“Modern Hippocratic Oath”: Evolution of the Hippocratic Oath & WMA Declaration of Geneva

“Modern Hippocratic Oath”: Evolution the Hippocratic Oath & WMA Declaration of Geneva

• The classical Hippocratic oath was formulated in 400 BC, a long time before the “Era of Bioethics” by Hippocrates who is considered to be the father of medicine.

• Different cultures & societies had their own oaths that were the sociocultural product of the era they were created.

• Hippocratic oath has been universally regarded as the gold standard of medical ethics in the early 19th century however the relevance of this classical oath in the modern era has been questioned by many authorities & scholars led to a need for a revised version of the Hippocratic oath. Many countries & medical schools have come up with their own modified oaths to fit their cultural needs.

• The “Modern Hippocratic Oath” is the revised Hippocratic Oath to fit the medical ethical scenarios in the multicultural, and multiethnic modern world.

Oaths & evolution

1. Charaka Samhita: The pre-2nd century CE text in India “Charaka Samhita” had its own version of the physician’s oath.
2. Hippocratic oath: The disciples of Hippocrates were made to swear an oath to the Gods of healing of the Greek pantheon to help them in what is expected from their conduct as the healers & understanding the gravity of their situation before starting to learn medicine (Click here for the Hippocratic Oath and others).
3. Charge/Oath of Maimonides: it is thought to be developed by Maimonides, a renowned Jewish physician from Cordova, Spain & often recited instead of or along with the Hippocratic Oath (Click here for the Hippocratic Oath and others).
4. Lasagna Version of Hippocratic Oath: written by Louis Lasagna, Academic Dean of the School of Medicine at Tufts University by 1964 and it is being used in many medical schools today (Click here for the Hippocratic Oath and others).
5. Modern Hippocratic Oath: first adopted by the World Medical Association in 1948 (Click here for the Modern Hippocratic Oath).

Ethical concerns of the classical Hippocratic oath

• 59% of the physicians who polled in a recent study perceived that the Hippocratic oath was very meaningful to them & the Hippocratic oath inspires the doctors with a sense of pride about their chosen profession.

The “Modern Hippocratic Oath”

• As a member of the medical profession:
  1. I solemnly pledge to dedicate my life to the service of humanity;
  2. The health and well-being of my patient will be my first consideration;
  3. I will respect the autonomy and dignity of my patient;
  4. I will maintain the utmost respect for human life;
  5. 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;
  6. I will respect the secrets that are confided in me, even after the patient has died;
  7. I will practise my profession with conscience and dignity and in accordance with good medical practice;
  8. I will foster the honour and noble traditions of the medical profession;
  9. I will give to my teachers, colleagues, and students the respect and gratitude that is their due;
  10. I will share my medical knowledge for the benefit of the patient and the advancement of healthcare;
  11. I will attend to my own health, well-being, and abilities in order to provide care of the highest standard;
  12. I will not use my medical knowledge to violate human rights and civil liberties, even under threat;
  13. I make these promises solemnly, freely, and upon my honour.
• The “Modern Hippocratic Oath” was first adopted by the 2nd General Assembly of the World Medical Association held in Geneva, Switzerland in September 1948 and revised a number of times, most recently at the 68th General Assembly of the World Medical Association held in Chicago in October 2017.
• World Medical Association (WMA):
  • Founded in 1947 and represents 95+ national professional associations.
  • The headquarters of the World Medical Association is currently located in Ferney-Voltaire, France.

Discussion

• It’s wise to emphasize that everything is subjected to change with the tide of time. Any oath should be constantly reviewed and re-evaluated as per the needs of the society.
• Most of those who choose medicine happen to have a pungent sense of ethics & perceive themselves to have a higher purpose however few choose this very field to earn money therefore the oath is redundant for those with a strong sense of ethical values & an exercise in hypocrisy for those who lack these values.

Also Watch:

• The Oath of Hippocrates from the Youtube channel “Johns Hopkins Medicine”

• Hippocratic Oath / Physician’s Creed from the Youtube channel “BurnFree Global”

• When Doctors Break Their Oath from the Youtube channel “Medlife Crisis”

• The Need For A New Hippocratic Oath from the Youtube channel “The Medical Futurist”

Also Read:

1. First, do no harm – Harvard Health Blog
2. The myth of the Hippocratic Oath

References:

1. Indla V, Radhika MS. Hippocratic oath: Losing relevance in today’s world?. Indian J Psychiatry. 2019;61(Suppl 4):S773-S775. doi:10.4103/psychiatry.IndianJPsychiatry_140_19
2. Sritharan K, Russell G, Fritz Z, et al. Medical oaths and declarations. BMJ. 2001;323(7327):1440-1441. doi:10.1136/bmj.323.7327.1440
3. Romankow J. Hippocrates and Schweitzer – Comparison of their concepts of medical ethics. Arch Hist Filoz Med. 1999;62:245–50.
4. Antoniou SA, Antoniou GA, Granderath FA, Mavroforou A, Giannoukas AD, Antoniou AI. Reflections of the Hippocratic Oath in modern medicine. World J Surg. 2010;34:3075–9.
5. Jotterand F. The Hippocratic Oath and contemporary medicine: Dialectic between past ideals and present reality? J Med Philos. 2005;30:107–28.
6. Kao AC, Parsi KP. Content analyses of oaths administered at U.S. Medical schools in 2000. Acad Med. 2004;79:882–7.
7. Kumar R, Pal R. India achieves WHO recommended doctor population ratio: A call for paradigm shift in public health discourse!. J Family Med Prim Care. 2018;7(5):841-844. doi:10.4103/jfmpc.jfmpc_218_18
8. WMA Declaration of Geneva. 2017
9. The Glaring Case of Indian Medical Ecosystem: More Female Medical Graduates, but Less Female Doctors.
10. Image credit: A fragment of the oath on the 3rd-century Papyrus Oxyrhynchus 2547 by Wellcome Images.