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September 27, 2016

Why the Hippocratic Oath is disappearing from medical schools

Daily Briefing

Editor's note: This popular story from the Daily Briefing's archives was republished on Oct. 7, 2019.

Medical schools increasingly are asking students to recite alternatives to the once-ubiquitous Hippocratic Oath, Melissa Bailey reports for STAT News.

Oath-taking is a nearly universal tradition at U.S. medical schools, but relatively few use the original Hippocratic oath. The original is "out of fashion" and incorporates ideas that now appear dated or controversial, Bailey writes.

For example, the original oath—believed to have been penned 2,000 years ago by the Greek "father of medicine," Hippocrates—asks physicians to swear to the Greek gods, including Apollo and Asclepius. It also includes language related to abortion and euthanasia.

Now, some students are reciting different takes on the Hippocratic Oath—including, at some institutions, oaths customized to the graduating class.

Alternative oaths

According to Alex Foster, an assistant professor at the University of Texas Health Science Center in San Antonio, most medical schools now use one of three main versions of the oath: Hippocrates', Louis Lasagna's, or the Declaration of Geneva.

Lasagna's version is the most popular, used by 33 percent of medical schools, according to a 2009 survey of 135 U.S. and Canadian institutions, which found that just 11 percent of schools used the original Hippocratic version.

Lasagna's oath, written in 1964, reads in part, "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."

Meanwhile, some medical schools let students revise their oaths to reflect their personal values.

Last year, medical students at Creighton University in Nebraska revised their oath to include a pledge not to discriminate against patients based on sexual orientation, according to spokesperson Cindy Workman.

Similarly, students at New York Medical College, Tulane University, and the University of California, San Francisco, all vow not to discriminate against patients based on gender, race, religion, or sexual orientation.

Dell Medical School at the University of Texas at Austin, which opened this summer, let its inaugural class select its own oath. They chose to modify parts of Lasagna's to include vows such as, "I will remember that I do not treat a fever chart, or a cancerous growth, but a sick human being."

Steve Smith, associate dean for student affairs at Dell Medical School, said, "We see health as a much broader context than just the physical symptoms and diagnoses" (Bailey, STAT News, 9/21).

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