Hippocratic Oath

The Hippocratic Oath is one of the earliest written texts that form the ethical foundation of medicine and express the social responsibilities of the medical profession. Attributed to Hippocrates (460–370 BCE) in ancient Greece, this oath is not merely a historical document; it also serves as a universal ethical framework that defines the moral obligations of the medical profession. Although the oath has evolved in form over the centuries, it has retained its core principles and continues to be taken by physicians upon entering the profession.

Hippocrates and the Moral Foundations of Medicine

Hippocrates is regarded as the founder of Western medicine. His work abandoned the traditional view that illnesses were caused by supernatural forces and instead grounded medicine in observation, experience, and rational thought.^【1】 The Hippocratic Oath, contained within the collection of texts known as the “Corpus Hippocraticum,” is a concrete expression of the belief that the medical profession must be bound by ethical principles.

Hippocrates advocated for living in harmony with nature and for analyzing illnesses through observation, thereby centering values such as trust, confidentiality, non-harm, and honesty in the physician-patient relationship. This ethical perspective was sustained not only in ancient Greece but also during the Roman era by Galen and later by Islamic physicians.

Content and Linguistic Features of the Original Text

The original text of the oath was written in Ancient Greek and begins with an invocation to gods of health such as Apollo, Asclepius, Hygieia, and Panacea. This demonstrates that the text was interpreted not only as an ethical commitment but also within a religious and moral context. In the ancient version, the physician pledges to honor his teacher and his teacher’s family, to transmit medical knowledge only to worthy and ethical individuals, to cause no harm to patients, to abstain from practices such as euthanasia and abortion, and to preserve patient confidentiality.

Some key original phrases include:

• “I swear by Apollo the Healer, by Asclepius, by Hygieia and Panacea, and by all the gods and goddesses, that I will keep this oath…”
• “I will not give a lethal drug to anyone if I am asked, nor will I advise such a course.”
• “Into every house I enter, I will go only for the benefit of the patient.”
• “What I may see or hear in the course of treatment or even outside of it, concerning the lives of people, I will keep secret and will never speak of such things.”

These statements embody the foundational principles of medicine: non-maleficence, patient confidentiality, beneficence, and professionalism.

Core Principles of the Hippocratic Oath

The ethical principles of the oath can be summarized as follows:

1. Respect for the Teacher and Knowledge: The oath requires loyalty and gratitude toward the teacher, financial support for the teacher, and free education for the teacher’s children. This underscores that the transmission of knowledge is a sacred duty and that medical ethics are passed down from generation to generation as a moral responsibility.

2. Professional Boundaries and Specialization: The phrase “I will not use the knife” indicates the need to distinguish between areas of expertise. It emphasizes that physicians should intervene only within the scope of their competence.

3. Non-Maleficence: The physician’s primary duty is to avoid harming the patient or worsening their condition. This principle remains a cornerstone of medical ethics in modern practice.

4. Prohibition of Euthanasia and Abortion: The oath explicitly forbids the physician from administering lethal drugs or performing abortions. These provisions are grounded in the sanctity of life.

5. Avoidance of Sexual and Ethical Misconduct: The text prohibits any sexual approach toward patients, whether male or female. This clause emphasizes patient safety and the principle of professional boundaries.

6. Protection of Confidentiality: Information obtained about the patient must not be disclosed to third parties. This principle aligns directly with modern concepts of patient privacy and the protection of personal data.

The Evolution of the Hippocratic Oath in the Modern Era

As societal values and medical practice have changed over time, the original text of the Hippocratic Oath has been revised to meet contemporary needs. Beginning in the mid-20th century, institutions such as the World Medical Association began developing documents that defined the ethical framework of modern medicine. To illustrate the evolution of the oath, the 2006 and 2017 versions are presented here together.

The 2006 Hippocratic Oath, as adopted by the World Medical Association’s Declaration of Geneva, reads as follows:

UPON BEING ADMITTED INTO THE MEDICAL PROFESSION:

I SOLEMNLY PROMISE to dedicate my life to the service of humanity;

I will give my teachers the respect and gratitude that is their due;

I will practice my profession with conscience and dignity;

THE HEALTH OF MY PATIENT will be my first consideration;

I will respect the secrets that are confided in me, even after the patient has died;

I will maintain by all means in my power the honor and noble traditions of the medical profession;

MY COLLEAGUES will be my brothers;

I will not permit considerations of age, disease or disability, creed, ethnic origin, gender, nationality, political affiliation, race, sexual orientation, social standing or any other factor to intervene between my duty and my patient;

I will respect the human being and their dignity;

I will not use my medical knowledge contrary to the laws of humanity and civil liberties, even under threat;

I MAKE THESE PROMISES solemnly, freely, and upon my honor.

After the 2017 revision, the oath was updated as follows:

AS A MEMBER OF THE MEDICAL PROFESSION:

I solemnly pledge to dedicate my life to the service of humanity;

The health and well-being of my patient will always be my first concern;

I will respect the autonomy and dignity of my patient;

I will hold the highest regard for human life;

I will not allow age, disease or disability, creed, ethnic origin, gender, nationality, political affiliation, race, sexual orientation, social status or any other factor to interfere with my duty to my patient;

I will respect the secrets entrusted to me, even after the patient has died;

I will practice my profession with conscience and dignity, in accordance with good medical practice;

I will uphold the honor and noble traditions of the medical profession;

I will give my teachers, colleagues and students the respect and gratitude they deserve;

I will share my medical knowledge for the benefit of patients and the advancement of health care;

I will attend to my own health, well-being and professional competence, so that I may provide the highest standard of care;

I will not use my medical knowledge to violate human rights or civil liberties, even under threat;

I make these promises sincerely, freely and upon my honor.

Modern versions of the oath exhibit the following characteristics:

• The invocation of deities has been removed, establishing a secular framework.
• Contemporary values such as patient rights, social justice, and gender equality have been incorporated.
• The language is open to scientific advances and technological interventions.
• Expanded frameworks such as public health, global responsibility, and bioethics have been included.

Nevertheless, many medical schools continue to have graduates recite a modern version of this oath during graduation ceremonies. In this context, the Hippocratic Oath remains a living expression of individual professional responsibility and commitment to medical ethics.

Critiques and Current Debates

Some academics argue that due to its historical context, the oath is insufficient in addressing today’s complex ethical challenges. Issues such as abortion, euthanasia, genetic engineering, AI-assisted diagnostics, and medical autonomy fall outside the scope of the original text.

Nevertheless, it is widely accepted that the core ethical principles of the Hippocratic Oath—non-maleficence, confidentiality, and beneficence—remain valid and continue to form the foundation of modern medical ethics.

The Hippocratic Oath is one of the most fundamental texts in history to institutionalize the ethical dimension of the medical profession. It functions as an expression of individual responsibility, professional honor, and public trust in medical practice, both historically and symbolically. Although it does not directly address the complex ethical dilemmas of modern medicine, it has continuously evolved to uphold the humanistic values of the medical art.