Started by daksdaddy, Oct 27, 2004, 12:28 AM
Hippocratic Oath -- Classical VersionI swear by Apollo Physician and Asclepius and Hygieia and Panaceia and all the gods and goddesses, making them my witnesses, that I will fulfil according to my ability and judgment this oath and this covenant:To hold him who has taught me this art as equal to my parents and to live my life in partnership with him, and if he is in need of money to give him a share of mine, and to regard his offspring as equal to my brothers in male lineage and to teach them this art - if they desire to learn it - without fee and covenant; to give a share of precepts and oral instruction and all the other learning to my sons and to the sons of him who has instructed me and to pupils who have signed the covenant and have taken an oath according to the medical law, but no one else.I will apply dietetic measures for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice.I will neither give a deadly drug to anybody who asked for it, nor will I make a suggestion to this effect. Similarly I will not give to a woman an abortive remedy. In purity and holiness I will guard my life and my art.I will not use the knife, not even on sufferers from stone, but will withdraw in favor of such men as are engaged in this work.Whatever houses I may visit, I will come for the benefit of the sick, remaining free of all intentional injustice, of all mischief and in particular of sexual relations with both female and male persons, be they free or slaves.What I may see or hear in the course of the treatment or even outside of the treatment in regard to the life of men, which on no account one must spread abroad, I will keep to myself, holding such things shameful to be spoken about.If I fulfil this oath and do not violate it, may it be granted to me to enjoy life and art, being honored with fame among all men for all time to come; if I transgress it and swear falsely, may the opposite of all this be my lot.
Hippocratic Oath -- Modern VersionI 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 which 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.
I took the original Hippocratic Oath in 1982 upon my graduation from medical school and returned to this institution upon completion of my training. I have done my best working as an overworked, underpayed academic physician in high-risk obstetrics in a metropolitan city teaching university since then. I look back to the wisdom and guidance of Hippocrates everyday as I struggle to balance my duties, patient rights and allocation of hospital/societal resources for the sake of underprivileged and acutely ill mothers and their unborn children.Several years ago, a junior medical class within our Catholic medical school demanded removal of any version of the Hippocratic Oath at graduation. Their argument was this oath was outdated, degrading, and inappropriate for the "modern reality" of medicine. The majority of our faculty were initially stunned and confused by these arguments at the time. Our academic community eventually compromised with a modern version of the Hippocratic Oath and the option for objecting students to step off the graduation stage during that portion of the ceremony. Some students remain belligerent to this day in this gesture, though most still choose to take a version of the Hippocratic Oath at graduation.I now understand why this new generation of physicians might feel this way about the original Hippocratic Oath. It is particularly evident in this modern era when more students are choosing residencies in radiology, anesthesiology, and pathology for the sake of their lifestyle. Our outstanding residency program in OB/Gyne has difficulty in filling our slots because of significant workload and lifestyle issues. These Hippocratic Oath dissenters tend to openly complain about excessive clinical workload despite obvious patient needs. Many of these individuals rationalize a "shift-mentality" as their future practice of medicine that justifies going home when they are "off-duty" despite any other professional obligations. It appears that "job quality" is a priority when compared to "professional duty" in the medical practice of these particular future physicians.Some of these new breed of colleagues also has a public display of disrespect for the indigent, confused, and simplistic patient. Instead of becoming an advocate and/or protector of society's weakest element, they would discard this needy population in preference for the medical procedure, economizing their clinical practice or optimizing their time at home with family and friends.The most disconcerting attitude within this subset of these "New Age" practitioners is the blatant contempt and disrespect for their elder colleagues in our medical profession. Stated reasons are outdated practitioners and oblivious perspectives to the "modern face" of medicine. While I am still at an intermediate stage in my professional career, I continue to learn more about the practice and ethics of my specific profession from my soon-retiring colleagues than from any journal, Web site, or national meeting.While I am liberal and approachable on most professional matters, I am utterly dismayed by these radical attitudes of my junior colleagues who lambaste the Hippocratic Oath. Perhaps this conflict between the generations in our medical profession is why I have given up the important academic positions of Clerkship and Residency Director of our Ob/Gyne program over the past decade.While I truly love being a mentor, I see little opportunity to guide these young professionals into a lifelong career in service to humanity, when it is obvious their major interests lie in lifestyle and livelihood. This personal attitude may be further reinforced by the radical change in healthcare delivery that promotes the role of physician as clinical and economic manager rather than professional decision-maker and patient advocate in this era of managed medical care.I therefore contend that any attempt to eliminate an appropriate version of the Hippocratic Oath upon graduation from medical school by our younger colleagues reflects a self-centered, misguided, and ill-advised attempt to test their reality of current medical practice. This personal attitude is in defiance of the time-tested, patient-oriented, and physician-managed practice of medicine. While this original philosophy dates back to the Greeks, it continues to provide a roadmap that maximizes patient/societal outcomes within our profession while limiting the individual benefit of payment, stature, and control of physicians upon healthcare delivery. The original Hippocratic Oath should become standard learning for patients and physicians alike.Generation X has recently matriculated into the field of clinical medicine, and our national healthcare system will only suffer further when we tolerate physicians who do not care, apply inappropriate medical techniques, and have little professional respect for the patient-physician relationship as outlined in this product of early medical philosophy.P.S. - I continue to identify a small group of non-generation-X students and residents each year who defy this societal transformation and who strive to follow in the footsteps of myself and my elders. My solution for this "Gen X syndrome in medicine" is a realistic Third World medical experience for junior trainees (which I have done on several occasions) to give them a perspective that healthcare is a right for all human beings, not a scheduled or convenient privilege!!!R.E.B.