Use of the Hippocratic or other professional oaths in UK medical schools in 2017: practice, perception of benefit and principlism

Green, Ben

doi:10.1186/s13104-017-3114-7

Cited by 15 publications

(11 citation statements)

References 13 publications

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“…I en undersøkelse, utført av Association of American Medical Colleges 120 år senere, fant man at bare 19 % av skolene brukte eden (5). Selv om bruken økte etter -eller snarere på grunn avden annen verdenskrig, var det sjelden den originale hippokratiske eden som ble brukt (6,7). Den originale versjonen brukes ikke ved de norske universitetene, og i en undersøkelse fra Storbritannia i 2017 var det ingen av skolene som brukte den (7).…”

Section: Historisk Kontekstunclassified

Står legeeden i veien for dødshjelp?

Blomkvist¹,

Zadig²

2018

Tidsskriftet

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er lege i spesialisering 1 ved Sykehuset Østfold. Forfatter har fylt ut ICMJE-skjemaet og oppgir ingen interessekonflikter. PIA ZADIGPia Zadig (f. 1988) er doktorgradsstipendiat og lege i spesialisering i radiologi ved Universitetssykehuset Nord-Norge. Forfatter har fylt ut ICMJE-skjemaet og oppgir ingen interessekonflikter.Det finnes gode argumenter på begge sider av dødshjelpdebatten, men det blir misvisende og for lettvint å bruke den gamle hippokratiske eden som grunnlag for en avvisning av dødshjelp.I dødshjelpdebatten blir legeeden ofte presentert som en yrkesfaglig plikt til å vaere motstander av dødshjelp. I 2012 uttale davaerende leder for Rådet for legeetikk, Trond Markestad, at dødshjelp er «i strid med den gamle hippokratiske ed» og dermed med legeetikken (1). Leder og nestleder konstaterte noen år senere at den «hippokratiske legeed forplikter legen til å ikke gi aktiv dødshjelp» (2). På spørsmål om dødshjelp burde innføres i Norge, svarte lederen for Rådet i 2015, Svein Aarseth, at «legeetikken [har] vaert helt klar siden Hippokrates' tid -og det var jo fire hundre år før Kristus -at vi skal hjelpe, lindre, trøste og behandle, men aldri skade» (3). Historisk kontekstDen første dokumenterte bruken av den hippokratiske eden var i 1508, men den ble ikke brukt seremonielt før i 1804, da den ble innlemmet i Montpellier, Frankrike (4). I en undersøkelse, utført av Association of American Medical Colleges 120 år senere, fant man at bare 19 % av skolene brukte eden (5). Selv om bruken økte etter -eller snarere på grunn avden annen verdenskrig, var det sjelden den originale hippokratiske eden som ble brukt (6, 7). Den originale versjonen brukes ikke ved de norske universitetene, og i en undersøkelse fra Storbritannia i 2017 var det ingen av skolene som brukte den (7).Og det er ikke så rart. Den originale versjonen starter med at legene sverger troskap til Apollon, Asklepios, Hygieia, Panakeia og alle andre guder og gudinner, før eden så plikter legen til å aere sine laeremestere som egne foreldre, «gi ham del i mine midler» og «regne hans avkom som mine egne brødre» (8). Deretter finner vi nokså eksplisitt at «jeg skal ikke gi noe dødelig legemiddel til noen eller gi råd om noe slikt», men også «på samme måte skal jeg heller ikke gi noen kvinne fosterdrivende middel» og «jeg skal ikke operere, ikke engang dem som lider av stein, men overlate det til dem som utfører slike handlinger» (8).En normativ lesning, uten historisk kontekst, ville tilsi at leger -utover at de sverger troskap til gresk mytologi og hedrer sine laerere som egne foreldre -bør avstå fra dødshjelp, abort og operasjoner. Istedenfor å hevde at legeetikken forplikter kirurger til enten ikke å operere eller å slutte å kalle seg leger, er de fleste enige om at eden må tolkes i sin historiske

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Section: Historisk Kontekstunclassified

Står legeeden i veien for dødshjelp?

Blomkvist¹,

Zadig²

2018

Tidsskriftet

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“…However, for medical organizations, the situation is becoming increasingly complicated in this genomic era. Oaths of conduct and ethics are taken by healthcare professionals all over the world (Crawshaw, 1994;Green, 2017;Hulkower, 2016), many of which are based on the Hippocratic oath of the 3rd century CE (Loudon, 1994). The following statements are included in the modern Hippocratic oath: "I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know, " and "I will prevent disease whenever I can, for prevention is preferable to cure.…”

Section: Availability Of Health-related Genetic Information To Blood mentioning

confidence: 99%

To Tell or Not to Tell: The Ethics and Law of Disclosing Health-Related Genetic Information to Family Members

Chapman¹,

Devereux²,

Nanau³

et al. 2018

Psych. Rus.

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Background. Genetic conditions and susceptibilities differ from other diseases and health-related risks. Genetic information is shared between blood relatives, and therefore a genetic finding can have implications for the wider family. Objective. The present study investigates people's views on issues related to disclosing genetic information to relatives. Specifically, the study assesses opinions in relation to two issues: 1) whether people have a moral obligation to share their genetic data with family members; and 2) whether healthcare providers should have a legal obligation to share such data when consent is withheld. Design. A public engagement event was held based on the real-life court case of ABC vs the UK National Health Service (NHS). Participants were provided with information in three phases: first, about the case; then, with progressively more details of the case; and finally, with other relevant information. After being given each portion of information, the participants were asked to disclose their views on the rights and responsibilities related to the sharing of this information. Results. The results clearly demonstrate that people hold strong and polarized views regarding confidentiality, and the moral and legal duties to disclose genetic information to family members. Even when withholding information could have an adverse impact on the health and life choices of relatives, participants disagreed about the legal obligations for healthcare providers to disclose a person's genetic information to those relatives. Conclusion. The results suggest that the issues of privacy and disclosure of genetic information are complex and divisive.

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“…Over time, these pledges have been updated to account for evolving societal norms, expectations, and challenges, 3 and many students and health education institutions use adaptations of the original oath. 4 , 5 The public commitment to take responsibility for other people's lives and health at the transition from student to professional is an act of great personal and professional significance. 4 …”

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confidence: 99%

A pledge for planetary health to unite health professionals in the Anthropocene

et al. 2020

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In 1948, the Declaration of Geneva 1 was passed as one of the first official acts of the World Medical Association. The Declaration updated the ancient Hippocratic oath and defined ethical principles applicable to the medical profession worldwide. 2 Other health professions have similar pledges and oaths that guide their practice, generally based on the four bioethical principles of justice, autonomy, non-maleficence, and beneficence. Over time, these pledges have been updated to account for evolving societal norms, expectations, and challenges, 3 and many students and health education institutions use adaptations of the original oath. 4,5 A pledge for planetary health to unite health professionals in the Anthropocene national and international levels for predicting future disease outbreaks and pandemics, analogous to the US National Weather Service and the European Centre for Medium Range Weather Forecasts, which use extensive data from multiple sensors and supercomputing. So far during the COVID-19 pandemic in the USA, there has been inadequate central coordination and command in public health surveillance, response, and innovation. Although ACTIV and RADx have been established, it is unclear how such efforts work together. Further more, there are challenges for the coordinated implementation of innovations. A lack of coordination between US state and local public health departments, for example, led to difficulties in delivery of contact tracing programmes. 16 Globally, there is inadequate financing to sustain a coordinated strategy for COVID-19 innovations. The ACT-Accelerator, for example, brings together governments, health organisations, scientists, businesses, civil society, and foundations to accelerate development, ensure equitable allocation, and scale up delivery of new COVID-19 tools. But the ACT-Accelerator is principally dependent on funding from donor countries and foundations, which is an insufficient and unsustainable way to finance a global public good. The ACT-Accelerator will require long-term, predictable, and sustained financing based on global solidarity. Innovation to tackle COVID-19 must be centred within strategy, command, coordination, and sustainable financing. VJD served previously as a member of the Board of Medtronic Inc, ending in June, 2014, and received deferred compensation until 2018, unrelated to the topic of this Comment. CB declares no competing interests.

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Use of the Hippocratic or other professional oaths in UK medical schools in 2017: practice, perception of benefit and principlism

Cited by 15 publications

References 13 publications

Står legeeden i veien for dødshjelp?

Står legeeden i veien for dødshjelp?

To Tell or Not to Tell: The Ethics and Law of Disclosing Health-Related Genetic Information to Family Members

A pledge for planetary health to unite health professionals in the Anthropocene

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