How Many Countries Still Follow The Hippocratic Oath?
Reports of the National Medical Commission proposing to ditch the Hippocratic Oath in favour of the Charak Shapath led to an outcry from some opposition leaders over the move, calling it "saffronisation" of the medical profession.
How many countries still ask their doctors to swear by the oath? (A surprising amount don't) How many have opted for alternatives to the Hippocratic Oath?
And is the centuries-old text still even relevant in the field of modern medicine? Let's find out.
What Is The Hippocratic Oath?
Attributed to Hippocrates of Kos, the Hippocratic Oath is the code of conduct that new physicians have to swear by when they graduate medical school.
The most commonly quoted version of the oath dates back to 1595, with historical versions dating further back to the 10th century and fragments of the text first appearing in 275 AD. It's often believed to be the core ethical guide for doctors.
While the name of the oath often leads people to believe it was written by Hippocrates, contemporary scholars believe it goes back EVEN further, as far as 4 BC, well before Hippocrates' time.
Needless to say, it's an OLD text that's served as a general code of ethics for doctors for the past two millennia.
And while most doctors and medical schools still swear by its essence, parts of it have been reworked or rewritten to suit the needs of modern medicine.
How many countries still use the oath in its original form? How many use modified versions of the oath?
And how many have foregone it entirely in favour of another code of conduct?
The United States and Canada
Out of 135 medical schools that were surveyed in the two countries, only 11 percent still used the classical version of the Hippocratic oath.
A little over 30 percent use what's called Lasagna's Modern Hippocratic Oath, a version of the oath that was written by physician Louis Lasagna in 1964.
The American Medical Association also opts for its own Code of Medical Ethics, which covers nine principles that doctors must follow.
Australia and New Zealand
The Hippocratic Oath fell out of favour in Australia and New Zealand in the 1990s and as of the present day, none of the 12 medical schools in the two countries includes the oath as an essential for medical students.
However, many colleges have instead adopted the Declaration of Geneva, which was written in 1948 by the World Medical Association, along with its updates, as an alternative to the dated Hippocratic Oath.
The United Kingdom
Medical schools in the UK, especially Britain, have included the oath increasingly across the country. While only 50% of medical schools included it in their courses in 1997, this number rose to 70% in 2017.
But, with a caveat, this is also a modified version of the oath. The British Medical Association(a doctors' union) wrote its own oath in favour of the Hippocratic Oath, to be used by the World Medical Council, but it was never officially approved and was withdrawn.
So while some medical schools in the UK opt for the modified Hippocratic oath, others follow the Declaration of Geneva.
The General Medical Council handles the registration and regulation of doctors in the UK and oversees the administration of the oath.
Saudi Arabia & Other Islam-Majority Countries
The reading of the Hippocratic Oath is forbidden for Muslims because it invokes a number of gods. Instead, ethical and moral guidelines are all laid down in the Qur'an and the Sunna. These guide all aspects of life.
Many Muslim-majority countries have either opted for their own medical ethics guides, like Saudi Arabia's Professionalism and Ethics Handbook for Residents or like in Iran's case, opted for a censored version of the Hippocratic oath which does not invoke the names of gods.
Other such examples include Pakistan's Code of Medical Ethics of the Pakistan Medical & Dental Council, which replaces the Hippocratic Oath in the country.
Like many of the other countries we've named, the South African Medical Association (SAMA) welcomed the Declaration of Geneva, with all of its revisions, as its code of medical conduct.
Only this version is called the SAMA Doctors' Pledge. While the doctors call it the hippocratic oath, they're referring to this version of the oath, which like many others, has been modified to the specific needs of the country and its medical infrastructure.
The point here is, that despite the classical text of the Hippocratic Oath being touted as the "backbone of medical ethics", most medical schools don't follow the classical Hippocratic Oath.
Instead most opt for the Declaration of Geneva, a modified oath, or a country-specific oath that suits the needs and challenges of contemporary medicine.
However, given that we have no official confirmation or announcement about the decision to implement this change, we can't speculate further.
Remember, at this juncture, it's merely a proposal from the NMC and needs to clear several discussions before being officially announced and implemented
India and Charak Shapath
The Charak Shapath is a tribute to Maharshi Charaka, the author of the Charaka Samhita, which many consider the primary source of all information related to Ayurveda.
Medical schools across India make graduates swear the classical Hippocratic Oath, or a version that integrates parts of the Declaration of Geneva. Like many other parts of the world, different schools administer different versions of the oath.
The proposal by the NMC, if implemented, will change this and uniformly administer the Charak Shapath instead.
Charak Shapath, which is based in the principles mentioned in the Charaka Samhita, shares several elements with the Hippocratic oath.
However, it dates much further back, around 800-1000 BC. The Charaka Samhita is believed to precede even the Susruta Samhita, India's most ancient text about surgery.
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