Hippocratic Oath

Medicine’s Unbreakable Vow

The Hippocratic Oath holds the distinction of being one of the earliest and most renowned codes of ethics. Its origins are attributed to Hippocrates, a revered physician from ancient Greece widely acknowledged for initiating the approach to medicine as a logical science. Born around 460 BCE on the island of Kos, he is often referred to as the “Father of Medicine.”

Hippocrates founded a medical school on the island, authored numerous treatises concerning medical subjects, and is recognized as the pioneer of modern medicine due to his methodical and empirical exploration of diseases and treatments. He is also considered the earliest proponent of the idea that diseases had natural causes, breaking away from attributing them to superstitions and deities.

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If you want to learn about the health of a population, look at the air they breathe, the water they drink, and the places where they live.

Hippocrates

Before delving into the study of medicine, Hippocrates’ students had to take a solemn oath to the Gods associated with healing in the Greek pantheon: Apollo, Asclepius, Hygeia, and Panacea. This ritual aimed to instill in them a profound understanding of the significance of their role and the expectations for their conduct as healers.

While there is an ongoing debate about its precise authorship, the oath captures the fundamental principles of medical ethics that Hippocrates and his followers stressed in their medical practice.

Engraving: bust of Hippocrates by Paulus Pontius after Peter Paul Rubens, 1638

We all know that embedded within this oath is the famous maxim, “First, do no harm.” Right? Wrong.

Contrary to popular belief, the original Hippocratic Oath did not include the phrase “first, do no harm.” Instead, when reciting the pledge, ancient physicians vowed to “refrain from whatever is harmful and injurious,” to “refuse deadly medicine when asked,” and to “abstain from all willful acts of mischief and corruption.”

Those who undertook the “authentic” Hippocratic Oath also pledged to:

Show respect and assistance to their instructors.
Share medical wisdom with those who display an interest.
Employ their medical expertise and understanding of nutrition to aid patients.
Refrain from administering any treatment that induces abortion.
Solicit assistance from fellow practitioners (like surgeons) when the situation demands.
Safeguard the confidentiality of patient information.

The assurance of upholding patient confidentiality stands out as perhaps the earliest documented instance of such a commitment within professional practice.

The Hippocratic Oath demonstrated a remarkable degree of modernity for its era. In fact, its novelty might have been its downfall, given the lack of references to the oath from its initial appearance around 400 BCE until the Middle Ages. During the 1500s, scholars in medieval Germany stumbled upon and revised the document to align with Christian practices; however, its circulation remained limited.

Only in the 1700s, with its English translation, did Western medical institutions begin to consistently incorporate the oath into their academic ceremonies.

Subsequent revisions have steered clear of any reference to abortion and taken a more nuanced perspective on euthanasia, as demonstrated in a notable 1964 adaptation by Dr. Louis Lasagna:

“…it may…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.”

Though, the fundamental principles of the oath have remained steadfast across various adaptations: every version of it pledges to prioritize the patient’s well-being and safeguard their confidentiality. As values and methodologies undergo changes, the legacy of the original Hippocratic Oath is bound to endure.