Rethinking medical oaths using the Physician Charter and ethical virtues

Abstract

Medical oaths in North America appear to be highly variable in content. Greater attention to resources like the Physician Charter can help improve the ethical content and consistency of oaths across different institutions, and throughout their education medical students should be encouraged to discuss and reflect on the principles and virtues they will profess when they graduate.

Context, culture and beyond: medical oaths in a globalising world

“…Being aware of those values has become even more important now as medical educators start to recognise the importance of professional identity formation as a dominant goal of medical education 1. We therefore commend Greiner and Kaldjian for their paper reporting a content analysis of medical oaths taken in the USA and Canada,2 published in this issue of Medical Education . However, we do ask ourselves why the authors2 restricted their study to North America, and how we should interpret the observed plurality of medical oaths.…”

“…We therefore commend Greiner and Kaldjian for their paper reporting a content analysis of medical oaths taken in the USA and Canada,2 published in this issue of Medical Education . However, we do ask ourselves why the authors2 restricted their study to North America, and how we should interpret the observed plurality of medical oaths. In this commentary, we want to address three issues:…”

“…The prevalence of oath taking varies globally from a full 100% of medical students in the Netherlands and Brazil to, for instance, 50–70% in the UK4 and close to zero in many African countries 5. In addition, not only does the content of medical oaths vary considerably across medical schools in the USA and Canada, as Greiner and Kaldjian2 describe, but it also does so within other countries and around the world 6…”

“…To meet the demands of a changing society, the Declaration of Geneva has been amended or revised several times, with a last revision in 2017. As the oath is a symbol representing the social contract of physicians with society, we feel concerned about the development of new oaths that are based solely on local or individual needs, as described by Greiner and Kaldjian 2. We do realise that the oath needs to reflect ongoing societal developments; for instance in the Netherlands, the reference to protecting life has been altered following changes in legislation with regard to abortion and euthanasia 1.…”

“…Therefore, we would like to advocate for the introduction of standard companion pieces: when a highly context‐specific paper such as that by Greiner and Kaldjian2 is published, we hope that journals such as Medical Education will continue to invite medical educators from different parts of the world to write commentaries or companion papers on the same topic from different perspectives in order to open up the dominant Western gaze in search of context.…”