By Alessandra Suuberg, Decency LLC
By name, the Hippocratic Oath may be one of the most recognizable texts in medicine.
The oath is a public promise and an “expression of ideal conduct for the physician,” famously sworn by graduating MDs in the United States and abroad as a rite of passage into the medical profession.
But how many people, if asked, could pinpoint the “official” version, and how many could recite its contents?
That may be a trick question.
About the Hippocratic Oath
According to numerous sources, much remains unknown about the oath’s true origin, including its authorship.
What’s more, the ancient Greek version has undergone multiple translations and adjustments over time, evolving along with changes in society and norms in the medical profession.
One well-known classical, 1943 translation can be found here for reference (linked).
Another 19th century translation, attributed to Francis Adams, reads:
I swear by Apollo the physician, and Aesculapius, and Health, and All-heal, and all the gods and goddesses, that, according to my ability and judgment, I will keep this Oath and this stipulation—to reckon him who taught me this Art equally dear to me as my parents, to share my substance with him, and relieve his necessities if required; to look upon his offspring in the same footing as my own brothers, and to teach them this Art, if they shall wish to learn it, without fee or stipulation; and that by precept, lecture, and every other mode of instruction, I will impart a knowledge of the Art to my own sons, and those of my teachers, and to disciples bound by a stipulation and oath according to the law of medicine, but to none others. I will follow that system of regimen which, according to my ability and judgment, I consider for the benefit of my patients, and abstain from whatever is deleterious and mischievous. I will give no deadly medicine to any one if asked, nor suggest any such counsel; and in like manner I will not give to a woman a pessary to produce abortion. With purity and with holiness I will pass my life and practice my Art. I will not cut persons laboring under the stone, but will leave this to be done by men who are practitioners of this work. Into whatever houses I enter, I will go into them for the benefit of the sick, and will abstain from every voluntary act of mischief and corruption; and, further from the seduction of females or males, of freemen and slaves. Whatever, in connection with my professional practice or not, in connection with it, I see or hear, in the life of men, which ought not to be spoken of abroad, I will not divulge, as reckoning that all such should be kept secret. While I continue to keep this Oath unviolated, may it be granted to me to enjoy life and the practice of the art, respected by all men, in all times! But should I trespass and violate this Oath, may the reverse be my lot!
First-time readers may be surprised that the phrase “do no harm” does not appear anywhere in this text. They may also be surprised by some of the listed references and injunctions.
In particular, the classical Hippocratic Oath has been interpreted to prohibit abortion, euthanasia, and surgery—which may be controversial points for modern readers.
Modern Discussions and Adaptations
Given the potential for controversy, how does one reconcile this ancient Greek text with modern medical practice?
Some authors argue that the classical oath is still relevant today, and encourage readers to consider its “troubling” parts in historical context, or to focus on the basic underlying messages or principles.
Others, like physician Louis Lasagna in 1964, have written modernized versions (link here for reference).
Medical schools today may even ask students to write their own version of the oath to reflect changing standards. MDs may be asked, for example, to swear not by ancient Greek deities, but instead by “whatever each . . . holds most sacred” (“hopefully not something as banal as money or a treasured new house,” quips one physician commentary).
As a result, according to the Association of American Medical Colleges (AAMC) in 2018, “nearly all U.S. medical school graduations include[d] a public promise” at that time, but “not a single student [recited] the original Hippocratic Oath.”
The AAMC wrote that, in 2015, more than half of medical school graduations had included an oath unique to the school, and that students were “increasingly work[ing] together . . . to choose or craft their own oaths, creating a personalized declaration of what it means to be a physician.”
Proponents of the personalized approach have spoken positively about the chance to reflect, learn about colleagues’ perspectives and backgrounds, and create something meaningful.
In contrast, some students and physicians have opined on the benefits of a profession that is “committed to a shared set of essential ethical values,” or have asserted that writing individualized oaths “contradicts the purpose of an oath.” They have noted, for example, that “creating one’s own standards . . . suggests . . . good medicine is tantamount to personal preference,” and that “any morally serious understanding of medicine . . . argues against” this.
Regardless of one’s individual views on the Hippocratic Oath, it appears that—as a subject of continued discussion, adaptation, and controversy—it remains an essential text for understanding the past and present of the medical profession.
Updated on February 25, 2024 to add background on the function of the Hippocratic Oath in medical school graduations.
Disclaimer: The information and opinions on this site do not include legal advice or the advice of a licensed healthcare provider.