Oaths for Physicians -- Necessary Protection or Elaborate Hoax?

Erich H. Loewy, MD

Disclosures
In This Article

Introduction

One of the reasons frequently given by physicians to justify the standing and respect that they enjoy in society is that they have (in general) taken a patient-centered oath (similar to but not necessarily identical to the "Yale" oath) that has the Hippocratic Oath as the forefather. The old Hippocratic Oath is no longer suitable for modern times and is, therefore, subject to a variety of interpretations.[1,2,3,4,5] Depending on the individual, such oaths may be perceived critical to the way in which a particular physician perceives himself or herself, or it may be seen as another rite of passage, important in form but unimportant in detail. Even, however, if it is believed to be merely a symbolic rite of passage that does not become a part of what an individual thinks he/she is, it does constitute a public avowal and a public pledge. These oaths almost invariably promise, above all, fealty to one's actual or potential patients and to work for their good regardless of religion or lack thereof, race, ethnicity, gender, party or socioeconomic considerations. It is said to be "freely" taken and not to have been coerced.

In this article I want (1) to examine the concept of "oath" and try to differentiate an oath publicly made from a promise given to another individual; (2) to cast a somewhat skeptical eye on an oath that some may view as being essentially coerced and ask whether it is reasonable to make such an oath a condition of graduation; (3) to ask why the profession so frequently fails to sanction persons violating their oath; (4) to discuss the regrettable fact that we who administer the oath and the fledgling doctors taking the oath know fully well that the way in which society is constituted today, part of that oath is bound to be violated; and (5) to conclude from this that physicians who take such an oath are at least obligated to work for conditions making its implementation possible.

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