Tag Archives: Hippocratic Oath

Comparing Versions of the Hippocratic Oath in Western Medicine

Hippocratic Oath: Classical Version

I swear by Apollo Physician and Asclepius and Hygieia and Panaceia and all the gods and goddesses, making them my witnesses, that I will fulfill 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 fulfill 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 Version

I 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 [that] 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.

Power and Authority in the Patient/Physician Relationship in Western Medicine

The largest disparity between position in the social hierarchy of Western medicine is between the patient and the physician. The patient/physician interaction is critically shaped by the rigidity of the social hierarchy. In describing the nature of the patient/physician relationship, Parsons lays out four distinct features that establish and maintain a particular form of the subordinate/superior relationship, most commonly expressed in terms of power/authority.

Before going further, an extremely important distinction must be drawn. Power and authority are, categorically, not the same things. For instance, in at least one form, the legitimization of authority allows one to exercise more power. Authority therefore enhances elements like one’s reputation or one’s social standing. Authority, also, could be viewed as an entirely different form of power. Whereas power may stipulate the explicit use of force/coercion (i.e. violence), authority may stipulate a softer version of that with similar end results but without the use of force/coercion. Instead, psychological mechanisms and tools may be utilized. I don’t want to go too far down the rabbit hole on this, but suffice it to say they are conceptually and logically distinct and should be kept that way for current purposes.

In this case, the physician is bestowed with authority through his/her extensive knowledge of the human body, coupled with the recognition of the former by the social structure known as medical school. The authority of the physician allows him/her to suggest, recommend, and, in some cases, command the patient to complete or permit certain actions.

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Moral Reasoning in the Context of Physician Assisted Suicide (PAS)

A Statement of Values — Proponents versus Opponents

Collectively, the proponents of physician assisted suicide value personal autonomy and responsibility, the quality of life, and compassion towards others. Proponents of physician assisted suicide feel that by being allowed to choose between life and death as a personal and medical decision, patients are able to exercise personal autonomy, a freedom that they take to be fundamental to the nature of humanity. This autonomy ties directly into their perceptions about quality of life, in that some view life as undesirable or lackluster if they are not able to enjoy activities, events, and relationships that they previously did due to terminal or incurable medical conditions. They do not view life as inherently valuable and worth living, but derive life’s value from its pragmatic and functional elements. When the level and intensity of physical and mental suffering crosses a certain threshold, these proponents value the actions of those who will show compassion and act in accordance with their final wishes. Thus, proponents of physician assisted suicide feel obligated to protect the personal rights of patients as well as to ensure that they are being treated with compassion to alleviate their pain and suffering. Any events or legislation that interfere with those conditions are intolerable.

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Conscientious Objection: Some Thoughts

What I think I find most problematic about Conscientious Objection, or at least what lays the groundwork of my distaste for it, is its unique context. To put it more straightforwardly, Conscientious Objection can, but does not always, involve genuine cases of life and death.

Rather than considering one-off examples, let’s try a cluster approach.

i. A woman is in dire medical need of an abortion; if she does not receive an abortion, she will inevitably die during childbirth. If she lives, the fetus will die and vice versa.

ii. A woman is in significant medical need of an abortion; if she does not receive an abortion, she will inevitably suffer permanent physiological damage. If the fetus lives, she will live but in immense pain for the rest of her life. If she lives (i.e. has an abortion), the fetus will die.

iii. A woman is not in any medical need of an abortion; she elects to abort the fetus within the federally and state regulated timelines allowed to do so.

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A Typological Sketch of Various Arguments Against Physician-Assisted Suicide

Physician-Assisted Suicide/Physician-Assisted Death/Voluntary Euthanasia
(*henceforth PAS/PAD/VE)

In what follows, I will present a brief typology of some of the various arguments that are commonly raised against PAS/PAD/VE. This typological sketch will proceed in broad strokes. The general categories that I used to group these various arguments are: methodological arguments, consequentialist arguments, legal arguments, epistemological arguments, and moral arguments.

To the Five Burroughs (Methodological, Consequentialist, Legal, Epistemological, and Moral)

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