hippocratic oath hippocratic oath the hippocratic oath is an oath of ethics historically taken by physicians. it is one of the most widely known of greek medical texts. in its original form, it requires a new physician to swear, by a number of healing gods, to uphold specific ethical standards. the oath is the earliest expression of medical ethics in the western world, establishing several principles of medical ethics which remain of paramount significance today. these include the principles of medical confidentiality and non-maleficence. as the seminal articulation of certain principles that continue to guide and inform medical practice, the ancient text is of more than historic and symbolic value. it is enshrined in the legal statutes of various jurisdictions, such that violations of the oath may carry criminal or other liability beyond the oath's symbolic nature. the greek physician hippocrates (460–370 bc), to whom the oath is traditionally attributed the original oath was written in ionic greek, between the fifth and third centuries bc. although it is traditionally attributed to the greek doctor hippocrates and it is usually included in the hippocratic corpus, some modern scholars do not regard it as having been written by hippocrates himself. text of the oath earliest surviving copy a fragment of the oath on the 3rd-century papyrus oxyrhynchus 2547. the oldest partial fragments of the oath date to circa ad 275. the oldest extant version dates to roughly the 10th–11th century, held in the vatican library. a commonly cited version, dated to 1595, appears in koine greek with a latin translation. in this translation, the author translates "πεσσὸν" to the latin "fœtum." below is the hippocratic oath, in greek, from the 1923 loeb edition, followed by the english translation: ὄμνυμι ἀπόλλωνα ἰητρὸν καὶ ἀσκληπιὸν καὶ ὑγείαν καὶ πανάκειαν καὶ θεοὺς πάντας τε καὶ πάσας, ἵστορας ποιεύμενος, ἐπιτελέα ποιήσειν κατὰ δύναμιν καὶ κρίσιν ἐμὴν ὅρκον τόνδε καὶ συγγραφὴν τήνδε:ἡγήσεσθαι μὲν τὸν διδάξαντά με τὴν τέχνην ταύτην ἴσα γενέτῃσιν ἐμοῖς, καὶ βίου κοινώσεσθαι, καὶ χρεῶν χρηΐζοντι μετάδοσιν ποιήσεσθαι, καὶ γένος τὸ ἐξ αὐτοῦ ἀδελφοῖς ἴσον ἐπικρινεῖν ἄρρεσι, καὶ διδάξειν τὴν τέχνην ταύτην, ἢν χρηΐζωσι μανθάνειν, ἄνευ μισθοῦ καὶ συγγραφῆς, παραγγελίης τε καὶ ἀκροήσιος καὶ τῆς λοίπης ἁπάσης μαθήσιος μετάδοσιν ποιήσεσθαι υἱοῖς τε ἐμοῖς καὶ τοῖς τοῦ ἐμὲ διδάξαντος, καὶ μαθητῇσι συγγεγραμμένοις τε καὶ ὡρκισμένοις νόμῳ ἰητρικῷ, ἄλλῳ δὲ οὐδενί.διαιτήμασί τε χρήσομαι ἐπ᾽ ὠφελείῃ καμνόντων κατὰ δύναμιν καὶ κρίσιν ἐμήν, ἐπὶ δηλήσει δὲ καὶ ἀδικίῃ εἴρξειν.οὐ δώσω δὲ οὐδὲ φάρμακον οὐδενὶ αἰτηθεὶς θανάσιμον, οὐδὲ ὑφηγήσομαι συμβουλίην τοιήνδε: ὁμοίως δὲ οὐδὲ γυναικὶ πεσσὸν φθόριον δώσω.ἁγνῶς δὲ καὶ ὁσίως διατηρήσω βίον τὸν ἐμὸν καὶ τέχνην τὴν ἐμήν.οὐ τεμέω δὲ οὐδὲ μὴν λιθιῶντας, ἐκχωρήσω δὲ ἐργάτῃσιν ἀνδράσι πρήξιος τῆσδε.ἐς οἰκίας δὲ ὁκόσας ἂν ἐσίω, ἐσελεύσομαι ἐπ᾽ ὠφελείῃ καμνόντων, ἐκτὸς ἐὼν πάσης ἀδικίης ἑκουσίης καὶ φθορίης, τῆς τε ἄλλης καὶ ἀφροδισίων ἔργων ἐπί τε γυναικείων σωμάτων καὶ ἀνδρῴων, ἐλευθέρων τε καὶ δούλων.ἃ δ᾽ ἂν ἐνθεραπείῃ ἴδω ἢ ἀκούσω, ἢ καὶ ἄνευ θεραπείης κατὰ βίον ἀνθρώπων, ἃ μὴ χρή ποτε ἐκλαλεῖσθαι ἔξω, σιγήσομαι, ἄρρητα ἡγεύμενος εἶναι τὰ τοιαῦτα.ὅρκον μὲν οὖν μοι τόνδε ἐπιτελέα ποιέοντι, καὶ μὴ συγχέοντι, εἴη ἐπαύρασθαι καὶ βίου καὶ τέχνης δοξαζομένῳ παρὰ πᾶσιν ἀνθρώποις ἐς τὸν αἰεὶ χρόνον: παραβαίνοντι δὲ καὶ ἐπιορκέοντι, τἀναντία τούτων. i swear by apollo healer, by asclepius, by hygieia, by panacea, and by all the gods and goddesses, making them my witnesses, that i will carry out, according to my ability and judgment, this oath and this indenture. to hold my teacher in this art equal to my own parents; to make him partner in my livelihood; when he is in need of money to share mine with him; to consider his family as my own brothers, and to teach them this art, if they want to learn it, without fee or indenture; to impart precept, oral instruction, and all other instruction to my own sons, the sons of my teacher, and to indentured pupils who have taken the healer's oath, but to nobody else. i will use those dietary regimens which will benefit my patients according to my greatest ability and judgment, and i will do no harm or injustice to them. neither will i administer a poison to anybody when asked to do so, nor will i suggest such a course. similarly i will not give to a woman a pessary to cause abortion. but i will keep pure and holy both my life and my art. i will not use the knife, not even, verily, on sufferers from stone, but i will give place to such as are craftsmen therein. into whatsoever houses i enter, i will enter to help the sick, and i will abstain from all intentional wrong-doing and harm, especially from abusing the bodies of man or woman, bond or free. and whatsoever i shall see or hear in the course of my profession, as well as outside my profession in my intercourse with men, if it be what should not be published abroad, i will never divulge, holding such things to be holy secrets. now if i carry out this oath, and break it not, may i gain for ever reputation among all men for my life and for my art; but if i break it and forswear myself, may the opposite befall me. – translation by w.h.s. jones. "first do no harm" main article: primum non nocere it is often said that the exact phrase "first do no harm" (latin: primum non nocere) is a part of the original hippocratic oath. although the phrase does not appear in the ad 245 version of the oath, similar intentions are vowed by, "i will abstain from all intentional wrong-doing and harm". the phrase primum non nocere is believed to date from the 17th century. another equivalent phrase is found in epidemics, book i, of the hippocratic school: "practice two things in your dealings with disease: either help or do not harm the patient". the exact phrase is believed to have originated with the 19th-century english surgeon thomas inman. context and interpretation a 12th-century greek manuscript of the oath the oath is arguably the best known text of the hippocratic corpus, although most modern scholars do not attribute it to hippocrates himself, estimating it to have been written in the fourth or fifth century bc. alternatively, classical scholar ludwig edelstein proposed that the oath was written by the pythagoreans, an idea that others questioned for lack of evidence for a school of pythagorean medicine. while pythagorean philosophy displays a correlation to the oath's values, the proposal of a direct relationship has been mostly discredited in more recent studies. its general ethical principles are also found in other works of the corpus: the physician mentions the obligation to keep the 'holy things' of medicine within the medical community (i.e. not to divulge secrets); it also mentions the special position of the doctor with regard to his patients, especially women and girls. however, several aspects of the oath contradict patterns of practice established elsewhere in the corpus. most notable is its ban on the use of the knife, even for small procedures such as lithotomy, even though other works in the corpus provide guidance on performing surgical procedures. providing poisonous drugs would certainly have been viewed as immoral by contemporary physicians if it resulted in murder. however, the absolute ban described in the oath also forbids euthanasia. several accounts of ancient physicians willingly assisting suicides have survived. multiple explanations for the prohibition of euthanasia in the oath have been proposed: it is possible that not all physicians swore the oath, or that the oath was seeking to prevent widely held concerns that physicians could be employed as political assassins. the interpreted ad 275 fragment of the oath contains a prohibition of abortion that is in contradiction to original hippocratic text on the nature of the child, which contains a description of an abortion, without any implication that it was morally wrong, and descriptions of abortifacient medications are numerous in the ancient medical literature. the oath's stance on abortion was unclear even in the ancient world where physicians debated whether the specification of pessaries was a ban on simply pessaries, or a blanket ban on all abortion methods. scribonius largus was adamant in ad 43 (the earliest surviving reference to the oath) that it precluded abortion. in the 1st or 2nd century ad work gynaecology, soranus of ephesus wrote that one party of medical practitioners followed the oath and banished all abortifacients, while the other party—to which he belonged—was willing to prescribe abortions, but only for the sake of the mother's health. william henry samuel jones states that "abortion…though doctors are forbidden to cause it, was possibly not condemned in all cases". he believed that the oath prohibited abortions, though not under all circumstances. john m. riddle argues that because hippocrates specified pessaries, he only meant pessaries and therefore it was acceptable for a hippocratic doctor to perform abortions using oral drugs, violent means, a disruption of daily routine or eating habits, and more. other scholars, most notably ludwig edelstein, believe that the author intended to prohibit any and all abortions. olivia de brabandere writes that regardless of the author's original intention, the vague and polyvalent nature of the relevant line has allowed both professionals and non-professionals to interpret and use the oath in. while many christian versions of the hippocratic oath, particularly from the middle ages, explicitly prohibited abortion, the prohibition is often omitted from many oaths taken in us medical schools today, though it remains controversial. the oath stands out among comparable ancient texts on medical ethics and professionalism through its heavily religious tone, a factor which makes attributing its authorship to hippocrates particularly difficult. phrases such as 'but i will keep pure and holy both my life and my art' suggest a deep, almost monastic devotion to the art of medicine. he who keeps to the oath is promised 'reputation among all men for my life and for my art'. this contrasts heavily with galenic writings on professional ethics, which employ a far more pragmatic approach, where good practice is defined as effective practice, without reference to deities. the oath's importance among the medical community is nonetheless attested by its appearance on the tombstones of physicians, and by the fourth century ad it had come to stand for the medical profession. the oath continued to be in use in the byzantine christian world with its references to pagan deities replaced by a christian preamble, as in the 12th-century manuscript pictured in the shape of a cross. modern versions and relevance an engraving of hippocrates by peter paul rubens, 1638 the hippocratic oath has been eclipsed as a document of professional ethics by more extensive, regularly updated ethical codes issued by national medical associations, such as the ama code of medical ethics (first adopted in 1847), and the british general medical council's good medical practice. these documents provide a comprehensive overview of the obligations and professional behaviour of a doctor to their patients and wider society. doctors who violate these codes may be subjected to disciplinary proceedings, including the loss of their license to practice medicine. nonetheless, the length of these documents has made their distillations into shorter oaths an attractive proposition. in light of this fact, several updates to the oath have been offered in modern times, some facetious. the oath has been modified numerous times. in the united states, the majority of osteopathic medical schools use the osteopathic oath in place of or in addition to the hippocratic oath. the osteopathic oath was first used in 1938, and the current version has been in use since 1954. one of the most significant revisions was first drafted in 1948 by the world medical association (wma), called the declaration of geneva. "during the post world war ii and immediately after its foundation, the wma showed concern over the state of medical ethics in general and over the world. the wma took up the responsibility for setting ethical guidelines for the world's physicians. it noted that in those years the custom of medical schools to administer an oath to its doctors upon graduation or receiving a license to practice medicine had fallen into disuse or become a mere formality". in nazi germany, medical students did not take the hippocratic oath, although they knew the ethic of "nil nocere"—do no