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13: The Hippocratic Oath
Hippocrates, born about 460 BC, lived in an era when there were no medical schools and no medical profession as we now know it. Although the Oath laid the foundation for the ethical ideals to which medical practitioners should aspire, its detailed wording, relevant to social conditions prevailing 2400 years ago, is not appropriate to the practice of modern medicine. Consequently few, if any, medical schools require their students to take the original form of the Oath. The oaths required by various medical schools vary from none at all, to edited statements which reveal their historic origins, to modern statements that bear no resemblance to the original Oath. An example of a modern statement is provided by the following Declaration, in use at the Faculty of Medicine, Adelaide University.
- At the time of being admitted as a member of the medical profession I solemnly pledge myself to consecrate my life to the service of humanity;
- I will give to my teachers the respect and gratitude which is their due;
- I will practice my profession with conscience and dignity;
- The health of my patients will be my first consideration;
- I will respect the secrets which are confided in me, even after a patient has died;
- I will maintain by all means in my power the honour and the noble traditions of the medical profession;
- I will not use my medical knowledge contrary to the laws of humanity;
- I make these promises solemnly, freely and upon my honour.
The Hippocratic Oath and the injunction to 'do no harm' are often cited as a defense against assisted dying. However avoiding harm is not always possible, as many medical procedures have side effects, and doctors may need to evaluate harms and benefits before advising a course of action. Although doctors are expert advisors it is the patient who makes the ultimate decision on which treatment, or none, represents the greater benefit and lesser harm. An incurably ill patient with unremitting suffering may decide, after consultation and advice, that a peaceful death is the lesser harm
While demanding the highest ethical standards, the Hippocratic Oath does not rule out the possibility of circumstances arising in which requested help to a hastened death may rightly be given.
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