of Ethics Online Collection:None
Oath of Hippocrates
The Oath of Hippocrates was not the first of the pagan medical oaths; however, it is the best known and is the one most commonly used by the medical profession. Both the traditional and the revised versions continue to be used as a professional pledge of ethical behavior. The oath indicates the apprentice's responsibility to his teacher and the teacher's family. It includes his responsibility to transmit medical knowledge, to abide by an ethical code, and to observe certain rules in the practice of medicine. The American Medical Association, founded in 1847, adopted the Oath of Hippocrates in its pagan form.
OATH OF HIPPOCRATES
"I SWEAR BY APOLLO, THE PHYSICIAN, AND AESCULAPTUS AND
HEALTH AND ALL-HEAL AND ALL THE GODS AND GOD
CODES OF ETHICS OF PROFESSIONS
DESSES THAT, ACCORDING TO MY ABILITY AND JUDGMENT,
I WILL KEEP THIS OATH AND STIPULATION:
TO RECKON him who taught Me this art
equally dear to me as my parents, to share my substance with
him and believe his necessities if required to regard his
offspring as on the same footing with my own brothers, and
to teach them this art if they should to learn it, without
fee or stipulation, and that by precept, lecture and every
other mode of instruction, I will impart a knowledge of the
art to my own sons and to those of my teachers, and to disciples
bound by a stipulation and oath, according to the law of medicine,
but to none others.
I WILL FOLLOW that method of treatment which, according to my ability and judgment, I consider for the benefit of my patients, and abstain from whatever is deleterious and mischievous, I Will give no deadly medicine to anyone if asked, nor suggest any such counsel; furthermore, I will not give to a woman an instrument to produce abortion.
WITH PURITY AND WITH HOLINESS I will pass my life and practice my art. I will not cut a person who is suffering With a stone, but will leave this to be done by practitioners of this work. Into whatever houses I enter I will go into them for the benefit of the sick and will abstain from every voluntary net of mischief and corruption; and further from the seduction of females or males, bond or free.
WHATEVER, in connection with my professional practice, or not in connection with it, I may see or hear in the lives of men which ought not to be spoken abroad I will not divulge, as reckoning that all such should be kept secret.
WHILE I CONTINUE to keep this oath unviolated may it be granted to me to enjoy life and the practice of the art, respected by all men at all times but should I trespass and violate this oath, may the reverse be my lot.'
The Hippocratic Oath has been modified so that Christians may promise to abide by it. However, the Christian versions of the oath have never been accepted universally. The pagan text continues to be used, but not exclusively, in both Christian and non-Christian circles. In some medical schools the Declaration of Geneva is used, and other schools use oaths of various origins. The Christian version of the Hippocratic Oath omits the invocation to the pagan gods of mythology-Apollo, Aesculapius, Hygeia, and Panacea.
DECLARATION OF GENEVA
It is of interest to note that after World War 11 the Nuremberg Code of Ethics in Medical Research was framed to guide the Allied Military Tribunal in the prosecution of Nazi physicians accused of brutal experiments on political prisoners. As a result, the World Medical Association appointed a committee to prepare a Charter of Medicine and to make necessary revisions to bring the Hippocratic Oath up to date. Minor changes and substitutions were made in the oath, and in 1948, at Geneva, the Second General Assembly adopted what is now known as the Declaration of Geneva.
DECLARATION OF GENEVA
Adopted by the General Assembly of the World Medical
Association at Geneva, Switzerland, September, 1948
At the time of being admitted as a Member of the Medical Profession,
I SOLEMNLY PLEDGE myself to consecrate my life to the service of humanity.
I WILL GIVE to my teachers the respect and gratitude which is their due;
I WILL PRACTICE my profession with conscience and dignity; THE HEALTH OF MY PATIENT will be my first consideration;
I WILL RESPECT the secrets which are confided
in me;
I WILL MAINTAIN by all the means in my power, the honor and the noble traditions of the medical profession;
MY COLLEAGUES will be my brothers;
I WILL NOT PERMIT considerations of religion, nationality, race, party politics or social standing to intervene between my duty and my patient;
I WILL MAINTAIN the utmost respect for human
life, from the time of conception; even under threat, I will
not use my medical knowledge contrary to the laws of humanity
I MAKE THESE PROMISES solemnly, freely and upon my honor
MEDICAL ETHICS
The statements of principles of medical ethics of the A.M.A. express in a general way the duty of the physician to his patients, to other members of the profession, to members of allied professions, and to the public. These principles are an admixture of ethics and etiquette. Ethics deals with the rightness and wrongness of the physician's actions in relation to the principles originating in the nature of man. These guides govern specific situations so that the rights of the patient are always preserved. In contrast, professional etiquette deals with matters stemming from the relations of physicians with each other and the dignity of the profession.
It is generally accepted that in choosing a profession, a person should understand and accept the obligation to conduct himself in accord with the ideals of the profession. To illustrate, the physician is obligated to respect his patient's right to secrecy regarding certain information related to the. patient's medical condition, such as a diagnosis of venereal disease, which if divulged might threaten his welfare. Also, because it is considered unwise for a physician to treat a member of his own family who is seriously ill, lie is expected to respond without hesitation to a request from another physician to give medical care,, in these circumstances. Advertising to procure patients would -not be considered an appropriate practice for a professional person. Criticism of a nurse, a member of an allied profession, is a practice that would be avoided by the doctor. The responsibility of the physician to the public includes cooperating with the proper authorities in the administration of health laws and regulations and helping to provide high-quality medical service.
To guide the physician in the maintenance of high standards in the practice of medicine, the A.M.A. approved the Principles of Medical Ethics, as follows:
Preamble. These principles arc intended to aid physicians individually and collectively in maintaining a high level of ethical conduct. They are not laws but standards by which a physician may determine the propriety of his conduct in his relationship with patients, with colleagues, with members of allied professions, and with the public.
Section 1. The principal objective of the medical profession is to render service to humanity with full respect for the dignity of man. Physicians should merit the confidence of patients entrusted to their care, rendering to each a full measure of service and devotion.
Section 2. Physicians should strive continually to improve medical knowledge and skill, and should make available to their patients and colleagues the benefits of their professional attainments.
Section 3. A physician should practice a method of healing founded on a scientific basis; and lie should not voluntarily associate professionally with anyone who violates this principle.
Section 4. The medical profession should safeguard the public and itself against physicians deficient in moral character or professional competence. Physicians should observe all laws, uphold the dignity and honor of the profession and accept its self-imposed disciplines. They should expose, without hesitation, illegal or unethical conduct of fellow members of the profession.
Section 5. A physician may choose whom he will serve. In an emergency, however, be should render service to tile best of his ability. Having undertaken the care of a patient, he may not neglect him; and unless lie has been discharged he may discontinue his service only after giving adequate notice. He should not solicit patients.
Section 6. A physician should not dispose of his services under terms or conditions which tend to interfere with or impair the free and complete exercise of his medical judgment and skill or tend to cause a deterioration of the quality of medical care.
Section 7. In the practice of medicine a physician should limit the source of his professional income to medical services actually rendered by him, or under his supervision, to his patients. His fee should be commensurate with the services rendered and the patient's ability to pay. lie should neither pay nor receive a commission for referral of patients. Drugs, remedies of 'appliances may be dispensed or supplied by the physician provided it is in the best interests of the patient.
Section 8. A physician should seek consultation upon request; in doubtful or difficult cases; or whenever it appears that the quality of medical service may be enhanced thereby.
Section 9. A physician may not reveal the confidences entrusted to him in the course of medical attendance, or the deficiencies he may observe in the character of patients, unless lie is required to do so by law or unless it becomes necessary to protect the welfare of the individual or of the community.
Section 10. The honored ideals of the medical profession imply that the responsibilities of the physician extend not only to the individual, but also to society where these responsibilities deserve his interest and participation in activities which have the purpose of improving both the health and well-being of the individual and the community.
Of course, ethical principles ideally are to be observed rather than enforced; however, observance is not possible unless physicians are fully aware of the principles. Therefore, those ethical principles are interpreted for doctors, hospitals, and the public, through national, state, and local medical associations. Codes have been established between the medical and allied professions, such as pharmacy, to help their interrelated practices; at the same time, these codes do not interfere with the governing codes of each profession individually. These codes are reviewed and revised at periodic intervals.
The close working relationship of the professional nurse with the doctor makes a joint code imperative. Although the Principles of Medical Ethics and the Code for Professional Nurses are both concerned with the dignity and rights of the individual, interrelated professional practices will no doubt affect the opera
