A few weeks ago, a pre-med student and friend of mine men­tioned her dis­covery that medical stu­dents today rarely take an oath of doing no harm. Intrigued, it only took a few minutes of Googling to come across the evo­lu­tionary history of the medical oath. Sifting through the many ver­sions of the Hip­po­cratic Oath, I couldn’t help but wonder who it is that a physician is vowing to be, and what it means to be a physician.

A few medical schools have started the practice of letting the stu­dents write their own oaths. It seems dubious that a standard of medical practice and ethics could be pos­sible in a system where every doctor pledges to a dif­ferent def­i­n­ition of their identity.

Many, espe­cially the fans of newer, seem­ingly more rel­evant ver­sions of the oath, are quick to point out that the original Oath of Hip­pocrates didn’t even include its famous and now absent line to “do no harm.”

But this defense is vague and mis­leading. In fact, the original Hip­po­cratic Oath is far more clear than the buried line sug­gests:
“I will follow that system of regimen which, according to my ability and judgment, I con­sider for the benefit of my patients, and abstain from whatever is dele­te­rious and mis­chievous. I will give no deadly med­icine to any one if asked, nor suggest any such counsel; and in like manner I will not give to a woman a pessary to produce abortion.”

The physician, taking this oath, is not just promising to “do no harm.” Rather, he is ded­i­cating his edu­cation to the benefit of his patient, and denies himself the temp­tation of dele­te­rious or mis­chievous treatment.

The word “physician” came from the Old French “fisique,” meaning “art of healing,” from the Latin “physica,” or “natural science.” And doctor comes from the Latin “docere,” meaning “to teach.” So physi­cians are healers, and doctors are teachers.

The com­parison of these two def­i­n­i­tions affirmed some­thing I’ve become increas­ingly aware of as I’ve tran­si­tioned into adulthood and started making my own medical deci­sions: The medical vocation is not to take the freewill from one’s patient, coercing them into any pro­cedure, treatment, or decision that seems best to the doctor’s per­sonal judgment. Just as much as a doctor has a “gut feeling,” so too does the patient. A doctor’s role is to guide their patient, through care and edu­cation, to make the deci­sions which will promote the most whole life for the patient.

This is, perhaps, a reflection of the evolving public life of America and the West in general. Lately, every­thing is everyone’s business, or at least the government’s. It is hard to find a medical prac­ti­tioner or insurance provider free to make deci­sions entirely according to their con­science and intu­ition. Rather, many medical deci­sions are made oppressed by reg­u­la­tions, afraid of financial risk, or for the sake of the expense of the pro­cedure. The per­sonhood of the patient is scarcely rec­og­nizable anymore.

That claim of jeop­ar­dized per­sonhood is not a con­clusion drawn by my own obser­va­tions, although I have plenty of those to make about our current medical system. The most widely-recited oath today is called the Lasagna Oath, named after Louis Lasagna, who wrote the oath in 1964. While it has many good and true things to say, this section from the middle is prob­lematic:

“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.”

It is within no one’s power to take a life, not even his own. No healer or teacher is an exception. We are stewards, not owners, of the lives given to us as a gift from God. To vow to take a life is vastly dif­ferent than being present to witness a person’s passing from this life into the next. In one, you are actor; in the other, you are audience.

I can’t help but compare this mod­ernized, “more humane” and rel­evant oath with that oath of antiquity.

The words of Hip­pocrates do not form the oath of a nice doctor with good bedside manners, but rather a code of heroic char­acter.

This is the oath of a doctor who isn’t afraid to say no to the patient begging to end his own life. This is the oath of a doctor who will not stand by as women abandon their children, and them­selves, in iso­lation and fear. This is the oath of a doctor who does not champion despair as inde­pen­dence and freedom but rather sees it as a serious cause for com­passion and treats it as a need for healing.

It is obvious to me that our medical system is in des­perate need of more Hip­po­cratic doctors. The Hip­po­cratic doctor defends the seven-year-old child from his parents’ polit­i­cally influ­enced opinions, finds real solu­tions for the woman in need, and has hap­piness rather than pleasure as the goal of his practice.

Reagan Cool is a senior studying the­ology and a columnist on faith and religion.