The Spirit of the Hippocratic Oath

Photo: Wikipedia: A fragment from the 3rd century.

   Doctors no longer take the Hippocratic Oath as regularly as they once did, for a number of reasons. The first was that the Christians do not swear oaths to Apollo, and the second was that the oath forbids abortion and assisted suicide. This is from the Greek tradition, independent of the Biblical tradition, which is the basis in America for the opposition to these things. This independent confirmation is stronger than the support from scripture for the conservative positions on assisted suicide and abortion. The purpose of medicine is to heal, and medicine is not to be used to kill. Hippocrates lived about 460-377 B. C, a contemporary of Socrates. He turned away from the superstitious attempts to ascribe the causes of disease to the divinities, and showed that diseases have natural causes. As such, he is the founder of modern or scientific medicine. He also taught “Our natures are the physicians of our diseases,” and treated many problems with proper diet and living. The World Book Encyclopedia (1972, vol. H, p. 227) includes: “His favorite medicine was honey.” The Hippocratic oath is still the basis of medical ethics. It binds physicians to practice no injustice and to keep secrets and to refrain from the seduction of patients and their relatives.

   As a doctor not of medicine, to cure the body, but of politics, and a bachelor of psychology, we consider the principles of the Hippocratic oath to be minimal. But it is Socrates, in Plato’s Republic, who teaches the things most relevant to prescription drug abuse and the questions of contemporary medicine. In Book One, Socrates distinguishes the art of medicine, and all arts, from the art of money making, and states, “medicine doesn’t consider the advantage of medicine, but of the body” and “not the doctor’s advantage, but that of the sick man” (342 a-c). Later, while discussing gymnastics as the art that produces health, Socrates famously contrasts two kinds of medicine, ours with that of the ancient Aesclepiads, who would not flatter the valetudinarianism of the rich, treating many maladies, living to keep medical regimens, but rather, like carpenters, would do medicine to get back to work, but otherwise would be content to die rather than live to no purpose (404-408). He then contrasts a doctor, who treats a body with the soul, with a judge, who treats “a soul with a soul.” For the latter, it is not good to be too familiar with the diseases until they are older.

   As with my radiator leak on my car, the solution to some maladies is to simply “put up with it.” So far, it has proven to be not worthwhile to have spent 850$ to fix my radiator leak because I need only pay attention and add a bit of fluid once in a while. These principles by analogy are very important to our attempts at a national health care system. We have said repeatedly that this will be unworkable if we do not end insurance fraud and the lobbying of the prescription drug industry. We need not invent new names for maladies ad infinitum, like “restless leg syndrome,” which then need prescription drugs for their treatment and cure.

   The practice of the art of psychology and medicine depend upon the more fundamental practices of chastity and justice, and of what- in the matters of the soul- is like gymnastic in the health of the body. As there is medicine and gym for the body, so there is “therapy” and study for the soul, contemplation and inquiry, and certain other liberal practices like music that tend the health of the soul as gym does the body. The psychologist must study the nature of man and look upon the health of the soul. That these would prescribe drugs not as a last resort, but as a first and most profitable resort, would be unthinkable within a Socratic psychology. And for us it has become a hopeless corruption.

   I once thought it would be a good business to nicely print the oath and frame it for doctor’s offices. So here it is for free on “da plog.” Print it out if you like. The Hippocratic Oath, translated not by me but by an encyclopedia, reads as follows:

I swear by Apollo the physician and Aesculapius and health and all-heal (panacea) and all the gods and goddesses making them my witness that, according to my ability and judgement I will keep this oath and 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 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 covenant 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 judgement 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 council; 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 art 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 inviolate 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 supremacy of the oath above political law one interesting point. The “Doctors Without Borders” view of the supremacy of medical practice to political law has been with us for some time. Another interesting point is the dependence of medical ethics upon common sense and philosophic principles of justice that cannot possibly come from the science of medicine. For example, is it unhealthy to seduce one’s patients, or would one not thereby obey Darwinian principles of survival and reproduction that are the supposed goals of the body? How could medicine determine that it is unhealthy to attribute the purposes of the body to the soul? Or that it is unjust to subject the art of medicine to the art of money-making? The health of the soul is the higher study, and even Hippocrates knew regarding the body that nature is, and our natures are, the physician or the guide regarding health and disease, and the knowledge that guides practice is a knowledge of this and these: the intelligible health of the body and soul on one hand, and the diseased particulars on the other. Even if one has never seen the healthy body empirically, or the virtuous soul, it is still the principle that guides both medicine and psychology or education. It is truly amazing just how the body knows by genetically coded knowledge how to heal a cut, and some animals can grow whole new appendages. Socrates taught that the soul contains knowledge of the soul, and that is the basis of politics and psychology. And don’t forget that spoonful of honey!

Appendix: The modern replacement

Declaration of Geneva

From Wikipedia, the free encyclopedia

This article is about a declaration in the medical profession. For other uses, see Geneva Declaration (disambiguation).

The Declaration of Geneva was adopted by the General Assembly of the World Medical Association at Geneva in 1948, amended in 1968, 1983, 1994, editorially revised in 2005 and 2006 and amended in 2017.

It is a declaration of a physician‘s dedication to the humanitarian goals of medicine, a declaration that was especially important in view of the medical crimes which had just been committed in German-occupied Europe. The Declaration of Geneva was intended as a revision^[1] of the Hippocratic Oath to a formulation of that oath’s moral truths that could be comprehended and acknowledged in a modern way.^[2] Unlike the case of the Oath of Hippocrates, the World Medical Association calls the statement a “pledge”.

Appendix 2: The Greek text, from Wikipedia:

Below is the Hippocratic Oath, in Ancient Greek, from the 1923 Loeb edition, followed by the English translation:

ὄμνυμι Ἀπόλλωνα ἰητρὸν καὶ Ἀσκληπιὸν καὶ Ὑγείαν καὶ Πανάκειαν καὶ θεοὺς πάντας τε καὶ πάσας, ἵστορας ποιεύμενος, ἐπιτελέα ποιήσειν κατὰ δύναμιν καὶ κρίσιν ἐμὴν ὅρκον τόνδε καὶ συγγραφὴν τήνδε:ἡγήσεσθαι μὲν τὸν διδάξαντά με τὴν τέχνην ταύτην ἴσα γενέτῃσιν ἐμοῖς, καὶ βίου κοινώσεσθαι, καὶ χρεῶν χρηΐζοντι μετάδοσιν ποιήσεσθαι, καὶ γένος τὸ ἐξ αὐτοῦ ἀδελφοῖς ἴσον ἐπικρινεῖν ἄρρεσι, καὶ διδάξειν τὴν τέχνην ταύτην, ἢν χρηΐζωσι μανθάνειν, ἄνευ μισθοῦ καὶ συγγραφῆς, παραγγελίης τε καὶ ἀκροήσιος καὶ τῆς λοίπης ἁπάσης μαθήσιος μετάδοσιν ποιήσεσθαι υἱοῖς τε ἐμοῖς καὶ τοῖς τοῦ ἐμὲ διδάξαντος, καὶ μαθητῇσι συγγεγραμμένοις τε καὶ ὡρκισμένοις νόμῳ ἰητρικῷ, ἄλλῳ δὲ οὐδενί.διαιτήμασί τε χρήσομαι ἐπ᾽ ὠφελείῃ καμνόντων κατὰ δύναμιν καὶ κρίσιν ἐμήν, ἐπὶ δηλήσει δὲ καὶ ἀδικίῃ εἴρξειν.οὐ δώσω δὲ οὐδὲ φάρμακον οὐδενὶ αἰτηθεὶς θανάσιμον, οὐδὲ ὑφηγήσομαι συμβουλίην τοιήνδε: ὁμοίως δὲ οὐδὲ γυναικὶ πεσσὸν φθόριον δώσω.ἁγνῶς δὲ καὶ ὁσίως διατηρήσω βίον τὸν ἐμὸν καὶ τέχνην τὴν ἐμήν.οὐ τεμέω δὲ οὐδὲ μὴν λιθιῶντας, ἐκχωρήσω δὲ ἐργάτῃσιν ἀνδράσι πρήξιος τῆσδε.ἐς οἰκίας δὲ ὁκόσας ἂν ἐσίω, ἐσελεύσομαι ἐπ᾽ ὠφελείῃ καμνόντων, ἐκτὸς ἐὼν πάσης ἀδικίης ἑκουσίης καὶ φθορίης, τῆς τε ἄλλης καὶ ἀφροδισίων ἔργων ἐπί τε γυναικείων σωμάτων καὶ ἀνδρῴων, ἐλευθέρων τε καὶ δούλων.ἃ δ᾽ ἂν ἐνθεραπείῃ ἴδω ἢ ἀκούσω, ἢ καὶ ἄνευ θεραπείης κατὰ βίον ἀνθρώπων, ἃ μὴ χρή ποτε ἐκλαλεῖσθαι ἔξω, σιγήσομαι, ἄρρητα ἡγεύμενος εἶναι τὰ τοιαῦτα.ὅρκον μὲν οὖν μοι τόνδε ἐπιτελέα ποιέοντι, καὶ μὴ συγχέοντι, εἴη ἐπαύρασθαι καὶ βίου καὶ τέχνης δοξαζομένῳ παρὰ πᾶσιν ἀνθρώποις ἐς τὸν αἰεὶ χρόνον: παραβαίνοντι δὲ καὶ ἐπιορκέοντι, τἀναντία τούτων.^[3]

Translation, Wikipedia:

I swear by Apollo Healer, by Asclepius, by Hygieia, by Panacea, and by all the gods and goddesses, making them my witnesses, that I will carry out, according to my ability and judgment, this oath and this indenture.To hold my teacher in this art equal to my own parents; to make him partner in my livelihood; when he is in need of money to share mine with him; to consider his family as my own brothers, and to teach them this art, if they want to learn it, without fee or indenture; to impart precept, oral instruction, and all other instruction to my own sons, the sons of my teacher, and to indentured pupils who have taken the Healer's oath, but to nobody else.I will use those dietary regimens which will benefit my patients according to my greatest ability and judgment, and I will do no harm or injustice to them.^[4] Neither will I administer a poison to anybody when asked to do so, nor will I suggest such a course. Similarly I will not give to a woman a pessary to cause abortion. But I will keep pure and holy both my life and my art. I will not use the knife, not even, verily, on sufferers from stone, but I will give place to such as are craftsmen therein.Into whatsoever houses I enter, I will enter to help the sick, and I will abstain from all intentional wrong-doing and harm, especially from abusing the bodies of man or woman, bond or free. And whatsoever I shall see or hear in the course of my profession, as well as outside my profession in my intercourse with men, if it be what should not be published abroad, I will never divulge, holding such things to be holy secrets.Now if I carry out this oath, and break it not, may I gain for ever reputation among all men for my life and for my art; but if I break it and forswear myself, may the opposite befall me.^[3]

—Translation by W.H.S. Jones