Editing Hippocratic Oath (section)

==Context and interpretation==
[[File:Hippocrates.jpg|thumb|The Greek physician [[Hippocrates]] (460–370 BC), to whom the oath is traditionally attributed, though most modern scholars challenge that attribution.]]
The oath is arguably the best known text of the [[Hippocratic Corpus]], although most modern scholars do not attribute it to Hippocrates himself, estimating it to have been written in the fourth or fifth century BCE.<ref>{{cite book|last1=Jouanna|first1=Jacques|title=Hippocrates|date=2001|publisher=Johns Hopkins University Press|location=Baltimore, Md.|isbn=978-0-8018-6818-4|url-access=registration|url=https://archive.org/details/hippocrates0000joua}}</ref> Its general ethical principles are also found in other works of the Corpus: the work entitled ''Physician'' mentions the obligation to keep the "holy things" of medicine within the medical community (i.e. not to divulge secrets); it also mentions the special position of the doctor with regard to his patients, especially women and girls.<ref>{{cite book|editor-last=Potter|editor-first=Paul|title=Hippocrates|date=1995|publisher=Harvard Univ. Press u.a.|location=Cambridge, Massachusetts|isbn=978-0-674-99531-4|pages=[https://archive.org/details/hippocrates01hipp_0/page/295 295–315]|edition=Reprint|url=https://archive.org/details/hippocrates01hipp_0/page/295}}</ref> In antiquity, the punishment for breaking the Hippocratic oath could range from a penalty to losing the right to practice medicine.<ref>{{cite book|last=Nutton|first=Vivian|title=Ancient Medicine|year=2004|publisher=Routledge|location=New York, NY}}</ref> However, several aspects of the oath contradict patterns of practice established elsewhere in the Corpus. Most notable is its ban on the use of the knife, even for small procedures such as [[lithotomy]], even though other works in the Corpus provide guidance on performing surgical procedures.<ref>{{cite book|last1=Nutton|first1=Vivian|title=Ancient medicine|date=2012|publisher=Routledge|location=Milton Park, Abingdon, Oxon|isbn=978-0-415-52095-9|page=68|edition=2nd}}</ref>

=== Euthanasia ===
Providing poisonous drugs would certainly have been viewed as immoral by contemporary physicians if it resulted in murder. However, the absolute ban described in the oath also forbids [[euthanasia]]. Several accounts of ancient physicians willingly [[Assisted suicide|assisting suicides]] have survived.<ref>{{cite book|last1=Edelstein|first1=Ludwig|title=Ancient Medicine: Selected Papers of Ludwig Edelstein|date=1967|publisher=Johns Hopkins Press|location=Baltimore, Md.|isbn=978-0-8018-0183-9|pages=9–15}}</ref> Multiple explanations for the prohibition of euthanasia in the oath have been proposed: it is possible that not all physicians swore the oath, or that the oath was seeking to prevent widely held concerns that physicians could be employed as political assassins.<ref name="swear by">{{cite journal|last1=Markel|first1=Howard|title="I Swear by Apollo" – On Taking the Hippocratic Oath|url=http://www.praxis-hegibach.ch/downloads-10/downloads-13/files/the%20hippocratic%20oath.pdf|journal=The New England Journal of Medicine|year=2004|volume=350|issue=20|pages=2026–2029|publisher=Massachusetts Medical Society|doi=10.1056/NEJMp048092|pmid=15141039|access-date=1 March 2017}}</ref>

=== Abortion ===
The oath contains a prohibition of abortion, which contradicts another Hippocratic text ''On the Nature of the Child'', which contains a description of an abortion, without any implication that it was morally wrong,<ref>{{cite book|last1=Lonie|first1=Iain M.|title=The Hippocratic treatises, "On generation," "On the nature of the child," "Diseases IV" a commentary|date=1981|publisher=De Gruyter|location=Berlin|isbn=978-3-11-086396-3|page=7}}</ref> and descriptions of abortifacient medications are numerous in the ancient medical literature.<ref>{{cite book|last1=King|first1=Helen|title=Hippocrates' woman: reading the female body in ancient Greece|date=1998|publisher=Routledge|location=London|isbn=978-0-415-13895-6|pages=132–156}}</ref> 

The oath's stance on abortion was unclear even in the ancient world where physicians debated whether the specification of pessaries was a ban on simply [[Pessary|pessaries]], or a blanket ban on all abortion methods:<ref name=":0">{{Cite thesis |title=The "Hippocratic" Stance on Abortion: The Translation, Interpretation, and Use of the Hippocratic Oath in the Abortion Debate from the Ancient World to Present-Day |url=https://qspace.library.queensu.ca/handle/1974/24465 |date=2018 |degree=Master of Arts |language=en |first=Olivia |last=De Brabandere |publisher=Queen's University |pages=3–4, 7, 58}}</ref> In the earliest surviving reference to the oath, written in 43 AD, [[Scribonius Largus]] was adamant that it precluded abortion.<ref name=Largus/> In the 1st or 2nd century AD work ''Gynaecology'', [[Soranus of Ephesus]] wrote that one party of medical practitioners followed the Oath and banished all abortifacients, while the other party—to which he belonged—was willing to prescribe abortions, but only for the sake of the mother's health.<ref name=Largus>[http://penelope.uchicago.edu/~grout/encyclopaedia_romana/aconite/largus.html "Scribonius Largus"]</ref><ref name=Soranus>{{cite book|last1=Soranus, Owsei Temkin|title=Soranus' Gynecology|date=1956|publisher=JHU Press|location=I.19.60|url=https://books.google.com/books?id=YsKWfh31gxwC&q=soranus%20gynecology%20digital&pg=PR1|access-date=6 October 2015|isbn=978-0-8018-4320-4}}</ref> [[William Henry Samuel Jones]] believes that, although the oath prohibited abortions, it may not have been condemned under all circumstances.<ref name=":0" /> [[John M. Riddle]] argues that because Hippocrates specified pessaries, he only meant pessaries and therefore it was acceptable for a Hippocratic doctor to perform abortions using oral drugs, violent means, a disruption of daily routine or eating habits, and more. Other scholars, most notably [[Ludwig Edelstein]], believe that the author intended to prohibit any and all abortions.<ref name=":0" /> Olivia De Brabandere writes that regardless of the author's original intention, the vague and polyvalent nature of the relevant line has allowed both professionals and non-professionals to interpret and use the oath in several ways.<ref name=":0" /> While many Christian versions of the Hippocratic Oath, particularly from the Middle Ages, explicitly prohibited abortion, the prohibition is often omitted from many oaths taken in US medical schools today, though it remains controversial.<ref name="swear by"/>

=== Religious themes ===
[[File:HippocraticOath.jpg|thumb|upright=1.2|A 12th-century [[Byzantine Empire|Greek]] manuscript of the oath in the shape of a cross. The oath continued to be in use in the Byzantine Christian world, with its references to pagan deities replaced by a Christian preamble.]]
The oath stands out among comparable ancient texts on medical ethics and professionalism through its heavily religious tone, a factor which makes attributing its authorship to Hippocrates particularly difficult. Phrases such as "but I will keep pure and holy both my life and my art" suggest a deep, almost monastic devotion to the art of medicine. He who keeps to the oath is promised "reputation among all men for my life and for my art". This contrasts heavily with Galenic writings on professional ethics, which employ a far more pragmatic approach, where good practice is defined as effective practice, without reference to deities.<ref>{{cite book|editor1-last=Wear|editor1-first=Andrew|editor2-last=Geyer-Kordesch|editor2-first=Johanna|editor3-last=French|editor3-first=Roger Kenneth|title=Doctors and Ethics: The Earlier Historical Setting of Professional Ethics|date=1993|publisher=Rodopi|location=Amsterdam|pages=10–37}}</ref> The oath's importance among the medical community is nonetheless attested by its appearance on the tombstones of physicians, and by the fourth century AD it had come to stand for the medical profession.<ref>{{cite journal|last1=von Staden|first1=H|title=In a pure and holy way. Personal and professional conduct in the Hippocratic Oath|journal=Journal of the History of Medicine and Allied Sciences|volume=51|date=1996|issue=4|pages=404–437|doi=10.1093/jhmas/51.4.404|pmid=9019063}}</ref> The oath continued to be in use in the Byzantine Christian world with its references to pagan deities replaced by a Christian preamble.<ref>{{cite book|last1=Nutton|first1=Vivian|title=Ancient medicine|date=2012|publisher=Routledge|location=Milton Park, Abingdon, Oxon|isbn=978-0-415-52095-9|page=415, note 87|edition=2nd}}</ref>

==="First do no harm"===
{{Main|Primum non nocere}}
Although it is often said that "First do no harm" ({{Langx|la|Primum non nocere}}) is a part of the original Hippocratic oath, no such phrase from which "First" or "Primum" can be translated appears in the text of the original oath, although a similar intention is vowed by, "I will abstain from all intentional wrong-doing and harm". Another related phrase is found in Epidemics, Book I, of the Hippocratic school: "Practice two things in your dealings with disease: either help or do not harm the patient".<ref>{{cite book|editor1-last=Lloyd|editor1-first=Geoffrey|title=Hippocratic Writings|date=1983|publisher=Penguin Books|location=London|isbn=978-0-14-044451-3|pages=[https://archive.org/details/hippocraticwriti0000hipp/page/94 94]|edition=2nd|url=https://archive.org/details/hippocraticwriti0000hipp/page/94}}</ref> and it likely took shape from longstanding popular nonmedical expression.<ref>{{Cite journal |last=Suss |first=Richard A. |date=November 21, 2024 |title=''First Do No Harm'' Is Proverbial, Not Hippocratic |journal=OSF Preprints |language=en |doi=10.31219/osf.io/c23jq}}</ref>