Who takes a professional oath. Hippocratic Oath: myths and reality

Hippocrates, who lived in Hellas two and a half thousand years ago, in his writings that have survived to our time, took an oath, noting that “... medicine is truly the noblest of all arts. But due to the ignorance of those who practice it, and those who judge them with frivolous condescension, it is now far below all the arts.” Articles written by him About the doctor, About decent behavior. According to Hippocrates, a doctor is the only profession that should begin with an oath to society, since a person who has chosen this profession, who has studied for many years in order to help a person, a suffering individual, naturally must make a promise to be worthy of his chosen cause.

Hippocrates believed that the medical oath has special meaning. As one of the founders of medicine, Hippocrates asked doctors to swear:

“I swear by Apollo the physician, Asclepius, Hygieia and Panacea and all the gods and goddesses, taking them as witnesses, to honestly fulfill, according to my strength and my understanding, the following oath and written obligation: to honor the one who taught me on an equal basis with my parents, to share with him my wealth and, if necessary, help him in his needs; consider his offspring as their brothers, and this art, if they want to study it, teach them free of charge and without any contract; communicate instructions, oral lessons and everything else in the teaching to his sons, the sons of his teacher and students bound by an obligation and oath according to the medical law, but to no one else. I will direct the treatment of the sick to their benefit in accordance with my strength and my understanding, refraining from causing any harm or injustice. I will not give anyone who asks me a deadly drug and will not show the way for such a plan; Likewise, I will not give any woman an abortion pessary. I will conduct my life and my art purely and immaculately. In no case will I perform sections on those suffering from stone disease, leaving this to the people involved in this matter. Whatever house I enter, I will enter there for the benefit of the sick, being far from everything intentional, unrighteous and harmful, especially from love affairs with women and men, free and slaves.

So that during treatment - and also without treatment - I neither see nor hear about human life that should never be disclosed, I will remain silent about it, considering such things a secret. May I, who inviolably fulfill my oath, be given happiness in life and in art and glory among all people for eternity; but to him who transgresses and swears a false oath, let the opposite be done.”

The god Apollo mentioned here is the patron saint of doctors in ancient Greece and Rome (and the god of music, poetry, divination and the founding of cities). Asclepius, the son of Apollo, was considered a special god - the patron saint of doctors. Hygieia (Hygiene) - goddess of health, Panacea (Panacea) - goddess-healer of all diseases - daughters of Asclepius.

If we discard the indispensable original witnesses of the reigning myths of that time, this oath is still modern. It appeared when the Ten Commandments of Moses were not yet known, there was no Sermon on the Mount Christ, but the level of morality of Hippocrates is in no way inferior to the level of morality of today's righteous people.

The oath proposed by Hippocrates has basically survived to this day. With minor changes, it is still pronounced today by those entering this field. In 1948, the General Assembly of the International Medical Association adopted a declaration (called the Geneva Declaration), which, in essence, is nothing more than a modern version of the Hippocratic Oath.

In 1949, the General Assembly adopted the International Code of Medical Ethics, which includes the Declaration of Geneva.

However, many countries also have their own Hippocratic Oaths. In Russia before the revolution, doctors took the so-called Faculty Promise, the text of which was attached to the certificate of completion of the medical faculty.

In our time, the “Oath of the Doctor of the Soviet Union,” approved in 1971, was replaced by the “Oath of the Russian Doctor,” and in 1999 the State Duma adopted a new text Doctor's oaths, which doctors give in a solemn ceremony when receiving a diploma. And the difference from the text of Hippocrates and its subsequent versions is the ban on euthanasia.

The form and language of the oath changes over time, but the basis of medical ethics follows the main provisions of the Hippocratic Oath.

Julius Krelin

DOCUMENTS

Faculty Promise

(pre-revolutionary Russia). Accepting with deep gratitude the rights of a doctor bestowed upon me by science and comprehending the full importance of the duties assigned to me by this title, I promise throughout my life not to tarnish the honor of the class into which I am now entering: Helping those who suffer, I promise to sacredly keep the family secrets entrusted to me and not to abuse the trust placed in me: I promise to be fair to my fellow doctors and not to insult their personalities, however, if the benefit of the patient requires it, to tell the truth without hypocrisy. In important cases, I promise to resort to the advice of doctors who are more knowledgeable and experienced than me; When I myself am called to the meeting, I undertake in good conscience to give justice to their merits and efforts.”

Geneva Declaration

(1949). I solemnly vow to dedicate my life to the service of humanity. I will give my teachers due respect and gratitude; I will perform my professional duties with dignity and conscientiousness; the health of my patient will be my main concern; I will respect the secrets entrusted to me; I will, by all means in my power, uphold the honor and noble traditions of the medical profession; I will treat my colleagues as brothers; I will not allow religious, national, racial, political or social motives to prevent me from fulfilling my duty towards the patient; I will maintain the deepest respect for human life, starting from the moment of conception; Even under threat, I will not use my knowledge against the laws of humanity. I promise this solemnly, voluntarily and sincerely.”

Oath of a Russian doctor.

Receiving the high title of doctor and starting professional activity, I solemnly swear:

Honestly perform your medical duty, devote your knowledge and skills to the prevention and treatment of diseases, preserving and strengthening human health;

Be always ready to provide medical care, maintain medical confidentiality, treat the patient with care and attention, act exclusively in his interests, regardless of gender, race, nationality, language, origin, property and official status, place of residence, attitude to religion, beliefs, affiliation to public associations, as well as other circumstances;

Show the highest respect for human life and never resort to euthanasia;

Maintain gratitude and respect for your teachers, be demanding and fair towards your students, and promote their professional growth;

Treat your colleagues kindly, turn to them for help and advice if the interests of the patient require it, and never refuse your colleagues help and advice;

Constantly improve your professional skills, protect and develop the noble traditions of medicine.

It is a valuable document that illuminates the medical life of medical schools in the era of Hippocrates. Here, as in other works of the Hippocratic collection (as well as in Plato), no attitude of doctors towards temple medicine can be discerned; doctors - although they are Asclepiads, in the sense that they descend from Asclepius and swear by him, but are not priests of the Asclepeion.

In ancient times medicine was family business; it was cultivated in the depths of certain families and passed on from father to son. Then its scope expanded, doctors began to take students from outside. This is what Galen testifies. And Plato has indications that doctors in his time taught medicine for a fee; for example, he takes Hippocrates (see Introduction). True, this aspect of the matter is not mentioned in the “Oath”; there the student must enter, as it were, into the teacher’s family and help him if he is in need, but the monetary contract could be drawn up separately. When entering a medical practice or corporation, a doctor had to behave accordingly: refrain from any reprehensible actions and not lose his dignity. The rules of medical ethics formulated in the “Oath” had great influence for all subsequent times; Faculty promises were drawn up on its model, which were pronounced by doctors of medicine when receiving their degrees at the University of Paris and, more recently, here, in old Russia. Undoubtedly, the Hippocratic Oath was caused by the need to dissociate ourselves from single doctors, various charlatans and healers, of whom, as we learn from other books, there were many in those days, and to ensure public trust in the doctors of a certain school or corporation of Asclepiads.

Much has been written about the “Oath”: see Littre, IV, 610; V lately Kerner (Körner O., Der Eid des Hippocrates, Vortrag. München u. Wiesbaden, 1921); He also provides literature.

I swear by Apollo the physician, Asclepius, Hygia and Panacea 1 and all the gods and goddesses, taking them as witnesses, to honestly fulfill, according to my strength and my understanding, the following oath and written obligation: to consider the one who taught me the art of medicine on an equal basis with my parents, to share with him with your income and, if necessary, help him in his needs; consider his offspring as their brothers, and this art, if they want to study it, teach them free of charge and without any contract; instructions, oral lessons and everything else in the teaching 2 communicate to your sons, the sons of your teacher and students bound by an obligation and oath according to the medical law, but to no one else. I will direct the treatment of the sick to their benefit in accordance with my strength and my understanding, refraining from causing any harm or injustice. I will not give anyone the deadly means they ask from me and I will not show the way for such a plan; Likewise, I will not give any woman an abortion pessary. I will conduct my life and my art purely and immaculately. In no case will I perform sections on those suffering from stone disease, leaving this to the people involved in this matter 3 . Whatever house I enter, I will enter there for the benefit of the sick, being far from everything intentional, unrighteous and harmful, especially from love affairs with women and men, free and slaves.
So that during treatment - and also without treatment - I see or hear about human life that should never be disclosed, I will keep silent about it, considering such things a secret 4. May I, who inviolably fulfill my oath, be given happiness in life and in art and glory among all people forever; to the one who transgresses and takes a false oath, let the opposite be done to this 5.

1. Apollo was considered in post-Homeric times to be the physician of the gods. Asclepius, Ασκληπιός, Roman. Aesculapius, Aesculapius, son of Apollo, god of the medical arts; Hygieia, Ύγεία and Ύγίεια, daughter of Asclepius, goddess of health (hence our hygiene); she was depicted as a blooming girl with a cup from which a snake drank. Panacea, Πανάκεια, all-healing, another daughter of Asclepius; hence the panacea, the cure for all diseases, which medieval alchemists were looking for.

2. Types of teaching are listed here. The instructions, παραγγελίαι, praecepta, contained, perhaps, general rules medical behavior and profession, judging by the book of the same name in the Hippocratic collection included in this edition. Oral teaching, ακροασις, probably consisted of systematic readings in various departments of medicine. At least in the time of Aristotle, this was the name of the lectures that he read to listeners and which were then published in a processed form; such, for example, is his Physics. Φυσική ακρόασις. “Everything else” probably included the practical part of teaching at the bedside or operating table.

3. This phrase has always caused commentators some confusion as to why the doctor should not perform lithotomy (λιθοτομία) - an operation long known among the Egyptians and Greeks. The easiest way, of course, is to answer in accordance with the text that this operation was carried out by special specialists, as was the case in Egypt and the West at the end of the Middle Ages; they were probably also united in special organizations and owned the secrets of production, and an organized doctor should not have invaded someone else's field in which he could not be competent enough without losing his prestige. There is no reason to assume that this operation, or even all operations in general, were beneath the dignity of a doctor and were left to the lower medical class; The Hippocratic collection sufficiently refutes this. But back in the 17th century, Moreau (René de Moreau) translated ού τεμεω “I will not castrate,” since this verb also has this meaning, and more recently this version was defended by none other than Gomperz (Gomperz, Gr"echische Denker, Lpz. , 1893, I, 452). He translates: “I will not castrate even those who suffer from stone thickening (of the testicle).” This version, of course, is unlikely in every sense, and was refuted by Hirschberg (Hirschberg, 1916, see Körner). , 1. p., p. 14).

4. The prohibition for a doctor who has taken an oath to divulge other people's secrets, having passed through the centuries, has become in Russian and German legislation into a law punishing the divulgence of secrets that the doctor became familiar with during his professional activities. But a more or less attentive reading shows that the oath posed a broader question: one cannot generally disclose incriminating things seen or heard not only in connection with treatment, but also without it. A shop-floor, organized doctor should not be a malicious gossip: this undermines public trust not only in him, but also in the entire corporation.

5. I cite for comparison the “faculty promise”, which in the past, after a satisfactory defense of the dissertation and the proclamation of the dissertation candidate as a doctor, was read to him by the dean of the faculty and which the new doctor signed. It was also published on back side diploma “Accepting with deep gratitude the rights of a doctor granted to me by science and comprehending the full importance of the duties assigned to me by this title, I promise throughout my life not to tarnish the honor of the class into which I am now entering. I promise to help at all times, according to my best understanding, those who suffer and resort to my benefits, to sacredly preserve those entrusted to me family secrets and not to abuse the trust placed in me. I promise to continue to study medical science and contribute with all my might to its prosperity, communicating to the scientific world everything that I discover. I promise not to prepare and sell secret remedies. I promise to be fair to my fellow doctors and not to insult their personalities; however, if the benefit of the patient required it, tell the truth directly and without hypocrisy. In important cases, I promise to resort to the advice of doctors who are more knowledgeable and experienced than me; when I myself am called to the meeting, I will, in good conscience, give justice to their merits and efforts.”

In the above promise one can distinguish 3 parts, each of which has its primary source in the Hippocratic collection. Of these, the first, which has the patient as its subject, is directly adjacent to the “Oath”. The second - about medical secrets and secret remedies - is an echo of the struggle that Greek doctors of the 5th century. conducted with all sorts of quackery. In particular, the phrase: “....telling the learned world everything that I discover” is a retelling of the phrase: “they give to general information everything that was accepted from science,” which characterizes the wise doctor in the book “On Decent Behavior,” ch. 3. And finally, the third part about the doctor’s attitude towards colleagues and consultations quite closely conveys what can be read in the “Instructions”, ch. 8.

If a doctor made a mistake, was negligent in his official duties, or violated ethical standards in his professional activities, most often he will be reminded of the violation of the Hippocratic Oath. Moreover, a doctor who is involved in outright criminality is reproached for non-compliance with the same Hippocratic oath, although his actions often fall within the scope of the Criminal Code. What kind of oath is this that almost everyone has heard about, but few people have thought about who remembers it and why?

In the vast majority of cases, the Hippocratic Oath is associated with the doctor’s selfless service to people and his devotion to the ideals of humanism, selflessness and self-sacrifice. Almost everyone who has encountered in their life medical workers, we are sure that a doctor must be a highly professional specialist, a kind and sympathetic person and have an aversion to money. In general, the collective image of a doctor in our requirements for him is an angel-like creature, feeding on nectar and ready to “burn ourselves, shining for others...”. Why? This is what is written in the Hippocratic Oath!

The Hippocratic Oath is used by all and sundry to emphasize that a doctor, initially, in essence of his chosen profession, is obliged to serve (!) people free of charge (i.e., for nothing), sacrificing himself and the well-being of his loved ones. Why? And again: “He took the Hippocratic oath!”

Let's first deal with the Hippocratic oath itself, and after that we will decide why and who uses this oath and why he does it. Let's not trust the links, but read the original text:

« PerApollinemmedicumetAesculapium,HygiamqueetPanaceamjuro,deosdeasqueomnestestscitans,mepteviribusetjudiciomeohosjusjurandumethancstipulationemplenepraestaturum.

Ilium nempe parentum meorum loco habitumm spondeo, qui me artem istam docit, eique alimenta impertirurum, et quibuscunque opus habuerit, suppeditaturum.

Victus etiam rationem pro virili et ingenio meo aegris salutarem praescripturum a pemiciosa vero et improba eosdem prohibiturum. Nullius praeterea precibus adductus, mortiferum medicamentum cuique propinabo, neque huius rei consilium dabo. Casie et sancte colam et artem meam.

Quaecumque vero in vita hominum sive medicinam factitans, sive non, vel videro, vel audivero, quae in vulgus efferre non decet, ea reticebo non secus atque arcAnafidei meae commissa.

Quod si igitur hocce jusjurandum fideliter servem, neque violem, contingat et prospero successu tarn in vita, quam in arte mea fruar et gloriam immortalem gentium consequar. Sine autem id transgrediar et pejerem contraria hisce mihi eveniam.”

I don’t want to offend the users of the portal, but I would still risk suggesting that many of them were not taught Latin in secondary or higher school, so I will offer a translation from Latin into Russian:

“I swear by Apollo the physician, Asclepius, Hygeia and Panacea and all the gods and goddesses, taking them as witnesses, to fulfill honestly, according to my strength and my understanding, the following oath and written obligation: to honor the one who taught me on an equal basis with my parents, to share with him my prosperity and, if necessary, help him with his needs; consider his offspring as their brothers, and this art, if they want to study it, teach them free of charge and without any contract; communicate instructions, oral lessons and everything else in the teaching to your sons, the sons of your teacher and students bound by an obligation and oath according to the medical law, but to no one else.

I will direct the treatment of the sick to their benefit in accordance with my strength and my understanding, refraining from causing any harm or injustice.

I will not give anyone the deadly means they ask from me and I will not show the way for such a plan; In the same way, I will not give any woman an abortion pessary. I will conduct my life and my art purely and immaculately.

In no case will I perform sections on those suffering from stone disease, leaving this to the people involved in this matter.

Whatever house I enter, I will enter there for the benefit of the sick, being far from everything intentional, unrighteous and harmful, especially from love affairs with women and men, free and slaves.

Whatever during treatment - and also without treatment - I see or hear about human life that should never be disclosed, I will keep silent about it, considering such things a secret.

May I, who inviolably fulfill my oath, be given happiness in life and in art and glory among all people for eternity; to the one who transgresses and takes a false oath, let the opposite be done to this.”

Being sensible and unbiased people (and I really hope so), let’s still analyze the text of the Hippocratic Oath and try to perceive it from the point of view of existing realities.

“I swear by Apollo the physician, Asclepius, Hygia and Panacea and all the gods and goddesses...”

Sorry, but take vows pagan gods V best case scenario not respectable for a modern doctor, but for a Christian it is completely sinful.

“To honor the one who taught me on an equal basis with my parents, to share my wealth with him and, if necessary, to help him in his needs; consider his offspring as their brothers, and this art, if they want to study it, teach them free of charge and without any contract; communicate instructions, oral lessons and everything else in the teaching to your sons, the sons of your teacher and students bound by an obligation and oath according to the medical law, but to no one else.”

Is a doctor obliged to teach his art to the children of all teachers at the medical institute? Should he support them financially, no matter who they are or what they do? A doctor should consider all his relatives to be his brothers. teaching staff medical school where he studied? Let's leave this part of the oath without comment...

“I will not give anyone the lethal means they ask from me and I will not show the way for such a plan...”

It doesn’t take a rocket scientist to understand that this is a direct ban on a doctor engaging in euthanasia. Clearly and unambiguously. But here the Hippocratic Oath comes into direct conflict with the existing legislation of some countries. Euthanasia is legally permitted in Holland, Belgium and one of the US states - Oregon. Those. A doctor who observes the Hippocratic oath can in some cases be called a criminal; by definition, he cannot comply with the laws and maintain fidelity to the oath he took.

“...in the same way, I will not give any woman an abortion pessary.”

Simple and clear: all practicing gynecologists are oathbreakers who do not comply with the Hippocratic Oath. Even those who have abortions for medical and social reasons, as is permitted in the legislation of most countries. Doesn't fit? Or will we declare all gynecologists as oathbreakers?

“In no case will I perform sections on those suffering from stone disease, leaving this to the people involved in this matter.”

“Whatever house I enter, I will enter there for the benefit of the sick, being far from everything intentional, unrighteous and harmful, especially from love affairs with women and men, free and slaves.”

Well, and finally: “When treating a patient, I will not do nasty things in his house, incl. and engage in sexual contact with the patient and his relatives.” In my opinion, this is the only relevant requirement for a modern doctor. Slaves are somewhat inappropriate, but in the light modern trends with prosecutions for sexual harassment, they are also suitable as legal entities.

Sorry, but that's it! There is nothing else in the Hippocratic Oath that can be interpreted as a doctor’s obligations to patients, colleagues and society! So why speculate on something that is not in the text of the oath? Let's try to start from the beginning, i.e. since the advent of the Hippocratic oath.

So, the Hippocratic oath appeared in the 5th century BC. and was written in the Ionian dialect of ancient Greek. And from this time on, inconsistencies begin. It is generally accepted that the text of the oath was written by Hippocrates himself. However, many researchers argue that the text of the oath appeared much later after the death of Hippocrates, i.e. already after 356 (or, according to other sources, 377) BC. But no one even denies that the original text of the oath was repeatedly rewritten and edited, and with a significant change in the meaning of the oath. By the way, the commandment “do not treat for free” was actually present in one of the ancient Roman versions of the text. The above version of the Hippocratic Oath is a repeatedly redrawn and edited version of the text, published in 1848 in Geneva under the title “The Medical Commandment.”

It is unlikely that we will have access to the original version of the Hippocratic Oath, written about 2,400 years ago, especially since of the 72 works attributed to Hippocrates, not all are genuine (Galen claimed that only 11 of them belong to Hippocrates, and the rest were written by his sons or students ).

So why is there such a huge demand in modern society enjoys it so much ancient text, that it is repeatedly rewritten, edited, supplemented, and sometimes with the exact opposite change in the meaning of what is written?

There are now many clones of the Hippocratic oath in the form of various versions of the ethical and professional code of doctors, but all of them are colloquially, from old memory, called the Hippocratic oath. In the USA and Europe there is now a “Professional Code of Physicians” (adopted in 2006), in Israel - the “Oath of the Jewish Doctor” (an oath to the gods of the ancient Greek pantheon is unacceptable for Israelis, which runs counter to the principles of Judaism), in the Soviet Union they adopted “” (approved in 1971). In the mid-90s of the last century, this oath was changed to “”, which, in turn, was replaced by the text “”, approved by the State Duma of Russia in 1999.

In 1948, the General Assembly of the International Medical Association adopted a declaration (the so-called Declaration of Geneva), which, in essence, is nothing more than a modern version of the Hippocratic Oath. Later in 1949, the declaration was included in the International Code of Medical Ethics.

Faculty Promise: « Accepting with deep gratitude the rights of a doctor granted to me by science and comprehending the importance of the duties assigned to me by this title, I promise throughout my life not to tarnish the honor of the class into which I am now entering: Helping those who suffer, I promise to sacredly keep the family secrets entrusted to me and not to abuse the trust placed in me: I promise to be fair to my fellow doctors and not to insult their personalities, however, if the benefit of the patient requires it, to tell the truth without hypocrisy. In important cases, I promise to resort to the advice of doctors who are more knowledgeable and experienced than me; When I myself am called to the meeting, I undertake in good conscience to give justice to their merits and efforts.”

And the text of the Geneva Declaration: « I solemnly vow to dedicate my life to the service of humanity. I will give my teachers due respect and gratitude; I will perform my professional duties with dignity and conscientiousness; the health of my patient will be my main concern; I will respect the secrets entrusted to me; I will, by all means in my power, uphold the honor and noble traditions of the medical profession; I will treat my colleagues as brothers; I will not allow religious, national, racial, political or social motives to prevent me from fulfilling my duty towards the patient; I will maintain the deepest respect for human life, starting from the moment of conception; Even under threat, I will not use my knowledge against the laws of humanity. I promise this solemnly, voluntarily and sincerely.”

I hope that no one will have any illusions about the fact that the doctor swore to be poor and hungry and to give all of himself in the service of all members of society. But starting with the text of the Soviet doctor’s oath, all the “misunderstandings” begin...

Again, the text of the Geneva Declaration roughly corresponds to the “Medical Commandment” of 1848, but here the principle “... dedicate your life to serving humanity" And in “The Oath of a Doctor of the Soviet Union” an ideological component appears quite unambiguously like “... work conscientiously where the interests of society require it" Accidentally? No. Moreover, these principles are not only absent in the more ancient (even if many times corrected and edited) versions of the text of the Hippocratic Oath.

Now let's remember the Soviet People's Commissar of Health N. Semashko and his catchphrase: “The people will feed a good doctor, but we don’t need bad ones.” Since then, the image of a disinterested doctor has appeared. Since then, for a long time and persistently, the idea has been persistently implanted in the consciousness of all members of society that a doctor is obliged to be a beggar and follow the moral and ethical principles that the existing government has outlined for him. The doctor is left with the ownership of his knowledge, experience, professional skills and the physical ability to use them. He is charged with everything that the same power needs. To be brief, we are engaged in implementing the healthcare model chosen by the existing government. And without reasoning! “You took the Hippocratic oath (or its other variants)! For some reason, everyone has forgotten that a doctor, in fact, works, like other members of society, and this work should be paid. The state “pays” for this work in the range of $150-200 and makes enormous demands on the doctor’s functional duties - up to door-to-door visits to residents who fall under regular social, medical, public programs (tube-infected, HIV-infected, low-income, disabled, etc. ). Is someone paying for this? No. “You took the Hippocratic oath!”...

If someone appeals to the name of Hippocrates, then let me remind you that the fees of Hippocrates and his colleagues were very large by the standards of that time (even higher than those of famous and still famous architects). Moreover, Hippocrates was not only a brilliant doctor, but also a very intelligent specialist in the field of advertising: “And I advise that you do not behave too inhumanely, but that you pay attention to both the abundance of funds (for the patient) and their moderation, and sometimes I would treat for nothing, considering grateful memory higher than momentary glory.” By the way, Hippocrates advises treating for free only sometimes, so to speak, to improve his image: “If you first deal with the matter of remuneration, then, of course, you will lead the patient to the idea that if an agreement is not made, you will leave him or be careless to him, and you will not give him present moment advice. We should not worry about establishing remuneration, since we believe that paying attention to this is harmful for the patient, especially in case of an acute illness - the rapidity of the disease, which does not give an opportunity for delay, forces a good doctor to seek not benefits, but rather acquisitions glory. It is better to reproach those who are saved than to rob those in danger in advance.”

Currently, a rather absurd, but nevertheless long-existing state model of healthcare has emerged, which assumes that the people (doctors) who implement it must be highly professional specialists, but their work must be paid at a minimum. Sorry for this example, but a prostitute on Tverskaya sets a price for her services (usually a firm and very considerable one), a girl in a short skirt and with complete absence voices “sing” for very decent money in a club or concert hall, builders, after all, work having agreed in advance on the price for their work. But a doctor is obliged to work for a meager salary, after spending 8-10 years studying textbooks or in a clinic. In order not to be unfounded, I will give the following example: one volume of Mitkov’s guide to ultrasound diagnostics (this is, in fact, the “bible” of an ultrasound diagnostician) now costs about $200, the monthly salary of a doctor is approximately the same amount (or even less) How can this happen? be? But you also need to read (and buy it somewhere) periodical literature, purchase literature not only in your specialty, but also in other clinical areas (so as not to become dull, in the end). Forgive me for my indiscretion, but doctors also have families, children, they also want to eat, pay for utilities, teach their children something, and go to the sea at least once a year... But this is all well-established public opinion does not perceive: “You took the Hippocratic oath!” This means that he is obliged to work and fulfill his duty, which is indicated in the same Hippocratic oath...

I don’t want to deify the image of a modern doctor now, much less come to his defense. But I want you to understand that doctors are people! Honest and deceitful. Good and evil. Polite and rude. At night, standing at the operating table and spending time in an easy chair in the office of the city health department. Falling from fatigue at the site and determining the number of calls at this very site. Surgeons with golden hands and clueless farriers. Brilliant diagnosticians and stupid officials who manage them. They are all different, like all of us, but they are people, with all the advantages and disadvantages, pros and cons. But to demand from them something described in a prehistoric manuscript is at least unreasonable.

And let's treat doctors like real people, and not fictitious characters from a fairy tale, imposed on people mythical creature from the Hippocratic oath. Do you think that a doctor selling dietary supplements will remember the Hippocratic Oath? Or will a clinic specialist who prescribed a course of a completely useless, but very expensive laboratory examination be concerned about medical ethics? Do you still believe that free medical care guaranteed by the Constitution exists? Let's be realistic. Medicine is now one of the forms of providing services to the population. Their prices are determined in accordance with the quality and volume of these services. This is our reality. And there is no need to create illusions that you can get the services of a highly qualified specialist for next to nothing just because he is bound by the obligations of some ephemeral oath.

And, returning to reality. The oath taken by a doctor upon graduation from an institute or university has no legal basis. Yes, someone signs the text of the oath (our stream, for example, in the cowboy 90s, when it was not clear where we lived and to whom we should swear, did not sign anything at all). But this signature has absolutely no mechanisms of influence on those who do not follow it. The Hippocratic Oath is being intensively exploited by the government, which is unable to create an effective and efficient healthcare model and is trying to plug holes in the existing system of providing medical care to the population, while appealing to some medieval examples of corporate ethics. The state is actually trying to support the populist myth of free healthcare through the violent exploitation of the knowledge, experience and qualifications of doctors. And this violence is expressed in the fact that the doctor is forced to solve his financial problems at the expense of his patients. We will not talk about who receives this remuneration and in what amount (some people buy meat cheaper, others are torn between choosing between BMW and Mercedes), but the existing system not only forces honest and decent doctors to receive remuneration from patients (take my word for it - very a humiliating and unpleasant procedure), but also opens up enormous opportunities for all kinds of swindlers and bribe-takers.

In conclusion, I would like to quote the words of the famous ophthalmologist Svyatoslav Fedorov: “I good doctor, because it’s free, and I have 480 free doctors. The “Hippocratic Oath” is all a fiction. But in fact there is real life- you need to eat every day, have an apartment, dress. They think that we are some kind of flying angels. An angel receiving a salary of 350 rubles? And there are one and a half million such doctors in Russia today. One and a half million poor people higher education, intellectual slaves. Demanding that medicine work well in these conditions is absurd!”

When preparing the material, information from

History of medicine E. V. Bachilo

10. “The Hippocratic Oath”

10. “The Hippocratic Oath”

A special place in medicine Ancient Greece occupied "Hippocratic Oath" or "Oath of the future doctor" which was given to everyone who completed their training in the medical profession. The “oath” was not invented by Hippocrates; he only summarized into a single text all its main features that existed long before his medical practice. It first received literary design in the same Alexandria Library in the 3rd century. BC e.

Any oath of that time implied the support of the gods, who were supposed to be the first punishers in the event of perjury. The medical oath contained references to gods who had direct relation to the medical art, and those who practiced it. These were Apollo, Asclepius, Hygieia, Panacea. There are suggestions that the “Hippocratic Oath” received its name also because it mentions Asclepius, the ancestor of Hippocrates II the Great in the seventeenth generation.

By taking the “Oath” at the end of his training, the doctor ensured the trust of society and provided a guarantee of a high level of professionalism. "Oath" translated from ancient Greek it reads as follows: “I swear by Apollo the physician, Asclepius, Hygieia and Panacea and all the gods and goddesses, taking them as witnesses, to honestly fulfill, according to my strength and my understanding, the following oath and written obligation: to consider the one who taught me the art of medicine as an equal with my parents, share my wealth with him and, if necessary, help with his needs; consider his offspring as their brothers, and this art, if they want to study it, teach them free of charge and without any contract; communicate instructions, learned lessons and everything else in the teaching to your sons, your teacher and students, bound by obligation and oath according to the medical law, but to no one else.

I direct the treatment of the sick to their benefit in accordance with my strength and my understanding, refraining from causing any harm or injustice. I will not give anyone the deadly plan they ask of me and I will not show the way for such a plan; in the same way, I will not give any woman an abortifacient Caesarea.

I will conduct my life and my art purely and immaculately. In no case will I perform sections on those suffering from stone disease, leaving this to the people involved in this matter. Whatever house I enter, I will enter there for the benefit of the sick, being far from everything intentional, unfair and harmful, especially from love affairs with women and men, free and slaves.

Whatever, during treatment - and also without treatment - I see or hear about human life that should never be disclosed, I will keep silent about it, considering such things a secret. May I, who inviolably fulfill my oath, be given happiness in life and in art and glory among all people for all eternity; but to those who transgress and give a false oath, may the opposite be true.”