Hippocratic oath

The Hippocratic Oath was the ethical foundation and guiding light for medical practice for roughly twenty-four centuries until the latter half of the 20th Century.
  • In ancient pagan times doctors had a dual role, they could heal and also kill.
  • The Oath, with its prohibition on performing abortion and euthanasia, conflicted with the legalisation of abortion.
  • "Semantic gymnastics" are necessary to rationalise abortion and euthanasia because while a new ethic is being accepted, the old one has not yet been rejected.
  • The acceptance of the attitude of "a life not worthy to be lived led to the Nazi euthanasia programme.
Until the 1970s, throughout 24 centuries newly graduated doctors took the solemn Hippocratic Oath.

This Oath was the ethical foundation and guiding light for medical practice.

Origins
In ancient pagan times doctors had a dual role, they could heal and also kill.

The earliest known medical guild was established, on the island of Cos in the Aegean Sea. While other physicians were seeking magic cures, Hippocrates began teaching that every disease had only natural causes.

It is for this reason Hippocrates is known as the "father of medicine."

The Greek doctor Hippocrates (460-377 BC) believed that the virtuous doctor must reject any role in killing, and be devoted to the arts of healing.

The inspirational noble standards of the Hippocratic Oath gained universal acceptance .

The Oath of Hippocrates

I swear by Apollo, the Physician, and Aesulapius and Health and All-Heal and All the Gods and Goddesses that, according to my ability and judgement, I will keep this Oath and Stipulation:

To reckon him who taught me this art equally dear to me as my parents, to share my substance with him and relieve his necessities if required:

To regard his offspring as on the same footing as my own brothers, and to teach them this art if they should wish to learn it without fee of stipulation, and that by precept lecture and every other mode of instruction.

I will impart knowledge of the Art to my own sons, and those of my teachers, and to disciples bound by a stipulation and oath, according to the law of medicine, but to none others.

I will follow that system of regimen which,according to my ability and judgment, I consider for the benefit of my patients, and abstain from whatever is deleterious and mischievous.

I will give no deadly medicine to any one if asked, nor suggest any such counsel; and in like manner I will not give to a woman a pessary to procure an abortion.

With purity and with holiness I will pass my life and practice my Art.

I will not cut persons laboring under the stone, but will leave this to be done by men who are practitioners of this work.

Into whatever houses I enter, I will go into them for the benefit of the sick, and will abstain from every voluntary act of mischief and corruption; and, further from the seduction of females or males, of freemen and slaves.

Whatever, in connection with my professional practice or not, in connection with it, I see or hear, in the life of men, which ought not to be spoken of abroad, I will not divulge, as 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, respected by all men, in all times! But should I trespass and violate this Oath, may the reverse be my lot!


Similar Oath
In the ancient world of Arabia, doctors took a similar oath: "I will not give my patients any poisonous drug, if they ask first, nor will I advise them thus, nor aid in a miscarriage."

How the Hippocratic Oath was allowed to atrophy
Throughout history in the western world, the Oath was the universal standard. There were always a minority of doctors prepared to perform abortions, but they operated on the outer boundaries of the medical profession.

The Enlightenment challenged the ascendancy of Christian moral absolutes. By the early 20th century, secular humanism was increasingly dominant. In the Soviet Union, the ideology of Marxist-Leninism introduced and sanctioned abortion on demand as social progress.

The Sexual Revolution of the 1960s effectively ensured the retreat of Christian values from the public domain. The 1967 British Abortion Act , allied with the emerging feminist movement, triggered the wave of legal abortion that would sweep through the western world over the next decade.

A crucial factor with the passing of the 1967 Abortion Act was the overnight conversion of the British medical establishment. Once the law was passed by Parliament , the establishment ended any opposition and accepted the new legal reality. Doctors who continued to oppose abortion found themselves a minority within the profession and facing peer disapproval within their practices.

The Hippocratic Oath with its prohibition on performing abortions, clearly conflicted with the new legal and ethical realities of medical practice. Medical schools chose to drop the Oath or administer a more ambiguous one that suited the new era.

The Oath and changes in medical ethics
Dr J.P.Wilkie, in "Why Can't We Love Them Both?" illustrated the change of policy in the American Medical Association's ethical leadership, with this editorial in the Journal of California State Medical Association, September 1970:

"The reverence of each and every human life has been a keystone of Western medicine, and is the ethic which has caused physicians to try to preserve, protect, repair, prolong and enhance every human life."

"Since the old ethic has not yet been fully displaced, it has been necessary to separate the idea of abortion from the idea of killing, which continues to be socially abhorrent. The result has been a curious avoidance of the scientific fact, which everyone knows, that human life begins at conception, and is continuous, whether intra-or extra-uterine, until death."

"The very considerable semantic gymnastics which are required to rationalise abortion as anything but taking a human life would be ludicrous if they were not often put forth under socially impeccable auspices. It is suggested that this schizophrenic sort of subterfuge is necessary because, while a new ethic is being accepted, the old one has not yet been rejected."

Semantic Gymnastics
History has shown that changing people's attitudes is much easier if verbal engineering precedes social engineering. When scientists want to do something the public abhors, they simply change the terminology. They either use a euphemism or use technical jargon that nobody really understands.

As an example of this, in September 2004, Leonard Zon, president of the International Society for Stem Cell Research (ISSCR) sent out a memo which stated:

"Nuclear transfer (NT) should be used instead of 'therapeutic cloning'. Cells created by nuclear transfer should be described as 'NT stem cells' or 'NTSC'. If an acronym is used for human embryonic stem cells, "HESC" should be used. If we use these terms consistently, the public, journals, newspapers and magazines will follow our lead and use adequate terminology. The negative connotation of the commercial term 'therapeutic cloning', make a change in terminology necessary..."
The practice of changing the meanings of words and phrases, in an effort to change the way the public views the issues of abortion and euthanasia, has added to the confusion.

Wesley J. Smith, an attorney for the International Task Force on Euthanasia and Assisted Suicide said:

"When "euthanasia" didn't rouse people to march in the streets demanding a right to be killed if they get cancer, activists began using the terms "deliverance" and, more recently, "physician-assisted suicide" to assure a wary public that they would only be dispatched upon request. But apparently these terms don't poll well, especially any term containing the word "suicide." So, activists dropped "assisted suicide," and replaced it with the currently favored euphemism, "aid in dying." 

The gradual change in Germany from the 1920s into World War II
Dr Leon Alexander, a psychiatrist at the Nuremberg War Crimes Trials, interviewed the Nazi doctors involved in euthanasia and medical experiments on prisoners. In 1949, he wrote on the lessons to be learned.

"The beginnings were at first a subtle shift in emphasis in the basic attitude of the physicians. It started with the acceptance of the attitude, basic in the euthanasia movement, that there is such a thing as a life not worthy to be lived."

"This attitude in its early stages concerned itself merely with the severely and chronically sick. Gradually the sphere of those to be included in this category was enlarged to encompass the socially unproductive, the ideologically unwanted, the racially unwanted, and finally all non-Germans. But it is important to realize that the infinitely small wedged-in lever from which this entire trend of mind received its impetus was the attitude towards the non-rehabilitable sick."

(L. Alexander, "Medical Science Under Dictatorship", New England Journal of Medicine, Vol 241, July 14th, 1949)