Oaths for Physicians -- Necessary Protection or Elaborate Hoax?

Erich H. Loewy, MD

Disclosures
In This Article

Principles of Medical Ethics:

  1. A physician shall be dedicated to providing competent medical care, with compassion and respect for human dignity and rights.

  2. A physician shall uphold the standards of professionalism, be honest in all professional interactions, and strive to report physicians deficient in character or competence, or engaging in fraud or deception, to appropriate entities.

  3. A physician shall respect the law and also recognize a responsibility to seek changes in those requirements which are contrary to the best interests of the patient.

  4. A physician shall respect the rights of patients, colleagues, and other health professionals, and shall safeguard patient confidences and privacy within the constraints of the law. A physician shall continue to study, apply, and advance scientific knowledge, maintain a commitment to medical education, make relevant information available to patients, colleagues, and the public, obtain consultation, and use the talents of other health professionals when indicated.

  5. A physician shall, in the provision of appropriate patient care, except in emergencies, be free to choose whom to serve, with whom to associate, and the environment in which to provide medical care.

  6. A physician shall recognize a responsibility to participate in activities contributing to the improvement of the community and the betterment of public health.

  7. A physician shall, while caring for a patient, regard responsibility to the patient as paramount.

  8. A physician shall support access to medical care for all people.

These oaths together with the AMA Code of Ethics are what most of the public not unreasonably expects of its physicians today. When I received my bachelor of arts from New York University (NYU) all divisions of NYU graduated together -- undergraduate, medicine, law, doctorate, master of arts, etc. Mrs. Eleanor Roosevelt was speaker for the graduating medical students. I remember what she said: "The Gods are different, the times are different but the underlying precepts of caring for the sick wherever or whoever they may be remain the same." Consistent with her remarks, I believe that the cardinal points of all such oaths are as follows:

  1. Service to humanity, caring for the sick, promoting good health, and last but not least alleviating pain and suffering.

  2. A promise of integrity, honesty, humility, and -- above all -- compassion.

  3. A realization that although harm is inevitable it must be outweighed by benefit.

  4. Gender, race, religion, political affiliation, sexual orientation, nationality, or social (and in some oaths by implication and in other oaths in so many words) financial standing shall not influence the physician's judgment.

  5. A promise to oppose policies in breach of human rights and a promise not to participate in them. Physicians will strive to change laws that are contrary to their profession's ethics and will work toward a fairer distribution of health resources.

  6. A promise to recognize mistakes in self and others, and to learn from them.

  7. A statement that teaching those who come after us as well as our colleagues and learning from them as well as research leading to better patient care in the future shall have an equal standing as does patient care today.

  8. This promise is made freely and without coercion.

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