June 22, 2005

Revised Hippocratic Oath resonates with graduates

NEW YORK -- Revisiting a hallowed ritual for doctors, a committee within the Weill Cornell Medical College (WCMC) convened this spring to craft an updated Hippocratic Oath, one that responds to the state of modern medicine. Originally composed in ancient Greece, the oath expresses principles still fundamental to the practice of medicine today. Over the years, it has become an emotional rite of passage in medical school graduations across the world.

On June 1, the college's new oath was unveiled at Commencement ceremonies for the WCMC and Graduate School of Medical Sciences. After Antonio M. Gotto Jr., dean of WCMC, administered the oath to the graduates, he invited the medical faculty and other physicians present to stand and recommit themselves to the oath's principles by raising their right hands. (The oath is at the end of this story.)

"With this gesture," Gotto said, "we will join our new colleagues in affirming the values that guide both our work and our lives."

The original Hippocratic Oath has been revised many times to reflect changes in medical practice, historically by individuals or professional associations. The new Weill Cornell oath is unusual because it represents a single institution's effort. Comprising faculty from both Weill Cornell campuses in New York City and Doha, Qatar, the 20-member Dean's Committee on the Hippocratic Oath included two senior associate deans, two associate deans, two student leaders and three department chairs. At Gotto's request, this representative committee was headed by Joseph J. Fins, chief of the Division of Medical Ethics and professor of medicine, public health and medicine in psychiatry.

The committee members took a scholarly, systematic and inclusive approach, enriching their knowledge with background reading and categorizing the key elements of earlier medical oaths, including the classical Hippocratic Oath; a well-known 1964 revision by Louis Lasagna; the Oath of Maimonides, a medieval Jewish philosopher; and an oath for Muslim physicians.

In addition to content, the committee examined the language of the oath. "We wanted to be respectful of the diversity of perspectives on faith and belief," explained Fins, "and to be mindful that there are a number of ways to express personal commitment." With this in mind, the members chose to replace phrases that have a religious connotation with more ecumenical expressions, such as changing "I swear" to the more secular "I vow."

The revised oath ends on a more positive note than the classical version, which threatens retribution for any doctor who transgresses the oath and swears falsely. Revised, it reads: "I now turn to my calling, promising to preserve its finest traditions, with the reward of a long experience in the joy of healing." It concludes: "I make this vow freely and upon my honor," again underscoring personal responsibility as a guidepost in one's profession.

The committee also considered the history of medicine, the enduring principles of medical practice, and the profound social and scientific changes affecting the profession today.

New emphases in the revised oath address doctors' responsibilities and duties to serve as advocates for their patients, champion social justice for the sick and forge strong bonds throughout the healing process.

The oath reaffirms a "sacred trust" between doctors and patients, reminding doctors to "use their power wisely." It also fosters trust and respect within the profession by including a pledge to help sustain colleagues in their service to humanity. In a culture preoccupied with wealth and power, the oath serves as an antidote to professional arrogance, obligating doctors to practice humility and self-awareness, accept their limitations and pursue lifelong learning to better care for the sick and prevent illness.

"It was so invigorating to have a group of colleagues together, talking about these important issues and thinking deeply about why we're here and what we're doing," Fins said. "It helped reconnect us as a group, and I hope it will encourage our broader college community to recommit to the values embodied in the oath."

The committee first met in February 2005 to discuss the core values of the oath in the context of 21st-century medicine.

"Our goal was to preserve the enduring precepts and obligations of doctoring, but also to make the oath reflective of some of the current challenges that the health-care system faces today, trying to balance the old with the new," Fins said. "We had to express the core principles in a more modern way; otherwise it becomes platitudinous."

 


Weill Cornell Medical College's Hippocratic Oath

I do solemnly vow, to that which I value and hold most dear:

That I will honor the Profession of Medicine, be just and generous to its members, and help sustain them in their service to humanity;

That just as I have learned from those who preceded me, so will I instruct those who follow me in the science and the art of medicine;

That I will recognize the limits of my knowledge and pursue lifelong learning to better care for the sick and to prevent illness;

That I will seek the counsel of others when they are more expert so as to fulfill my obligation to those who are entrusted to my care;

That I will not withdraw from my patients in their time of need;

That I will lead my life and practice my art with integrity and honor, using my power wisely;

That whatsoever I shall see or hear of the lives of my patients that is not fitting to be spoken, I will keep in confidence;

That into whatever house I shall enter, it shall be for the good of the sick;

That I will maintain this sacred trust, holding myself far aloof from wrong, from corrupting, from the tempting of others to vice;

That above all else I will serve the highest interests of my patients through the practice of my science and my art;

That I will be an advocate for patients in need and strive for justice in the care of the sick.

I now turn to my calling, promising to preserve its finest traditions, with the reward of a long experience in the joy of healing.

I make this vow freely and upon my honor.