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Publicado el 06-30-2011
Reportero: Jane M. Orient, M.D.

Roll Over Hippocrates

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Jane M. Orient, M.D.

Everybody seems to think that doctors swear to the Oath of Hippocrates, and follow a long ethical tradition dating back to the 5th century before Christ.

Not anymore. The new doctors seem to be making it up as they go along. The tradition is not being set by a white beard who sat at many a patient’s bedside, taught a generation or more of disciples, earned the respect of his contemporary colleagues, and wrote a corpus of observations and reflections still esteemed millennia after his death.

For example, the oath taken by the first graduating class of the Phoenix branch of the University of Arizona College of Medicine was written by the students themselves.

They were charged with the task as they entered, and had all of 4 years to think about it.

The graduates do not use the word swear.

That is a verb that implies an object (to whom?), and a concept that assumes the existence of a higher authority, such as the Greek gods to whom the original Oath is addressed, or the Creator referred to in the Bible.

The new graduates promise or pledge perhaps to themselves.

The graduates appreciate, are grateful and humbled, and they aspire and strive. They commit to lives of practice and learning, to living artfully and with passion.

Among the hopes: Let us always remember the excitement and awe that we feel at this moment. 

But passing from feelings to action, the actual promises of things we will do are few.

First, we will respect and honor all who are involved in the healing arts. Those who taught them the art are evidently no more worthy than anybody else who is somehow “involved” in one of the allied professions.

Standing on the shoulders of those who came before, “we will support those who follow.” As to dedication, “we will balance our commitment to medicine and our relationships with loved ones.” Finally, “we will stay true to our profession, our values, our morality and our personal ethics.”

Patients, in other words, do not come first: their needs must be balanced against other priorities.

This is perhaps a natural consequence of restrictions on working hours. These days, there is no time to dawdle over teaching points; the law requires the young physicians to leave after a certain number of hours, and to ...
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