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"Hippocratic Oath" |
"The Hippocratic Oath is an oath historically taken by physicians. It is one of the most widely known of Greek medical texts. In its original form, it requires a new physician to swear, by a number of healing gods, to uphold specific ethical standards. Of historic and traditional value, the oath is considered a rite of passage for practitioners of medicine in many countries, although nowadays various modernized versions are often used; the message delivered is still the same: do no harm. Hippocrates is often called the father of medicine in Western culture. The original oath was written in Ionic Greek, in the late Fifth Century BC. It is usually included in the Hippocratic Corpus. Scholars widely believe that Hippocrates or one of his students wrote the oath between the 5th and 3rd century BC. Alternatively, classical scholar Ludwig Edelstein proposed that the oath was written by the Pythagoreans, an idea that others questioned for lack of evidence for a school of Pythagorean medicine. This is the earliest surviving version of the Hippocratic Oath, in Greek and then followed by the English translation:
"Earliest surviving copy" "ὄμνυμι Ἀπόλλωνα ἰητρὸν καὶ Ἀσκληπιὸν καὶ Ὑγείαν καὶ Πανάκειαν καὶ θεοὺς πάντας τε καὶ πάσας, ἵστορας ποιεύμενος, ἐπιτελέα ποιήσειν κατὰ δύναμιν καὶ κρίσιν ἐμὴν ὅρκον τόνδε καὶσυγγραφὴν τήνδε: ἡγήσεσθαι μὲν τὸν διδάξαντά με τὴν τέχνην ταύτην ἴσα γενέτῃσιν ἐμοῖς, καὶ βίου κοινώσεσθαι, καὶ χρεῶν χρηΐζοντι μετάδοσιν ποιήσεσθαι, καὶ γένος τὸ ἐξ αὐτοῦ ἀδελφοῖς ἴσον ἐπικρινεῖν ἄρρεσι, καὶ διδάξειν τὴν τέχνην ταύτην, ἢν χρηΐζωσι μανθάνειν, ἄνευ μισθοῦ καὶ συγγραφῆς, παραγγελίης τε καὶ ἀκροήσιος καὶ τῆς λοίπης ἁπάσης μαθήσιος μετάδοσιν ποιήσεσθαι υἱοῖς τε ἐμοῖς καὶ τοῖς τοῦ ἐμὲ διδάξαντος, καὶ μαθητῇσι συγγεγραμμένοις τε καὶ ὡρκισμένοις νόμῳ ἰητρικῷ, ἄλλῳ δὲ οὐδενί. διαιτήμασί τε χρήσομαι ἐπ᾽ ὠφελείῃ καμνόντων κατὰ δύναμιν καὶ κρίσιν ἐμήν, ἐπὶ δηλήσει δὲ καὶ ἀδικίῃ εἴρξειν. οὐ δώσω δὲ οὐδὲ φάρμακον οὐδενὶ αἰτηθεὶς θανάσιμον, οὐδὲ ὑφηγήσομαι συμβουλίην τοιήνδε: ὁμοίως δὲ οὐδὲ γυναικὶ πεσσὸν φθόριον δώσω. ἁγνῶς δὲ καὶ ὁσίως διατηρήσω βίοντὸν ἐμὸν καὶ τέχνην τὴν ἐμήν. οὐ τεμέω δὲ οὐδὲ μὴν λιθιῶντας, ἐκχωρήσω δὲ ἐργάτῃσιν ἀνδράσι πρήξιος τῆσδε. ἐς οἰκίας δὲ ὁκόσας ἂν ἐσίω, ἐσελεύσομαι ἐπ᾽ ὠφελείῃ καμνόντων, ἐκτὸς ἐὼν πάσης ἀδικίης ἑκουσίης καὶ φθορίης, τῆς τε ἄλλης καὶ ἀφροδισίων ἔργων ἐπί τε γυναικείων σωμάτων καὶ ἀνδρῴων, ἐλευθέρων τε καὶ δούλων. ἃ δ᾽ ἂν ἐνθεραπείῃ ἢ ἴδω ἢ ἀκούσω, ἢ καὶ ἄνευ θεραπείης κατὰ βίον ἀνθρώπων, ἃ μὴ χρή ποτε ἐκλαλεῖσθαι ἔξω, σιγήσομαι, ἄρρητα ἡγεύμενος εἶναι τὰ τοιαῦτα. ὅρκον μὲν οὖν μοι τόνδε ἐπιτελέα ποιέοντι, καὶ μὴ συγχέοντι, εἴη ἐπαύρασθαι καὶ βίου καὶ τέχνης δοξαζομένῳ παρὰ πᾶσιν ἀνθρώποις ἐς τὸν αἰεὶ χρόνον: παραβαίνοντι δὲ καὶ ἐπιορκέοντι, τἀναντία τούτων." "I swear by Apollo the Healer, by Asclepius, by Hygieia, by Panacea, and by all the gods and goddesses, making them my witnesses, that I will carry out, according to my ability and judgment, this oath and this indenture. To hold my teacher in this art equal to my own parents; to make him partner in my livelihood; when he is in need of money to share mine with him; to consider his family as my own brothers, and to teach them this art, if they want to learn it, without fee or indenture; to impart precept, oral instruction, and all other instruction to my own sons, the sons of my teacher, and to indentured pupils who have taken the physician’s oath, but to nobody else. I will use treatment to help the sick according to my ability and judgment, but never with a view to injury and wrong-doing. Neither will I administer a poison to anybody when asked to do so, nor will I suggest such a course. Similarly I will not give to a woman a pessary to cause abortion. But I will keep pure and holy both my life and my art. I will not use the knife, not even, verily, on sufferers from stone, but I will give place to such as are craftsmen therein. Into whatsoever houses I enter, I will enter to help the sick, and I will abstain from all intentional wrong-doing and harm, especially from abusing the bodies of man or woman, bond or free. And whatsoever I shall see or hear in the course of my profession, as well as outside my profession in my intercourse with men, if it be what should not be published abroad, I will never divulge, holding such things to be holy secrets. Now if I carry out this oath, and break it not, may I gain for ever reputation among all men for my life and for my art; but if I transgress it and forswear myself, may the opposite befall me.
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"First do no harm"
"It is often said that the phrase "First do no harm" Primum non nocere, Latin is a part of the Hippocratic oath. The phrase as such does not appear in the oath, although the oath does contain noxamvero et maleficium propulsabo, Latin (I will utterly reject harm and mischief). The phrase "primum non nocere" is believed to date from the 17th century. Another equivalent phrase is found in Epidemics, Book I, of the Hippocratic school: "Practice two things in your dealings with disease: either help or do not harm the patient.” The exact phrase is believed to have originated with the 19th-century surgeon Thomas Inman." "Modern use and relevance" The oath has been modified numerous times. One of the most significant revisions was first drafted in 1948 by the World Medical Association called the Declaration of Geneva. "During the post World War II and immediately after its foundation, the WMA showed concern over the state of medical ethics in general and over the world. The WMA took up the responsibility for setting ethical guidelines for the world's physicians. It noted that in those years the custom of medical schools to administer an oath to its doctors upon graduation or receiving a license to practice medicine had fallen into disuse or become a mere formality." In Germany during the Third Reich, medical students did not take the Hippocratic Oath, although they knew the ethic of "nil nocere," do no harm. In the 1960s, the Hippocratic Oath was changed to require "utmost respect for human life from its beginning", making it a more secular obligation, not to be taken in the presence of God or any gods, but before only other people. When the Oath was rewritten in 1964 by Louis Lasagna, Academic Dean of the School of Medicine at Tufts University, the prayer was omitted, and that version has been widely accepted and is still in use today by many US medical schools. In the United States, the majority of osteopathic medical schools use the Osteopathic Oath in place of or in addition to the Hippocratic Oath. The Osteopathic Oath was first used in 1938, and the current version has been in use since 1954. In a 1989 survey of 126 US medical schools, only three reported use of the original oath, while thirty-three used the Declaration of Geneva, sixty-seven used a modified Hippocratic Oath, four used the Oath of Maimonides, one used a covenant, eight used another oath, one used an unknown oath, and two did not use any kind of oath. Seven medical schools did not reply to the survey. In a 2000 survey of US medical schools, all of the then extant medical schools administered some type of profession oath. Among schools of modern medicine, sixty-two of 122 used the Hippocratic Oath, or a modified version of it. The other sixty schools used the original or modified Declaration of Geneva, Oath of Maimonides, or an oath authored by students and or faculty. All nineteen osteopathic schools used the Osteopathic Oath. In France, it is common for new medical graduates to sign a written oath. In 1995, Sir Joseph Rotblat, in his acceptance speech for the Nobel Peace Prize, suggested a Hippocratic Oath for Scientists." "Interpretation" "While many Christian versions of the Hippocratic Oath, particularly from the middle-ages, explicitly prohibited abortion, the prohibition is often omitted from many oaths taken in US medical schools today, though it remains controversial. Scribonius Largus was adamant in 43 AD (the earliest surviving reference to the oath) that it preclude abortion. As with Scribonius Largus, there seemed to be no question to Soranus that the Hippocratic Oath prohibits abortion, although apparently not all doctors adhered to it strictly in his time. According to Soranus' 1st or 2nd century AD work Gynaecology, one party of medical practitioners banished all abortives as required by the Hippocratic Oath; the other party—to which he belonged—was willing to prescribe abortions, but only for the sake of the mother's health. As of 1993, only 14 percent of medical oaths prohibited euthanasia and the Hippocratic oath is not one of them." "Breaking the Hippocratic Oath" "There is no direct punishment for breaking the Hippocratic oath, although an arguable equivalent in modern times is malpractice. Medical malpractice carries a wide range of punishments, from legal action to civil penalties. In the US, several major judicial decisions have made reference to the classical Hippocratic Oath, either upholding or dismissing its bounds for medical ethics: Roe v. Wade, Washington v. Harper, Compassion in Dying v. State of Washington (1996) and Thorburn v. Department of Corrections (1998). In antiquity, the punishment for breaking the Hippocratic oath could range from a penalty to losing the right to practice medicine." |
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