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Ethical principles contained in currently professed medical oaths
E Dickstein1, J Erlen, J A Erlen
1Department of Medicine, Northeastern Ohio Universities College of Medicine, Rootstown.
Summary
Medical school oaths in 1989 primarily affirmed traditional principles like nonmaleficence and beneficence, with few addressing patient autonomy or veracity. These pledges did not reflect the evolving doctor-patient dynamics of the 1990s.
Area of Science:
- Medical Ethics
- Medical Education
- Professionalism in Medicine
Background:
- Analysis of medical school accreditation in 1989.
- Examination of pledges and ethical principles in medical oaths.
- Focus on the Association of American Medical Colleges and American Medical Association accreditation standards.
Purpose of the Study:
- To determine the pledges affirmed by U.S. medical schools.
- To identify the ethical principles contained within these medical oaths.
- To assess the alignment of oaths with contemporary medical practice.
Main Methods:
- Systematic analysis of pledges from all U.S. medical schools accredited in 1989.
- Content analysis of oaths to identify affirmed pledges and ethical principles.
- Categorization of principles including autonomy, veracity, nonmaleficence, beneficence, justice, and confidentiality.
Main Results:
- The Oath of Hippocrates was the most common pledge (used by 60 schools).
- Few oaths demonstrated respect for patient autonomy or included the principle of veracity.
- Nonmaleficence, beneficence, and justice were present in half of pledges; confidentiality in three-fourths.
Conclusions:
- Medical oaths from 1989 largely failed to incorporate emerging ethical considerations of the 1990s doctor-patient relationship.
- Traditional principles of nonmaleficence and beneficence remained dominant in medical oaths.
- Oaths require updating to reflect modern medical ethics and patient-centered care.