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Sixty seconds on . . . the Hippocratic oath

BMJ 2018; 362 doi: https://doi.org/10.1136/bmj.k3404 (Published 06 August 2018) Cite this as: BMJ 2018;362:k3404
  1. Susan Mayor
  1. London, UK

Ye gods, that’s as old as the hills. What’s new?

Exeter Medical, which has just seen its first cohort of medical students graduate, has put a new spin on the Ancient Greek oath. They promised to “work towards a fairer distribution of health resources,” as well as the usual Hippocratic stuff such as “never intentionally cause harm to patients.” The graduands also promised to oppose policies that breach human rights.

Have they lost their marbles?

Traditional medical commitments were in the oath too, from doctors doing their best “to serve humanity—caring for the sick, promoting good health, and alleviating pain and suffering,” to respecting the autonomy and dignity of their patients.

More Acropolis than Gherkin, then?

As I said, a new spin on a moral code handed down from the “father of modern medicine” who walked the Earth from 460 to 377 BC. Although the Hippocratic oath doesn’t contain the often quoted maxim “first do no harm,” it promises non-maleficence, which essentially means the same thing. It wasn’t until the 1700s that the oath began to be used by Western medical schools.

No “one size fetas all” any more?

Quite. The World Medical Association adopted the Declaration of Geneva in 1948, adding to Hippocratic principles the pledges that doctors would not use medical knowledge to violate human rights and would practise medicine without discrimination. And the version introduced by Tufts University in 1964 promised to avoid overtreatment and pursue disease prevention. Other medical schools, such as Aberdeen and Dundee, have adapted the oath, while Bristol uses the “Bristol promise,” which is said together out loud at graduation.1

It’s all a bit Greek to me

It’s no longer compulsory to say the oath, though many medical students still take a version of it. Today’s UK doctors have the General Medical Council to answer to rather than the gods on Olympus. Although, like any good deity, the council expects doctors to follow its rules,2 and woe betide anyone who transgresses.

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