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PubMedDate not supplied

[Commitment hierarchy of the Geneva declaration].

There is a revival at present in the use of the medical oath. A study of the text is necessary from the first year of study in medical school. The aim of this work was to know how medical students rank the commitments of the Geneva Declaration. One hundred seventy 1st-year students were evaluated. They were asked to enumerate the commitments in a hierarchy according to their perception of medical work. The greatest percentages of the principles for each position were obtained. The commitments placed first were respect to life (39.4%), consideration of patient health as first concern (23.5%), and non-discrimination (27.1%). Votes placed last in the ranking were related to honor and professional traditions (24.1%) and consideration of colleagues as brothers (28.8% and 44.7%). The difference among percentages was significant, mainly with regard the last commitment. Medical students located in the first places obligations with reference to ethical principles of physician-patient relationship, considering less relevant commitments with the profession and its members. It will be of interest to determine the reason for this dichotomy and to encourage reflection upon medical oaths, generating greater commitment.

Delivery of Health Care↗
PubMed2005

Comparative analysis of the Code of Professional Ethics in Bulgaria and the Hippocratic Oath, Declaration of Geneva and International Code of Medical Ethics.

In this paper I aim at making a comparative analysis of The Code of Professional Ethics in Bulgaria (CPEB), The Hippocratic Oath, The Declaration of Geneva, and The World Medical Association International Code of Medical Ethics. Two problems of special interest are explored: whether the leading principles of fundamental ethical codes are presented in CPEB and whether the code itself is relevant to the current medical professional and social situation in the country. The conclusion reached after a step-by-step analysis is that CPEB attempts to cover a wide range of principles and problems in medical practice and corresponds with the fundamental ethical codes. Although the code is criticized in some points, it could be very useful, provided that it is well publicized in the profession.

Bulgaria↗
PubMed2000

Abuse of psychiatry.

The Geneva Declaration of 1948 states that doctors shall not permit considerations of religion, nationality, race, party politics or social standing to intervene between their duty as a doctor and their patients. They shall not use their medical knowledge contrary to the laws of humanity. The UN Principles of Medical Ethics also reminds doctors that their professional relation to persons deprived of their liberty is solely to evaluate, protect or improve their health. Similarly, the Hawaii Declaration from 1983 and the Madrid Declaration from 1996 outline the ethical duties of the psychiatric profession. Thus, there is no doubt as to the professional role as it is delineated in the medical ethics codes. The presence of such codes is, however, only one of the necessary steps to prevent the abuse of psychiatry; others include educational interventions or the establishment of international networks.

Ethics, Medical↗
PubMed1986

Codes of medical ethics: traditional foundations and contemporary practice.

The Hippocratic Coprus recognized the interaction of 'business' and patient-health moral considerations, and urged that the former be subordinated to the latter. During the 1800s with the growth of complexity in both scientific knowledge and the organization of health services, the medical ethical codes addressed themselves to elaborate rules of conduct to be followed by the members of the newly emerging national medical associations. After World War II the World Medical Association was established as an international forum where national medical associations could debate the ethical problems presented by modern medicine. The International Code of Medical ethics and the Declaration of Geneva were written as 20th century restatements of the medical profession's commitment to the sovereignty of the patient-care norm. Many ethical statements have been issued by the World Medical Association in the past 35 years; they show the variety and difficulties of contemporary medical practice. The newest revisions were approved by the General Assembly of the World Medical Association in Venice, Italy October 1983. Their content is examined and concern is voiced about the danger of falling into cultural relativism when questions about the methods of financing medical services are the subject of an ethical declaration which is arrived at by consensus in the W.M.A.

Bioethical Issues↗
PubMed2002

Declarations made by graduating medical students in Australia and New Zealand.

OBJECTIVE: To survey the use of declarations of ethical commitment made by graduating medical students in Australia and New Zealand. METHODS: Information, obtained by email and telephone, from faculty officers of all faculties of medicine (or medicine and health sciences) in Australia and New Zealand. RESULTS: Declarations are made by graduating medical students at seven of 12 Australasian faculties of medicine. To date, declarations have been based on the Declaration of Geneva or the Hippocratic Oath or have been formulated by academic staff or the students themselves. In six of the seven universities, declarations are made as part of a special declaration ceremony (usually combined with a prize-giving ceremony). One university includes a declaration as part of the official graduation ceremony. DISCUSSION: We discuss the relative merits of a declaration selected for students by staff members and a declaration written anew by each group of graduating students.

Australia↗
PubMed2000

Ethics in surgery: historical perspective.

Ethics codes and guidelines date back to the origins of medicine in virtually all civilizations. Developed by the medical practitioners of each era and culture, oaths, prayers, and codes bound new physicians to the profession through agreement with the principles of conduct toward patients, colleagues, and society. Although less famous than the Hippocratic oath, the medical fraternities of ancient India, seventh-century China, and early Hebrew society each had medical oaths or codes that medical apprentices swore to on professional initiation. The Hippocratic oath, which graduating medical students swear to at more than 60% of US medical schools, is perhaps the most enduring medical oath of Western civilization. Other oaths commonly sworn to by new physicians include the Declaration of Geneva (a secular, updated form of the Hippocratic oath formulated by the World Medical Association, Ferney-Voltaire, France) and the Prayer of Moses Maimondes, developed by the 18th-century Jewish physician Marcus Herz.

Ethics, Medical↗
PubMed2005

Beneficence, justice, and lifelong learning expressed in medical oaths.

INTRODUCTION: The principles of justice, beneficence, and nonmaleficence are prescriptions of the Hippocratic Oath. To fulfill them, physicians are obligated morally to lifelong learning; yet, there is little evidence that the relationship of beneficence to lifelong learning or to continuing medical education (CME) is expressed in medical oaths. METHODS: We analyzed 48 medical oaths written from the first century Ce through the present day, searching for a commitment to lifelong learning and for specification of a relationship to the principle of beneficence. Thirteen ancient and medieval and 35 modern and contemporary oaths were inventoried for source, such as corresponding to a medical school. They were sorted by those that mention the commitment toward lifelong learning and to determine their relationship with the principle of beneficence. RESULTS: Of the 48 medical oaths analyzed, only 20 manifest the commitment to lifelong learning. However, most of the oaths that contain this commitment do not pertain to medical schools, with the exception of the Declaration of Geneva. Of this group, 16 also indicate the principle of beneficence. Of these 16, only 3 establish a link between both. One medical oath indicated this commitment, and none of them analyzed the relation with the principle of beneficence. DISCUSSION: The commitment toward CME should not be absent in the present medical oaths. It is a duty and right of all physicians, and in turn, society should recognize this obligation in order to offer opportunities for the achievement of the principle of beneficence that will result in better health care.

Beneficence↗
PubMed2006

An 'Honest Broker' mechanism to maintain privacy for patient care and academic medical research.

PURPOSE: From the Hippocratic Oath to the World Medical Association's Declaration of Geneva, physicians have sworn to protect patients' privacy. However, as systems move to more integrated architectures, protecting this medical data becomes more of a challenge. The increase in complexity of IT environments, the aggregation of data, and the desire of other entities to access this data, often 24 h/day x 7 day/week x 365 day/year, is putting serious strains on our ability to maintain its security. This problem cuts across all electronic record sources from patient care records to academic medical research records. APPROACH: In order to address this issue, we are rethinking the way we store, transmit, process, access, and federate patient data from clinical and research applications. Our groups at the University of Michigan are developing a system called the "Honest Broker" to help manage this problem. The Honest Broker will offload the burden of housing identifiable data elements of protected health information (PHI) (e.g., name and address) as well as manage data transfer between clinical and research systems. Lab results and other non-identifiable data will be stored in separate systems with either a research study ID or clinical ID number. This two-component architecture increases the burden on attackers who now need to compromise two systems, one of which is seriously hardened, in order to match health data with a patient's actual identity. CONCLUSIONS: While no security system is truly intrusion-proof, this architecture provides a high security choke point reducing the likelihood of a breach. By redesigning the method of integrating clinical care and research, we have enabled projects that would be cost prohibitive to conduct otherwise. The scalability of this mechanism is dependant on nature of the heterogenous nature of the clinical systems serving patients.

Biomedical Research↗
PubMedDate not supplied

Thoughts after reading Robert Jay Lifton's 'The Nazi Doctors'.

Robert Jay Lifton's remarkable book The Nazi Doctors and its tragic subject matter provided an opportunity to try and place the complicity of doctors in such barbarity in historical perspective. Massive episodes of killing of human beings by other human beings have been an ongoing saga for centuries. Misguided belief and misguided science, and the abuse of constantly advancing technology in the name of one or other nation-state, have made possible the acceleration of megadeath. The Nazi concentration and death camps were a particularly vicious manifestation within the spectrum of killing. Modern weaponry makes omnicide quite feasible. Our urgent need is to learn the lesson and to cultivate and promote planetary patriotism as promptly as possible. Adherence to an international code of human ethics is a compelling requirement. The origin of the International Committee of the Red Cross in 1863 was an inspiring and promising beginning. The formulation of the Declaration of Geneva by the World Medical Association in 1947 profoundly enhanced the value of the Hippocratic Oath and provides a sound ethical basis for the national and international guidance of the medical profession today. The International Physicians for the Prevention of Nuclear War establishes another firm step in the right direction.

Codes of Ethics↗
PubMedDate not supplied

[Human rights and informed consent].

The right to information is a right that all human beings have; it is unrenounceable and confers to the human being the Rights to the Political Constitution of the United States of Mexico, the Universal Declaration of Human Rights, the Declaration of Geneva, and the Code of Behavior for Health Personnel. Information given to a sick person should suffice so that he/she can make a decision on management and treatment. Information is related directly with medical ethics and is obligatory not only for health workers but for all professionals in general.

Bioethics↗
PubMed1998

[Analysis of the ethical principles in medical oaths used by medical schools of Argentina in relation to the Hippocratic Oath].

Medical oaths have consulted the source of all Medical Ethics through centuries. Since the 60s a new consensus on ethics was sought to apply to the new medical problems. The consensus was on the basic principles: beneficence, non-maleficence, justice and respect for the patient's autonomy with its two rules of confidentiality and veracity. The Hippocratic Oath specifies the principles of beneficence and non-maleficence and the rule of confidentiality. They are included in the texts used in different Medical Schools of the United States, Canada and the United Kingdom. The purpose of this analysis is to determine which of those ethical principles are included in the Argentinian Medical Oaths. At present, out of the ten Faculties of Medicine that use a formula, six choose the Declaration of Geneva and the rest use their own texts. No schools use the Hippocratic Oath. Neither of the five different Oaths include the four principles. The rule of confidentiality is the one most frequently mentioned followed by the principles of beneficence and justice. The principles of non-maleficence and of respect for the patient's autonomy, in general, and the rule of veracity, in particular, are not indicated. Revision of the Medical Oaths used in Argentina, is basically for the ethical revision suggested, in order to include all the ethical principles strongly agreed upon.

Argentina↗
PubMed1999

What is an oath and why should a physician swear one?

While there has been much discussion about the role of oaths in medical ethics, this discussion has previously centered on the content of various oaths. Little conceptual work has been done to clarify what an oath is, or to show how an oath differs from a promise or a code of ethics, or to explore what general role oath-taking by physicians might play in medical ethics. Oaths, like promises, are performative utterances. But oaths are generally characterized by their greater moral weight compared with promises, their public character, their validation by transcendent appeal, the involvement of the personhood of the swearer, the prescription of consequences for failure to uphold their contents, the generality of the scope of their contents, the prolonged time frame of the commitment, the fact that their moral force remains binding in spite of failures on the part of those to whom the swearer makes the commitment, and the fact that interpersonal fidelity is the moral hallmark of the commitment of the swearer. Oaths are also distinct from codes. Codes are collections of specific moral rules. Codes are not performative utterances. They do not commit future intentions and do not involve the personhood of the one enjoined by the code. Recent attacks on oath-taking by physicians are discussed. Two arguments in favor of oath-taking are presented: one on the basis of the nature of medicine as a profession and the other on the basis of rule-utilitarian considerations. No attempt is made to define which oath a physician should swear.

Codes of Ethics↗