The late Edmund Pellegrino, M.D., revered medical educator, ethicist, and physician, often made the point that a professional professes something. Merriam-Webster confirms that the etymology of the word, profession, includes the Latin for “public declaration.”
The Hippocratic Oath, probably penned by members of the Pythagorean sect, according to Ludwig Edelstein (see Ancient Medicine: Selected Papers of Ludwig Edelstein. Baltimore: Johns Hopkins University Press, 1987), has for centuries been accepted as the gold standard for the practice of medicine. Nigel M. deS. Cameron (The New Medicine: Life and Death After Hippocrates. Chicago: Bioethics Press, 2001) explicates the Hippocratic Oath as containing four parts:
1. Covenant with Apollo and others
2. Duties to teacher
Regard teacher as equal to parent
Treat him as a partner in livelihood
Share money with him when needed
Consider his children as siblings
Teach medicine to own children, children of teacher, and pupils who take the oath
3. Duties to patients
Use treatment to help the sick, never to injure or wrong them
Give no poison to anyone though asked to do so, nor suggest such a plan
Give no pessary to cause abortion
In purity and in holiness to guard the practitioner’s life and art
Use no knife on “sufferers from stone,” but allow others trained to do so
Enter houses to help the sick, not to participate in wrong doing or harm
Keep oneself from fornication with woman or man, slave or free
Not to divulge, but guard as holy secrets those things that are heard by the practitioner
Oath-taking by medical students has increased in the last 50 years, as reported by Neil Chesanow, in “Is it time to retire the Hippocratic Oath?” Medscape, 25 Jan 2017. The form of oath taken by medical students has also changed. Many schools have re-written the oath in “updated” language, and a good number of students craft their own.
Do they swear not to have sex with their patients? Do the medical students or newly minted physicians now swear not to give poisons or pessaries? What oaths are taken in those states where physician-assisted suicide has been made legal? It would be good for the public to know. Perhaps it is time for physicians to post on their walls (actual and virtual) exactly what it is they profess to be and to do.
— D. Joy Riley, M.D., M.A., is executive director of The Tennessee Center for Bioethics & Culture.