Of Doctors’ Oaths And Declaration: Misuse And Misinterpretation? — Dr Timothy Cheng

“You may disagree with me, but I dare say that there is more, so much more to the oaths and declarations that doctors take than taking the phrase ‘first do no harm’ and repeating it like a broken record,” writes Dr Timothy Cheng.

The Hippocratic Oath has been quoted multiple times in the past, and more recently in the light of recent issues in health care system, mainly to urge doctors not to strike as this will cause harm to patients, because we are called to “first do no harm”.

Or really?

The Hippocratic Oath

It begins by touching on teachers and students, and then calls on doctors to do no harm and injustice to patients. Suboptimal care by burnt out, tired health care workers; broken-down facilities, delayed treatment – these also constitute injustice to patients. 

Doctors who suffer from wage theft, doctors with same responsibilities but unequal benefits, unrecognised qualifications, etc. – these too, are forms of injustice.

The phrase “first do no harm” does not appear in the early version of the oath, although some extrapolate it from the phrase “I will abstain from all intentional wrongdoing and harm”, but that is followed by “from abusing the bodies of man or woman, bond or free”. 

Is this only restricted to physical torture of patients, or does it also apply to the deliberate turning of a deaf ear to the cries of health care workers?

The rewriting in 1964 included “to remain a member of society, with special obligations to all my fellow human beings”. Surely this includes standing up for injustice occurring within the medical fraternity itself!

The Declaration Of Geneva

Published by the World Medical Association in 2017, allow me to highlight a few phrases:

  • “Maintaining the utmost respect for human life.”
  • “Giving to colleagues and students the respect and gratitude that is due.”
  • “Attending to own health, wellbeing and abilities to provide care of the highest standard.”

Sounds nice on paper, but how do we reconcile this with a system that claims to be transparent and objective, but is not? 

The same issues come to mind, including wage theft, suppressing voices of change, migration of young and bright talents, broken infrastructure, etc.

Social Advocacy

A quick Google search on “doctors and social advocacy” will show you that it is an obligation, and not an option, for doctors to stand up and speak up for the oppressed.

While it usually refers to fighting for patients or the general public, it also includes doctors themselves, who are not only human, but aslo overworked and burnt-out health care workers who might bring slow but sure detriment to the delivery of health care.

You may disagree with me, but I dare say that there is more, so much more to the oaths and declarations that doctors take than taking the phrase “first do no harm” and repeating it like a broken record.

To those in the corridors of power who have held office for years and forgotten the real meaning of our oaths and declarations, I suggest you pause, reflect, and let others take over.

To those who are still pushing and fighting for change, especially against leaders who sit and look at pen and paper without a single clue about what a doctor’s on-call shift really means, I salute you. Please do not give up.

Dr Timothy Cheng is an orthopaedic surgeon serving at Hospital Duchess of Kent, Sandakan, Sabah.

  • This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.

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