From the Hippocratic Oath to Modern-Day Medical Standards: The Evolution of Medical Ethics

When we go to the doctor, we trust that they have our best interests at heart. We expect them to treat us with respect, communicate honestly with us, and use their skills and knowledge to provide us with the best care possible. But this wasn't always the case. Throughout history, medical ethics have evolved significantly, from the ancient Hippocratic Oath to the modern-day standards that guide medical professionals today.

The Influence of Hippocrates in Medicine

The Hippocratic Oath (Ορκος) is perhaps the most famous example of an early medical code of ethics. It dates back to ancient Greece, in the 5th century BC, and is named after the Greek physician Hippocrates, who is often referred to as the father of Western medicine. The oath, which is still recited by some medical students today, includes a promise to "do no harm" and to respect patient confidentiality. Additionally, this Oath has proven to mark the early stages of medical training to the first families of Hippocratic medicine as it requires strict loyalty. Despite the ancient significance of the Hippocratic Oath, it has been relevant in the 21st century as well. The Oath has been taught to many modern medical schools, though some have adopted more modern versions.

It is significant to note that Hippocrates had made many other massive impacts in medicine during his time, though we cannot discuss all of it. Though, he has made numerous impacts for future physicians. Skipping ahead in time for a bit, Claudius Galenus (129 AD - 216 AD), or simply Galen, is a physician and philosopher. He was heavily influenced by Hippocrates and believed him to be a paradigm of medical ethics. Galen believed that the knowledge of the human body must be just as profound as the importance of logic and language. Additionally, he proposed that physicians should have absolutely perfect self-control, scorn money and pleasures of the flesh, and live a very laborious life. Now, we look at these standards and some may think that they are absolutely ridiculous. However, if you really think about it, these standards are not entirely wrong. Healthcare workers today do have great self-control and they are always incredibly busy. Many also have a passion for medicine and the human body. Because of this, Galen’s ideology technically carries over to today.

Now, let us skip further into time and see the role of Thomas Sydenham, also referred to as “The English Hippocrates” in the 1600s. Sydenham is most known for his discovery of the disease Sydenham’s chorea, or St Vitus’ Dance, along with his treatise on gout. However, what were his views on medical ethics? Well, as his alias suggests, he adopted many ideas from Hippocrates. As a physician, he did very detailed physical exams, extensive records keeping, and attention to the treatment of illness. He emphasized that hard work was necessary in physicians. Additionally, his inspiration from Hippocrates is further shown from his famous quote: “The physician must… have two special objects in view with regard to disease, namely, to do good or to do no harm.”

Furthermore, Sir William Osler, a Canadian physician from the 1800s is referred to as “the father of modern medicine,” and that is for a good reason! He played a massive role in ethics in medicine during his time. Osler believed that physicians must be able to have a clear mind along with a kind heart. This way, they are able to stay calm and remain imperturbable throughout the day. This ideology can be applied to today, many physicians must have the ability to remain calm under pressure and make quick decisions. In addition, Osler also treated patients as human beings first, allowing him to show great amounts of empathy along with maintaining a great demeanor. He also called for a nondiscriminatory policy so that women would be admitted into medical school. Additionally, he emphasized hard work and education in his book The Principles of Practice of Medicine, in order to become a physician. Already, many of Osler's ideas have carried over to the modern world. After all, becoming a doctor today requires extremely hard work and many years of education!

How has Medicine Changed Since Hippocrates?

However, medical ethics have changed significantly since the time of Hippocrates. One major factor in this evolution was the rise of modern medicine in the 19th century. As medicine became more scientific and specialized, new ethical issues arose. For example, how should doctors balance their duty to their patients with their responsibility to advance medical knowledge through research?

In response to these challenges, medical organizations began to develop formal codes of ethics. One of the most influential of these was the Code of Ethics developed by the American Model Association (AMA) in 1874. This code served multiple purposes, most significantly as a public declaration of the values of medical professionals. It sets the expectations that physicians must uphold their roles as healers, leaders, educators, and scientists. As a result, this code allows for a framework that permits trust between patients and physicians. Furthermore, the Declaration of Geneva, which was first adopted by the World Medical Association in 1948, is also an incredibly influential document. This document expanded on the Hippocratic Oath and included provisions such as a commitment to treating all patients equally and a promise to maintain the highest standards of professional competence.

Moving on to the mid-1900s, many events called into question the ethics of medical testing and experimentation on human beings. One of the most significant events that called this into question was the Nuremberg Trials. During the Holocaust in Nazi Germany, many German doctors were using medical experiments on people. After America intervened, calling out the unethical actions of Germany, the Nuremberg Code was created in response. The code outlines ten points regarding the ethical research principles for human experimentation. As a result, peoples’ rights were more protected from experimentation. Moreover, another example of ethical debates on human experimentation was from the Willowbrook Experiments. These infamous tests took place at the Willowbrook State School in Staten Island, New York. Mentally retarded children were given hepatitis to track the development of the viral infection. As a result of this experiment, new debates were raised on medical testing on children.

Now, what we have covered is nothing but a tiny fraction of other acts and laws passed to further enforce good medical ethics. There is a lot to this topic and we highly encourage you to research more about this topic! But for now, we have to learn, how has this evolution of medical transfer to today?

Medical Ethics Today

Today, medical ethics continue to evolve in response to new challenges and advances in medical technology. For example, the development of genetic testing has raised questions about the appropriate use of this technology and the implications of its results. In response, organizations such as the American Medical Association have developed guidelines for the ethical use of genetic testing.

In conclusion, the evolution of medical ethics has been shaped by a wide range of factors, from changes in medical practice to advances in technology. But throughout this evolution, the goal has remained the same: to provide patients with the best possible care while upholding the highest standards of professional conduct.

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