HIPPOCRATIC OATH
Hippocrates (460-370 BC)
A guide to the Hippocratic Oath
By Dr Daniel Sokol
Medical ethicist
Written nearly 2,500 years ago, the Oath is the most famous text in Western medicine, yet most people (including doctors) know precious little about it. Here is a brief guide to the Oath.
The Oath starts: "I swear by Apollo the physician and by Asclepius and Hygieia and Panacea... to bring the following oath to fulfillment." Apollo, the god of healing, fell in love with a human, Coronis.
I will use treatments for the benefit of the ill in accordance with my ability and my judgment, but from what is to their harm and injustice I will keep them
Hippocratic Oath
In his absence, Apollo sent a white crow to look after her. When the crow informed Apollo that Coronis loved another man, Apollo's rage turned the crow black. To avenge her brother, Apollo's sister shot Coronis with an arrow and, as she lay dying, Coronis told Apollo that she was bearing his child. Although Apollo could not save Coronis, he rescued the unborn child, Asclepius. Hygieia, the goddess of health, and Panacea, the goddess of cures, are the daughters of Asclepius. According to legend, Hippocrates was a descendant of one of Asclepius' sons. Doctors taking the Oath would doubtless have been inspired by this illustrious lineage of healers.
The next section instructs the doctor to treat his teachers as his parents, and to pass on the art of medicine to the next generation of healers.
In a pure and holy way, I will guard my life and my art and science
Hippocratic Oath
The Oath continues: "And I will use treatments for the benefit of the ill in accordance with my ability and my judgment, but from what is to their harm and injustice I will keep them."
In other words, doctors should act in the best interests of their patients, and when unjust circumstances arise they should strive to correct the injustice harming their patients.
The next part seemingly concerns euthanasia or physician-assisted suicide, saying: "And I will not give a drug that is deadly to anyone if asked, nor will I suggest the way to such a counsel."
Two leading scholars of the Oath, Littre and Miles, have however suggested that this passage alludes to the then common practice of using doctors as skilled political assassins. Steven Miles notes: "Fear of the physician-poisoner may be traced very close to the time of the Oath."
The word "euthanasia" (meaning "easeful death") was only coined a century after the writing of the Oath. The text continues: "And likewise I will not give a woman a destructive pessary." This passage is often interpreted as a rejection of abortion. However, abortion was legal at the time and the text only mentions pessaries (a soaked piece of wool inserted in the vagina to induce abortion), not the oral methods of abortion also used in ancient Greece. As pessaries could cause lethal infections, the author of the Oath may have had a clinical objection to the method, rather than a moral objection to abortion itself.
The next sentence - "In a pure and holy way, I will guard my life and my art and science" - is a call for professional integrity.
Doctors should refrain from immoral behavior and resist the temptations that accompany their privileged position.
The Oath continues: "I will not cut, and certainly not those suffering from stone, but I will cede this to men who are practitioners of this activity."
Another common misconception is that the Oath forbids surgery.
About whatever I may see or hear in treatment, or even without treatment, in the life of human beings, I will remain silent, holding such things to be unutterable
Hippocratic Oath
In fact, it instructs doctors to acknowledge the limits of their competence and to refer cases to more specialized practitioners.
Next, the doctor enters the patient's house: "Into as many houses as I may enter, I will go for the benefit of the ill, while being far from all voluntary and destructive injustice, especially from sexual acts both upon women's bodies and upon men's."
The need for such a statement reflects the wide distrust in healers at the time. In a competitive marketplace where quacks abounded, it was necessary to reassure the public that doctors would not exploit patients.
The penultimate section deals with confidentiality and reads: "And about whatever I may see or hear in treatment, or even without treatment, in the life of human beings, I will remain silent, holding such things to be unutterable." As today, patients in ancient times shared deeply personal information with doctors on the assumption that their details would not be revealed to others. Without this trust, patients may withhold facts that would help the doctor make an accurate diagnosis.
The text ends with the rewards that await those who respect the Oath ("the benefits both of life and of art and science, being held in good repute among all human beings for time eternal") and the punishment of those who do not ("if, however, I transgress and swear falsely, the opposite of these").
This whistle-stop tour of the Oath gives some idea of the content and spirit of this ancient text.
In an age of technological developments, cosmetic surgery, complementary medicine, drug companies, and many other temptations for patients and doctors alike, the spirit of the Oath is as relevant as ever.
• Dr Daniel Sokol is a medical ethicist at St George's, University of London, and Director of the Applied Clinical Ethics (ACE) program at Imperial College, London.
Definition of Hippocratic Oath
Hippocratic Oath: One of the oldest binding documents in history, the Oath written by Hippocrates is still held sacred by physicians: to treat the ill to the best of one's ability, to preserve a patient's privacy, to teach the secrets of medicine to the next generation, and so on.
There are many versions of the Hippocratic Oath. We here present two versions. First, the "classic" version (or more precisely, one translation of the original oath). And then, following it, is presented one of the fine "modern" versions of the Hippocratic Oath.
Classic Version of the Hippocratic Oath
I swear by Apollo Physician and Asclepius and Hygieia and Panaceia and all the gods and goddesses, making them my witnesses, that I will fulfil according to my ability and judgment this oath and this covenant:
To hold him who has taught me this art as equal to my parents and to live my life in partnership with him, and if he is in need of money to give him a share of mine, and to regard his offspring as equal to my brothers in male lineage and to teach them this art - if they desire to learn it - without fee and covenant; to give a share of precepts and oral instruction and all the other learning to my sons and to the sons of him who has instructed me and to pupils who have signed the covenant and have taken an oath according to the medical law, but no one else.
I will apply dietetic measures for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice.
I will neither give a deadly drug to anybody who asked for it, nor will I make a suggestion to this effect. Similarly I will not give to a woman an abortive remedy. In purity and holiness I will guard my life and my art.
I will not use the knife, not even on sufferers from stone, but will withdraw in favor of such men as are engaged in this work.
Whatever houses I may visit, I will come for the benefit of the sick, remaining free of all intentional injustice, of all mischief and in particular of sexual relations with both female and male persons, be they free or slaves.
What I may see or hear in the course of the treatment or even outside of the treatment in regard to the life of men, which on no account one must spread abroad, I will keep to myself, holding such things shameful to be spoken about.
If I fulfil this oath and do not violate it, may it be granted to me to enjoy life and art, being honored with fame among all men for all time to come; if I transgress it and swear falsely, may the opposite of all this be my lot.
A Modern Version of the Hippocratic Oath
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 which are required, 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 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.
A guide to the Hippocratic Oath
By Dr Daniel Sokol
Medical ethicist
Written nearly 2,500 years ago, the Oath is the most famous text in Western medicine, yet most people (including doctors) know precious little about it. Here is a brief guide to the Oath.
The Oath starts: "I swear by Apollo the physician and by Asclepius and Hygieia and Panacea... to bring the following oath to fulfillment." Apollo, the god of healing, fell in love with a human, Coronis.
I will use treatments for the benefit of the ill in accordance with my ability and my judgment, but from what is to their harm and injustice I will keep them
Hippocratic Oath
In his absence, Apollo sent a white crow to look after her. When the crow informed Apollo that Coronis loved another man, Apollo's rage turned the crow black. To avenge her brother, Apollo's sister shot Coronis with an arrow and, as she lay dying, Coronis told Apollo that she was bearing his child. Although Apollo could not save Coronis, he rescued the unborn child, Asclepius. Hygieia, the goddess of health, and Panacea, the goddess of cures, are the daughters of Asclepius. According to legend, Hippocrates was a descendant of one of Asclepius' sons. Doctors taking the Oath would doubtless have been inspired by this illustrious lineage of healers.
The next section instructs the doctor to treat his teachers as his parents, and to pass on the art of medicine to the next generation of healers.
In a pure and holy way, I will guard my life and my art and science
Hippocratic Oath
The Oath continues: "And I will use treatments for the benefit of the ill in accordance with my ability and my judgment, but from what is to their harm and injustice I will keep them."
In other words, doctors should act in the best interests of their patients, and when unjust circumstances arise they should strive to correct the injustice harming their patients.
The next part seemingly concerns euthanasia or physician-assisted suicide, saying: "And I will not give a drug that is deadly to anyone if asked, nor will I suggest the way to such a counsel."
Two leading scholars of the Oath, Littre and Miles, have however suggested that this passage alludes to the then common practice of using doctors as skilled political assassins. Steven Miles notes: "Fear of the physician-poisoner may be traced very close to the time of the Oath."
The word "euthanasia" (meaning "easeful death") was only coined a century after the writing of the Oath. The text continues: "And likewise I will not give a woman a destructive pessary." This passage is often interpreted as a rejection of abortion. However, abortion was legal at the time and the text only mentions pessaries (a soaked piece of wool inserted in the vagina to induce abortion), not the oral methods of abortion also used in ancient Greece. As pessaries could cause lethal infections, the author of the Oath may have had a clinical objection to the method, rather than a moral objection to abortion itself.
The next sentence - "In a pure and holy way, I will guard my life and my art and science" - is a call for professional integrity.
Doctors should refrain from immoral behavior and resist the temptations that accompany their privileged position.
The Oath continues: "I will not cut, and certainly not those suffering from stone, but I will cede this to men who are practitioners of this activity."
Another common misconception is that the Oath forbids surgery.
About whatever I may see or hear in treatment, or even without treatment, in the life of human beings, I will remain silent, holding such things to be unutterable
Hippocratic Oath
In fact, it instructs doctors to acknowledge the limits of their competence and to refer cases to more specialized practitioners.
Next, the doctor enters the patient's house: "Into as many houses as I may enter, I will go for the benefit of the ill, while being far from all voluntary and destructive injustice, especially from sexual acts both upon women's bodies and upon men's."
The need for such a statement reflects the wide distrust in healers at the time. In a competitive marketplace where quacks abounded, it was necessary to reassure the public that doctors would not exploit patients.
The penultimate section deals with confidentiality and reads: "And about whatever I may see or hear in treatment, or even without treatment, in the life of human beings, I will remain silent, holding such things to be unutterable." As today, patients in ancient times shared deeply personal information with doctors on the assumption that their details would not be revealed to others. Without this trust, patients may withhold facts that would help the doctor make an accurate diagnosis.
The text ends with the rewards that await those who respect the Oath ("the benefits both of life and of art and science, being held in good repute among all human beings for time eternal") and the punishment of those who do not ("if, however, I transgress and swear falsely, the opposite of these").
This whistle-stop tour of the Oath gives some idea of the content and spirit of this ancient text.
In an age of technological developments, cosmetic surgery, complementary medicine, drug companies, and many other temptations for patients and doctors alike, the spirit of the Oath is as relevant as ever.
• Dr Daniel Sokol is a medical ethicist at St George's, University of London, and Director of the Applied Clinical Ethics (ACE) program at Imperial College, London.
Definition of Hippocratic Oath
Hippocratic Oath: One of the oldest binding documents in history, the Oath written by Hippocrates is still held sacred by physicians: to treat the ill to the best of one's ability, to preserve a patient's privacy, to teach the secrets of medicine to the next generation, and so on.
There are many versions of the Hippocratic Oath. We here present two versions. First, the "classic" version (or more precisely, one translation of the original oath). And then, following it, is presented one of the fine "modern" versions of the Hippocratic Oath.
Classic Version of the Hippocratic Oath
I swear by Apollo Physician and Asclepius and Hygieia and Panaceia and all the gods and goddesses, making them my witnesses, that I will fulfil according to my ability and judgment this oath and this covenant:
To hold him who has taught me this art as equal to my parents and to live my life in partnership with him, and if he is in need of money to give him a share of mine, and to regard his offspring as equal to my brothers in male lineage and to teach them this art - if they desire to learn it - without fee and covenant; to give a share of precepts and oral instruction and all the other learning to my sons and to the sons of him who has instructed me and to pupils who have signed the covenant and have taken an oath according to the medical law, but no one else.
I will apply dietetic measures for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice.
I will neither give a deadly drug to anybody who asked for it, nor will I make a suggestion to this effect. Similarly I will not give to a woman an abortive remedy. In purity and holiness I will guard my life and my art.
I will not use the knife, not even on sufferers from stone, but will withdraw in favor of such men as are engaged in this work.
Whatever houses I may visit, I will come for the benefit of the sick, remaining free of all intentional injustice, of all mischief and in particular of sexual relations with both female and male persons, be they free or slaves.
What I may see or hear in the course of the treatment or even outside of the treatment in regard to the life of men, which on no account one must spread abroad, I will keep to myself, holding such things shameful to be spoken about.
If I fulfil this oath and do not violate it, may it be granted to me to enjoy life and art, being honored with fame among all men for all time to come; if I transgress it and swear falsely, may the opposite of all this be my lot.
A Modern Version of the Hippocratic Oath
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 which are required, 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 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.
- The classical version of the Hippocratic Oath is from the translation from the Greek by Ludwig Edelstein. From The Hippocratic Oath: Text, Translation, and Interpretation, by Ludwig Edelstein. Baltimore: Johns Hopkins Press, 1943.
- The modern version of the Hippocratic Oath was written in 1964 by Louis Lasagna, Dean of the School of Medicine at Tufts University.
