Oath of medical ethics

• The National Medical Commission (NMC), the regulator for medical education and practices that replaced the Medical Council of India in 2020, has suggested to medical colleges that the traditional Hippocratic Oath should be replaced by a “Charak Shapath”.

Hippocrates and 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, until the death of Alexander the Great in 323 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 were the Athenian philosopher Plato and his teacher Socrates, and Plato’s student and Alexander’s tutor, the polymath Aristotle.
• The Corpus Hippocraticum is a collection of 70 books on medicine.
• However, most scholars agree that the Hippocratic Oath was probably not the work of the individual identified as the historical Hippocrates, the “father of modern medicine”.
• The oath seems rather to be “more Pythagorean (who lived a century or more before Hippocrates) in its moral and ethical flavour… (and it) might have been enriched by other authors in antiquity”.

No one version of the oath

• There is no universally accepted version of the physician’s oath.
• Many medical schools around the world hold a ceremony in which graduating doctors swear to a broad charter of ethics that are sometimes customised by individual institutions.
• A version of the ‘physician’s code of ethics’ is commonly displayed in hospitals or clinics in most places, including India.
• The AMA describes its Code of Medical Ethics as a living document that has evolved as medicine and society have changed.
• The AMA’s Code was adopted in 1847, and underwent updates in 1903, 1949, 1957, and 2008.
• The World Medical Association (WMA) adopted an international code of medical ethics in 1949, which was amended in 1968, 1983, and 2006.
• In May last year, the WMA published a proposed modernised version of the international code, “outlining physicians’ duties towards their patients, other physicians, health professionals and society as a whole”, according to the WMA website.

Charaka and Charak Samhita

• Like several other sages mentioned in the literature of ancient India, the historicity of Charaka is uncertain, and the compendium of medicine that carries his name is unlikely to have been the work of a single individual.
• The Charak Samhita is a medical pharmacopoeia and collection of commentaries and discussions on medical practices that is 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 resembled that of Hippocrates and Galen (2nd century AD), and was in some ways ahead of the Greeks.
• The ancient Indian interest in physiology is understood to have 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.
• In theory and praxis, ayurvedic medicine today remains broadly unchanged from these ancient Indian principles.

The medical ethics of Charaka

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