Swearing to Life

In 1972, deep in the library of the Mayo Clinic, Supreme Court Justice Harry Blackmun found an essay, written by the classicist Ludwig Edelstein in 1943, that described the Hippocratic Oath as “a Pythagorean manifesto and not an absolute standard of medical conduct.” With this ammunition, Justice Blackmun was able, in his Roe v. Wade decision, to explain away as a meaningless historical accident the medical profession’s traditional prohibition against doctors performing abortions: “This it seems to us is a satisfactory explanation of the Hippocratic Oath’s apparent rigidity. It enables us to understand in historical context a long accepted and revered statement of medical ethics.”

Hippocrates (460-377 b.c. ), a Greek physician on the Isle of Cos, was called even in ancient times the “Father of Medicine.” Modern classicists have long argued back and forth about the authorship of his Oath and the other writings in the Hippocratic corpus. But, regardless of its actual author, classicists all acknowledge that the Hippocratic Oath dates back at least to the fourth century b.c. and marks the moment when”thanks to Hippocrates’ influence on his many students and apprentices”medicine separated itself from magic and pledged itself to preserving life. “I will give no one a deadly medicine, nor counsel any such thing,” the Oath declares; “I will not give a woman a pessary to induce abortion.” The anthropologist Margaret Mead observed, “Throughout the primitive world, the doctor and the sorcerer tended to be the same person . . . . With the Greeks the distinction was made clear. One profession . . . [was] to be dedicated completely to life under all circumstances, regardless of rank, age, or intellect”the life of a slave, the life of the Emperor, the life of a foreign man, the life of a defective child.”

The Hippocratic Oath, administered in its modern translations to nearly all medical school graduates since the ancient Greeks, has virtually disappeared from medicine in the late twentieth century. After the Russian Revolution, the Soviet government replaced the Oath with a mandatory pledge “to conduct all my actions according to the principles of Communist morality.” The shocking disclosures at the Nuremberg trials of Nazi doctors for “crimes against humanity” brought a temporary reversion. The 1949 Medical Declaration of Geneva added to the Hippocratic Oath the explicit line, “I will maintain the utmost respect for human life from the time of its conception.” At almost the same time, protocols were established at a conference in Helsinki for assuring informed consent regarding medication and nontherapeutic experimentation.

But the decline and modification of the Oath continued, and when the Supreme Court asserted the right to doctor-performed abortion in 1973, the members of the medical profession by and large refused to declare abortion a violation of the ethical ideal asserted in the Hippocratic Oath they had all taken. With the widespread notion that the Supreme Court had settled for doctors the issue of abortion, fewer and fewer medical schools administered either the Oath or its occasional substitute, the Prayer of Maimonides. By 1977, only 6 percent of American medical schools offered the unmodified oath.

As the evil wrought by abortion and its logical corollary of euthanasia becomes ever more apparent, there are some hopeful signs of ethical resurgence. With the collapse of communism, the Russian government has rejected the Soviet Oath and demanded from its doctors a pledge “to revise the moral foundations of Russian physicians” and promote “the restoration of the priority of universal moral principles.” The physician who heads the ethics section of the British Medical Association has recently called for restoration of the ancient Hippocratic Oath.

Little agreement has been reached, however, about what such an oath would entail. At least twenty-five proposed substitutes have been published in the United States, none of which have managed either to be faithful to the original Oath or to find wide acceptance. One proposed oath, by Dr. Louis Weinstein, somehow asserts that “I shall always have the highest respect for human life” and yet also that the termination of life in certain, unspecified circumstances can be “an act of charity.” The oath proposed by Dr. Louis Lasagna, Dean of Tufts University Medical School, proclaims, “If it is given to me to save a life, all thanks. But it may also be within my power to take a life.”

Reflecting on the disordered state of medical oaths in the era of abortion, the Value of Life Committee in early 1995 sent a letter of inquiry to a group of prominent scholars and physicians, including distinguished authors of texts on medical ethics. Collating the suggestions received and presenting them as far as possible in the language of the original Oath (360 words in the original; 410 in the restatement), the Committee arrived at a consensus, publishing its proposed “1995 Restatement of the Oath of Hippocrates” in April 1995. [See opposite page-Eds.] To date more than five thousand copies have been distributed to medical ethicists, practicing physicians, and medical students.

Almost at the same time as the “Restatement” was published, Pope John Paul II issued the encyclical Evangelium Vitae , which summons health care professionals “to be guardians and servants of life, . . . something already recognized by the still relevant Hippocratic Oath.” The widest possible adoption of a medical oath that recognizes the sacredness of human life”and recognizes the necessity to preserve doctors from becoming society’s paid killers”stands as one of the best and surest ways the medical profession can combat the culture of death.

Joseph R. Stanton, M.D. , one of the founding members of the pro-life movement in the United States, is a retired physician living in Needham, Mass.

E. Joanne Angelo, M.D. , is a practicing psychiatrist, an Assistant Clinical Professor of Psychiatry at Tufts University School of Medicine in Boston, Mass., and a member of Women Affirming Life, a Catholic pro-life organization.

Marianne Rea-Luthin, M.Ed. , is President of the Value of Life Committee in Brighton, Mass., and is also a member of Women Affirming Life.

Framable copies of the Oath are available upon request from the Value of Life Committee, Inc., P.O. Box 35279, Brighton, Mass. 02135.

I SWEAR in the presence of the Almighty and before my family, my teachers, and my peers that according to my ability and judgment I will keep this Oath and Stipulation: TO RECKON all who have taught me this art equally dear to me as my parents and in the same spirit and dedication to impart a knowledge of the art of medicine to others. I will continue with diligence to keep abreast of advances in medicine. I will treat without exception all who seek my ministrations, so long as the treatment of others is not compromised thereby, and I will seek the counsel of particularly skilled physicians where indicated for the benefit of my patient. I WILL FOLLOW that method of treatment which according to my ability and judgment I consider for the benefit of my patient and abstain from whatever is harmful or mischievous. I will neither prescribe nor administer a lethal dose of medicine to any patient even if asked nor counsel any such thing nor perform act or omission with direct intent deliberately to end a human life. I will maintain the utmost respect for every human life from fertilization to natural death and reject abortion that deliberately takes a unique human life. WITH PURITY, HOLINESS, AND BENEFICENCE I will pass my life and practice my art. Except for the prudent correction of an imminent danger, I will neither treat any patient nor carry out any research on any human being without the valid informed consent of the subject or the appropriate legal protector thereof, understanding that research must have as its purpose the furtherance of the health of that individual. Into whatever patient setting I enter, I will go for the benefit of the sick and will abstain from every voluntary act of mischief or corruption and further from the seduction of any patient. WHATEVER IN CONNECTION with my professional practice or not in connection with it I may see or hear in the lives of my patients which ought not be spoken abroad I will not divulge, reckoning that all such should be kept secret. WHILE I CONTINUE to keep this Oath unviolated may it be granted to me to enjoy life and the practice of the art and science of medicine with the blessing of the Almighty and respected by my peers and society, but should I trespass and violate this Oath, may the reverse be my lot.

E. Joanne Angelo, M.D. Boston, Mass.

Henry G. Armitage, M.D., F.A.C.S. North Andover, Mass.

Anne E. Bannon, M.D. St. Louis, Missouri

Prof. Rabbi J. David Bleich, Ph.D. Cardozo Law School New York, N.Y.

Prof. Harold O.J. Brown, Ph.D. Trinity Evangelical Divinity School Deerfield, Illinois

Matthew Bulfin, M.D., F.A.C.O.G. Lauderdale by the Sea, Florida

Paul A. Byrne, M.D. Sylvania, Ohio

William Colliton, M.D., F.A.C.O.G. Washington, D.C.

Prof. John Jefferson Davis, Ph.D. Gordon-Conwell Seminary South Hamilton, Mass.

Prof. Patrick Derr, Ph.D. Clark University Worcester, Mass.

Eugene Diamond, M.D., F.A.A.P. Chicago, Illinois

Mark Druffner, M.D. Minneapolis, Minn.

Prof. Arthur J. Dyck Cambridge, Mass.

Richard Fenigsen, M.D. Cambridge, Mass.

Albert E. Gunn, M.D. Houston, Texas

Curt Harris, M.D., J.D. Oklahoma City, Oklahoma

Gloria V. Heffernan, M.D. Fort Lauderdale, Florida

Helen Jackson, M.D., F.A.C.O.G. Boston, Mass.

Prof. C. Ward Kischer, Ph.D. Tucson, Arizona

C. Everett Koop, M.D. Bethesda, Maryland

Micheline Mathews-Roth, M.D. Boston, Mass.

Prof. William May, Ph.D. John Paul II Institute Washington, D.C.

Assoc. Prof. Ralph Miech, M.D., Ph.D. Providence, R.I.

Gertrude H. Murphy, M.D., F.A.A.P. Weymouth, Mass.

Prof. J. Robert Nelson Houston, Texas

Samuel Nigro, M.D. Cleveland Heights, Ohio

Robert Nixon, M.D., F.A.C.P. Pittsboro, N.C.

Prof. Edmund Pellegrino, M.D. Georgetown University Washington, D.C.

Francis Rockett, M.D., F.A.C.S. Newton, Mass.

Msgr. William Smith, S.T.D. Dunwoodie, N.Y.

Joseph R. Stanton, M.D., F.A.C.P. Needham, Mass.

Leonie S. Watson, M.D. Evans, Georgia

Richard A. Watson, M.D. Evans, Georgia

John J. C. Wilke, M.D. Cincinnati, Ohio

Prof. George H. Williams Cambridge, Mass.

Institutional designations for identification purposes only. Copyright Value of Life Committee, Inc.