The Hippocratic Oath and the Declaration of Geneva

My sayings for~

The Hippocratic Oath and the Declaration of Geneva

류지미 2024. 2. 21. 21:07

 

 

손수 쓴 사직서는 즉각 수리하고 그 면허는 바로 취소해 야

The Hippocratic Oath and the Declaration of Geneva

The Greek physician Hippocrates (460–370 BC), to whom the oath is traditionally attributed

Hippocratic Oath

The Hippocratic Oath is an oath of ethics historically taken by physicians. It is one of the most widely known of Greek medical texts. In its original form, it requires a new physician to swear, by a number of healing gods, to uphold specific ethical standards. The oath is the earliest expression of medical ethics in the Western world, establishing several principles of medical ethics which remain of paramount significance today. These include the principles of medical confidentiality and non-maleficence. As the seminal articulation of certain principles that continue to guide and inform medical practice, the ancient text is of more than historic and symbolic value. It is enshrined in the legal statutes of various jurisdictions, such that violations of the oath may carry criminal or other liability beyond the oath's symbolic nature.

 

The original oath was written in Ionic Greek, between the fifth and third centuries BC.  Although it is traditionally attributed to the Greek doctor Hippocrates and it is usually included in the Hippocratic Corpus, some modern scholars do not regard it as having been written by Hippocrates himself.

 

Text of the oath

Earliest surviving copy

A fragment of the oath on the 3rd-century Papyrus Oxyrhynchus 2547.

 

The oldest partial fragments of the oath date to circa AD 275. The oldest extant version dates to roughly the 10th–11th century, held in the Vatican Library. A commonly cited version, dated to 1595, appears in Koine Greek with a Latin translation.[3][4] In this translation, the author translates "πεσσὸν" to the Latin "fœtum."

Below is the Hippocratic Oath, in Greek, from the 1923 Loeb edition, followed by the English translation:

ὄμνυμι Ἀπόλλωνα ἰητρὸν καὶ Ἀσκληπιὸν καὶ Ὑγείαν καὶ Πανάκειαν καὶ θεοὺς πάντας τε καὶ πάσας, ἵστορας ποιεύμενος, ἐπιτελέα ποιήσειν κατὰ δύναμιν καὶ κρίσιν ἐμὴν ὅρκον τόνδε καὶ συγγραφὴν τήνδε:

ἡγήσεσθαι μὲν τὸν διδάξαντά με τὴν τέχνην ταύτην ἴσα γενέτῃσιν ἐμοῖς, καὶ βίου κοινώσεσθαι, καὶ χρεῶν χρηΐζοντι μετάδοσιν ποιήσεσθαι, καὶ γένος τὸ ἐξ αὐτοῦ ἀδελφοῖς ἴσον ἐπικρινεῖν ἄρρεσι, καὶ διδάξειν τὴν τέχνην ταύτην, ἢν χρηΐζωσι μανθάνειν, ἄνευ μισθοῦ καὶ συγγραφῆς, παραγγελίης τε καὶ ἀκροήσιος καὶ τῆς λοίπης ἁπάσης μαθήσιος μετάδοσιν ποιήσεσθαι υἱοῖς τε ἐμοῖς καὶ τοῖς τοῦ ἐμὲ διδάξαντος, καὶ μαθητῇσι συγγεγραμμένοις τε καὶ ὡρκισμένοις νόμῳ ἰητρικῷ, ἄλλῳ δὲ οὐδενί.

διαιτήμασί τε χρήσομαι ἐπ᾽ ὠφελείῃ καμνόντων κατὰ δύναμιν καὶ κρίσιν ἐμήν, ἐπὶ δηλήσει δὲ καὶ ἀδικίῃ εἴρξειν.

οὐ δώσω δὲ οὐδὲ φάρμακον οὐδενὶ αἰτηθεὶς θανάσιμον, οὐδὲ ὑφηγήσομαι συμβουλίην τοιήνδε: ὁμοίως δὲ οὐδὲ γυναικὶ πεσσὸν φθόριον δώσω.

ἁγνῶς δὲ καὶ ὁσίως διατηρήσω βίον τὸν ἐμὸν καὶ τέχνην τὴν ἐμήν.

οὐ τεμέω δὲ οὐδὲ μὴν λιθιῶντας, ἐκχωρήσω δὲ ἐργάτῃσιν ἀνδράσι πρήξιος τῆσδε.

ἐς οἰκίας δὲ ὁκόσας ἂν ἐσίω, ἐσελεύσομαι ἐπ᾽ ὠφελείῃ καμνόντων, ἐκτὸς ἐὼν πάσης ἀδικίης ἑκουσίης καὶ φθορίης, τῆς τε ἄλλης καὶ ἀφροδισίων ἔργων ἐπί τε γυναικείων σωμάτων καὶ ἀνδρῴων, ἐλευθέρων τε καὶ δούλων.

ἃ δ᾽ ἂν ἐνθεραπείῃ ἴδω ἢ ἀκούσω, ἢ καὶ ἄνευ θεραπείης κατὰ βίον ἀνθρώπων, ἃ μὴ χρή ποτε ἐκλαλεῖσθαι ἔξω, σιγήσομαι, ἄρρητα ἡγεύμενος εἶναι τὰ τοιαῦτα.

ὅρκον μὲν οὖν μοι τόνδε ἐπιτελέα ποιέοντι, καὶ μὴ συγχέοντι, εἴη ἐπαύρασθαι καὶ βίου καὶ τέχνης δοξαζομένῳ παρὰ πᾶσιν ἀνθρώποις ἐς τὸν αἰεὶ χρόνον: παραβαίνοντι δὲ καὶ ἐπιορκέοντι, τἀναντία τούτων.

 

I swear by Apollo Healer, by Asclepius, by Hygieia, by Panacea, and by all the gods and goddesses, making them my witnesses, that I will carry out, according to my ability and judgment, this oath and this indenture.

To hold my teacher in this art equal to my own parents; to make him partner in my livelihood; when he is in need of money to share mine with him; to consider his family as my own brothers, and to teach them this art, if they want to learn it, without fee or indenture; to impart precept, oral instruction, and all other instruction to my own sons, the sons of my teacher, and to indentured pupils who have taken the Healer's oath, but to nobody else.

I will use those dietary regimens which will benefit my patients according to my greatest ability and judgment, and I will do no harm or injustice to them. Neither will I administer a poison to anybody when asked to do so, nor will I suggest such a course. Similarly I will not give to a woman a pessary to cause abortion. But I will keep pure and holy both my life and my art. I will not use the knife, not even, verily, on sufferers from stone, but I will give place to such as are craftsmen therein.

Into whatsoever houses I enter, I will enter to help the sick, and I will abstain from all intentional wrong-doing and harm, especially from abusing the bodies of man or woman, bond or free. And whatsoever I shall see or hear in the course of my profession, as well as outside my profession in my intercourse with men, if it be what should not be published abroad, I will never divulge, holding such things to be holy secrets.

Now if I carry out this oath, and break it not, may I gain for ever reputation among all men for my life and for my art; but if I break it and forswear myself, may the opposite befall me. – Translation by W.H.S. Jones.

"First do no harm"

Main article: Primum non nocere

 

It is often said that the exact phrase "First do no harm" (Latin: Primum non nocere) is a part of the original Hippocratic oath. Although the phrase does not appear in the AD 245 version of the oath, similar intentions are vowed by, "I will abstain from all intentional wrong-doing and harm". The phrase primum non nocere is believed to date from the 17th century.

 

Another equivalent 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". The exact phrase is believed to have originated with the 19th-century English surgeon Thomas Inman.

HippocraticOath

 

 

 

The Declaration of Geneva was adopted by the General Assembly of the World Medical Association at Geneva in 1948, amended in 1968, 1983, 1994, editorially revised in 2005 and 2006 and amended in 2017.

 

It is a declaration of a physician's dedication to the humanitarian goals of medicine, a declaration that was especially important in view of the medical crimes which had just been committed in German-occupied Europe. The Declaration of Geneva was intended as a revision of the Hippocratic Oath to a formulation of that oath's moral truths that could be comprehended and acknowledged in a modern way.  Unlike the case of the Oath of Hippocrates, the World Medical Association calls the statement a "pledge".

 

Unlike the Hippocratic Oath, the Geneva Declaration does not make arrangements for descendants of the oath takers. It contains no reference to God, no prohibition of surgery, no explicit restrictions on euthanasia or abortion, but simply a commitment to “the utmost respect for human life”.

 

The Declaration of Geneva is one of the World Medical Association's (WMA) oldest policies adopted by the 2nd General Assembly in Geneva in 1948. It builds on the principles of the Hippocratic Oath, and is now known as its modern version. It also remains one of the most consistent documents of the WMA.

 

 

WMA DECLARATION OF GENEVA

 

Adopted by the 2nd General Assembly of the World Medical Association, Geneva, Switzerland, September 1948
and amended by the 22nd World Medical Assembly, Sydney, Australia, August 1968
and the 35th World Medical Assembly, Venice, Italy, October 1983
and the 46th WMA General Assembly, Stockholm, Sweden, September 1994
and editorially revised by the 170th WMA Council Session, Divonne-les-Bains, France, May 2005
and the 173rd WMA Council Session, Divonne-les-Bains, France, May 2006
and amended by the 68th WMA General Assembly, Chicago, United States, October 2017

 

The Physician’s Pledge

 

AS A MEMBER OF THE MEDICAL PROFESSION:

I SOLEMNLY PLEDGE to dedicate my life to the service of humanity;

THE HEALTH AND WELL-BEING OF MY PATIENT will be my first consideration;

I WILL RESPECT the autonomy and dignity of my patient;

I WILL MAINTAIN the utmost respect for human life;

I WILL NOT PERMIT considerations of age, disease or disability, creed, ethnic origin, gender, nationality, political affiliation, race, sexual orientation, social standing or any other factor to intervene between my duty and my patient;

I WILL RESPECT the secrets that are confided in me, even after the patient has died;

I WILL PRACTISE my profession with conscience and dignity and in accordance with good medical practice;

I WILL FOSTER the honour and noble traditions of the medical profession;

I WILL GIVE to my teachers, colleagues, and students the respect and gratitude that is their due;

I WILL SHARE my medical knowledge for the benefit of the patient and the advancement of healthcare;

I WILL ATTEND TO my own health, well-being, and abilities in order to provide care of the highest standard;

I WILL NOT USE my medical knowledge to violate human rights and civil liberties, even under threat;

 

I MAKE THESE PROMISES solemnly, freely, and upon my honour.

 

손수 쓴 사직서는 즉각 수리하고 그 면허는 바로 취소해 야

 

인간의  생명은 생사간에 존재하며

너무도 엄숙한고로 거짓이 없으며 숭고하다. 당연히 결코 장난질 대상이 아니다.

 

무슨 ~테스 선서나 맹세 쯤은 헌신짝 버리듯 차버린다. 미련도 없이~

돌팔이들에겐 똔은 생명보다 비교할 수 없도록 소중하니까... 

 

똔 탓~ 거짓말쟁이가 되어버린 적지않은 수의  명색 의료인들이 있다.

돈에 빨대나  꽂고 똔빠는 저질들을 어이하여야 하는가.

 

 

사직서 내고 파업하는 인간 등외품[等外品]들은 반드시 사표 수리하고

기왕이면 차제에 그  면허도 친절하게 취소해 드림이 가하고 적당하다고 확신한다.

 

거짓말 전문가들은 말카 다 원대로 사직이 이루어지도록 열렬한 국민의 성원이 있어야 마땅하다.

 

ㅉㅉㅉ~~~

 

*************************************************

히포크라테스 선서

 

의과대학을 졸업할 때 흰 가운을 입고 졸업식장에서 일명 히포크라테스 선서를 하고 있다.

 

 히포크라테스 선서는 BC5세기경 히포크라테스 학파에 의해 만들어진 혁명적인 개혁선언이었다. 낙태와 독약 처방이 성행하고 환자를 자기에게 유인하기 위해 동료의사에 대한 음해가 유행하던 시절 히포크라테스 학파의 의사들이 만들고 주장한 고대판 의사윤리선언이다. 이 선언은 후대에 까지 전해져 내려와 의사들이 지켜야할 전문 직업성과 의료윤리의 기초를 이루고 있었다.
 

 

하지만 의학의 발달과 함께 원래의 히포크라테스 선서는 시대의 요구에 맞게 문구의 개정이 이루어져 왔다.

 

제네바선언(Declaration of Geneva)

 

현재 의과대학 졸업생들이 선서하는 문구는 1948년 스위스 제네바에서 개최된 제22차 세계의사협회(WMA World Medical Association )에서 개정된 제네바 선언이다. 제네바선언은 이 헌장이 발표되기 직전에 행해졌던 나치의 비윤리적인 인체실험 범죄행위가 개정의 주된 배경이 되었다. 제네바 선언은 현 시대와 잘 맞지 않거나 부족한 히포크라테스 선서를 현대화하기 위하여 시도된 것이다.
 

그 후에도 제네바 선언으로 탈바꿈한 현대판 히포크라테스 선서는 여러 차례 문구 수정이 이루어지고 있다.

1968년 Sydney총회에서는 제5항 환자 비밀보장조항에 ‘환자의 사후에도 비밀을 지킬 의무’를 추가하였다.

1983년 Venice총회에서는 제9항 ‘from the time of conception(수태의 순간부터)’를 ‘from its beginning(생명의 시작)’으로 변경을 했다.

1994년 Stockholm총회에서 제7항에 형제 뒤에 ‘자매(姉妹)’를 부가하고, 제8항을 유엔의 인권 결의에 맞추어 수정을 했다. 2006년의 중간 이사회에서 1968년 Sydney개정 시에 개정한 제9항의 ‘수태의 순간부터’를 삭제하는 제안이 있었지만, Catholic국인 Island의사회로부터, 삭제를 하면 WMA가 중절을 인정하는 것이 된다고 하는 반대가 있어, 결국 ‘생명의 시작’으로 타협하게 되었다.
 

이 제네바선언은 1949년 10월 실제 의사들이 지켜야할 더 구체화된 문구로 WMA 런던총회에서 ‘국제의사의 윤리강령’을 탄생시켰다. 제네바선언과 함께 국제의사의 윤리강령은 몇 차례 개정을 통해 그 결과를 각 나라에 통보하고 있다. 각 국은 이 개정 결과를 의사윤리강령 개정적업의 기초로 이용되고 있다.

 

 

 

제네바선언(Declaration of Geneva)

 

의료 전문가로서 나는,

 

인류를 위해 내 삶을 바칠 것을 맹세합니다.

나의 스승에게 존경과 감사를 드리겠습니다.

양심과 품위를 유지하면서 의술을 베풀겠습니다.

환자의 건강과 생명을 우선적으로 생각하겠습니다.

환자에 관한 모든 비밀을 절대로 지키겠습니다.

의료계의 명예와 고귀한 전통을 지키겠습니다.

동료 의사들을 형제처럼 여기겠습니다.

국적, 인종, 정치적 입장, 사회적 신분을 초월하여 오직 환자에 대한 나의 의무를 다하겠습니다.

생명이 수태된 순간부터 인간의 생명을 최대한 존중하겠습니다.

어떤 위협을 받더라도 의학 지식을 인륜에 어긋나게 쓰지 않겠습니다.

 

나는 자유 의사에 따라 명예를 걸고 위와 같이 서약합니다.

 

 

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