
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 foundational 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 original oath was written in Ionic Greek, between the fifth and third centuries BCE. 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
The oldest partial fragments of the oath date to circa 275 CE. 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: | 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. |
—Translation by W.H.S. Jones |
"First do no harm"
It is often said that "First do no harm" (Latin: Primum non nocere) is a part of the original Hippocratic oath. A related 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". Although no such phrase from which "First" or "Primum" can be translated appears in any well recognized version of the oath, a similar intention is vowed by, "I will abstain from all intentional wrong-doing and harm". "Primum non nocere" was claimed by the 19th-century English surgeon Thomas Inman to date from the 17th-century English physician Thomas Sydenham, but Sydenham's available writings contain no such phrase or equivalent, and it more likely took shape from longstanding popular nonmedical expression.
Context and interpretation
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 BCE. 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 the 275 CE 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 several ways. 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
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 American Medical Association's 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.
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 harm.[failed verification]
In the 1960s, the Hippocratic Oath was changed to require "utmost respect for human life from its beginning", making it a more secular obligation, not to be taken in the presence of any gods, but before only other people. When the oath was rewritten in 1964 by Louis Lasagna, Academic Dean of the School of Medicine at Tufts University, the prayer was omitted, and that version has been widely accepted and is still in use today by many US medical schools:
I swear to fulfill, to the best of my ability and judgment, this covenant:
I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.
I will apply, for the benefit of the sick, all measures [that] are required, avoiding those twin traps of overtreatment and therapeutic nihilism.
I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug.
I will not be ashamed to say "I know not", nor will I fail to call in my colleagues when the skills of another are needed for a patient's recovery.
I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.
I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.
I will prevent disease whenever I can, for prevention is preferable to cure.
I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.
If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.
In a 1989 survey of 126 US medical schools, only three of them reported use of the original oath, while thirty-three used the Declaration of Geneva, sixty-seven used a modified Hippocratic Oath, four used the Oath of Maimonides, one used a covenant, eight used another oath, one used an unknown oath, and two did not use any kind of oath. Seven medical schools did not reply to the survey.
As of 1993, only 14% of medical oaths prohibited euthanasia, and only 8% prohibited abortion.
In a 2000 survey of US medical schools, all of the then extant medical schools administered some type of professional oath. Among schools of modern medicine, sixty-two of 122 used the Hippocratic Oath, or a modified version of it. The other sixty schools used the original or modified Declaration of Geneva, Oath of Maimonides, or an oath authored by students or faculty or both. All nineteen osteopathic schools in the United States used the Osteopathic Oath, which is taken 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.
In France, it is common for new medical graduates to sign a written oath.
In 1995, Sir Joseph Rotblat, in his acceptance speech for the Nobel Peace Prize, suggested a Hippocratic Oath for Scientists.
In November 2005, Saparmurat Niyazov, then leader of Turkmenistan, declared that doctors should swear an oath to him instead of the Hippocratic Oath.
In 2007, US citizen Rafiq Abdus Sabir was convicted for making a pledge to al-Qaeda, thus agreeing to provide medical aid to wounded terrorists.
As of 2018, all US medical school graduates made some form of public oath but none used the original Hippocratic Oath. A modified form or an oath unique to that school is often used. A review of 18 of these oaths was criticized for their wide variability: "Consistency would help society see that physicians are members of a profession that's committed to a shared set of essential ethical values."
Violations
There is no direct punishment for breaking the Hippocratic Oath, although an arguable equivalent in modern times is medical malpractice, which carries a wide range of punishments, from imprisonment to civil penalties. Medical professionals may also be subject to other parts of the criminal and civil law for conduct contrary to both an oath taken and to a more general prohibition on, for example, doing physical or other harm to other persons. In the United States, several major judicial decisions have made reference to the classical Hippocratic Oath, either upholding or dismissing its bounds for medical ethics: Roe v. Wade, Washington v. Harper, Compassion in Dying v. State of Washington (1996), and Thorburn v. Department of Corrections (1998). In antiquity, the punishment for breaking the Hippocratic oath could range from a penalty to losing the right to practice medicine.
In 2022, at a college in the Indian state of Tamil Nadu, medical students took the Charaka shapath, a Sanskrit oath attributed to ancient sage and physician Maharishi Charak instead of the Hippocratic oath. The state government subsequently dismissed the Dean of the Madurai medical college for this act. However, he was reinstated by the Tamil Nadu government and assumed office 4 days later.
See also
- Hospital Corpsman Pledge
- Medical ethics
- Participation of medical professionals in American executions
- Patient safety
- Peelian principles
- Primum non nocere
- Sushruta § Followers
- Sun Simiao
- White Coat Ceremony
- Ethical codes of conduct for physicians
- Charaka shapath
- Declaration of Geneva
- Nightingale Pledge
- Oath of Asaph
- Seventeen Rules of Enjuin
- Vejjavatapada
- Ethical principles for human experimentation
- Declaration of Helsinki
- Human experimentation in the United States
- Nuremberg code
- Ethical practices for engineers
- Iron Ring
- Order of the Engineer
- Ritual of the Calling of an Engineer
- Science
- Hippocratic Oath for Scientists
References
- Edelstein, Ludwig (1943). The Hippocratic Oath: Text, Translation and Interpretation. Johns Hopkins Press. p. 56. ISBN 978-0-8018-0184-6.
- "Codices urbinates graeci Bibliothecae Vaticanae: Folio 64(Urb.gr.64)". Vatican Library: DigiVatLib. 900–1100. p. folio:116 microfilm: 121.
- North, Michael (2002). "Greek Medicine: "I Swear by Apollo Physician...": Green Medicine from the Gods to Galen". National Institute of Health; National Library of Medicine; History of Medicine Division.
- Wecheli, Andreae (1595). "Hippocrates. Τα ενρισκομενα Opera omnia". Frankfurt: National Institute of Health; National Library of Medicine; History of Medicine Division).
- Hippocrates of Cos (1923). "The Oath". Loeb Classical Library. 147: 298–299. doi:10.4159/DLCL.hippocrates_cos-oath.1923. Retrieved 6 October 2015.
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- Lloyd, Geoffrey, ed. (1983). Hippocratic Writings (2nd ed.). London: Penguin Books. pp. 94. ISBN 978-0-14-044451-3.
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- Smith, C. M. (2005). "Origin and Uses of Primum Non Nocere – Above All, Do No Harm!". The Journal of Clinical Pharmacology. 45 (4): 371–77. doi:10.1177/0091270004273680. PMID 15778417. S2CID 41058798.
- Suss, Richard A. (November 21, 2024). "First Do No Harm Is Proverbial, Not Hippocratic". OSF Preprints. doi:10.31219/osf.io/c23jq.
- Jouanna, Jacques (2001). Hippocrates. Baltimore, Md.: Johns Hopkins University Press. ISBN 978-0-8018-6818-4.
- Temkin, Owsei (2002). "On second thought" and other essays in the history of medicine and science. Baltimore, MD: Johns Hopkins University Press. ISBN 978-0-8018-6774-3.
- Askitopoulou, Helen; Vgontzas, Antoniοs N. (2018-07-01). "The relevance of the Hippocratic Oath to the ethical and moral values of contemporary medicine. Part I: The Hippocratic Oath from antiquity to modern times". European Spine Journal. 27 (7): 1481–1490. doi:10.1007/s00586-017-5348-4. ISSN 1432-0932. PMID 29080001. S2CID 10142596.
- Potter, Paul, ed. (1995). Hippocrates (Reprint ed.). Cambridge, Massachusetts: Harvard Univ. Press u.a. pp. 295–315. ISBN 978-0-674-99531-4.
- Nutton, Vivian (2012). Ancient medicine (2nd ed.). Milton Park, Abingdon, Oxon: Routledge. p. 68. ISBN 978-0-415-52095-9.
- Edelstein, Ludwig (1967). Ancient Medicine: Selected Papers of Ludwig Edelstein. Baltimore, Md.: Johns Hopkins Press. pp. 9–15. ISBN 978-0-8018-0183-9.
- Markel, Howard (2004). ""I Swear by Apollo" – On Taking the Hippocratic Oath" (PDF). The New England Journal of Medicine. 350 (20). Massachusetts Medical Society: 2026–2029. doi:10.1056/NEJMp048092. PMID 15141039. Retrieved 1 March 2017.
- Lonie, Iain M. (1981). The Hippocratic treatises, "On generation," "On the nature of the child," "Diseases IV" a commentary. Berlin: De Gruyter. p. 7. ISBN 978-3-11-086396-3.
- King, Helen (1998). Hippocrates' woman: reading the female body in ancient Greece. London: Routledge. pp. 132–156. ISBN 978-0-415-13895-6.
- De Brabandere, Olivia (2018). The "Hippocratic" Stance on Abortion: The Translation, Interpretation, and Use of the Hippocratic Oath in the Abortion Debate from the Ancient World to Present-Day (Master of Arts thesis). Queen's University. pp. 3–4, 7, 58.
- "Scribonius Largus"
- Soranus, Owsei Temkin (1956). Soranus' Gynecology. I.19.60: JHU Press. ISBN 978-0-8018-4320-4. Retrieved 6 October 2015.
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- Nutton, Vivian (2012). Ancient medicine (2nd ed.). Milton Park, Abingdon, Oxon: Routledge. p. 415, note 87. ISBN 978-0-415-52095-9.
- Buchholz B, et al. Prohibición de la litotomía y derivación a expertos en los juramentos médicos de la genealogía hipocrática. Actas Urologicas Espanolas. Volume 40, Issue 10, December 2016, Pages 640–645.
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- World Medical Association, Inc. "WMA History". www.wma.net. World Medical Association, Inc. Archived from the original on 6 February 2015. Retrieved 1 November 2014.
- Baumslag, Naomi (2005). Murderous Medicine: Nazi Doctors, Human Experimentation, and Typhus. Praeger Publishers. pp. xxv. ISBN 978-0-275-98312-3.
- "The Hippocratic Oath Today". PBS. 27 March 2001.
- Crawshaw, R (8 October 1994). "The Hippocratic oath. Is alive and well in North America". BMJ (Clinical Research Ed.). 309 (6959): 952–953. doi:10.1136/bmj.309.6959.952. PMC 2541124. PMID 7950672.
- Markel, Howard (2004). ""I Swear by Apollo" — On Taking the Hippocratic Oath" (PDF). The New England Journal of Medicine. 350 (20). Massachusetts Medical Society: 2026–9. doi:10.1056/NEJMp048092. PMID 15141039. Retrieved 1 March 2017.
- Kao, AC; Parsi, KP (September 2004). "Content analyses of oaths administered at U.S. medical schools in 2000". Academic Medicine. 79 (9): 882–7. doi:10.1097/00001888-200409000-00015. PMID 15326016.
- "Osteopathic Oath". American Osteopathic Association. Retrieved 28 November 2014.
- Sritharan, Kaji; Georgina Russell; Zoe Fritz; Davina Wong; Matthew Rollin; Jake Dunning; Bruce Wayne; Philip Morgan; Catherine Sheehan (December 2000). "Medical oaths and declarations". BMJ. 323 (7327): 1440–1. doi:10.1136/bmj.323.7327.1440. PMC 1121898. PMID 11751345.
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- "Nobel Prize winner calls for ethics oath". Physics World. 19 December 1997. Retrieved 2008-07-19.
- "Turkmen Doctors Pledge Allegiance To Niyazov". RadioFreeEurope/RadioLiberty. 15 November 2005. Retrieved 24 August 2024.
- "Trial and Terror". Archived from the original on 2021-05-07. Retrieved 2021-05-07.
- Weiner, Stacey (10 July 2018). "The solemn truth about medical oaths". aamc.org. American Association of Medical Colleges. Retrieved 17 June 2022.
- Groner M.D., Johnathan (2008). "The Hippocratic Paradox: The Role of The Medical Profession In Capital Punishment In The United States". Fordham Urban Law.
- Hasday, Lisa (23 February 2013). "The Hippocratic Oath as Literary Text: A Dialogue". Yale Journal of Health Policy, Law, and Ethics. 2 (2): Article 4. Retrieved 6 October 2015.
- Nutton, Vivian (2004). Ancient Medicine. New York, NY: Routledge.
- "Madurai college dean removed after MBBS students take 'Charak Shapath'". The News Minute. 2022-05-01. Retrieved 2022-05-02.
- "Sanskrit replaces Hippocratic Oath; Tamil Nadu shunts out Madurai Medical College dean". Deccan Herald. 2022-05-01. Retrieved 2022-05-02.
- "TN medical college dean removed after row over Charak Shapath". Google News. Retrieved 2022-05-02.
- "Charak Shapath row: A Rathinavel returns as dean of Madurai Medical College". The New Indian Express. 2022-05-06. Retrieved 2025-03-05.
Further reading
- Hulkower, Raphael (2010). "The History of the Hippocratic Oath: Outdated, Inauthentic, and Yet Still Relevant". The Einstein Journal of Biology and Medicine. 25/26: 41–44.
- The Hippocratic Oath Today: Meaningless Relic or Invaluable Moral Guide? – a PBS NOVA online discussion with responses from doctors as well as 2 versions of the oath.
- Kass, Leon (2008). Toward a More Natural Science. Simon & Schuster. ISBN 978-0-02-917071-7.
- Lewis Richard Farnell, Greek Hero Cults and Ideas of Immortality, 1921.
- "Codes of Ethics: Some History" by Robert Baker, Union College in Perspectives on the Professions, Vol. 19, No. 1, Fall 1999 Archived 2021-02-25 at the Wayback Machine, ethics.iit.edu
External links
- Hippocratic Oath, The Hitchhiker's Guide to the Galaxy (h2g2).
- Hippocratic Oath – Classical version, pbs.org
- Hippocratic Oath – Modern version, pbs.org
- Hippocratis jusiurandum – Image of a 1595 copy of the Hippocratic oath with side-by-side original Greek and Latin translation, bium.univ-paris5.fr
- Hippocrates | The Oath – National Institutes of Health page about the Hippocratic oath, nlm.nih.gov
- Tishchenko P. D. Resurrection of the Hippocratic Oath in Russia, zpu-journal.ru
- AMA Code of Medical Ethics
- Good Medical Practice (from Britain's General Medical Council)
- Hippocratic oath for Medical Bloggers
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 foundational 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 BCE 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 oathEarliest surviving copy A fragment of the oath on the 3rd century Papyrus Oxyrhynchus 2547 The oldest partial fragments of the oath date to circa 275 CE 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 pessὸn to the Latin fœtum Below is the Hippocratic Oath in Greek from the 1923 Loeb edition followed by the English translation ὄmnymi Ἀpollwna ἰhtrὸn kaὶ Ἀsklhpiὸn kaὶ Ὑgeian kaὶ Panakeian kaὶ 8eoὺs pantas te kaὶ pasas ἵstoras poieymenos ἐpitelea poihsein katὰ dynamin kaὶ krisin ἐmὴn ὅrkon tonde kaὶ syggrafὴn thnde ἡghses8ai mὲn tὸn dida3anta me tὴn texnhn taythn ἴsa genetῃsin ἐmoῖs kaὶ bioy koinwses8ai kaὶ xreῶn xrhizonti metadosin poihses8ai kaὶ genos tὸ ἐ3 aὐtoῦ ἀdelfoῖs ἴson ἐpikrineῖn ἄrresi kaὶ dida3ein tὴn texnhn taythn ἢn xrhizwsi man8anein ἄney mis8oῦ kaὶ syggrafῆs paraggelihs te kaὶ ἀkrohsios kaὶ tῆs loiphs ἁpashs ma8hsios metadosin poihses8ai yἱoῖs te ἐmoῖs kaὶ toῖs toῦ ἐmὲ dida3antos kaὶ ma8htῇsi syggegrammenois te kaὶ ὡrkismenois nomῳ ἰhtrikῷ ἄllῳ dὲ oὐdeni diaithmasi te xrhsomai ἐp ὠfeleiῃ kamnontwn katὰ dynamin kaὶ krisin ἐmhn ἐpὶ dhlhsei dὲ kaὶ ἀdikiῃ eἴr3ein oὐ dwsw dὲ oὐdὲ farmakon oὐdenὶ aἰth8eὶs 8anasimon oὐdὲ ὑfhghsomai symboylihn toihnde ὁmoiws dὲ oὐdὲ gynaikὶ pessὸn f8orion dwsw ἁgnῶs dὲ kaὶ ὁsiws diathrhsw bion tὸn ἐmὸn kaὶ texnhn tὴn ἐmhn oὐ temew dὲ oὐdὲ mὴn li8iῶntas ἐkxwrhsw dὲ ἐrgatῃsin ἀndrasi prh3ios tῆsde ἐs oἰkias dὲ ὁkosas ἂn ἐsiw ἐseleysomai ἐp ὠfeleiῃ kamnontwn ἐktὸs ἐὼn pashs ἀdikihs ἑkoysihs kaὶ f8orihs tῆs te ἄllhs kaὶ ἀfrodisiwn ἔrgwn ἐpi te gynaikeiwn swmatwn kaὶ ἀndrῴwn ἐley8erwn te kaὶ doylwn ἃ d ἂn ἐn8erapeiῃ ἴdw ἢ ἀkoysw ἢ kaὶ ἄney 8erapeihs katὰ bion ἀn8rwpwn ἃ mὴ xrh pote ἐklaleῖs8ai ἔ3w sighsomai ἄrrhta ἡgeymenos eἶnai tὰ toiaῦta ὅrkon mὲn oὖn moi tonde ἐpitelea poieonti kaὶ mὴ sygxeonti eἴh ἐpayras8ai kaὶ bioy kaὶ texnhs do3azomenῳ parὰ pᾶsin ἀn8rwpois ἐs tὸn aἰeὶ xronon parabainonti dὲ kaὶ ἐpiorkeonti tἀnantia toytwn 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 It is often said that First do no harm Latin Primum non nocere is a part of the original Hippocratic oath A related 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 Although no such phrase from which First or Primum can be translated appears in any well recognized version of the oath a similar intention is vowed by I will abstain from all intentional wrong doing and harm Primum non nocere was claimed by the 19th century English surgeon Thomas Inman to date from the 17th century English physician Thomas Sydenham but Sydenham s available writings contain no such phrase or equivalent and it more likely took shape from longstanding popular nonmedical expression Context and interpretationA 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 BCE 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 the 275 CE 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 several ways 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 relevanceAn 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 American Medical Association s 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 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 harm failed verification In the 1960s the Hippocratic Oath was changed to require utmost respect for human life from its beginning making it a more secular obligation not to be taken in the presence of any gods but before only other people When the oath was rewritten in 1964 by Louis Lasagna Academic Dean of the School of Medicine at Tufts University the prayer was omitted and that version has been widely accepted and is still in use today by many US medical schools I swear to fulfill to the best of my ability and judgment this covenant I will respect the hard won scientific gains of those physicians in whose steps I walk and gladly share such knowledge as is mine with those who are to follow I will apply for the benefit of the sick all measures that are required avoiding those twin traps of overtreatment and therapeutic nihilism I will remember that there is art to medicine as well as science and that warmth sympathy and understanding may outweigh the surgeon s knife or the chemist s drug I will not be ashamed to say I know not nor will I fail to call in my colleagues when the skills of another are needed for a patient s recovery I will respect the privacy of my patients for their problems are not disclosed to me that the world may know Most especially must I tread with care in matters of life and death If it is given me to save a life all thanks But it may also be within my power to take a life this awesome responsibility must be faced with great humbleness and awareness of my own frailty Above all I must not play at God I will remember that I do not treat a fever chart a cancerous growth but a sick human being whose illness may affect the person s family and economic stability My responsibility includes these related problems if I am to care adequately for the sick I will prevent disease whenever I can for prevention is preferable to cure I will remember that I remain a member of society with special obligations to all my fellow human beings those sound of mind and body as well as the infirm If I do not violate this oath may I enjoy life and art respected while I live and remembered with affection thereafter May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help In a 1989 survey of 126 US medical schools only three of them reported use of the original oath while thirty three used the Declaration of Geneva sixty seven used a modified Hippocratic Oath four used the Oath of Maimonides one used a covenant eight used another oath one used an unknown oath and two did not use any kind of oath Seven medical schools did not reply to the survey As of 1993 only 14 of medical oaths prohibited euthanasia and only 8 prohibited abortion In a 2000 survey of US medical schools all of the then extant medical schools administered some type of professional oath Among schools of modern medicine sixty two of 122 used the Hippocratic Oath or a modified version of it The other sixty schools used the original or modified Declaration of Geneva Oath of Maimonides or an oath authored by students or faculty or both All nineteen osteopathic schools in the United States used the Osteopathic Oath which is taken 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 In France it is common for new medical graduates to sign a written oath In 1995 Sir Joseph Rotblat in his acceptance speech for the Nobel Peace Prize suggested a Hippocratic Oath for Scientists In November 2005 Saparmurat Niyazov then leader of Turkmenistan declared that doctors should swear an oath to him instead of the Hippocratic Oath In 2007 US citizen Rafiq Abdus Sabir was convicted for making a pledge to al Qaeda thus agreeing to provide medical aid to wounded terrorists As of 2018 all US medical school graduates made some form of public oath but none used the original Hippocratic Oath A modified form or an oath unique to that school is often used A review of 18 of these oaths was criticized for their wide variability Consistency would help society see that physicians are members of a profession that s committed to a shared set of essential ethical values ViolationsThere is no direct punishment for breaking the Hippocratic Oath although an arguable equivalent in modern times is medical malpractice which carries a wide range of punishments from imprisonment to civil penalties Medical professionals may also be subject to other parts of the criminal and civil law for conduct contrary to both an oath taken and to a more general prohibition on for example doing physical or other harm to other persons In the United States several major judicial decisions have made reference to the classical Hippocratic Oath either upholding or dismissing its bounds for medical ethics Roe v Wade Washington v Harper Compassion in Dying v State of Washington 1996 and Thorburn v Department of Corrections 1998 In antiquity the punishment for breaking the Hippocratic oath could range from a penalty to losing the right to practice medicine In 2022 at a college in the Indian state of Tamil Nadu medical students took the Charaka shapath a Sanskrit oath attributed to ancient sage and physician Maharishi Charak instead of the Hippocratic oath The state government subsequently dismissed the Dean of the Madurai medical college for this act However he was reinstated by the Tamil Nadu government and assumed office 4 days later See alsoHospital Corpsman Pledge Medical ethics Participation of medical professionals in American executions Patient safety Peelian principles Primum non nocere Sushruta Followers Sun Simiao White Coat Ceremony Ethical codes of conduct for physiciansCharaka shapath Declaration of Geneva Nightingale Pledge Oath of Asaph Seventeen Rules of Enjuin Vejjavatapada Ethical principles for human experimentationDeclaration of Helsinki Human experimentation in the United States Nuremberg code Ethical practices for engineersIron Ring Order of the Engineer Ritual of the Calling of an Engineer ScienceHippocratic Oath for ScientistsReferencesEdelstein Ludwig 1943 The Hippocratic Oath Text Translation and Interpretation Johns Hopkins Press p 56 ISBN 978 0 8018 0184 6 Codices urbinates graeci Bibliothecae Vaticanae Folio 64 Urb gr 64 Vatican Library DigiVatLib 900 1100 p folio 116 microfilm 121 North Michael 2002 Greek Medicine I Swear by Apollo Physician Green Medicine from the Gods to Galen National Institute of Health National Library of Medicine History of Medicine Division Wecheli Andreae 1595 Hippocrates Ta enriskomena Opera omnia Frankfurt National Institute of Health National Library of Medicine History of Medicine Division Hippocrates of Cos 1923 The Oath Loeb Classical Library 147 298 299 doi 10 4159 DLCL hippocrates cos oath 1923 Retrieved 6 October 2015 Greek Medicine The Hippocratic Oath www nlm nih gov National Library of Medicine NIH Retrieved 29 July 2020 Lloyd Geoffrey ed 1983 Hippocratic Writings 2nd ed London Penguin Books pp 94 ISBN 978 0 14 044451 3 Sokol Daniel K 2013 First do no harm revisited BMJ 347 f6426 doi 10 1136 bmj f6426 PMID 24163087 S2CID 33952216 Retrieved 20 September 2014 Smith C M 2005 Origin and Uses of Primum Non Nocere Above All Do No Harm The Journal of Clinical Pharmacology 45 4 371 77 doi 10 1177 0091270004273680 PMID 15778417 S2CID 41058798 Suss Richard A November 21 2024 First Do No Harm Is Proverbial Not Hippocratic OSF Preprints doi 10 31219 osf io c23jq Jouanna Jacques 2001 Hippocrates Baltimore Md Johns Hopkins University Press ISBN 978 0 8018 6818 4 Temkin Owsei 2002 On second thought and other essays in the history of medicine and science Baltimore MD Johns Hopkins University Press ISBN 978 0 8018 6774 3 Askitopoulou Helen Vgontzas Antonios N 2018 07 01 The relevance of the Hippocratic Oath to the ethical and moral values of contemporary medicine Part I The Hippocratic Oath from antiquity to modern times European Spine Journal 27 7 1481 1490 doi 10 1007 s00586 017 5348 4 ISSN 1432 0932 PMID 29080001 S2CID 10142596 Potter Paul ed 1995 Hippocrates Reprint ed Cambridge Massachusetts Harvard Univ Press u a pp 295 315 ISBN 978 0 674 99531 4 Nutton Vivian 2012 Ancient medicine 2nd ed Milton Park Abingdon Oxon Routledge p 68 ISBN 978 0 415 52095 9 Edelstein Ludwig 1967 Ancient Medicine Selected Papers of Ludwig Edelstein Baltimore Md Johns Hopkins Press pp 9 15 ISBN 978 0 8018 0183 9 Markel Howard 2004 I Swear by Apollo On Taking the Hippocratic Oath PDF The New England Journal of Medicine 350 20 Massachusetts Medical Society 2026 2029 doi 10 1056 NEJMp048092 PMID 15141039 Retrieved 1 March 2017 Lonie Iain M 1981 The Hippocratic treatises On generation On the nature of the child Diseases IV a commentary Berlin De Gruyter p 7 ISBN 978 3 11 086396 3 King Helen 1998 Hippocrates woman reading the female body in ancient Greece London Routledge pp 132 156 ISBN 978 0 415 13895 6 De Brabandere Olivia 2018 The Hippocratic Stance on Abortion The Translation Interpretation and Use of the Hippocratic Oath in the Abortion Debate from the Ancient World to Present Day Master of Arts thesis Queen s University pp 3 4 7 58 Scribonius Largus Soranus Owsei Temkin 1956 Soranus Gynecology I 19 60 JHU Press ISBN 978 0 8018 4320 4 Retrieved 6 October 2015 a href wiki Template Cite book title Template Cite book cite book a CS1 maint location link Wear Andrew Geyer Kordesch Johanna French Roger Kenneth eds 1993 Doctors and Ethics The Earlier Historical Setting of Professional Ethics Amsterdam Rodopi pp 10 37 von Staden H 1996 In a pure and holy way Personal and professional conduct in the Hippocratic Oath Journal of the History of Medicine and Allied Sciences 51 4 404 437 doi 10 1093 jhmas 51 4 404 PMID 9019063 Nutton Vivian 2012 Ancient medicine 2nd ed Milton Park Abingdon Oxon Routledge p 415 note 87 ISBN 978 0 415 52095 9 Buchholz B et al Prohibicion de la litotomia y derivacion a expertos en los juramentos medicos de la genealogia hipocratica Actas Urologicas Espanolas Volume 40 Issue 10 December 2016 Pages 640 645 Oswald H Phelan P D Lanigan A Hibbert M Bowes G Olinsky A 1994 Outcome of childhood asthma in mid adult life BMJ Clinical Research Ed 309 6947 95 96 doi 10 1136 bmj 309 6947 95 PMC 2540578 PMID 8038676 Schiedermayer D L 1986 The Hippocratic Oath Corporate Version New England Journal of Medicine 314 1 62 doi 10 1056 NEJM198601023140122 PMID 3940324 World Medical Association Inc WMA History www wma net World Medical Association Inc Archived from the original on 6 February 2015 Retrieved 1 November 2014 Baumslag Naomi 2005 Murderous Medicine Nazi Doctors Human Experimentation and Typhus Praeger Publishers pp xxv ISBN 978 0 275 98312 3 The Hippocratic Oath Today PBS 27 March 2001 Crawshaw R 8 October 1994 The Hippocratic oath Is alive and well in North America BMJ Clinical Research Ed 309 6959 952 953 doi 10 1136 bmj 309 6959 952 PMC 2541124 PMID 7950672 Markel Howard 2004 I Swear by Apollo On Taking the Hippocratic Oath PDF The New England Journal of Medicine 350 20 Massachusetts Medical Society 2026 9 doi 10 1056 NEJMp048092 PMID 15141039 Retrieved 1 March 2017 Kao AC Parsi KP September 2004 Content analyses of oaths administered at U S medical schools in 2000 Academic Medicine 79 9 882 7 doi 10 1097 00001888 200409000 00015 PMID 15326016 Osteopathic Oath American Osteopathic Association Retrieved 28 November 2014 Sritharan Kaji Georgina Russell Zoe Fritz Davina Wong Matthew Rollin Jake Dunning Bruce Wayne Philip Morgan Catherine Sheehan December 2000 Medical oaths and declarations BMJ 323 7327 1440 1 doi 10 1136 bmj 323 7327 1440 PMC 1121898 PMID 11751345 Crawshaw R Pennington T H Pennington C I Reiss H Loudon I October 1994 Letters BMJ 309 6959 952 953 doi 10 1136 bmj 309 6959 952 PMC 2541124 PMID 7950672 Nobel Prize winner calls for ethics oath Physics World 19 December 1997 Retrieved 2008 07 19 Turkmen Doctors Pledge Allegiance To Niyazov RadioFreeEurope RadioLiberty 15 November 2005 Retrieved 24 August 2024 Trial and Terror Archived from the original on 2021 05 07 Retrieved 2021 05 07 Weiner Stacey 10 July 2018 The solemn truth about medical oaths aamc org American Association of Medical Colleges Retrieved 17 June 2022 Groner M D Johnathan 2008 The Hippocratic Paradox The Role of The Medical Profession In Capital Punishment In The United States Fordham Urban Law Hasday Lisa 23 February 2013 The Hippocratic Oath as Literary Text A Dialogue Yale Journal of Health Policy Law and Ethics 2 2 Article 4 Retrieved 6 October 2015 Nutton Vivian 2004 Ancient Medicine New York NY Routledge Madurai college dean removed after MBBS students take Charak Shapath The News Minute 2022 05 01 Retrieved 2022 05 02 Sanskrit replaces Hippocratic Oath Tamil Nadu shunts out Madurai Medical College dean Deccan Herald 2022 05 01 Retrieved 2022 05 02 TN medical college dean removed after row over Charak Shapath Google News Retrieved 2022 05 02 Charak Shapath row A Rathinavel returns as dean of Madurai Medical College The New Indian Express 2022 05 06 Retrieved 2025 03 05 Further readingHulkower Raphael 2010 The History of the Hippocratic Oath Outdated Inauthentic and Yet Still Relevant The Einstein Journal of Biology and Medicine 25 26 41 44 The Hippocratic Oath Today Meaningless Relic or Invaluable Moral Guide a PBS NOVA online discussion with responses from doctors as well as 2 versions of the oath Kass Leon 2008 Toward a More Natural Science Simon amp Schuster ISBN 978 0 02 917071 7 Lewis Richard Farnell Greek Hero Cults and Ideas of Immortality 1921 Codes of Ethics Some History by Robert Baker Union College in Perspectives on the Professions Vol 19 No 1 Fall 1999 Archived 2021 02 25 at the Wayback Machine ethics iit eduExternal linksWikiquote has quotations related to Hippocratic Oath Hippocratic Oath The Hitchhiker s Guide to the Galaxy h2g2 Hippocratic Oath Classical version pbs org Hippocratic Oath Modern version pbs org Hippocratis jusiurandum Image of a 1595 copy of the Hippocratic oath with side by side original Greek and Latin translation bium univ paris5 fr Hippocrates The Oath National Institutes of Health page about the Hippocratic oath nlm nih gov Tishchenko P D Resurrection of the Hippocratic Oath in Russia zpu journal ru AMA Code of Medical Ethics Good Medical Practice from Britain s General Medical Council Hippocratic oath for Medical BloggersPortal Medicine