The Physician's Oath Considered Critically

- Dr. Yaman Ors

Unit of Medical Ethics , Ankara Medical Faculty , Sihhiye, 06100 Ankara, Turkey

Eubios Ethics Institute Newsletter 3 (1993), 60-61.

March 14 is the day when the beginning of a "modern" medical education more than one hundred years ago (at the time of the Ottoman Empire) is celebrated in Turkey. For the last two decades or so, this has been an occasion whereby academic and professional meetings are held in different parts of the country with critical discussions on medico-social issues, on medical ethics, the state of the medical profession as well as on medical education. Sometimes, the related activities last a whole week.

"Oaths and Declarations in Medicine" was the title of a meeting held in Ankara on March 12, 1993, and organized jointly by the Central Council of the Turkish Medical Association and the Bioethics Section of the Turkish Philosophical Society. The three sessions, followed by a general discussion, had the titles: "Oaths from the standpoint of philosophy and law," "Oaths and declarations in health professions, " and "The physician's oath after 2500 years." And among the presentations were such topics as "The meaning of oath for man," "A look at the declarations of the World Medical Association," "Evolution of the physician's oath," and the "Rationales of the physician's oath."

The present writer summarized his views on the topic in a presentation with the title, "A critical analysis of the physician's oath." In his view, the so-called Geneva Declaration and similar texts based on the historical "Hippocratic Oath" are all outmoded. With their devotion solely to the patient-physician relationship of clinical medicine and with the exclusion, above all, of preventive medicine and biomedical research, they all reflect a rather narrow conception of medical activity. The overall understanding underlying the related texts, with their superfluous or unnecessary mention of respect for the teacher, brotherhood within the profession, maintaining the noble traditions of the medical profession and the like, are far from being relevant within the context of the contemporary interhuman relationships. So far as the contemporary bioethical problems are concerned, the oaths are certainly so deficient that only the concerned, the oaths are certainly so deficient that only the general human tendency of uncritical acceptance of traditions would explain, I think, their being taken so much for granted.

The oath known after Hippocrates is not the oldest such text in medical evolution - we have the Oath of Imhotep, the ancient Egyptian physician (and statesman and architect) who lived almost 2500 years earlier than Hippocrates. And even in terms of history, the Hippocratic text was not the best one in certain respects - "giving one's care gratuitously to the needy, " "never demanding a payment beyond the limits of one's service, " "diligence in the pursuit of knowledge" and so on, points mentioned in similar moral formulations before and after the times of Hippocrates, are not found in "his" text. As for a "logical and scientific" relationship between Hippocratic medicine and the Hippocratic Oath, I can just mention it here as an evidently interesting historical topic.

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