This spring, nearly 20,000 medical students will graduate from medical schools across the country and will probably be asked to raise their hands for a new kind of Hippocratic Oath that now emphasizes a patient's right to choose their own destiny.
The Hippocratic oath is a 2500-year-old promise that doctors outline the professional duties and ethical principles that make the profession sacred. The first modern version of the Hippocratic oath was adopted in 1948. Published in November by the World Medical Association in Chicago, it took two years to complete and is the first major update to the ancient text. A new name has also been proposed: "The promise of the doctor".
In an article by the American Medical Association, Dr. Ramin Walter Parsa-Parsi, chair of the Working Group of the Geneva Working Group of the World Medical Association, said the changes "will enable this key document to address the challenges and needs of the modern medical profession."
Of course, patients were at the forefront of all versions of the historical document, but now there is a memory to prioritize a patient's autonomy. It's hard to limit a complex medical ethics concept such as "patient autonomy" to one definition, but Google's top hit does a great job: "The right of patients to make decisions about their medical care without their doctor influencing the patient." Treatment must take decision. "
Practically and emotionally it's not always easy to disagree with a patient's wishes, but I've learned a lot about becoming a doctor by asking patients what they want next. I still have patients who ask me to choose the best, but even in those cases, we always end up deciding together.
Another interesting change to the pledge is a renewed appeal to physicians to take care of each other in the vast "House of Medicine," which sometimes can stress relationships like any other profession. The first version of the 1948 oath asked a doctor to "behave towards his colleagues as if he were behaving towards him." Nobody ever gets rid of the fact that doctors called it men, but the language reflects what medicine looked like in the 1950s. According to the Association of American Medical Colleges, only 6 percent of physicians in 1950 were women. But today there are as many female medical students as male medical students at American medical schools.
In 2006, the line about colleagues was changed to "My colleagues will be my sisters and brothers." And in 2017, there was a renewed call to treat each other well: "I will give my teachers, peers and students the respect and gratitude they deserve."
On this day of national physicians, I thank Drs. Timothy Johnson, one of my mentors and one of the first physicians to receive the "America's Doctor" award as former editor-in-chief of ABC News. And with this new Hippocratic oath I am today with Dr. med. Tim checked in, the doctor who took me under his wing to start my career as a journalist a decade ago. He said, "I think the changes are spectacular – and long overdue – reflecting the dramatic changes in the relationship between physicians and patients that have taken place over the last few decades."
A happy national doctors day for physicians everywhere!
"The Physician's Pledge"
The Geneva Declaration of the World Medical Association, as of 2017
AS A MEMBER OF THE MEDICAL PROFESSION:
I PRAY ONLY to devote my life to serving humanity;
THE HEALTH AND THE WELL-BEING OF MY PATIENT will be my first consideration;
I REMEMBER the autonomy and dignity of my patient; I will not allow any consideration for age, illness or disability, creed, ethnicity, gender, nationality, political affiliation, race, sexual orientation, social status or any other factor intervene between my duty and my patient;
I will keep in mind the secrets entrusted to me even after the death of the patient;
I WILL practice my profession with conscience and dignity and in accordance with good medical practice;
I will promote the honor and the noble traditions of the medical profession;
I will give my teachers, colleagues, and students the respect and gratitude they deserve;
I will share my medical knowledge for the benefit of the patient and the advancement of the health care system;
I will join my own health, well-being and abilities to ensure the highest level of care;
I will NOT use my medical knowledge to violate human rights and civil rights, even under threat;
I MAKE THIS PREMISE solemn, free and to my credit.
Adopted by the 2nd General Assembly of the World Medical Association, Geneva, Switzerland, September 1948
and modified by the 22nd World Medical Convention, Sydney, Australia, August 1968
and the 35th World Medical Assembly, Venice, Italy, October 1983
and the 46th WMA General Assembly, Stockholm, Sweden, September 1994
and editorially revised by the 170th WMA Council meeting, Divonne-les-Bains, France, May 2005
and the 173rd WMA Council Meeting, Divonne-les-Bains, France, May 2006
and amended by the 68th WMA General Assembly, Chicago, USA, October 2017
Mark Abdelmalek is a medical associate at ABC News. He is board-certified by the American Board of Dermatology and a Mohs surgeon specializing in the treatment of skin cancer.