SWEAR BY IT
What the Hippocratic Oath means today to up-and-coming health professionals is a little bit different from what it meant in 400 B.C.
by Christopher Tedeschi
"I swear by Apollo the Physician and all the gods and goddesses, and by whatsoever I hold most sacred, that I will be loyal to the profession of Medicine and just and generous to its members; that I will lead my life and practice my art in uprightness and honour; that into whatsoever house I shall enter, it shall be for the good of the sick to the utmost of my power, holding myself far aloof from wrong, from corruption, from the tempting of others to vice; that I will exercise my art solely for the cure of my patients and will give no drug, perform no operation for a criminal purpose, even if solicited, far less suggest it; that whatsoever I shall see or hear of the lives of men and women which is not fitting to be spoken, I will keep inviolably secret. Now if I keep this oath and break it not, may I enjoy honour, in my life and art, for all time."--Hippocratic Oath,
administered at USC School of Medicine graduation,
edited for contemporary usagage
When Hippocrates sat down to write the oath that would direct the moral and ethical sensibilities of his fellow physicians in ancient Greece, he had no word processor, which may be why the document is relatively short.He also probably had no idea that the words would be repeated by new doctors more than 2,000 years into the future. Or he might have made it even shorter.
That, anyway, is the thinking of some modern medical students who find a lot has changed since the Peloponnesian war.
The original oath establishes moral standards for physician practice, including the well-known counsel to do no harm to the patient. As part of ongoing efforts to integrate an ethical sensibility into tomorrow's physicians, more and more medical schools in the U.S. are administering some form of the Hippocratic Oath, usually as part of their graduation ceremonies.
According to a survey by Robert Orr, M.D., and Norman Pang, M.D. of the University of Chicago, 98 percent of all medical schools in the U.S. and Canada administered an oath in 1993, compared to only 26 percent of schools in 1928. The oath was generally some form of the original document written by Hippocrates.
At the same time, says Orr, "there has been a steady decrease in the inclusion of content items found in the classical Hippocratic Oath."
Most pledges still repeat Hippocrates's main themea commitment to patients. But only 11 percent invoke a deity as part of the oath, only 8 percent forswear abortion and only 3 percent promise no sexual contact with patients.
"There's been a lot of political correctness added in some versions," says Brian Roehmholdt, 22, a first-year medical student at USC School of Medicine, such as a recent version that includes stipulations that the doctor do no treatment without "informed consent." On the other hand, some versions still include a reference to God or a deity, "which makes some people uncomfortable."
For other students, the words themselves aren't as important as the intentions of the oath, which they say are timeless tenets of the profession. "I think [the oath] means that you treat anyone who's ill, even those who can't pay," says Tiffany Grunwald, 29, a second-year medical student. "For me, this is just part of the profession anyway."
Padmanabha Smakkottai, a 24-year-old second-year medical school student, feels the oath may be even more important in the current medical environment. "It's like marriage in a sense," he says. "You're actually taking an oath. When we have all kinds of external factorsHMOs and downsizing of testsI think it helps you realize that your patients come first and not just monetary considerations."
In the end, though, many feel the changes are incidental to the larger role of the oath: connecting new physicians with the tradition of the profession. "It just brings it home a little more, to know what doctors are about and what we should be doing," says Errika Walker, 24. a first-year medical student. "It's more than just the words. When you say it, you feel it like you are carrying on something very importantsomething you don't take lightly."
