a. The Oath
- To hold my teacher in this art on a par with my parents. To make my teacher a partner in my livelihood To look after my teacher and financially share with her/him when s/he is in need. To consider him/her as a brother/sister along with his/her family. To teach his/her family the art of medicine, if they want to learn it, without tuition or any other conditions of service. To impart all the lessons necessary to practice medicine to my own sons and daughters, the sons and daughters of my teacher and to my own students, who have taken this oath-but to no one else.
- I will help the sick according to my skill and judgment, but never with an intent to do harm or injury to another.
- I will never administer poison to anyone-even when asked to do so. Nor will I ever suggest a way that others (even the patient) could do so. Similarly, I will never induce an abortion. Instead, I will keep holy my life and art.
- I will not engage in surgery--not even upon suffers from stone, but will withdraw in favor of others who do this work.
- Whoever I visit, rich or poor, I will concern myself with the well being of the sick. I will commit no intentional misdeeds, nor any other harmful action such as engaging in sexual relations with my patients (regardless of their status).
- Whatever I hear or see in the course of my professional duties (or even outside the course of treatment) regarding my patients is strictly confidential and I will not allow it to be spread about. But instead, will hold these as holy secrets.
b. The Oath and Modern Codes of Conduct
In the modern world there are many professional codes of conduct. One could look at the American Medical Association Code, the American Bar Association Code, et al. However, the Hippocratic Oath set the standard of what a professional code is. A few key features that will tell why one should accept or reject such codes as solutions to the problems that have been outlined.
It is this author's opinion that among professional codes, the Hippocratic Oath is a good one. It balances between very specific prohibitions such as not administering poison or not having sexual relations with one's patients, to more general principles such as "I will concern myself with the well being of the sick." and "do no harm." These general principles are very useful because they govern a larger domain than simply prohibiting a particular action. These principles are not set out without context. Instead they are put into the context medicine's mission.
Beginning in #1 the tone is set that medicine is an art that is "given by the gods." It is an esoteric art that is to be reserved for those who are willing to commit to the provisions of the code. Thus, it is not open to everyone. This fulfills the condition of specialized knowledge mentioned earlier. It is for the sake of doing good to others and always avoiding harm. This fulfills the condition of providing a service for others.
Thirdly, the code ties itself to the larger moral tradition, "I will commit no intentional misdeeds." Whereas "harm" has a direct link to manner in which medicine is practiced, "misdeeds" links the physician to the larger moral tradition. There is no possible hiding in the shared community perspective alone.
These three factors are the basis of any good professional code.
A Good Professional Code Should Contain
- A specific listing of common abuses.
- A few general guidelines that tie behavior to the mission of the profession.
- A link to general theories of morality.
This is the most important point from my perspective. So often the "practice" of the profession defines its excellence in an introspective way such that the achievement of these functional requirements is all that matters-divorced from any other visions, viz., moral visions.
In the modern arena, many professional codes have evolved from a legal perspective. The practitioners of the profession do not want to go to jail or to be sued. Thus, they create certain codes that will make this possible situation less probable. These sorts of codes are defensive in nature and stand at the opposite end of the spectrum from the Hippocratic Oath. Their mission is not to set internal standards and link to common morality, rather they seek to "shave" as close as possible to maximizing an egoistic bottom line at the expense of the pillars of professionalism: one's specialized education and one's mission to serve others.
Any code that takes as its basis merely a negative approach designed to protect the practitioner from going to jail or being sued is fundamentally inadequate. This is not where one should set her sights. Rather, we should dream about what the profession may be-in the best of all possible worlds. The Oath of Hippocrates thus properly sets the mission that should drive all codes of ethics.
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