The Physician’s Honor
Even a man “born in pagan darkness,” John Henry Newman observed, “has within his breast a certain commanding dictate—not a mere sentiment, not a mere opinion, or impression, or view of things, but a law, an authoritative voice—bidding him to do certain things and avoid others.” One of the most impressive witnesses to the truth that conscience is the voice of God speaking within is the Oath ascribed to Hippocrates, the father of physicians.
A contemporary of Socrates, who drank the fatal hemlock in 399 B.C., Hippocrates was born to a clan of physicians said to have descended from the demi-god Asclepius, the fabled son of Apollo. The oath that bears his name calls upon those supposedly-divine forbears as witnesses and so is indeed a relic from the time of pagan darkness. It nevertheless embodied a decisively rational act.
Hippocrates was the first member of the Asclepiad clan to train non-family members in their medical practices. The Oath was a means of delineating the newly-emerging medical profession or guild from practitioners unworthy of the name physician. It was imperative that the distinction be reliably made. The knowledge and skill of the physician could even then be turned to harm, as the potion concocted to kill off the Athenian Gadfly instances. And the physician’s practices were not merely potent, they were also necessarily invasive in a deeply personal way, bringing the doctor into the sacred space of the home and giving him access to private information and to the very body of his patient.
The central provisions of the Oath hold the physician accountable for a character that is entirely trustworthy and for deeds beyond reproach:
Regimens I will use for the benefit of the sick according to my ability and judgment, but what is used for harm and injustice I will keep away from the sick. I will neither give a deadly drug to anyone, though having been asked, nor will I lead the way to such counsel; and, similarly, to a woman a destructive pessary I will not give. But purely and piously I will watch over my art. . . . Into as many houses as I enter, I will go in order to benefit the sick, being free from all voluntary injustice and corruption, especially sexual acts with the bodies of females and of males, of free and of slaves. About whatever in therapy I see or hear, or also outside of therapy concerning the life of men, that ought never to be spoken out, I will be silent, holding such things not to be spoken (translated by T. A. Cavanaugh).
To live and to practice in accord with these provisions is to be worthy of trust, which is the absolutely first requirement that any patient makes of his doctor.
Among the provisions of the Oath that would prevent the physician from harming his patient, prominent is the prohibition of administering deadly drugs and abortifacients. The clarity of Hippocrates’ conscience with respect to the sacredness of life is altogether arresting. In an important new study, Hippocrates’ Oath and Asclepius’ Snake: The Birth of the Medical Profession (Oxford, 2018), T. A. Cavanaugh insists on the essential relevance of these clauses to the practice of medicine today with this pressing and unanswerable question: “as a vulnerable patient one must trust one’s physician . . . yet, were medical practitioners on record as open to killing, upon what grounds could one base such confidence in one’s doctor not to kill?”
As our own generation wades out into the unknown waters of bioengineering, the Oath of the Hippocratic physician will only become more important, and perhaps could be amended to include an explicit promise to be measured by what nature affords, rather than according to some imagined standard of what might be considered healthier than healthy, or, worse, by whatever the patient or some third party may happen to request by way of intervention.
The Oath is also a document of extraordinary historical importance, for it is one of the earliest testimonies to the ideal of the disinterested pursuit of knowledge. Just as we would not trust a physician who was unwilling to guarantee that his highest ideal was the patient’s health, so also we should not trust a teacher of any kind unwilling to swear—to borrow terms from Aristotle—that he is a greater friend to the truth than to Plato.
A Roman physician of the first century once credited Hippocrates with having preserved the “honor of medicine with a holy and devoted heart.” The high ideal of his Oath—of living so that our deeds match our words, while our words conform to the being of things—remains the essential starting point for the quest for wisdom, happiness, and a clear conscience.
