About a month ago I had the privilege of speaking to a group of health professionals that were in the final stages of study for their PhD. It had been a few years since I had done such a task, so I reviewed the material I felt was the epitome of the chiropractic profession, and also brushed up on some of my medical terminology for good measure.
Shortly after reading the 33 Principles of Chiropractic by Stephenson, I was jolted with a thought that I couldn’t let go of. The Hippocratic Oath.
With the exception of the saying the oath upon my 2001 graduation from Life Chiropractic College West, the closest thought in my mind was, “first, do no harm.”, which most people use to paraphrase the lengthy pledge.
So after reviewing the majority of the chiropractic material I wanted to cover I decided to review the Hippocratic Oath in detail so I could include it in my upcoming presentation.
First, do no harm.
This, of course, was the first phrase I tried to find. Guess what? It’s not in there. This phrase is not found in the classic version, nor is it found in the modern version that was written in 1964.
Now it does make reference to doing the best for a patient in some roundabout ways, but this phrase is simply attributed to Hippocrates. After reading both versions I can see how “First, do no harm.” may suffice for some people, but in my opinion, it ends up skirting the most important points of the oath.
After doing more research about the oath, including reading some responses about the oath by M.D.’s via the PBS’s the Doctor Diaries, I would like to break down the classic version of the Oath with my own commentary found below.
Apollo Physician and Asclepius and Hygieia and Panaceia and all the gods and goddesses, making them my witnesses, that I will fulfill according to my ability and judgment this oath and this covenant:
To hold him who has taught me this art as equal to my parents and to live my life in partnership with him, and if he is in need of money to give him a share of mine, and to regard his offspring as equal to my brothers in male lineage and to teach them this art – if they desire to learn it – without fee and covenant; to give a share of precepts and oral instruction and all the other learning to my sons and to the sons of him who has instructed me and to pupils who have signed the covenant and have taken an oath according to the medical law, but to no one else.
While the concept of pledging to Greek Gods might be hard to swallow nowadays, the first paragraph simply states how serious of an oath you are about to take. Similar to swearing on a bible in a court of law, this was the old school way of handling things. They updated this for the modern version of the oath, but the changed words serve the same purpose.
The second paragraph is a fascinating one. It speaks of the brotherhood of doctors and the importance of passing on knowledge to one another for the betterment of themselves and the profession. I cannot speak for all doctors, chiropractors or otherwise, but in my experience doctor’s do a wonderful job sharing their knowledge and skill set with peers through both instruction and published literature.
However, I doubt any M.D., D.O., or D.C. would agree that this knowledge has been without fee. The entire health profession has ignored this en masse, and I am reminded of it every time I read about skyrocketing debts of students in the field of chiropractic, medicine, and other areas of health care. Not to mention the ever increasing campuses of our local medical schools and hospitals.
I will apply dietetic measures for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice.
When was the last time you entered your M.D.’s office and the first thing they recommended was a diet change? In my personal experience, and from the feedback I hear from friends, family, and patients, diet change is not a treatment option that is available.
I want to clarify that I have heard sound diet and nutritional advice from medical doctors, but it is typically from friends who are M.D.’s. I have had many discussions about the importance of diet, but it is usually in reference to weight loss or diabetes, not as a form of treatment to prevent or cure disease.
This phrase has been modified in the modern version, and many of the reasons include that the strides in scientific methods and treatment far outweigh anything a change in diet could do.
I am not sure if this is always the case, especially since most American diets are so off base for such a long period of time.
I will neither give a deadly drug to anybody if asked for it, nor will I make a suggestion to this effect.
With the amount of prescription drugs ads and commercials we are regularly bombarded with, you can be assured this was modified or removed in the modern version of the oath.
What drug does no harm? Which drug isn’t deadly via it’s potential side effects? I understand the cost benefit ratio that doctors must utilize to determine whether a drug should be given, but if you look at how profit-driven modern medicine is practiced, this is the last thing on many people’s minds. I do not want to point the finger solely at physicians, as many as highly intelligent people doing the absolute best they can. However, the model is based on profit, and supported by billions from drug manufacturers.
Evidence tells me this part of the oath hasn’t been taken seriously in a very long time.
I will not use the knife, not even on sufferers from stone, but will withdraw in favor of such men as are engaged in this work.
I have read that this has no relevance as barbers used to be the experts who performed surgery by doing the cutting. My opinion is that it simply means to refer to the person or profession that knows best.
A family practice physician referring a patient to a surgeon would be a modern example. A dentist referring someone to an endodontist. A back surgeon referring a patient to a chiropractor. You get my drift. Refer the patient to most qualified professional that can help them get well in the safest way possible.
In my research one I was lucky to have found a physician who succinctly addressed his current issue with today’s medical students and modern practice:
I therefore contend that any attempt to eliminate an appropriate version of the Hippocratic Oath upon graduation from medical school by our younger colleagues reflects a self-centered, misguided, and ill-advised attempt to test their reality of current medical practice. This personal attitude is in defiance of the time-tested, patient-oriented, and physician-managed practice of medicine. While this original philosophy dates back to the Greeks, it continues to provide a roadmap that maximizes patient/societal outcomes within our profession while limiting the individual benefit of payment, stature, and control of physicians upon healthcare delivery. The original Hippocratic Oath should become standard learning for patients and physicians alike. -R.E.B.
It was wonderful to read an honest perspective that doesn’t simply toe the line. In the next couple of months I will follow up with curious examples that go against this oath in hopes of educating the public on how far we are away from this important pledge.
I was surprised to find out through this statement that there are health professionals that believe the Hippocratic Oath is inappropriate in this day and age, or at the very least obsolete. It just might explain why we have so many health problems in this country.
Hopefully someone other than this Seattle chiropractor is thinking worried about it.