Content analyses of oaths administered at U.S. medical schools in 2000.

Abstract

Oath taking is an important aspect of professionalization that all physicians share. The authors conducted a content analysis of the medical oaths administered at all allopathic and osteopathic medical schools in the United States to evaluate variations in ethical content. The authors collected medical oaths administered at all accredited allopathic and osteopathic medical schools (122 and 19, respectively) in the year 2000. Using a modified conceptual framework developed by Baker, the oaths were analyzed for differences in their substantive content. Content differences based on schools' characteristics were also analyzed. Just over half (62 of 122) of the allopathic schools administered an oath other than the Hippocratic Oath or a modified version of it. Thirty allopathic schools administered an oath written by students and/or faculty, and 18 schools offered students more than one oath option. All 19 osteopathic schools used the Osteopathic Oath. Nearly all allopathic and osteopathic schools' oaths included content protecting patients' confidentiality (129 schools), but few cited the importance of avoiding sexual misconduct with patients (four schools). Although the Osteopathic Oath prohibits physician-assisted suicide or euthanasia, only six allopathic schools administered an oath with such a prohibition. One allopathic school's oath explicitly prohibited abortion. There were no major content differences in the oaths administered based on a school's ownership status, religious affiliation, or use of white coat ceremony. Many medical schools' oaths differ in substantive content. The impact of using a nonstandardized medical oath on physicians' professionalism and the inculcation of common ethical values and principles remains unknown.