Recovering the Original Covenantal Spirit of the Hippocratic Oath
Jonathan Wispe, M.D.; MTS, Center Member (OSU) and Attending Neonatologist (PMG),The Ohio State University Center for Bioethics and Pediatrix Medical Group
The original Hippocratic Oath described in covenantal terms the relationship between apprentice oath taker and mentor. It contained a code of physician conduct but in essence the Oath concerned physician character and virtue. The three common elements of early Hippocratic corpus were: 1. Witness to a transcendent other; 2. Instructions about caring and comforting relationships with patients; 3. Prohibition of deliberate killing. The Oath changed over time. Modern versions minimize or omit the last two elements. In this essay I will review the biblical foundations of these lost elements, discuss possible benefits of their recovery, and comment on their applicability in non-Christian or non-religious contexts.
Medicine began inextricably entwined with a belief in the transcendent, first in pagan gods and then in the Abrahamic God. It became rooted in an understanding of biblical covenants between God and humanity. The relationship between God and humans is a double relationship; that is, we are covenant partners with God and with His image-bearers. The divine covenant instructs our relationships with one another. “There is a fundamental Judeo-Christian belief that God made a covenant with humanity, offering steadfast love and fidelity and asking in return that humans manifest a love for each other that mirrors divine fidelity” (Ramsey). This seems especially true for physician-patient relationships. “Faith is the lantern that illuminates all the virtues of a Christian physician. Foremost of these virtues is the command to love God and to love our neighbors with the agapeistic love of Christ” (Pellegrino). Reflecting on Ramsey’s call for covenantal-fidelity, May said, “Covenants of trust are transformational; they have a gratuitous growing edge that comes from the fundamental changes in the partners.” A covenant of fidelity defines the moral quality of attitudes and actions of all covenantal partners. Honesty and trust are essential. Patients entrust their care to their physicians. To honor this trust, physicians promise to provide enduring compassionate and loving care with only the best interests of their patients at heart. Physicians commit to practice wisely, to be self-effacing, and “to be there no matter what.”
I believe that this model of covenantal care, instructed by the transcendent, can be used in broader contexts of contemporary medicine. It need not be limited to Christians. Physicians widely acknowledge the intrinsic worth of humankind and understand the importance of compassionate physician-patient relationships. “A biblical covenantal ethic can form the platform for broad appeals to a diverse collection of medical authorities” (Cahill). She proposes that participatory, respectful and non-judgmental discourse will make it possible to find constructive consensus without diverse discussion partners abandoning their core beliefs.
“Without faith in God we cannot envision a Christian beneficence which is grounded in love for God and neighbor and is vital for entry into covenantal care. The demoralizing climate of contemporary medicine impels us to recapture the moral virtue of charity and love” (Pellegrino).
Can we recover the original Hippocratic spirit: Cure sometimes, Relieve often, and Comfort always? (Something Hippocrates may wish he said!).
Medicine began inextricably entwined with a belief in the transcendent, first in pagan gods and then in the Abrahamic God. It became rooted in an understanding of biblical covenants between God and humanity. The relationship between God and humans is a double relationship; that is, we are covenant partners with God and with His image-bearers. The divine covenant instructs our relationships with one another. “There is a fundamental Judeo-Christian belief that God made a covenant with humanity, offering steadfast love and fidelity and asking in return that humans manifest a love for each other that mirrors divine fidelity” (Ramsey). This seems especially true for physician-patient relationships. “Faith is the lantern that illuminates all the virtues of a Christian physician. Foremost of these virtues is the command to love God and to love our neighbors with the agapeistic love of Christ” (Pellegrino). Reflecting on Ramsey’s call for covenantal-fidelity, May said, “Covenants of trust are transformational; they have a gratuitous growing edge that comes from the fundamental changes in the partners.” A covenant of fidelity defines the moral quality of attitudes and actions of all covenantal partners. Honesty and trust are essential. Patients entrust their care to their physicians. To honor this trust, physicians promise to provide enduring compassionate and loving care with only the best interests of their patients at heart. Physicians commit to practice wisely, to be self-effacing, and “to be there no matter what.”
I believe that this model of covenantal care, instructed by the transcendent, can be used in broader contexts of contemporary medicine. It need not be limited to Christians. Physicians widely acknowledge the intrinsic worth of humankind and understand the importance of compassionate physician-patient relationships. “A biblical covenantal ethic can form the platform for broad appeals to a diverse collection of medical authorities” (Cahill). She proposes that participatory, respectful and non-judgmental discourse will make it possible to find constructive consensus without diverse discussion partners abandoning their core beliefs.
“Without faith in God we cannot envision a Christian beneficence which is grounded in love for God and neighbor and is vital for entry into covenantal care. The demoralizing climate of contemporary medicine impels us to recapture the moral virtue of charity and love” (Pellegrino).
Can we recover the original Hippocratic spirit: Cure sometimes, Relieve often, and Comfort always? (Something Hippocrates may wish he said!).