Hippocrates Oath and the Noble Profession of Medicine

One of the headlines in Times of India a couple of days back read “Every doctor is bound by the Hippocratic Oath:  Panel”. This was in reference to Dr Manocha who had refused to help a dying man and then pleaded that “he was under no obligation to help the injured person as he was a private practitioner and there was no relationship of consumer and service provider between the two.”

Time to think about the Oath. What was there in the oath? What oath had we taken on the first day in the medical college? Did I really remember any of the words? No, I did not remember it word by word. I wonder how many doctors remember the Oath by heart!

I was so excited about having been selected for SCB Medical College, the premier medical college in my state. The excitement was more because of my ‘poor’ performance during the +2 Sc exams. After an 85+ % in the ICSE exam (it was considered a high score those days), I was down to in the sixties range after my plus 2 performance. Mom was upset. Very upset. Even Purna Babu, our neighbour wondered why I scored so low after a good performance in ICSE. I was a teenager who did everything that she felt like. I used to bunk classes and hang out at SnackO with my friends. Instead of attending Science classes, I used to go and attend Arts classes with my schoolmates just to check out their new teacher and trouble her. Studies did not seem to matter at that moment. Just enjoying life was all that seemed to matter. When I showed a decline after the +2 results, dad was not upset like mom was. Probably he knew I got the marks that I had worked for...not more, not less. So when mom shouted at me for my poor performance, dad just called me aside and said, “This is over. Don’t brood over the past. Learn to move ahead. Do well in your pre-medical entrance exam and nobody will ever ask you how much you scored in +2.” He was so right...When I got a good rank in the state level medical entrance, everything else seemed immaterial.

Somewhere I also started believing I had achieved something really great. I started believing that as a doctor I would probably get a lot of respect from my patients and their attendants. On our first day at SCB Medical College we were asked to gather at the auditorium for the welcome speech by the Principal and the Oath taking ceremony. It seemed like a great celebration for us.

With lighted candles in our hands and a lot of dreams in our eyes, over a hundred students in our late teens and early twenties gathered at the college auditorium. We raised our hands and took a pledge. Though today, I do not remember each word of it, it was something like pledging to be good humans and never saying ‘no’ to treat a person who needs our care. 

Original Oath borrowed from webpages.scu.edu 

Today, years later, I decided to check out the Hippocrates Oath once again. The original version when translated in English reads:

“I swear by Apollo, the healer, Asclepius, Hygieia, and Panacea, and I take to witness all the gods, all the goddesses, to keep according to my ability and my judgment, the following Oath and agreement:

To consider dear to me, as my parents, him who taught me this art; to live in common with him and, if necessary, to share my goods with him; To look upon his children as my own brothers, to teach them this art.

I will prescribe regimens for the good of my patients according to my ability and my judgment and never do harm to anyone.

I will not give a lethal drug to anyone if I am asked, nor will I advise such a plan; and similarly I will not give a woman a pessary to cause an abortion.

But I will preserve the purity of my life and my arts.

I will not cut for stone, even for patients in whom the disease is manifest; I will leave this operation to be performed by practitioners, specialists in this art.

In every house where I come I will enter only for the good of my patients, keeping myself far from all intentional ill-doing and all seduction and especially from the pleasures of love with women or with men, be they free or slaves.

All that may come to my knowledge in the exercise of my profession or in daily commerce with men, which ought not to be spread abroad, I will keep secret and will never reveal.

If I keep this oath faithfully, may I enjoy my life and practice my art, respected by all men and in all times; but if I swerve from it or violate it, may the reverse be my lot.”

Now that makes me wonder – Is it really possible to follow each word of the original Hippocratic Oath today? The modern revised version of the Oath today reads as:

"I swear to fulfill, to the best of my ability and judgment, this covenant:

I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow. 

I will apply, for the benefit of the sick, all measures [that] are requires, avoiding those twin traps of overtreatment and therapeutic nihilism. 

I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug.

I will not be ashamed to say "I know not," nor will I fail to call in my colleagues when the skills of another are needed for a patient's recovery.

I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given to me to save a life, all thanks. But it may also 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.

I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.

I will prevent disease whenever I can, for prevention is preferable to cure.

I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.

If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help." 

Why is the oath administered only on the very first day of medical college? By the time we come out of college, I wonder how many of us actually remember even parts of the oath! Should the oath not be administered once more just before a medical student graduates? What's your opinion?