Beneficence, justice, and lifelong learning expressed in medical oaths

Abstract

Introduction: The principles of justice, beneficence, and nonmaleficence are prescriptions of the Hippocratic Oath. To fulfill them, physicians are obligated morally to lifelong learning; yet, there is little evidence that the relationship of beneficence to lifelong learning or to continuing medical education (CME) is expressed in medical oaths.

Methods: We analyzed 48 medical oaths written from the first century Ce through the present day, searching for a commitment to lifelong learning and for specification of a relationship to the principle of beneficence. Thirteen ancient and medieval and 35 modern and contemporary oaths were inventoried for source, such as corresponding to a medical school. They were sorted by those that mention the commitment toward lifelong learning and to determine their relationship with the principle of beneficence.

Results: Of the 48 medical oaths analyzed, only 20 manifest the commitment to lifelong learning. However, most of the oaths that contain this commitment do not pertain to medical schools, with the exception of the Declaration of Geneva. Of this group, 16 also indicate the principle of beneficence. Of these 16, only 3 establish a link between both. One medical oath indicated this commitment, and none of them analyzed the relation with the principle of beneficence.

Discussion: The commitment toward CME should not be absent in the present medical oaths. It is a duty and right of all physicians, and in turn, society should recognize this obligation in order to offer opportunities for the achievement of the principle of beneficence that will result in better health care.