Stand by Me, Hippocrates

From 1997 to 1998, the Foundation for Medical Excellence, Lake Oswego, Ore., examined, through a national survey of physicians, the impact on clinical practice that physicians attribute to witnessing a medical oath or covenant.

Medicine considers itself a moral profession into which medical school graduates are inducted by taking a medical oath and/or signing a medical covenant expressing an ethical obligation to serve and protect the interests of their patients.

A medical oath is a solemn statement of service to mankind in which the graduate bears witness to his/her moral beliefs. A medical covenant is an agreement between a physician and his/her patients calling for a shared commitment to ethical standards.

Key Results

  • Survey results indicated that medical oaths play an active role in U.S. medical practice but medical covenants are not widely witnessed or used in decision-making.

  • The medical profession is of a mixed mind about the influence of medical oaths and covenants. Physicians who themselves swore an oath rated the influence of both oaths and covenants significantly higher than did physicians who did not swear an oath. Women physicians found oaths significantly more influential than did men.

  • Medical oaths play an active role in U.S. medical practice. Thirty percent of physicians refer to or use the memory of their oath on a daily basis while another 20 percent refer to their oath weekly.

  • A majority of physicians see their vocation to medicine (a commitment that serves higher ethical values) as dominating their own practices while they see other physicians motivated by reasons split between vocation and occupation (means of economic gain).