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Exercise 1

Hippocratic Oath, The Medical Ideal

Perhaps the most enduring----certainly the most quoted----tradition in the history of medicine is the Hippocratic Oath.Named after the famous Greek physician Hippocrates, this oath was written as a guideline for the medical ethics of doctors.Although the exact words have changed over time, the general content is the same----an oath to respect those who have imparted their knowledge upon the science of medicine, and respect to the patients as well as the promise to treat them to the best of the physicians’ ability.Who Was Hippocrates, and Did He Write the Oath?

For a man considered by many to the “Father of Medicine”, little is known about Hippocrates of Cos.He lived circa 460-380 BC, and was the contemporary of Socrates as well as a practising physician.He was certainly held to be the most famous physician and teacher of medicine in his time.Over 60 treatises of medicine, called the Hippocratic Corpus, have been attributed to him;however, these treatises had conflicting contents and were written sometime between 510 and 300 BC, and therefore could not all have been written by him.The Oath was named after Hippocrates, certainly, although its penmanship is still in question.According to authorities in medical history, the contents of the oath suggest that it was penned during the 4th Century BC, which makes it poible that Hippocrates had himself written it.Anyway, regardle of whether or not Hippocrates himself had written the Hippocratic Oath, the contents of the oath reflect his views on medical ehtics.From Medical Ideal to Standard Ethics Guidelines

The Hippocratic Oath was not very well received when it was first penned, being a representation of only a minor segment of Greek opinion at the time.However, by the end of ancient times, physicians began conforming to the conditions of the oath.It is poible that when scientific medicine suffered a gro decline after the fall of the Roman Empire, this oath, along with the dictates of Hippocratic medicine, was all but forgotten in the West.It was through the perservance of the spirit of inquiry in the East that the tenets of Hippocratic medicine----and the Hippocratic Oath----survived this period of deterioration, notably through the writings of Arabian authorities in medicine.The knowledge of Greek medicine was lately revived in the Christian West through the Latin translations of both these Arabic works and the original Greek texts.By the late 17th Century, standards of profeional behaviour had been set in the Western World.The first code of medical ethics to be adopted by a profeional organisation was written by English physician Thomas Percival(1740-1804)in 1794, which was adapted and adopted by the American Medical Aociation(AMA)in 1846.This code of ethics, which provided a gold standard for profeional physicians, dictated the moral authority and independence of physicians in service to others and their responsibility towards the sick, as well as the physician’s individual honour.The seeds had been sown by Hippocrates----or one of his ghost writers.After World War II, 23 doctors from Nazi Cermany concentration camps were found guilty of breaching the code of medical ethics by performing horrifying medical experiments on prisoners.This incident led to the composition of the Nuremberg Code(1947), which represented the

starting point in discuions regarding ethical treatment of human subjects, and outlined the ethics of medical research with regard to the rights of these subjects.This in turn led to the adoption of the Declaration of Geneva oath by the World Medical Aociation in 1948.Contemporary Dilemmas in the Modern World

The reintroduction of the oath has been problematic.Medical ethics are complex.They must balance patient expectations, social demands and taboos, economic and political realities, and evolving medical and scientific knowledge.For instance, the original oath required patients to be cured regardle of circumstances.However, using placebos in double-blind trials, considered eential for drug development, means doctors do not attempt a cure.The original oath would also forbid triage.This is used during war or disasters when treatment is prioritized based on patients’ survival chances.Different medical care for patients with or without health insurance would be impoible.Some dangerous types of chemotherapy using toxic drugs in high doses would be disallowed.Finally, the original oath prohibits aisted euthanasia to relieve the suffering of patients with incurable conditions.Therefore people argue that the original Hippocratic Oath is invalid in a society that has seen drastic socio-economic, political and moral changes since the time of Hippocrates.This has led to the modification of the oath to something better suited for our times.Four of the most widely used versions nowadays are the Declaration of Geneva----mentioned previously, the Prayer of Maimonides, the Oath of Lasagna, and Reinstatement of Hippocratic Oath, although they differ in wording and content, the main tenets are the same----treat patients to the best of one’s abilities, never cause intentional harm, and maintain patient confidentially----although none of them call upon various deities to punish the physician if he transgrees from the oath, save for the Reinstatement!

Today, most graduating medical students swear to some form of the oath before they go out into the world to practice medicine.However, this is usually a modern verison, which bears little resemblance to the original.Some medical schools, particularly in the United States, combine other oaths with modern rules to create a workable ethical model.Unlike the original, the new oath does not require that doctors swear it before they can practice.Instead, it is a code of pracitce, and a symbol for young doctors entering the profeion and their coomitment to healing.The question is----why has such an old bit of writing, descended form ancient times, so profoundly influenced the practice of medicine throughout the history of medical science?

G.E.R.Lloyd said of Hippocratic medicine: “ In the Western world, the name Hippocrates has always stood of an ideal”.And this is what the oath is all about----an ideal gold ethics standard representing a clear dividing line seperating healers and killers, a commitment that physicians make to protect life, and never to take life away deliberately.In a world where society is always attempting to put the blame on physicians when things go wrong, this oath, when upheld, would protect not only physicians and their patients, but also their families and the society as a whole.It is understandable that some radicals may demand the removal of the Hippocratic Oath at graduation with the argument that it is too antiquated to be of use.However, even in this modern age of technological and medical enlightenment, a gold standard in moral and medical ethics----no matter how utopian it sounds----it still needed not only to set an example to those who are inheriting the medical busine, but also to protect those at the receiving end of the medical practice.Modification of the original oath is unavoidable----Hippocrates, being a man who was meticulous in his scientific methods and keen in his observations of the world with regard to man

and disease, would surely have approved of the changes for the sake of keeping up with the developments of the world----but as long as our physicians and practitioners hold true to the basic tenets of the Hippocratic Oath, it would continue to serve mankind for long after the name of its writer has been forgotten.I.Fill in the blanks in the following sentences with the words or expreions given

below.Change the form where neceary.breach;tenet;dictate;impart;antiquate;meticulous;name after;conform to;attribute to;to the best of

1.The latest discoveries in neurological reconstruction __________ the old doctrines on stroke

management.2.Parkinson’s disease ___________ the doctor who first documented the symptoms of the

disease.3.Many profeors devoted their precious time to ________ their medical knowledge gained

from the clinical practice.4.The famous scientist ___________ the ethics of the commitment when he falsified the

statistics.5.Operators of experimental instrument must be really ___________ because it is very delicate.6.The succe of the breakthrough _________ the diligent exploration of the whole team rather

than the principal investigator himself.7.He was determined to help the patients _________ his ability and knowledge.8.Though doubtful about the instruction of his supervisor, the student followed his

____________ earnestly in the experiment.9.Prescribing overdosed medicine for the sake of economical benefits seriously violates the

_______ of a doctor.10.The primitive lab does not _________ the safety regulations on conducting virulent studies.II.Translation exercise

Section APut the following paragraph into Chinese.Although the exact words have changed over time, the general content is the same----an oath to respect those who have imparted their knowledge upon the science of medicine, and respect to the patients as well as the promise to treat them to the best of the physicians’ ability.And this is what the oath is all about----an ideal gold ethics standard representing a clear dividing line seperating healers and killers, a commitment that physicians make to protect life, and never to take life away deliberately.In a world where society is always attempting to put the blame on physicians when things go wrong, this oath, when upheld, would protect not only physicians and their families and the society as a whole.Section BPut the following paragraph into English.今天，大多数即将毕业的医学生在进入社会从医前都会进行某种形式的宣誓。誓言常常是现代版的，跟原版大不一样。有些医学院，特别是美国的学校，将其他誓言和现代准则糅合而创作出务实可行的道德模式。与原版不同，新誓词不再要求医生们执业前必须宣誓。相反，它更是一种行为守则，是年轻医生们进入医疗行业并承诺投身医疗的象征。