The Hippocratic oaths, Charak Shapath and Physician’s Pledge

Context

• Months after it triggered a row by suggesting that the traditional Hippocratic Oath in medical colleges should be replaced by a “Charak Shapath”, the National Medical Commission has released draft regulations for the professional conduct of doctors without including either of the two oaths.
• Instead, the draft – National Medical Commission Registered Medical Practitioner (Professional Conduct) Regulations, 2022 – has included ‘The Physician’s Pledge’ as per the World Medical Association’s Declaration of Geneva.
• Even earlier regulations by the Medical Council of India, that predated the NMC, had no mention of the Hippocratic Oath.

What is the Physician’s Pledge in the draft NMC resolution?

• The Physician’s Pledge that is part of the WMA’s Declaration of Geneva was adopted by the Second General Assembly of the World Medical Association, Geneva, in September 1948. There were minor revisions over the years and the last amendment took place during the 68th WMA General Assembly in Chicago, in October 2017. NMC’s draft regulations, released on May 23, mention this Physician’s Pledge from the “Declaration of Geneva 2017” as an inclusion at the end of its 14-point code of ethics. The Pledge reads, “as a member of the medical profession”:

  

  • I solemnly pledge to dedicate my life to the service of humanity
  • The health and well-being of my patient will be my first consideration
  • I will respect the autonomy and dignity of my patient
  • I will maintain the utmost respect for human life
  • I will not permit considerations of age, disease or disability, creed, ethnic origin, gender, nationality, political affiliation, race, sexual orientation, social standing, or any other factor to intervene between my duty and my patient
  • I will respect the secrets that are confided in me, even after the patient has died
  • I will practice my profession with conscience and dignity and in accordance with good medical practice
  • I will foster the honour and noble traditions of the medical profession
  • I will give to my teachers, colleagues, and students the respect and gratitude that is due.
  • I will share my medical knowledge for the benefit of the patient and the advancement of healthcare
  • I will attend my own health, well-being, and abilities in order to provide care of the highest standard
  • I will not use my medical knowledge to violate human rights and civil liberties, even under threat
  • I will make these promises solemnly, freely, and upon my honour.

What was the controversy over the Charak Shapath?

• The controversy began after the National Medical Commission (NMC), the regulator for medical education and practices (which replaced the Medical Council of India in 2020) suggested to medical colleges on February 7 that the Hippocratic Oath should be replaced by a “Charak Shapath”.
• While some medical practitioners welcomed the proposal, the Indian Medical Association (IMA), the national representative platform of doctors of modern medicine, took up the matter with Health Minister.

Back to Basics

Who was Charaka and what is the Charak Samhita?

• Like several other sages mentioned in the literature of ancient India, the historicity of Charaka is uncertain. The compendium of medicine that carries his name is unlikely to have been the work of a single individual, and not all of it is likely to have been written at the same time.
• The Charak Samhita is a medical pharmacopoeia and collection of commentaries and discussions on medical practices that is historically dated to the 1st-2nd centuries AD.
• Along with the compendium of Susruta (c. 4th century AD), which is about surgery, the Charak Samhita is considered the foundational text of ancient Indian medicine, which was an evolved system of understanding and treating disease that was in several ways ahead of the Greeks.
• The ancient Indian interest in physiology is understood to have been drawn from yoga and mysticism, and to have been enriched by the growth and spread of Buddhism to new lands, the arrival of the first Christian missionaries, and the contact with Hellenic practitioners of medicine.

What are the medical ethics of the sage Charaka?

• The physician was an important and respected member of ancient Indian society, and medical practice followed rules of professional conduct and ethical principles.

What is the Hippocratic Oath?

• The Hippocratic Oath is attributed to Hippocrates of the island of Kos, a Greek physician of the classical period (4th-5th centuries BC), broadly corresponding to the period from the death of the Buddha (486 BC) to the rise of the Mauryas (321 BC) in India.
• Among the great contemporaries of Hippocrates, the so-called “father of modern medicine”, were the Athenian philosopher Plato and his teacher Socrates, and Plato’s student and a tutor of Alexander the Great, Aristotle.
• The Oath is a charter of ethical principles that physicians over the ages have sworn to uphold in the practice of their profession. The earliest available fragments of what is understood to be the original oath date back to the late 3rd century AD, and a millennium-old version is kept in the library of the Holy See.

What does the Hippocratic Oath say?

• I will use treatment to help the sick according to my ability and judgment, but I will never use it to injure or wrong them.
• I will not give poison to anyone though asked to do so, nor will I suggest such a plan. Similarly, I will not give a pessary to a woman to cause abortion. But in purity and in holiness I will guard my life and my art.
• I will not use the knife either on sufferers from stone, but I will give place to such as are craftsmen therein.
• Into whatsoever houses I enter, I will do so to help the sick, keeping myself free from all intentional wrongdoing and harm, especially from fornication with woman or man, bond or free.
• Whatsoever in the course of practice I see or hear (or even outside my practice in social intercourse) that ought never to be published abroad, I will not divulge, but consider such things to be holy secrets.

Reference:

https://indianexpress.com/article/explained/explained-physician-pledge-new-draft-code-ethics-doctors-differs-charak-hippocrates-oaths-7957194/

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