This article appears in the August 2003 edition of the Catholic Medical Quarterly

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The Hippocratic Oath:

Its contents and the limits to its adaptation

From a lecture given at the Guild's 2003 symposium
David Albert Jones

References

Hippocratic Oath - a literal translation

The aim of this paper is to examine the ethical content of the doctor's oath known to us as the "Hippocratic Oath". There are now many medical oaths that claim to be updated versions or adaptations of the Hippocratic Oath1. This in itself is now a new phenomenon. For medieval (and possibly much earlier) Christians and Muslims both made adaptations to the Oath to make it acceptable to them.2 However, what needs to be assessed is the degree to which these ancient and modern adaptations are genuinely Hippocratic, that is, the degree to which they show ethical congruence with the original Oath. Before considering this question, it is first necessary to consider the historical setting of the Oath.

The Hippocratic Oath occurs within a body of some sixty to seventy Greek texts attributed to Hippocrates, the fourth/fifth century BCE physician from the island of Cos3. Since the second century CE it has been recognised that these texts are not all by the same hand. They vary in style, tone and medical doctrine. It is most likely that the Hippocratic corpus is a collection of medical texts from more than one school, though in which the school of Cos is certainly represented, perhaps gathered together at the great ancient library of Alexandria. However, it appears impossible to determine specifically which works were written by Hippocrates himself. While the Oath is the most famous text in the collection, it is not the most characteristic. Most are works devoted to the diagnosis, prognosis, explanation and treatment of disease (for example Prognosis, Airs, Waters and Places, Epidemics I and II, on Fractures). Indeed, at several points the Oath seems actually to contradict certain of the medical texts, in particular with respect to abortion and to the forbidding of surgery, both of which appear in other Hippocratic works.4

Over the years there has been a number of different scholarly reconstructions of the origin of the Oath. Significant among these has been the conjecture of Judwig Edelstein. In 1943, Edelstein, a German Jew who had fled to the United States, wrote an important and influential monograph on the origin of the Hippocratic Oath5. He pointed out that the Oath not only seemed to contradict other Hippocratic texts, but also seemed to contradict the common mores of ancient Greek society. In particular, Greek law and custom allowed abortion as well as infanticide, not only for medical reasons but for a variety of reasons. Suicide was also viewed without opprobrium at this time. Plato and Aristotle both explicitly advocate abortion and infanticide6 and neither the followers of Plato nor Aristotle held that human life began at conception7. For the Platonists it was the moment of birth. For the Aristotelians it was formation or quickening. There is also no evidence, from this period, of a general separation between physicians and surgeons such as might explain the paragraph forbidding surgery. Edelstein sought to explain all these anomalies by a single conjecture. He supposed that the Oath was the product of one very specific and unusual philosophical and religious movement: the Pythagoreans. Only the Pythagoreans clearly argued that life began at conception; furthermore, Edelstein argued, there were other peculiarities of the Pythagoreans which seemed to fit very well with the Oath. The dramatic conclusion of Edelstein's monograph was that the Oath was "a Pythagorean manifesto and not the expression of an absolute standard of medical conduct"8

Edelstein's conjecture about the original setting of the Oath was invoked in Roe v Wade, the legal decision that revolutionised American abortion law. The apparently esoteric and religious character of the Oath was given as the explanation for its "apparent rigidity" in respect of abortion9. The witness of the Oath to the unethical character of abortion was thus effectively neutralised.

Nigel Cameron has made rather different use of Edeistein's conjecture to claim that the Oath should be seen, not as the expression of the common values of society, or of all physicians, but as the voice of a reforming party10. If the Oath once fulfiled this role, it could do so again. The lack of universal consensus need not be seen as a reason for abandoning the Oath. Rather it can now be restored to its original function.

At the same time, Leon Kass has pointed out the logical flaw in Edeistein's conclusion. The question of the ethical values inherent in the Oath, that is, whether the Oath bears witness to perennial ethical standards, is wholly independent of the question of the origin of the Oath. "He (Edelstein) never raises for himself or for us the question of whether, despite its dated beginnings, it might nevertheless speak truly and timelessly."11

The work of Edelstein still has currency among bioethicists, but it was penned sixty years ago, and its (mis)use by Roe v Wade was thirty years ago. Since that time, among classicists and historians of medicine, Edelstein's views have long ceased to convince. While it is true that the Oath is compatible with Pythagorean doctrines, there are more similarities between the Oath and other Greek practices and attitudes than Edelstein allowed. For example, Edelstein claims that the practice of physician assisted suicide was widespread and that its prohibition in the Oath is therefore anomalous. However, whereas there is much evidence of suicide in the ancient world, there is relatively little evidence of physician assisted suicide. Furthermore, the interpretation of the relevant line of the Oath is now debated. Is this injunction in fact a prohibition of physician assisted suicide? Or is it a prohibition of supplying poisons for murder (a particularly feared crime in the ancient world) or supplying a drug for some other purpose (for example as a love potion or as an abortifacient)12 that could have lethal consequences? Edelstein's conjecture is still discussed, but there are few scholars who would accept it in the way that it was first put forward.

What then is the current consensus? Some take a weakened form of Edelstein's thesis, arguing that the Oath was the product of Pythagorean influences, but also of other influences, while maintaining that it was uncharacteristic of Greek Society and medicine13. Others have taken a far more radical approach, arguing that the original meaning of the text is lost to us and that all that we can be sure of is the way it was later interpreted. Furthermore, the very variety of subsequent use and the number of different groups who appealed to the Oath (from the Nazi doctors to the BMA) show that it is entirely plastic to whatever meaning the reader wishes to bestow upon it. This view has been argued forcefully by R'tten14 whose previous research has focused on the reception of the Oath in the Renaissance15 While R'tten fundamentally differs from Edelstein on the historical interpretation of the Oath, their views on the continuing ethical significance of the Oath coincide. Both Edelstein's bold conjecture and the radical scepticism of R'tten would deprive the Oath of the ethical authority it has often been given within the history of medicine. In fact the contemporary view is more challenging than Edelstein's because it questions not only the significance of the Oath in its original context but also the legitimacy of its reception in the later tradition. If we are to evaluate whether various adaptations of the Oath can still claim to be Hippocratic, we first have to consider whether the meaning of the Oath is actually accessible to us. To do this, it is necessary to examine the Oath paragraph by paragraph.

The text is framed by the oath-and-sanction paragraphs (1 & 10). The intervening content is two fold: a section of the relationship of teacher and pupil (2 & 3) and a section of the relationship of physician and patient (4 - 9).

Paragraph I contains an invocation of the Greek gods of healing. Apollo is invoked as physician or healer (iatros). Asclepius is the legendary father of medicine and physicians, a mythical hero or demigod. Hygeia and Panacea were the two most famous of Asclepius' daughters. Medicine was a craft commonly passed from father to son, medical families sometimes claim to be descended from Asclepius himself. This was true of Hippocrates, and this is probably the reason why Plato called him an "Asclepiad"16. Far from being a "strange collection" of gods17 this list would have been immediately recognised as an invocation of the patrons of medicine. Even from this cultural and historical distance, Panacea and, to a lesser extent, Hygeia (as in Hygiene) are recognisable as personifications of healing and of health. WHD Jones makes this point by translating the names as Health and All-heal"

On this interpretation, the Asclepiad was not a cult priest nor even, necessarily, a member of a guild, but a physician who traced his craft back to Asclepius. It is important to note that, in the Oath, the gods are not invoked to provide a method of treatment - for instance by exorcism, faith healing or ritual purification19 The methods of treatment mentioned in the Oath are the application of a dietary regime, the use of drugs and pessaries (vaginal suppositories) and the use of surgery. The gods are invoked not with reference to treatment but rather as witnesses, judges (historas) who will determine whether the ethical requirements of the Oath and covenant (written agreement -syngraphe) have been fulfilled. If they have been fulfilled, the gods will grant fame and honour; if they have been transgressed, the gods will ensure ill fortune and disgrace, The invocation of the gods, like swearing on the Bible in a court of law, brings a solemnity and supernatural sanction to the Oath which is precisely what makes it an Oath (as opposed to a promise or a declaration).

The invocation of pagan gods obviously creates problems for Jews, Christians and Muslims, as it seems to involve worshipping (or at least acknowledging) false gods. For some Jews and Christians, particularly in the period immediately after the time of Christ, there were also problems with swearing oaths at all, even to the one God or to Heaven or in the name of the Temple or the Scriptures. "But above all, my brethren do not swear, either by heaven or by earth or with any other oath, but let your yes be yes and your no be no, that you may not fall under condemnation."20 It is thus remarkable that the Oath was adapted and used both by Christians and Muslims (though not, it seems, by Jews). One early Christian version of the Hippocratic Oath not only replaces the pagan gods with Christ, but also adapts the Oath to become a declaration; there is no "I swear" but it begins instead:

Blessed to God the Father of our Lord Jesus Christ, who is blessed for ever and ever; I lie not.21

The Islamic translator renders the Oath safe first by putting it in the mouth of Hippocrates, but also makes a number of subtle changes to the theology of the Oath. Rather than swear by Hygeia and Panacea, Hippocrates is made to swear by the One God who is the God of Health and Healing. There is then a separate introduction to Asclepius who is presented as being one of the holy ones of god, that is, a saint and not god at all.

Hippocrates said: I swear in the name of God, the Master of life and death, the Giver of health and Creator of healing and of every treatment, and I swear in the name of Aesculapius, and of all the holy ones of god, male and female, and I call them to witness, that I will fulfil this oath and these conditions.22

One aspect shared by pagan, Christian and Islamic versions of the Oath, but lacking in, for example, the declaration of Geneva 23, is the appeal to a transcendent witness and to a supernatural sanction. From an ancient perspective, this appeal should be seen as among the defining characteristics of any oath24 including the Hippocratic Oath.

The next two paragraphs (2 & 3) are controversial. Many later interpreters have found them an embarrassment and, when the original form of the Hippocratic Oath is used in medical schools, this section is often omitted. Why does the pupil effectively have to adopt the teacher? The interpretation of this paragraph was important to Edelstein, who claimed that the quasi-adoption of the pupil was a practice without parallel in the ancient world, with the exception of the Pythagoreans. However, these arrangements are not so extraordinary. Such relations existed among Epicureans and, arguably, in the case of Socrates and Cito25. But why is the teaching of medicine to be confirmed to those who take the Oath and sign the covenant? This could be seen as a way to protect the power and exclusively of the medical elite.

The exclusion of those who will not abide by the physician's law is, of course, a sociological method of control, and a means to establish the reputation and prestige of those within the fellowship of the Oath. However, such mechanisms are not necessarily dubious and are certainly not confined to the ancient world. Any method of control of licensing aims to separate the reliable from the unreliable, the trustworthy from the untrustworthy. From the Royal Colleges and the GMC, to trade associations and organic farmers, bodies established to promote a certain standard of practice also function to promote the prestige and success of their members. Such bodies or associations always restrict entry to and, in case of behaviour likely to harm the reputation of the association, generally review continuing membership of the association.

These paragraphs of the Oath also stress the importance of passing on the knowledge of medicine and of ethical practice to the next generation. Of course, in the days of teaching hospitals, formal education and statutory exams, this task is no longer an aspect of the relationship of one physician and his apprentice. Nevertheless, the importance of passing on medical knowledge, and of impressing upon students the importance of standards of behaviour and of competence, is as great as ever. This is recognised in the new ethical code for nurses, which includes, for the first time, reference to a general duty to nurture and support those who are in training26

Paragraph 4 is arguably the core of the Oath. It immediately follows the section on the structures of medical education and sets out the fundamental meaning or role of medicine. The physician promises to use a regime (diaitema) for the benefit of those who are sick, according to ability and judgement and to refrain from doing harm or injustice. The typical Hippocratic method of treatment (as shown in the medical writers of the Hippocratic corpus) was to prescribe a particular regime of diet and exercise, specific to the disease and to the patient. A patient might also be advised to move to a different environment (drier, wetter, hotter, cooler etc.) Only if this failed was one to resort to drugs. Disease was believed to reflect a disharmony in the body, and in particular in the four humours: blood, yellow bile, black bile and phlegm. The role of the physician was to assist nature in restoring this balance. "Nature is the physician of diseases"27, This also fits with what is said of Hippocrates by Plato: "Hippocrates the Asclepiad says that the nature even of the body can only be understood as a whole.28

In this paragraph of the Oath the aim of medicine is described first as assisting those who are sick by application of the appropriate (dietary) regime. This is an important point because it implies a certain view of disease and a certain view of the role of medicine. Medicine is about benefiting those who are physically sick by assisting nature in restoring them to health. The aim of medicine is secondarily said to be to keep the sick person (or, another possible reading of the Greek, to keep the physician) from harm and from injustice. What this means is spelt out in subsequent paragraphs.

The paragraph which immediately follows concerns the provision of deadly drugs and of destructive pessaries. This paragraph is placed here because these actions are seen as archetypal acts of transgression, betraying the aim or meaning of medicine as outlined in paragraph 4. These prohibitions are thus central to the very understanding of medicine articulated in the Oath. However, we interpret the context for giving deadly poison, whether for murder, for assisted suicide, or the giving of dangerous drugs for unworthy non-medical purposes, it is clear that the wrong consists principally in the deadliness. Giving a lethal dose, for whatever reason, contradicts the meaning of medicine, understood as the fostering of physical health. Destroying the body (either of the sick patient or of the foetus) is contrary to the very nature of medicine.

This interpretation is backed up by the word homoios (similarly).29 I will not give a deadly drug and similarly I will not give a destructive pessary. Wherein does this similarity lie? What have these two acts got in common? These actions in some way contradict the most fundamental aim of medicine. Rather than assisting nature and bringing health, they bring death and destruction.

Soranus, great gynecologist of the second century CE, bears witness to a debate among ancient physicians on the question of abortion:

But a controversy has arisen. For one party banishes abortive, citing the testimony of Hippocrates who says: "I will not give an abortive"; moreover, because it is the specific task of medicine to guard and protect what has been engendered by nature. The other party prescribes abortives, but with discrimination, that is, they do not prescribe them when a person wishes to destroy the embryo because of adultery or out of consideration for youthful beauty; but only to prevent subsequent danger in parturition if the uterus is small... (or other such reasons)30

There are several important points to note about this passage.

First Soranus clearly says that there were physicians in the ancient world who would not prescribe abortives, citing the authority of Hippocrates.

Second, those who refuse to do abortions refuse because abortion contradicts a fundamental aim of medicine: "because it is the specific task of medicine to guard and protect what has been engendered by nature". The focus here is not on human or foetal rights, homicide or the moment of personhood, but is on the role of the physician to assist nature and foster health. Deliberately causing a miscarriage would radically contradict the aim of assisting a healthy pregnancy. Clearly this position is compatible with the Pythagorean and Early Christian belief that human life begins at conception, but it does not seem to require or to presuppose that belief.

It is interesting to compare this reasoning with that of Philo, a first century CE Jewish philosopher living in Alexandria about 100 years before Soranus. Philo thought that late abortion, after the human image was formed in the child, was straightforward homicide. Early abortion was not homicide, but it was gravely wrong "both as an outrage and for obstructing the artist nature in her creative role of bringing into life the fairest of living creatures31 The wrong lay not in homicide strictly speaking, but in acting against nature while she was at work in the development of the child. A similar point is made by Kass in his commentary on the Hippocratic Oath. He also stresses the way that abortion contradicts the role of the physician of assisting nature so as to care for the health of a pregnant woman.32

In this context, those, like Soranus, who allow abortion "with discrimination", can be seen as at least seeking to remain within the tradition of the Oath. For the reasons given for abortion relate specifically to the physical health of the pregnant woman and explicitly exclude certain personal or social reasons. This is not to say that Soranus is right to think that one may sacrifice the unborn child for the sake of the mother's health, only that in doing so he aims to remain within the Hippocratic understanding of medicine. A similar point could be made about much later debates concerning therapeutic abortion in the Catholic tradition.33 Some contributors to these debates were confused, others went too far, but all understood that the aim of medicine was to assist nature and to support life and health.

What is wholly alien to this tradition is the twentieth century attempt to justify abortion by appeal to privacy, free choice or autonomy, in such a way that it isolated such a choice from what is beneficial to life and health for mother and child.

The paragraph about surgery (paragraph 7) is obscure, but it is at least clear that it does not involve the same sort of objection as the prohibition of poisoning or abortives - for in the case of surgery the physician is allowed to make way for a workman (ergates) who carry out this action. The tone seems pejorative -leave it to more practical men. It may well involve an element of self-protection, for surgery then even more than now was a risky business, but it also implicitly recognises the possibility of a division of roles and thus of specialisation. Interpreted very broadly as a prohibition against practising beyond the limits of one s competence, this is certainly still relevant.

Brief mention may be made of the explicit egalitarianism in the paragraph concerning seduction or abuse of patients (paragraph 8), whether male or female, slave or free, and to the subtlety of the paragraph on discretion (paragraph 9), which does not treat all information equally but prohibits the disclosure of that which ought never be published abroad. In both cases the Oath shows itself to be an ethically acute and thoughtful document. It is not only because of its antiquity and its association with the "father of medicine" that the Oath has been so highly regarded in so many different periods of history. It is also because of the ethical content of the Oath.

What is most striking about the Christian and Muslim versions of the Hippocratic Oath is first that they exist at all and second that they are so close to the original - a few obscure or socio-historically specific paragraphs altered, reference to the pagan gods dropped - and that's about it. These alterations are generally far less radical than the changes made in producing the various modern versions of the Oath.34 Setting the interpretation of the Oath in the context of Philo and Soranus, and of the early Christian and Muslim adaptations, gives us a reasonable basis for defining what it takes for an oath to be Hippocratic in ethical content or spirit.

  1. It must appeal to a transcendent witness or sanction

  2. It must recognise that the aim of medicine is to benefit the sick

  3. It must prohibit deliberate killing, including the destruction of the unborn.

In conclusion, oaths that neglect a transcendent element, that make something other than service of the sick (precisely as sick, that is, with respect to their health) the aim of medicine, or which fail to prohibit lethal doses and abortifacients, have dubious claim to the name Hippocrates.35

References

  1. Hurwitz, B, Richardson, R (1977) "Swearing to care: the resurgence in medical oaths" BMJ Vol 315p. 1671-1674; Robin ES (1994) "The Hippocratic Oath Updated" BMJ 309: 96; "Crawshaw et al (1994) "The Hippocratic Oath" BMJ 309:952.Weinstein, L. (1991) "The Oath of the Healer" Journal of American Medical Association, V 265, p2484; Lasagna, L. (1995) "Modern Hippocratic Oath" Medical Economics, pp 197-202, June 11, 1995; Stanton, J., Angelo, E. Rea-Luthin, M.(1996) "Swearing to Life" First Things 59 (January 1996), 9-15. World Medical Association Declaration of Geneva (1948, amended 1968, 1983).

  2. Jones W.H.S. (1924) The Doctor's Oath Cambridge: CUP.

  3. See Lloyd, G. (ed.) (1978) Hippocratic Writings Harmondsworth, Middx: Penguin reprinted by Viking; Leob Classic Library Hippocrates Volume I-VII; Fabre J (1997) The Hippocratic Doctor London: RSM Press. Longrigg, J (1993) Greek Rational Medicine London: Routledge; Phillips ED (1973) Greek Medicine London: Thames and Hudson; Sigerist HL (1934) "On Hippocrates" Bulletin of History of Medicine XI: 190-214; Temkin, 0 (1991) Hippocrates in a world of pagans and Christians Baltimore: Johns Hopkins University Press.

  4. See, for example On the Nature of the Child 13 (Lloyd (1978) p. 325-326)

  5. Edelstein, L (1943) "The Hippocratic Oath" The Bulletin of the History of Medicine Supplement No.1; Reprinted by Ares Publishes, Chicago.

  6. Plato Republic V. 461c; Aristotle, Politics 7, 1335b 20.

  7. Carrick, P. (1985) Medical Ethics in Antiquity Dordrecht: D. Reidel, p. 112-119

  8. Edelstein, L (1943), p.64

  9. Roe v Wade, 410 U.S. 113 (1973) at 132.

  10. Cameron, N (1991). The New Medicine: The Crisis in Medicine and the Hippocratic Oath London: Hodder and Soughton

  11. Kass, L (1985) Towards a Moral Natural Science New York; Free Press, p. 227.

  12. The Roman Law against poisoners Lex Cornelia de sicarris et veneficis was subsequently applied in this way, though at a much later date than the Oath; see Connery (1977) Abortion: The Development of the Roman Catholic Perspective Loyola University Press, p. 28-29.

  13. Carrick, P (1985) Medical Ethics in Antiquity Dordrecht: D. Reidel, Amundsen, DW (1995) "Medical Ethics, History of Europe, A. Ancient and Medieval, 1. Greece and Rome" in Reich WT (1995) Encyclopedia of Bioethics New York: Macmillan, Baker, R "The History of Medical Ethics" in Bynum WF, Porter R (1993) Companion Encyclopedia of the History of Medicine London: Routledge

  14. "The Hippocratic Oath in Antiquity" paper given at the Royal Society of Medicine 17 February 2003

  15. R'tten, T (1996) "Receptions of the Hippocratic Oath in the Renaissance: The Prohibition of Abortion as a Case study in Reception" The Journal of the History of Medicine Vol 51 (Oct 1996).

  16. Phaedrus 13, 270c.

  17. Nicholson, R (1977) "Medical Ethics in Europe:A short history" NIRA Review Spring.

  18. Jones W.H.S. (1924) The Doctor's Oath Cambridge: CUP

  19. Such practices had no place in the Hippocratic conception of medical treatment. See, for example, The Sacred Disease (Lloyd (1978), p. 237-25 1.

  20. James 5:12 (see also Matthew 5:34-35, 23:18- 22)

  21. The Oath According to Hippocrates in so far as a Christian May Swear It (Urbinus 64 mss) in Jones (1924) p.23

  22. Lives of Physicians, Ibn abi Usayb ia, (d.1269) Transl. from Arabic by E.G. Grown and M.Z. Siddiqui. in Jones (1924) p31.

  23. World Medical Association Declaration of Geneva (1948, amended 1968, 1983)

  24. For example, "Human beings, of course, swear by someone greater than themselves, and an oath given as confirmation puts an end to all dispute." Hebrews 6:16.

  25. Carnck, P(1985) Medical Ethics in Antiquity Dordrecht: D. Reidel, p.77

  26. Nursing and Midwifery Council (2002) Code of Professional conduct 6.4 "You have a duty to facilitate students of nursing, midwifery and health visiting and others to develop their competence."

  27. Epidemics VI.5. 1

  28. Phaedrus 13, 270c.

  29. A point well brought out by Carrick (1985), p.84-85

  30. Temkin, 0. (trans.) (1956) Soranus Gynecology Baltimore: John Hopkins Press, II 19, p. 63.

  31. Special laws III.19.109

  32. Kass (1985) p. 235 "If medicine is constituted by the task to assist living nature in human bodies to the work of maintenance and function and perpetuation, then one must wince at the monstrous, because self-contradictory, union that is the obstetrician-abortionist".

  33. See Connery, J. (1977) Chapter 8: Discussion of Therapeutic Abortion (1500-1600).

  34. See note 1 above

  35. For an interesting comparison of the ethical content (or lack of it) of many medical oaths in current use, see On, RD, Pang, N, Pellegrino, ED, Siegler M, (1997) "Use of the Hippocratic Oath: A review of twentieth century practice and a content analysis of oaths administered in medical schools in the US and Canada in 1993" Journal of Clinical Ethics 8(4), 374-385. On, R (1998) "The Hippocratic Oath: Is it Still Relevant?" Centre for Christian Bioethics Vol 14, Number 1

Dr. D.A. Jones is Senior Lecturer in Bioethics at St. Mary's College, Strawberry Hill, which is a college of the University of Surrey.

In collaboration with the Linacre Centre for Healthcare Ethics and with encouragement from the Guild of Catholic Doctors and the Christian Medical Fellowship, St. Mary's has established an MA in Bioethics fully consonant with Catholic moral teaching. This can be taken full time or part time by evening seminars. For details see www.smuc.ac.uk/bioethics or e-mail jonesd@smuc.ac.uk or phone 020-8240 2311.

 

The Hippocratic Oath: a literal translation

  1. I swear by Apollo Physician, and by Asclepius, and by Hygeia, and by Panaceia and by all gods and godesses, making them witnesses, to fulfil, according to my ability and judgement.

  2. To regard my teacher in this art equal to my parents; and to share my livelihood in common with him, and, if he is in need, to make a contribution; and to judge his progeny equal to my brothers of the male line; and to teach this art if they require to learn, without fee or covenant;

  3. To make a contribution of instruction, and lecture, and all the other learning, to my sons, and to those of my teacher, and to pupils who have signed the covenant and sworn to obey the physician's law, but to none other.

  4. I will use dietary regimes to help the sick according to my ability and judgement and to refrain from harm and injustice.

  5. I will not give to anyone a deadly drug though asked, nor will I suggest a plan of such a kind. Similarly I will not give a woman a destructive pessary.

  6. But in a pure and holy way I will guard my life and my art.

  7. But I will not cut, not even sufferers from stone, but I will give place to workmen who engage in this practice.

  8. Into whatsoever houses I enter, I will go in to help the sick, being without all intentional injustice and corruption, and all the rest and especially without "works of Aphrodite" upon the bodies both of women and men, both of free and slaves.

  9. Whatsoever in the course of attending the sick I see or hear (or even when not attending the sick), concerning the life of men, which ought never be published outside, I will keep silent, considering such things as unutterable.

  10. Now if I fulfil this oath and do not violate it, may I reap, in my life and art, glory among all men for all time; but if I transgress and swear falsely, the opposite of these things.