Contemporary Medical Students' Perceptions of the Hippocratic Oath

Abstract

Background: The Hippocratic Oath is a standard of medical ethics. Oath adaptations are common. Objective: Evaluate students' perceptions regarding the oath. Design: Survey of University of California, Los Angeles (UCLA) Medical School graduating students regarding the oath's relevance, content, and application, and whether a choice of version should be provided.

Results: Forty-two of the fifty-three students (79 percent) considered the original oath relevant. Most (53 percent) disagreed that the oath in its original form be used, and most preferred a modified oath. More agreed (40 percent) than disagreed (28 percent) on providing a choice of version of the oath. The mean of correct answers as to the original oath's contents was 68 percent. Euthanasia and abortion prohibitions were recognized by 68 percent and 62 percent, respectively. Increased knowledge of the original's contents correlated with decreased desire that it be used (p = .02). Recognition of euthanasia/abortion prohibitions was significantly better for those in disagreement than in agreement that the original be used. Those who disagreed that a choice of oath versions be provided had significantly better knowledge of the original's euthanasia/abortion prohibitions than those who agreed. However, those who felt strongly that a choice should or should not be given each had a 100 percent accuracy of identifying euthanasia/abortion prohibitions.

Conclusions: Most students preferred an adapted oath to the original. Increased student knowledge of the original oath's contents, including reference to euthanasia/abortion, significantly correlated with decreased desire to use it. Given the original's importance in medical ethics, this is concerning. A subset of students, however, affirmed the original's value and desired its use. Improved education in the Hippocratic oath is important, given modern medicine's complex moral issues.

Summary: The Hippocratic oath is a standard of medical ethics. Oath adaptations eliminating the original's prohibitions of abortion/euthanasia are common. Most medical students who were questioned preferred the adapted oath to the original. Only two-thirds recognized the original's prohibitions of abortion/euthanasia. Those who knew of the original oath's prohibitions also had a decreased desire that it be used. Students disagreeing that a choice of versions of the oath be provided had better knowledge of these prohibitions. This is concerning, given the original oath's importance in medical ethics including at the 1945-1949 Nuremberg trials. Nonetheless, a subset of students affirmed the original Hippocratic oath's importance, desiring its use.

Keywords: Hippocratic oath; Nuremberg trials; abortion; euthanasia; medical education; medical ethics.