Hippocratic Ethics Research Articles

From the Hippocratic Oath to modern deontological codes: continuity or overcoming?

Even if the Hippocratic Oath in its enlightened synthesis encapsulates the essence of the great master's deontological teachings, there is no doubt that a more complete picture of Hippocratic ethics can be gleaned from the contents of the entire Corpus Hippocraticum, and it matters little if the various writings contained therein are not all attributable to him, but are in fact the work of various authors who lived between the 5th and 2nd centuries BC.

Ethics of the Corpus Hippocraticum: Philosophical Foundations of a Contemporary Debate

The article deals with a contemporary debate on Hippocratic ethics. Both the opponents and proponents of Hippocratic medical ethics seem to ignore the complexity of the said ethical system. The ethics of the Corpus Hippocraticum can be properly understood only in relation to physiological, psychological, and other factors. Therefore, the ongoing debate only partially represents ethical issues, and a number of arguments in it cannot be considered as valid. Moreover, the complexity of Hippocratic ethics reveals that quite a few of its principles are still valid today and deserve to be further analyzed. In addition, some of its principles have been incontestably incorporated into contemporary medical ethics.

Історичні передумови формування деонтологічної компетентності фахівців у галузі охорони здоров’я

The article reveals the historical preconditions for the formation of deontological competence of health professionals as a personality trait of the health workers, which allows them to interact productively with internal (professional) and external (social) environment, provides successful personal and professional interaction with patients and effective organization and solving professional problems. The peculiarities of ethical views and deontological models that have existed in health care during the historical development of mankind are considered; the essence of Hippocratic ethics and its further development are outlined. The main international and national legal documents and codes of ethics, which are the basis for regulating the relationship between doctor and patient, and determine the structure of deontological competencies are analyzed. It is determined that the moral and ethical principles and rules of professional behaviour in the field of health care have been formed, changed and improved over the course of historical development, shifting the emphasis from the interpersonal relationship between patient and doctor to ensure the ethics of the entire health care system.

The Virtue of Piety in Medical Practice

Following the Introduction, the second section of this essay lays out Tom Cavanaugh’s helpful and convincing account of the enduring significance of the Hippocratic Oath in terms of how it responds to the problem of iatrogenic harm. The third section discusses something underemphasized in Cavanaugh’s account, namely, the key role of the virtue of piety within the Oath and the profession it establishes, and argues that this virtue should be regarded as integral to an authentic Hippocratic ethic. The fourth and final section briefly examines the connection between medicine and philosophy, focusing on how both should be seen as wisdom-seeking ways of life, and shows the relevance of this for regarding the virtue of piety as the key virtue of medical practice.

Relating Hippocratic and Christian Medical Ethics

AbstractThis article articulates the Hippocratic medical ethic found in the Oath and the Christian medical ethic as exemplified in the parable of the Good Samaritan. It proposes that the Oath has a natural-law-based deontological character (as understood by Aquinas) that governs friendships of utility (as understood by Aristotle) between student and teacher and physician and patient. The article elaborates on the Samaritan’s conduct as exemplifying Christian agapeic-love. It contrasts agapeic-love with friendship-love, while noting that the Samaritan relies on friendship-love (as found between the Samaritan and the innkeeper) to realize agapeic-love towards the robbers’ victim. It concludes with noting that the grace-based Christian medical ethic perfects the nature-based Hippocratic ethic not by destroying it, but, rather, by employing it.

COVID-19: Paradox of increasing capacities versus focus on Hippocratic ethics?

A simple statistical review of the results of the increased availability of ICU beds in the EU shows that irrespective of whether a country has a lot of ICU beds or just a few, the death rates due to COVID-19 is still the same (P = 0 34, Fig 1 and Tab 1) An answer to the paradox comes from a group of intensive care physicians from long-suffering Italy [2], who claim that, at present, attention is focused mainly on increasing capacities (e g , the number of ICU beds, respirators and intensive care units, etc ) Conflict of interest The author, George Anogeianakis, certifies that he has no financial conflict of interest (e g , consultancies, stock ownership, equity interest, patent/licensing arrangements, etc ) in connection with this article 1

The ethical legacy of Hippocrates

The text analyses the ethical content of the Hippocratic Oath, evaluates its significance for modern-day medicine and answers the question of how relevant it is for today's physicians. The history of the Oath is explored from its origin to modern-day adaptations. The paper explains the difference of expressing moral norms through an oath, a promise and a code. The ethical contents of Hippocratic ethics are divided into three segments: the covenant, the code and decorum. The paper further discusses the interpretation of controversial parts on abortion, euthanasia and the use of surgery. In his other works, Hippocrates emphasises high morality and requires physicians to be virtuous, exemplary humanists and to preserve the honour of their profession. In spite of all its faults, the Hippocratic Oath continues to set an example for the medical practice by emphasising the responsibility of the physician for the well-being of the patient. It is necessary that physicians possess not only technical knowledge, but also ethical education, enabling them to make conscientious moral decisions. The Oath is old, non-authentic , modified, differently interpreted and incomplete, but remains relevant for modern-day biomedical ethics.

È morto Ippocrate, lunga vita a Ippocrate. Per una rivalutazione del paradigma medico ippocratico

Nel panorama bioetico contemporaneo trova credito l’idea per cui la tradizione ippocratica sarebbe ormai irrimediabilmente anacronistica ed inevitabilmente superata, come, ad esempio, sostengono autori quali Veatch, Riha, Heubel e Mori. Le ragioni profonde di questa ostilità rimandano al divieto di pratiche abortive e di atti finalizzati a provocare la morte, contenuti nel Giuramento di Ippocrate, nonché, più in generale, alla commistione con l’etica cristiana che la storia dell’ippocratismo racconta. Nel presente contributo intendo mostrare come il movimento anti-ippocratico contemporaneo si nutra di una nozione di ippocratismo affetta da una certa stereotipia, e così ricostruita allo scopo di accreditare l’opposto paradigma pro-choice. Il mio intento finale è quello di offrire alcuni spunti per una riconsiderazione del paradigma medico ippocratico, alla luce dell’apprezzamento di quelli fra suoi elementi costitutivi che possono definirsi “classici”. Dopo un breve ritorno alle origini storiche dell’ippocratismo, mi soffermerò sul primo Aforisma di Ippocrate, in quanto manifesto epistemologico della medicina ippocratica, e sul Giuramento, in quanto manifesto deontologico della professione medica ippocratica. A traghettarmi dall’Aforisma al Giuramento, a cavallo tra epistemologia e deontologia, sarà una specifica riflessione sulla concezione ippocratica del rapporto tra medico e paziente, così come emergente anche da altre fonti antiche. Nel compiere questo percorso, sarò supportata da autorevoli voci, che, nell’odierno panorama nazionale e internazionale, contribuiscono ad alimentare una sempre più attenta rivalutazione della tradizione ippocratica, sotto il profilo etico e deontologico.

To Be or Not to Be Vaccinated? The Ethical Aspects of Influenza Vaccination among Healthcare Workers.

Influenza is a highly contagious airborne disease with a significant morbidity and mortality burden. Seasonal influenza (SI) vaccination has been recommended for healthcare workers (HCWs) for many years. Despite many efforts to encourage HCWs to be immunized against influenza, vaccination uptake remains suboptimal. Sometimes there is a significant sign of improvement, only if numerous measures are taken. Is ‘the evidence’ and ‘rationale’ sufficient enough to support mandatory influenza vaccination policies? Most voluntary policies to increase vaccination rates among HCWs have not been very effective. How to close the gap between desired and current vaccination rates? Whether (semi)mandatory policies are justified is an ethical issue. By means of a MEDLINE search, we synthesized the most relevant publications to try to answer these questions. Neither the ‘clinical’ Hippocratic ethics (the Georgetown Mantra: autonomy, beneficence, non-maleficence, and justice), nor the ‘public health’ ethics frameworks resolve the question completely. Therefore, recently the ‘components of justice’ framework was added to the ethical debate. Most options to increase the uptake arouse little ethical controversy, except mandatory policies. The success of vaccination will largely depend upon the way the ethical challenges like professional duty and ethics (deontology), self-determination, vaccine hesitance, and refusal (‘conscientious objector’) are dealt with.

A propósito de la reforma de la ley de ética médica

La ley o código de ética médica debe ser entendida como la carta de navegación moral de profesionales de la medicina, como lo que se dirige con ella es ayudarlos a que no se pierden durante el curso de su trabajo, señalándolos de la manera correcta de actuar con sus pacientes y la comunidad. Esa guía es el "objetivo moral", es decir, el conjunto de normas que dicta la sociedad de sus componentes, incluidos los propios médicos.Como tal, el código de ética médica tiene el paciente como su primer beneficiario, que es el fundamento de la medicina. Lo que está dirigido es que el médico sea una prenda de garantía para el cuidado de la salud y vida de las personas, la interpretación de que el primero y el segundo representa sus mejores intereses. De ninguna manera se puede pensar que el único propósito de la ley es proteger los intereses de los médicos.En 1981, se promulgó la Ley 23, que es el estándar actual de la ética médica. Desde entonces - 34 años después - la aduana en el ámbito de la práctica han cambiado sustancialmente. Desde costumbres son moralmente calificado y valorado por la sociedad, moral debe ajustar su enfoque como los cambios. Así es entonces comprensible que muchas de las normas morales se hace referencia en la ley primaria han quedado obsoletos. Considerando que el paso del tiempo es la más grave y leyes justas juez, después de casi siete décadas de Ley 23 en evaluación, se han puesto de manifiesto tanto por su bondad y defectos.Con el advenimiento de la bioética en la década 70 del siglo pasado, tanto en la cara y el cerebro de la ética tradicional sufrieron cambios fundamentales. Tomado como una especialidad de la bioética, la ética médica también cambiaron, hasta el punto que su distancia de la ética hipocrática - vigente durante más de veinte siglos - forzado a reevaluar algunos de los principios en que se basaba la misma.

Hippocratic, Religious, and Secular Medical Ethics: The Points of Conflict. By Robert M.Veatch. Pp. 242, Washington, D.C., Georgetown University Press, 2012, $29.95.

Hippocratic, Religious, and Secular Medical Ethics: The Points of Conflict. By Robert M.Veatch. Pp. 242, Washington, D.C., Georgetown University Press, 2012, $29.95.

The Medical Duty of Confidentiality in the Hippocratic Tradition and Jewish Medical Ethics

The sources for the Jewish model of the patient-physician relationship, including the duty of confidentiality, have been quite different from those that have shaped the Western approach to medical ethics. In the United States, as in other Western countries, the concept of the medical duty of confidentiality has been influenced by the Hippocratic tradition, in particular the Hippocratic Oath, as well as the Christian concept of the confessional. In general, the Western model was based on the premise that all information imparted by the patient to the physician and the latter's assessment of it was exclusive – confidential – to the two parties. In contrast, the professional ethics of Jewish doctors have their sources in the Torah, the Talmud and the Halachah. Jewish law regards the duty of medical confidentiality as important but subordinate to the welfare interests of the community as a whole. The article examines the historical development of the model of the patient-physician relationship in Western medicine and the Jewish model of medical ethics which is grounded in the Halachah as the supreme authority in matters of ethical reasoning and conduct for both patients and attending physicians.

Bioethics - a brief history: from the Nuremberg code (1947) to the Belmont report (1979)

This study tells the story of Bioethics in the period between the Nuremberg Code (1947) and Belmont Report (1979). Bioethics is a word etymologically formed by two Greek etyma: bio (s) and ethike. A triple paternity and triple birth place was allocated to this neologism: Van Rensselaer Potter in Wisconsin; Shriver and Hellegers in Washington; and Fritz Jahr in Halle an der Saale (Germany). Potter was concerned, in principle, with the environment and sustainability of human life on the planet; the Washington group was mainly concerned with problems and ethical challenges imposed on Medicine by new technologies; and Fritz Jahr was concerned with ethical relations between human beings and animals and plants. Bioethics is born bringing into memory the inhuman experiments performed on vulnerable people during the World War II, and grows side by side with great scientific and technological development. That same technology that increases the potential of medicines brings serious moral challenges that the traditional Hippocratic ethics has difficulties to respond. All this is happening at the same time when people are fighting for more autonomy and rights. To reflect on this context and identify the best alternatives of conduct is one of the roles of Bioethics.

Book Review: Hippocratic, Religious, and Secular Medical Ethics: The Points of Conflict

Book Review: Hippocratic, Religious, and Secular Medical Ethics: The Points of Conflict

Moderna medicinska etika

The Hippocratic Oath, millennium mainstay of medical ethics, has had many interpretations and challenges on its way to modern medical ethics and codes of ethics. Hippocrates learn­ing in history changed in accordance with cur­rent social, religious and political values and requirements. The most important reasons for the new approach in the new medical ethics lie in the ethical theories: utilitarianism (and welfare benefits), deontology (duty and behavior), the moral duties of doctors and health workers, and virtue ethics (set of Hippocrates). In all this, we should bear in mind the theoretical and practical values that are most relevant to each individual case. Today there are many theories of civil with the potential to grow into bioethical theories, such as the feminist movement in bioethics, Marxism, libertarianism (the doctrine of free­dom) and other theological theories. Howev­er, none of them are imposed from a practical point of view, able to deal with ethical dilem­mas and problems that gave birth to modern science and technology. In a similar trend in the development of medical ethics at the beginning of the new millennium, the Hippocratic oath is augmented with the Geneva Declaration, and in England, the General Medical Board provides a clear and stylish guide Hippocratic Oath in terms of the doctor's rights and obligations, as well as the Code of Ethics as a guide for good medi­cal practice (General Medical Council, 2006). Professional medical ethics has finally over­taken the Hippocratic ethic. What is encour­aging is the strong development of codes of ethics in modern medicine and health care in many countries, including Serbia.

P-642 - Ethical principles in medicine and psychiatry

The ethical principles, from ancient times to the present, that have shaped our current ethical perceptions and relevant codes of ethics in Medicine and Psychiatry (Virtue Ethics, Casuistry, Deontological theory, Utilitarianism, Principlism, Ethics of Care) are reviewed and discussed. The primacy of principles, especially those related to virtue ethics, over rules and codes is emphasized and it is pointed out that moral decisions are always filtered through the set of values of the individual practitioner. It is emphasized that ethical principles should be taken into account not separately but as a whole because there are many cases in which there is contradiction and the physician must decide which principle takes precedence. A general ethical obligation with universal acceptance but with questionable applicability is that the well-being of the patient takes precedence over all other interests, including those of the physician. The relevance of Hippocratic Ethics and the pragmatism of the last revision of the Declaration of Helsinki on Medical Research are highlighted. Lastly, it is pointed out that there is perpetual cross-talk between attention to ethical values and respect for human rights.

Viewpoint: How to avoid a dichotomy between autonomy and beneficence: from liberalism to communitarianism and beyond

Viewpoint: How to avoid a dichotomy between autonomy and beneficence: from liberalism to communitarianism and beyond

Triage in public health emergencies: ethical issues

General concepts about medical disasters, public health and triage are outlined. Triage is described in the context of public health emergencies and disaster settings, and the main ethical values at stake in triage are discussed. Possible conflicts between competing values are outlined. Special attention is given to possible conflicts between the protection of individual interests (typical of clinical ethics), and the pursuit of collective interests (typical of public health and triage). Hippocratic ethics is compared to utilitarian ethics and to perspectives that emphasize the principle of justice. Three ethical attitudes are suggested that may contribute to a resolution of competing values: protection of human dignity, precaution and, especially, solidarity. Personalism promotes the collective good by safeguarding and giving value to the well-being of each individual. A personalistic perspective is suggested as a way to deepen the concept of solidarity as a pillar both of clinical and public health ethics.

The Legal Development of the Informed Consent Doctrine: Past and Present

For millennia physicians were admonished to obscure the details of patients’ illnesses and poor prognoses. The Hippocratic ethic precludes physicians from including patients in medical decisionmaking. That ethic demanded of doctors that they “[p]erform [their duties] calmly and adroitly, concealing most things from the patient … revealing nothing of the patient's future or present condition.”

Toward a Hippocratic Psychopharmacology

To provide a conceptual basis for psychopharmacology. This review compares contemporary psychopharmacology practice with the Hippocratic tradition of medicine by examining the original Hippocratic corpus and modern interpretations (by William Osler and Oliver Wendell Holmes). The Hippocratic philosophy is that only some, not all, diseases should be treated and, even then, treatments should enhance the natural healing process, not serve as artificial cures. Hippocratic ethics follow from this philosophy of disease and treatment. Two rules for Hippocratic medicine are derived from the teachings of Osler (treat diseases, not symptoms) and Holmes (medications are guilty until proven innocent). The concept of a diagnostic hierarchy is also stated explicitly: Not all diseases are created equal. This idea helps to avoid mistaking symptoms for diseases and to avoid excessive diagnosis of comorbidities. Current psychopharmacology is aggressive and non-Hippocratic: symptom-based, rather than disease oriented; underemphasizing drug risks; and prone to turning symptoms into diagnoses. These views are applied to bipolar disorder. Contemporary psychopharmacology is non-Hippocratic. A proposal for moving in the direction of a Hippocratic psychopharmacology is provided.