The Evolution of the Hippocratic Oath and Medical Ethics

The Doctor Weighs In
10 min readSep 22, 2019

By: Magdalyn Fiore

The oath that physicians take has changed a lot since the original 5th century BC Hippocratic Oath. What do these changes say about medical ethics today?

Photo Source: iStock

Do no harm” is the phrase people most associate with the Hippocratic Oath, but nowhere does the document say these exact words (“never do harm” is what it actually says [1]).

The Hippocratic Oath is the vow medical students take during their white coat ceremony at the beginning of medical training and again at graduation, proclaiming their commitment to medical ethics. The original oath has been modified multiple times in medicine’s history, but three versions are most commonly recited today. They are:

  • The original 5th-century-B.C. Oath of Hippocrates provided the first ethical guideline for physicians in ancient Greece.
  • The Declaration of Geneva was written in 1948 (amended numerous times, most recently in 2017) in response to the grotesquely inhumane treatment of individuals in Nazi Germany
  • The Modern Physician’s Oath is a 1964 revision by Dr. Louis Lasagna.

New versions of the Hippocratic Oath are increasingly vague

With each new version, however, the oath has grown increasingly vague to accommodate changing values within societies.

The 5th-century-B.C. oath proclaims, for example, “To please no one will I prescribe a deadly drug.” And later, “Nor will I give a woman a pessary to procure abortion.” These two issues are highly relevant in modern times. Physician-assisted suicide, over-prescription of opioids, and abortion are among other topics of debate and controversy today.

The first Declaration of Geneva kept the pledge to “maintain the utmost respect for human life from the time of conception.” However, there is no mention of physician-assisted suicide, euthanasia, or any deadly drug.

The closest the younger Lasagna oath comes to addressing these controversial topics is when it vaguely notes, “I tread with care in matters of life and death. If it is given to me to save a life, all thanks. But it may also be within my power to take a life.”

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