Doctors have so many different views about what professional oaths mean, says Kathy Oxtoby, that it could be time to consider what they should say or if they should take an oath at all.
“I swear by Apollo the 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.”
This pledge from the Hippocratic oath—written nearly 2500 years ago—forms part of the most famous text in Western medicine. An oath historically taken by physicians, it requires readers to swear by the healing gods that they will uphold specific medical standards.
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The Bristol promise
Richard Huxtable, professor of medical ethics and law and director of the Centre for Ethics in Medicine from the school of social and community medicine at Bristol University, describes why Bristol medical students have their own oath:
“The ethics centre was created in 1996 in Bristol, and its first director professor, Alastair Campbell, was approached by medical students who wanted to create, in collaboration with his ethics colleagues, an oath that they could take together on graduation.
“It was very much a staff and student initiative. The “promise” was driven by the need to collectively recognise the values that would guide graduates’ careers.
“Twenty years on, the promise remains one of the most powerful moments in the medical school year. Students take the promise at the start of their studies and then again more formally on graduation day, along with staff.
“The values of the promise include: conscience, integrity, confidentiality, and to care for the public’s wellbeing.
“I would invite colleagues to look to what their students want as future professionals when they take an oath. Some may feel their current oath is sufficient, but you should be mindful of changing values and open to the fact that these might change as medical practices evolve.
“At the same time you should acknowledge values that are core to medical endeavour, such as maintaining confidences, avoiding harm, and respecting people’s rights.
“It’s about keeping the essence of the original oath, whilst keeping an eye on future horizons.
Every year we tell students the story of how the promise evolved, to convey how this was not something imposed from on high, but was a collaboration between students and staff.
“I feel privileged to take students through the oath each year.”
Read the full article on the BMJ website
