The Hippocratic Oath, when written in the time of the Ancient Greeks, put forth a series of declarations of idealized conduct which for over two millennia has served as the basis for medical ethics that doctors and physicians would swear to uphold. While this Classical version may have been appropriate for its time, our advancements in scientific and medicinal understanding over the past 2000 years since the time of Hippocrates, call for an updated, more modernized edition, and one which also reflects the values and dilemmas we have in the world today. This more modern Hippocratic Oath places importance on uniform human welfare and less on religious undertones. It also grants more ethical flexibility instead of rigid moral rules, allowing for respect for patient rights and autonomy.
One of the drawbacks of the Classical Hippocratic Oath lies in the manner in which it expressly prohibits certain practices which could arguably lessen the suffering of some patients. Firstly, it forbids the use of abortive procedures. While this remains a controversial topic to this day, there may be instances where the life of the mother would be put into jeopardy should childbirth continue. Second, the clause to not “give a deadly drug to anybody who asked for it” would prevent physicians from administering end-of-life care to those when euthanasia may be a less painful or more dignified way to expire. In both instances, we see that the decision-making process is nonexistent for the patient and their caregiver. Praise for the modern oath may be given in that it removes these absolute prohibitions, offering the opportunity for decisions based on professional judgement and patient autonomy versus one-size-fits-all decrees. By recognizing that people have rights over their own bodies and treatment choices, this helps prevent abuse of authority and encourages trust between a doctor and their patient.
Another difference between the Hippocratic Oaths is the removal of the religious tones in the modern version. The original begins with the swearing to the Greek gods Apollo, Asclepius, Hygieia, and Panacea, while the modern only states that the person “not play at God”. This more secular stance allows the updated 1964 text to be more grounded in professional ethics rather than to be based in rigid religious beliefs. As modern societies are apt to be religiously diverse, this new phrasing where the oath is based on more universal ethical principles adds inclusivity to both physicians and patients, of all beliefs. While proponents of the classic may argue that the wearing to a higher power gives the oath a deeper sense of moral seriousness and personal accountability, advocates of the modern may propose that ethical responsibility does not require religious belief, and that professional accountability and personal conscience can provide as strong a moral compass in today’s society.
A final oversight of the classical oath is its heavy focus on loyalty to one’s teacher, and to the medical community at large. Not to imply that these entities are not important, but the new version shifts the focus of these statements so that they better align with responsibility for public welfare. The deference to the family of the teacher mentioned in the original could also be construed with nepotism, but the 1964 inclusion of the clause “nor will I fail to call in my colleagues when the skills of another are needed” shows the understanding that healthcare of today can involve working within large systems, and alongside interdisciplinary teams. While reliance on a team allows for a more comprehensive solution to health, the primary emphasis of our doctors should be in putting social responsibility first, by way of serving humanity.
Over the course of this essay, we highlighted some of the key distinctions between the Classical and Modern versions of the Hippocratic Oath. We discussed how the new edition better addresses the values and concerns of today’s society, while also preserving the ethical spirit of the original: to help patients and avoid harm. The inherent flexibility of this revised version should not be seen as an abandonment of morality but rather, shows its adaptability by taking these enduring principles and applying them more thoughtfully to modern realities. In summary, we conclude that our doctors and medical staff would be better equipped to face the rigors of contemporary healthcare by adhering to the version of the Hippocratic Oath updated by Louis Lasagna in 1964.
Sources
"Hippocratic Oath," Ludwig Edelstein (translator). Baltimore: Johns Hopkins University Press, 1943. Accessed via PBS website. (https://www.pbs.org/wgbh/nova/article/hippocratic-oath-today/)
"Hippocratic Oath," Louis Lasagna. Boston: Tufts University School of Medicine, 1964. Accessed via PBS website. (https://www.pbs.org/wgbh/nova/article/hippocratic-oath-today/)