A Discussion of the Hippocratic Oath
“The Hippocratic Oath and Its Role In Modern Medicine” was the topic of a recent conference under the auspices of the Onassis Public Benefit Foundation in collaboration with the Hellenic Medical Society of N.Y.. Panelists were Admiral Susan Blumenthal, M.D., Assistant Surgeon General; Antonio M. Gotto, Jr., M.D., D.Phil., Dean of Weill Medical College of Cornell University, and Edmund D. Pellegrino, M.D., Professor Emeritus of Medicine and Medical Bioethics, Georgetown University. The oath, written by the renowned Greek physician Hippocrates over 2,500 years ago, is sworn to by most graduating medical students. A modernized version was written in 1964 by Dr. Louis Lasagna, clinical pharmacologist.
Admiral Blumenthal spoke on the ancient oath’s implications for current public health challenges. The oath states, “What I hear in the course of the treatment or…in regard to the life of men…I will keep to myself.” “This concept is prescient,” Blumenthal said. The federal government will soon implement secure safeguards against the misuse and disclosure of medical records, in the new Health Insurance Portability and Accountability Act (HIPAA). Dr. Blumenthal stressed that prevention of disease is preferable to a cure. Most important advances in the past century are indeed based on prevention—for example, eradication of smallpox and diphtheria. Hippocrates mandated dietetic measures for the benefit of the sick. Currently a good proportion of disease is related to nutrition if one includes alcoholism, starvation, and obesity. The serge in incidence of diabetes, even in youth, is related to obesity. The oath states to do no harm. The Institute of Medicine has now recognized medical errors as causing over 50,000 deaths per year. The FDA has now proposed bar-coding of medication in hospital use to reduce this enormous toll.
Dean Gotto spoke on “Professionalism and Medical Education: Modern Expressions of the Hippocratic Oath.” He detailed the basic tenets of the oath: education, empirical/national approach, love of the sick, self-regulation, and confidentiality. Gotto stressed the importance of lifetime learning to a physician, as information becomes obsolete and new information becomes available. He spoke of the legacy of Hippocrates at Weill Medical College, symbolized by a transplanted seedling from the plane tree at the Island of Kos, said to have been planted by Hippocrates, who used to teach in its shade. The now adult tree at Weill Medical College is the site where medical school graduates annually take the Hippocratic oath, administered by the Dean. The tree is appropriately dedicated to Dr. George Papanicolaou, a Greek physician who worked for many years at the New York Hospital-Cornell Medical Center where he developed the “Pap” smear to detect uterine cancer.
The third panelist, Dr. Pellegrino, focused on criticisms directed at the oath and moral skepticism raised over the years. He responded to these accusations, emphasizing the oath taken by your physician is for the patient’s protection. A physician must be loyal to his patient and not worry about society’s resources. Entering the medical profession should engender a life of service to others.
Many guests, members of the diplomatic corps and members of the Hellenic Medical Society attended the symposium. This society has its origins in a medical fraternity organized by Dr. George Papanicolaou.#
Dr. Herman Rosen is Clinical Professor of Medicine at Weill Medical College of Cornell University.