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.