It’s often assumed that medical students take the Hippocratic Oath when they graduate or during the “white coat ceremony“—when they get their Official Doctor Coats at orientation. In fact, there’s a report from the Association of American Medical Colleges (AAMC) that most medical students never take that famous oath, and many classes write their own. Although there are still some “standard” oaths, the AAMC notes this:
. . . it was only around 20 years ago that schools began to allow students to craft their own promises.
Nancy Angoff, MD, remembers the decision to discard Yale’s long-standing oath back in 2000. “Some students and I didn’t care for the language,” says Angoff, associate dean for student affairs. “It seemed very impersonal, cold, and too pat.” At first, they considered reverting to the Hippocratic Oath.
“We debated it,” recalls Angoff. “The students didn’t want to promise things they couldn’t deliver on” that the ancient oath included, so they opted to write their own pledge.
Now Yale is among the 17% of surveyed schools that have an annual process for writing, revising, or selecting an oath. At Yale, the oath is written during a pregraduation course, explains Angoff. Each year, she says, “the students end up with a really personal and beautiful oath.”
You can see why they’ve ditched the original Hippocratic Oath if you read it here. There are parts that are really outmoded, such as this bit, which rules out assisted suicide and abortion:
I will not give a lethal drug to anyone if I am asked, nor will I advise such a plan; and similarly I will not give a woman a pessary to cause an abortion.
Now I’m not sure why the students write oaths rather than the faculty, for the faculty surely have a better idea of what good physicianship is all about. And of course the students, who are quite young, can go hog wild, as they apparently did at Pitt. And you know already what they did—and what’s probably happening all over the U.S. They pledged themselves as doctors to engage in social-justice activism.
From PittWire, a publication of the University of Pittsburgh, we have a report of one new oath (click on screenshot to read):
There was a committee to write an oath (always a bad idea), and they produced an oath that was sent to me by reader Ginger K., who commented, “Some of this is quite reasonable, such as the commitment to research and mentoring, collegiality, and personal health. But the woke vocabulary dilutes the good stuff.” Indeed. The titer of real physicianship is quite low here.
Read the oath for yourself. Right off the bat I was distressed by the ubiquitous ritual invocation of George Floyd, who has nothing to do with medical school or prospective doctors (The Floyd Invocation also initiates “antiracism” statements on some of the University of Chicago’s departmental websites that violate our University principles):
One gets the impression from this statement that medicine is more a social justice mission—fixing racial inequities, fostering allyship and so on—than a mission to bring health and save lives. There’s more about social justice here, including the au courant “self care”, than there is about caring for patients per se, or practicing ethical behavior towards all patients. (And where is the confidentiality clause that was in the Hippocratic oath?)
I’m not going to make too much of this, as students probably enjoy producing their own oaths. But in the end this seems to be an act of virtue signaling, for most of the physicians will be engaged in the quotidian duties of simply helping the afflicted rather than fixing racial inequality.
I do admire those who sacrifice a comfortable existence to help the oppressed and poor, but this is an individual choice, not something to be decreed with a pledge recited by everyone. For surely not all students agree with this oath—just like not all professors at the University of Chicago agree with their departments’ “anti-racism” statements.
Take this as a sign of the times, and of the racialization of everything. For some students it may be a genuine pledge, but for many of the others it’s performative wokeness, something to be forgotten as soon as they pass their boards.
h/t Ginger K
What happens if a proto-doctor refuses to utter that oath?
Seems you can use one of the standard ones. At least that’s how I read it.
Go the opposite and ask to swear the original in Greek.
I had no idea. I thought it was still the standard. I guess asking what oath they took will have to be part of my vetting of potential doctors.
To be fair, these students recited this oath in addition to reciting the Hippocratic Oath. I don’t have a problem with it, but I have been involved in supporting community health initiatives, so it sounds encouraging to me.
Given a choice between impersonal and cold versus touchy-feely quackery, I’d take the cold and impersonal any day of the week. There are some things which you really don’t want people to get their emotions involved in, and a complicated subject like medicine is high on the list of such things.
The students’ new Hippocratic Oath omits any pledge of allyship to certain other underserved communities. What about the hillbilly (or one should say hillbillx) community, historically oppressed in the hollows of Appalachia and the company mining towns of West Virginia? Or the immigrant Russianx community, victim of endless jokes because of inability to use definite article? Or the alcoholix community, marginalized and caricatured in so much literature, and singled out for traffic stops? A member of any of these communityxs should be offended.
The impulse to rewrite the Hippocratic Oath, like all the other woke gestures erupting everywhere, was in a sense forecast 50 years ago in Tom Wolfe’s prescient essay “Mau-Mauing the Flak-Catchers”. What has happened is that most of liberal society, led by academia, has taken on the role of flak-catcher. From a more general point of view, the near-totalitarian drumbeat of Diversity affirmations from English Departments, bird-watching societies, and similar offenders illustrates the down-side of well-meaning attempts at social engineering: namely that such attempts will be used, maybe hijacked altogether, by exhibitionists, virtue-flaunters, opportunists, and hustlers. One implication here is that attempts at social engineering always suffer a danger of misuse and over-reach. I used to reject this warning from certain thoughtful Conservatives, but I am beginning to think about it more than I used to.
There’s always room on the Social Justice train – until you get thrown off by someone else grabbing your seat. And then you often get run over by the hurtling juggernaut.
Plus if you ally to the LGBTQIA+ (etc) community does this mean you treat typical people less favourably?
No need to worry – the oath-writing committee was “diverse in the most collective sense. More than anything, this oath-writing process was human” according to one of its members. You can’t get better than that, unless bison-man of recent Capitol invasion fame is possibly excluded as non-human.
Now 72, I look back with embarrassment at how much in my early twenties I wrongly thought I knew about the world and my chosen career. Fortunately, I and my peers never had to write an oath.
One thing of many which annoyed me in the oath was ‘differently-abled’, which probably doesn’t mean LeBron James or Einstein, but refers to people such as my son, born partially-sighted, now blind in his forties, severely mentally handicapped, unable to speak, on medication for epilepsy, completely dependent on others – oh yeah, those different abilities.
I hope the ceremonies don’t become ruined. They are actually quite moving to watch. At my institution, the graduates stand & turn to the audience and say the hippocratic oath together facing their families and friends.
How good that in Germany the Hippocratic Oath does not have to be taken after licensing (“Approbation”). No chance for wokeness.
Seems like an excellent ‘hands on’ medical ethics teaching opportunity to me. It might make them think more deeply about what doctors should and should not do if they propose, critique, revise (and repeat), their own ethical guidelines.
If the discussion is reasonably well guided by an expert in medical ethics, at least…
I wonder if the oath-writers would tolerate a passing reference to logical, rational thinking, and a rejection of homeopathy.
There are international rules for ethical and moral conduct for physicians, as well as national rules. In Sweden, where I live, you agree to follow those rules when you become a member of the Swedish Medical Association.
Bear in mind that when Hippocrates wrote his oath, poisoning (“a lethal drug”) was considered a shameful form of execution — which is why the city elders forced it on Socrates. A real Athenian gentleman who wanted to commit suicide “opened his veins” (cut his wrists) or “fell” on his sword. Likewise, in those days, a “pessary” was a totally inefficient and possibly harmful means of abortion. Hippocrates himself prescribed other means.
That doesn’t make “do it yourself” medical oaths any less suspect.
I’d be happy if everyone followed “first, do no harm.”
Ironic that this is in the country which, compared to almost every other, virtually everything is expected to be regarded mainly as an opportunity to make a shitload of money. The healthcare industry there is right at the front of that charge. I realize that doctors are not all fixated on becoming millionaires, but the capitalism of investing in hospital chains, the prices charged by specialists (over $100,000CDN for Jerry’s afternoon visit IIRC), the move into such things as cosmetic surgery (well okay I guess if you paid entirely for your own post-secondary education), the sickening TV ads from drug companies (Covid got me watching CNN way too much!): all make it clear that many doctors are very happy to go along with the worst health care, the lowest life expectancy, in ‘advanced’ countries, as long as the money keeps rolling in.
The Hippocratic Oath needs to be renamed the Hypocritical Oath for many of them.
On the other hand, I think that some of them and certainly many others, especially nurses, have probably heroically done more in the US than anywhere else in the world to get the horrible effects of this pandemic much lower than they would have been if everything had been up to the whims of the Mass Murderer and his regime. It’s still the nearly worst in the ‘western world’ and vastly worse than average.
I’ll add again that as Canadian I’m ashamed and pissed off that it’s as bad as it is here, and people here should stop taking comfort from comparisons to US. Somebody should add the following to their listings of Covid stats per country: two columns next to each other, one showing the degree of Faux News TV watching, the other the deaths per million from Covid. The correlation here might really say something.
Pardon the negativity; I need to even stop reading WAPO for awhile. Let’s hope they can redeploy most these National Guardificationers to mass vaccination locations after Wednesday.