While researching for my book I decide it was important to include the Hippocratic Oath. So I looked online to find the original version and what I grew up to know as the "Do no harm" oath that I thought all doctors took. Well to my surprise the "oath" isn't what we were led to believe it was. Here is a direct quote from a website that had posted what they thought was the "Modern Oath".
"The AMA has a code of ethics, but there is, in fact, no version of
the Hippocratic Oath that the AMA espouses or promotes. This is the
information we have received from the AMA's Ethics Division. Our own research on the Hippocratic Oath, inspired by the discovery that
our posting of the Modern Oath did not originate from the AMA, has been
most interesting. While it is common knowledge among both doctors and the
lay public that doctors take an oath that says, "Never do harm," the fact
is that not all medical schools require their graduating doctors take the
Hippocratic Oath. In addition, Medicine's use of the Oath changes over
time. Here are some items for your consideration, the results of a study
by Robert Orr, M.D. and Norman Pang, M.D., in which 157 deans of allopathic
and osteopathic schools of medicine in Canada and the United States were
surveyed regarding the use of the Hippocratic Oath:
1. In 1993, 98% of schools administered some form of the Oath.
2. In 1928, only 26% of schools administered some form of the Oath.
3. Only 1 school used the original Hippocratic Oath.
4. 68 schools used versions of the original Hippocratic Oath.
5. 100% of current Oaths pledge a commitment to patients.
6. Only 43% vow to be accountable for their actions.
7. 14% include a prohibition against euthanasia.
8. Only 11% invoke a diety.
9. 8% prohibit abortion.
10. Only 3% prohibit sexual contact with patients.
From - "The Use of the Hippocratic Oath: A Review of 20th Century Practice
and a Content Analysis of Oaths Administered in Medical Schools in the U.S.
and Canada in 1993." by Robert D. Orr, M.D. and Norman Pang, M.D.
UPDATE
The British Medical Association, in March 1997, published their first draft
of a revised Hippocratic Oath to be considered by the World Medical
Association.
If you would like to hear the critique of this proposed revised Oath by The
Gersten Institute, click here.
"The Oath, a set of ethical principles derived from the writings of the
ancient Greek physician Hippocrates, has been updated to put patients
first. It aims to be a unifying force, superseding national, ethnic,
religious and cultural boundaries by focusing on widely shared values.
The new wording can be adapted by nurses, paramedics and other health
professionals."
Commenting on the revised wording, Dr Sandy Macara, chairman of the BMA
Council, said:
"It is as important now as ever it was for doctors to have an agreed
statement of ethical principles. On qualifying, doctors need such a
statement to make a public commitment to the professional responsibilities
they are assuming. Thereafter these principles should provide guidance in
the increasingly difficult ethical decisions they will make throughout
their professional lives.
"The value of this update will be all the greater if it comes into use by
every doctor qualifying from every medical school in the world."
The BMA has been campaigning for the past five years for a revitalisation
of the Hippocratic values. It has gathered examples of ethical codes from
all over the world and common points from these have been integrated into
the new wording.
The BMA has undertaken this work on behalf of the World Medical Association
as the first stage of a revision of the current international code of
medical ethics, the Geneva Declaration, which celebrates its 50th
anniversary next year.
Appendix I
DRAFT REVISION OF THE HIPPOCRATIC OATH
The practice of medicine is a privilege which carries important
responsibilities. All doctors should observe the core values of the
profession which center on the duty to help sick people and to avoid harm.
I promise that my medical knowledge will be used to benefit people's
health. They are my first concern. I will listen to them and provide the
best care I can. I will be honest, respectful and compassionate towards
patients. In emergencies, I will do my best to help anyone in medical need.
I will make every effort to ensure that the rights of all patients are
respected, including vulnerable groups who lack means of making their needs
known, be it through immaturity, mental incapacity, imprisonment or
detention or other circumstance.
My professional judgement will be exercised as independently as possible
and not be influenced by political pressures nor by factors such as the
social standing of the patient. I will not put personal profit or
advancement above my duty to patients.
I recognise the special value of human life but I also know that the
prolongation of human life is not the only aim of healthcare. Where
abortion is permitted, I agree that it should take place only within an
ethical and legal framework. I will not provide treatments which are
pointless or harmful or which an informed and competent patient refuses.
I will ensure patients receive the information and support they want to
make decisions about disease prevention and improvement of their health. I
will answer as truthfully as I can and respect patients' decisions unless
that puts others at risk of harm. If I cannot agree with their requests, I
will explain why.
If my patients have limited mental awareness, I will still encourage them
to participate in decisions as much as they feel able and willing to do so.
I will do my best to maintain confidentiality about all patients. If there
are overriding reasons which prevent my keeping a patient's confidentiality
I will explain them.
I will recognize the limits of my knowledge and seek advice from colleagues
when necessary. I will acknowledge my mistakes. I will do my best to keep
myself and colleagues informed of new developments and ensure that poor
standards or bad practices are exposed to those who can improve them.
I will show respect for all those with whom I work and be ready to share my
knowledge by teaching others what I know.
I will use my training and professional standing to improve the community
in which I work. I will treat patients equitably and support a fair and
humane distribution of health resources. I will try to influence positively
authorities whose policies harm public health. I will oppose policies which
breach internationally accepted standards of human rights. I will strive to
change
laws which are contrary to patients' interests or to my professional ethics.
APPENDIX 2
Translation of the Original Hippocratic Oath by authors of this BMA draft.
"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
judgement, I will keep this Oath . . . "
Commentary from The Gersten Institute
1. Be it declareth this date, October 4, 1998, that the above Revised
Hippocratic Oath, herein and hereafter referred to as RHO is a wee bit dry.
Okay, let's get to the point. There is not enough heart in the RHO. It
does not move or inspire. As a physician who has no recall at all if my
medical school administered any version of the Hippocratic Oath in 1975,
the year I graduated, I strongly believe that if doctors are to take an
Oath ONCE in their lifetime, it should be a powerful, impassioned Oath that
carries, at the very least, the spirit of the original Hippocratic Oath.
2. RHO is couched in a good deal of legal terminology. Perhaps that
is necessary in this era of medicine, but it only adds to the growing
distance between doctors and patients and does not, in my opinion, advance
the real issue, namely quality of care.
3. The philosophy and principles contained in the RHO are good and sound.
4. The BMA translation of the original Oath is interesting. Instead
of the correct translation in the first line, which refers to the Greek
Gods Apollo, Aesculapius, Hygeia, and Panacea, this translation
mis-tranlates "Hygeia" as "Health" and "Panacea" as "All-Heal." We should
have a genuinely honest translation before we can consider revisions.
5. Gallup polls in the 1990's show that 95% of Americans believe in
God and that 50% of atheists and agnostics PRAY! 50% of patients would
like their doctors to pray with them. While it is correct to "drop the
Greek Gods," is it a disservice to both doctors and patients to totally
leave out the spiritual dimension in the RHO? I think so. It is an
impossible task to try to capture the spirit of the original Hippocratic
Oath while throwing out all mention of God, holiness, sacredness, and
spirituality. It is necessary and sufficient as physicians to swear to
practice according to the highest dictates of our conscience, with God (as
we know and call Him or Her) as our witness.
6. With these items considered, perhaps the world should consider this
Revised Hippocratic Oath. On the other hand, perhaps Hippocrates knew what
he was doing. Perhaps we should keep the original Oath and simply make
note that Apollo, Aesculapius, Hygeia, and Panacea are not universally
accepted. Nor is Jesus, Buddha, Allah, Krishna or Ahura Mazda.
Dennis Gersten, M.D"
I found this quite interesting. So if you take the statistics in to count then it explains why we have a medical profession that does not live up to the standards set before them in the beginning. It is no wonder that we have doctors that are beholden to the pharmaceutical industry and why 57% will not hold themselves accountable for their actions and if you look at 6 to 10 the percentages of "in a patients best interest" is appalling to say the least. I ask you "Do you want your doctor to swear to the original Hippocratic Oath or some new modern version that has been rewritten to conform to the times?" I personally want my doctor to be one from the old school thought that they should "Do no harm."
I apologize this is such a long blog but this has been weighing heavily on my mind since I sat behind my laptop and started pounding out my book. I have lost sleep thinking back to conversations I had with doctors and then resorted to researching things myself because I never felt like they were doing enough. In several cases that is exactly what happened. Once I diagnosed my husbands Mononucleosis before the doctor did and the doctor had labs and medical expertise as well as 3 weeks to come up with the diagnosis. I have several stories just like this one and I shouldn't have one. I understand we are human, we all make mistakes but when those mistakes on countless occasions have almost cost our lives and have cost others their lives it is unacceptable.
I want to leave you with this last thought. Why is it in the late 5th century BC the Hippocrates felt that the people need an oath for the physicians to uphold certain medical ethics and today we don't hold our physicians to the same ethics? I believe this is where our esteemed medical profession derailed for lack of a better term. No more do our physicians as a whole truly put the patient first. I believe this because of what my husband and I have endure at the hands of this profession.
Cherise
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