, according to my ability and judgment, I consider for the benefit of my patients, and abstain from whatever is deleterious and mischievous. I will give no deadly medicine to anyone if asked, nor suggest any such counsel; furthermore, I will not give to a woman an instrument to produce abortion.

"With purity and with holiness I will pass my life and practice my art. I will not cut a person who is suffering with a stone, but will leave this to be done by 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, bond or free.

"Whatever in connection with my professional practice, or not in connection with it, I may see or hear in the lives of men which ought not to be spoken abroad, I will not divulge, as reckoning that all such should be kept secret.

"While I continue to keep this oath inviolate, may it be granted to me to enjoy life and the practice of my art, respected always by all men, but should I trespass and violate this oath, may the reverse be my lot."

   Apollo, referred to as "the physician" in the opening sentence of the oath, was the patron god of the physicians of ancient Greece and Rome (as well as the god of music, poetry, prophecy, and the founding of cities).

Apollo’s son, Æsculapius, became more exclusively the patron god of the physicians. Hygeia and Panacea, according to Greek mythology, were daughters of Æsculapius, Hygeia being the goddess of health, and Panacea a divine healer of all ailments.

Not strictly an oath, it was, rather, an ethical code or ideal, an appeal for right conduct. In one or other of its many versions, it has guided the practice of medicine throughout the world for more than 2,000 years.

Some duties of the oath are contrary to fundamental of Hippocratic medicine. Abortions were performed to limit and to regulate the size of families; suicide was allowed and physicians supplied poison; Hippocratic doctors were good surgeons. The oath itself is based upon Pythagorean philosophy, including parts of Hippocratic medicine.

At some universities and medical schools, the Hippocratic oath is still part of the final medical examination; in most European countries this is not the case. Parts of the Hippocratic oath are incorporated into general laws. Additional regulations within the Corpus Hippocraticum, a major work by Hippocrates, deal with relations to patients, furnishings of consultation rooms, compensation for the physician's services, and values of being a physician.

Declaration of Geneva

The Declaration of Geneva, adopted by the General Assembly of the World Medical Association in 1948 is a modified form of the Hippocratic Oath. The Declaration is as follows:

"I solemnly pledge myself to consecrate my life to the service of humanity. I will give to my teacher the respect and gratitude which is their due; I will practice my profession with conscience and dignity; the health of my patients will be my first consideration; I will respect the secrets which are confided in me; I will maintain by all means in my power the honor and the noble traditions of the medical profession; my colleagues will be my brothers; I will not permit considerations of religion, nationality, race, party politics or social standing to intervene between my duty and my patient; I will maintain the utmost respect for human life, from the time of conception; even under threat, I will not use my medical knowledge contrary to the laws of humanity. I make these promises solemnly, freely, and upon my honor."

Citation: Rinck PA. Some thoughts about contemporary ethics – Appendix. Rinckside 1999; 10,3: 9-13.

The Appendix contains the Hippocratic oath and the Declaration of Geneva (1948)