Hippocrates Code Of Ethics

Galen Hippocrates, often referred to as Hippocrates, is considered by many sources the “Father of Western Medicine.” He was from the Aegean island of Kos (Kerferd G.B, 1976). According to several sources Hippocrates was born around 450 to 470 B.C. and his death is claimed by many sources to be around 370 to 377 B.C., but some references place his death in 387 B.C.
He was also named Hippocrates of Kos, as he was from the Aegean island of Kos.
Hippocrates is considered by some sources to be the Father of Western Medicine and others just the Father of Medicine. He established a form of study of the human body with the emphasis on learning, documenting, and gaining a body of knowledge that would out live him (Kerferd G.B, 1976?). In doing this,
he established a school of medicine, and made the study and practice of medicine a profession. Physicians attended the Hippocratic School of Medicine and began to make discoveries of diseases and treatments. They shared their knowledge with other physicians and a body of knowledge began to be documented. The collection of his work is called the Hippocratic Corpus. The Corpus is very large, containing about 60 Volumes. It was written in about 19 writing styles and over large time span, with some additions being made after Hippocrates’ death. These facts lead to the belief that the Corpus was written by many of Hippocrates’ fellow physicians, or possibly students.
Portions of the Hippocratic Corpus have been found translated in Arabic, Hebrew, Siraic, and Latin, which is a testament of the effectiveness of Hippocrates’ and his followers’ methods and his discoveries.
While the Hippocratic Corpus made and enormous contribution to mankind and Hippocrates’ school of medicine taught physicians how to cure and document the cures, Hippocrates is more widely known for establishing a code of ethics.
The code of ethics created by Hippocrates has been elevated to an Oath that physicians still pledge to upon beginning their practice of medicine.
The code is still recognized as the proper way in which physicians should conduct themselves with their patients. The applications of various aspects of the Oath, translated from the original Greek, are still recognizable in our modern medical community after 2500 years. We will now look at the Hippocratic Oath by sections and discuss its implications to medicine.
The first section, or paragraph, is an introduction that establishes it as an Oath, enforceable by the current deities, (Apollo, Aesculapius, Hygena, and Panacea, and all the gods and goddessess). In today’s medicine, physicians ‘swear to God’ (source).
The second paragraph says that physicians are to give honor to his teacher and treat his teachers’ children as his own family. This appears to be Hippocrates round-about way of addressing “Professional Courtesy,” which is defined as one professional providing a service for another without charge or expectation of any direct repayment (source).
The third section discusses that physicians should first “Do no harm” (source). This may be the most famous, most direct, and most well known section of the Hippocratic oath. The section also discusses ordering the best diet for the patient that will render a recovery, which hints at Hippocrates belief in health and fitness for
health.
The fourth paragraph states that physicians are not to be entreated to allow harm to come to any human. This sections deals directly with ethics pertaining to life, and poisoning is mentioned specifically. Hippocrates goes on to specifically mention an infant in a mother’s womb. Doctors are routinely involved in declaration of death due to capital punishment. Occasionally a doctor must become part of the execution team by inserting an IV in a particularly hard to reach vein. This participation, as well as performing abortions or assisted suicide, has been challenged as a violation of the Hippocratic Oath.
Next, the physician is entreated to use his knowledge in a godly manner. This is a catch all to include potential illicit behaviors that Hippocrates had not thought of. While the physician at that time was thought of as only the men who dealt directly with the patient, the greater realm of medical science today could include people who work in pharmacies and even drug manufactures. Although these people are not under the Hippocratic Oath, manufacturing of addicting recreational drugs may fall under this section of the oath.
The sixth section refers to not “cutting the stone” refers to removal of kidney stones by surgery. Even today, surgical removal of kidney stones is a risky operation. For an average general physician to cut into a patient would have, more likely than not, led to an unsuccessful outcome. In more general terms, the purpose of this part of the oath is to keep physicians from operating outside of their areas of expertise.
The seventh paragraph, discusses making a house call, “for the convenience and advantage of the patient”. The physician is to refrain from acts of an “amorous nature”, no matter the social or economic standing of the patient. In this section, Hippocrates recognizes, possibly by experience, the vulnerable emotional and physical state of patients and the probably superior state of the doctor in social standing.
The eighth section pertains to doctor - patient confidentiality.
This has been expanded and codified in recent years to become the Health Insurance Portability and Accountability Act (HIPAA), which carries legal punishment for violators. Prior to the Act, a patient could be wronged in a number of ways by unwitting medical professional sharing patient information with a third party. The emphasis of the law is that unauthorized information could later be used against the patient to prevent him or her from obtaining health insurance.
The ninth and last section is a promise of a blessing for holding true the Oath or a curse for failing to keep it.
Hippocrates lived in a time of war; of Greek and Roman conquest. It was a time of idol worship and superstition. Hippocrates is credited with being one of the first learned men to believe that diseases were caused naturally, and not as the cause of superstition or of gods. He argued that disease were caused by environmental factors, such as air, water, temperature, food, and other living habits.
Hippocrates’ had a theory of causation of disease which involved ‘four humors’. These causations were based on observations of sick people. They included liquids that he had seen emanating from the body: Black Bile, Yellow Bile, Phlegm, and Blood. Hippocrates hypothesized that the humors needed to be in balance in a persons’ body. When they were out of balance, the person got
sick.