Saturday, October 18, 2008

Presidential Debates and the Hippocratic Oath

In a couple of presidential debates, the Hippocratic Oath was mentioned. What many people (including the presidential candidates) don't realize, however, is that the oath of Hippocrates is quite different today from the original, taking a sharp turn in the 1960's. If it is mandated at all for graduating medical students, it is markedly different today from what it was in the past.

The Oath of Hippocrates included the swearing off of terminating pregnancies: “I will not give to a woman an abortive remedy.” But alas, the classic Hippocratic oath has been left behind, modernized so that most med students today don't even realize just how far modern versions of the oath have strayed from the classical model. The PBS/NOVA site offers some interesting statistics with the article The Hippocratic Oath Today: Meaningless Relic or Invaluable Moral Guide? I've included several paragraphs in the “continue reading” section from that site in case your web surfing time is short:

“The Hippocratic Oath (see ancient and modern versions) is one of the oldest binding documents in history. Written in antiquity, its principles are held sacred by doctors to this day: treat the sick to the best of one's ability, preserve patient privacy, teach the secrets of medicine to the next generation, and so on. “The Oath of Hippocrates,” holds the American Medical Association's Code of Medical Ethics (1996 edition), “has remained in Western civilization as an expression of ideal conduct for the physician.”

“Today, most graduating medical-school students swear to some form of the oath, usually a modernized version. Indeed, oath-taking in recent decades has risen to near uniformity, with just 24 percent of U.S. medical schools administering the oath in 1928 to nearly 100 percent today.

“Yet paradoxically, even as the modern oath's use has burgeoned, its content has tacked away from the classical oath's basic tenets. According to a 1993 survey of 150 U.S. and Canadian medical schools, for example, only 14 percent of modern oaths prohibit euthanasia, 11 percent hold covenant with a deity, 8 percent forswear abortion, and a mere 3 percent forbid sexual contact with patients -- all maxims held sacred in the classical version.

“The original calls for free tuition for medical students and for doctors never to 'use the knife' (that is, conduct surgical procedures) -- both obviously out of step with modern-day practice. Perhaps most telling, while the classical oath calls for 'the opposite' of pleasure and fame for those who transgress the oath, fewer than half of oaths taken today insist the taker be held accountable for keeping the pledge.”