Although we may not think of our day to day work as loaded with ethical dilemmas, medical ethics is at play in every healthcare setting: patients slip through the cracks; systems fail; individuals make mistakes; we fail to understand pt. wishes; we provide treatments, even when the client is not benefiting.
I've felt my moral compass tested at work, and I've tried to coach myself with the most basic healthcare maxim "first do no harm." When this Hippocratic sentiment has felt inadequate, I've thought- "I should look up the entire Hippocratic Oath to see if it offers any more guidance!" I finally got around to pulling it up today and found that it was not the straight-forward guide I was expecting.
Composed in the late 5th century BC, the oath is surprisingly relevant and surprisingly out-dated. It addresses abortion, euthanasia, privacy, and the importance of diet. But, it also commands a familial relation with health care instructors and seems to set the moral bar surprising low by swearing to remain free from sexual relations with patients and families.
Read it for yourself below. If nothing else it is a good reminder that ethics has intertwined with healthcare for the past 1700 years.
I swear by 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 no one else.
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.
I will neither give a deadly drug to anybody who asked for it, nor will I make a suggestion to this effect. Similarly I will not give to a woman an abortive remedy. In purity and holiness I will guard my life and my art.
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.
Whatever houses I may visit, I will come for the benefit of the sick, remaining free of all intentional injustice, of all mischief and in particular of sexual relations with both female and male persons, be they free or slaves.
What I may see or hear in the course of the treatment or even outside of the treatment in regard to the life of men, which on no account one must spread abroad, I will keep to myself, holding such things shameful to be spoken about.
If I fulfill this oath and do not violate it, may it be granted to me to enjoy life and art, being honored with fame among all men for all time to come; if I transgress it and swear falsely, may the opposite of all this be my lot.
—Translation from the Greek by Ludwig Edelstein. From The Hippocratic Oath: Text, Translation, and Interpretation, by Ludwig Edelstein. Baltimore: Johns Hopkins Press, 1943.