The Hippocratic Oath today

doi:10.15406/mojs.2016.03.00039

MOJ

eISSN: 2379-6162

Surgery

Editorial Volume 3 Issue 2

The Hippocratic Oath today

Dimitrios Gakis

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Aristotle University of Thessaloniki, Greece

Correspondence: Dimitrios Gakis, Consultant Transplant Surgeon, Aristotle University of Thessaloniki, Greece

Received: May 30, 2016 | Published: May 31, 2016

Citation: Gakis D. The Hippocratic Oath today. MOJ Surg. 2016;3(2):35. DOI: 10.15406/mojs.2016.03.00039

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Editorial

Recently an announcement about an excavation done in Stagira village located in Central Macedonia in Greece proved that Aristotle tomb was revealed. Aristotle is considered as the biggest Philosopher through the centuries. He was ranked first between the people who have most influenced the planet the last 6000 years, in the research of MIT [1]. Aristotle was a student of Plato and teacher of Alexander the Great. His work forms the basis of the modern logic, and science and his metaphysics became an integral part of Christian theology [2]. He became renowned for his contribution to the field of ethics. This renovation gave me a great stimulus to look back at the course of Medicine I lived in my career. Medicine was largely influenced by his work. The Surgical Practice changed considerably the last decades. New drugs erased almost completely fields of surgery, like gastric ulcer surgery. Technology changed dramatically the way we are operating. There are no more “exploratory laparotomies” because the diagnosis is feasible before the operation, thanks to the preoperative diagnostic facilities we have. We, even, reached the ability to have noninvasive preoperative histologic diagnosis with advanced MRI. The safety for the patient was largely increased.

This, may be, gave us the sense of power and hat we don’t need the Ethics, or in order to be more accurate we modified gradually, through the time, the Ethical rules, to our benefit. Being enthusiastic about the newer, less invasive procedures we overuse them to our benefit and of course under the pressure of Medical Equipment Companies. Despite that we know that an open, small incision mesh graft hernia repair under local anaesthesia is much safer, has almost zero relapse rates and is of lower cost in comparison with a laparoscopic one, we are using the latter in the majority of cases. Similarly a big percentage of acute appendicectomies can be conservatively treated, at low cost, avoiding the postoperative infertility in a young thin females, and not only. We participate to “supported” researches, publishing biased papers. This became so common, that is very difficult to differentiate the important publications from the biased ones. The worst is that pharmaceutical companies undertake the responsibility to manage the acceptance of the biased research in a “good” Journal.

We started speaking about Euthanasia, we accept abortions, we accept, in the majority of countries, unconditionally, living unrelated graft donations, and despite we know that payment exist behind the closed doors. But the worst is that we discriminate patients according to the race, the status, the Nationality. We are forgetting that the patient is a supplicant, that is begging for our help and we treat him with hardness. I have to mention that in ancient Athens if somebody was treating inappropriately a supplicant, the penalty was death! And not infrequently, as young Doctors we are developing sexual relationships with our patients or their relatives. All the above, are some of the byproducts of the “progress”. This is the reason why Doctors are losing gradually their reputation in the Society.

What is the explanation for this degeneration? Is it because we lost the attachment to our traditional values? Is it because the society lost the traditional rules and ethical principles that were the cornerstone of progress?

We may find the answer looking at a research done about the adherence to the Hippocratic oath principles in the U.S. Medical Schools in 2004 [3]. “The State University of New York Upstate Medical University in Syracuse is the only U.S. school that still uses an unmodified version of the traditional Hippocratic Oath. 59 allopathic schools use a modified version, while the other 63 allopathic schools use a variety, from the Declaration of Geneva to oaths crafted by students and faculty. Here’s the percentage of oaths that maintain ethical values in the traditional Hippocratic oath:

Protecting patient confidentiality: 91%
Loyalty to colleagues, profession and teachers: 87%
Act with beneficence: 60%
Reward for adhering to oath: 48%
Sanction for violating oath: 38%
Do no harm, or nonmaleficence: 18%
Prohibition of physician-assisted suicide or euthanasia: 18%
Promise to deity or God: 18%
Avoiding sexual misconduct: 3%
Prohibition of abortion: 0.7% “

What do you think?

Is the appropriate timing to go back to the Ethics?

The society needs us.