The Hippocratic Oath: A Blueprint For Certain Legal Requirements Applicable to Ohio Physicians

The Hippocratic Oath (“Oath”) is arguably the most widely known ancient Greek medical text.  The Oath governs ancient Greek physicians’ professional and ethical behavior.  Although written approximately 2,500 years ago, certain standards in the Oath are reflected in current legal requirements concerning Ohio physicians’ medical practice and behavior.

This is a literal translation of the original version of the Oath:

I swear by Apollo Physician and Asclepius and Health and Panacea and all the gods and goddesses, making them witnesses, that I will make complete this oath and this written covenant according to my ability and discernment: 

To regard my teacher of this art as equal to my parents and to share my livelihood (with him), and to make a contribution to him when he is in need of a debt, and to judge his offspring as equal to my brothers in manhood, and to teach this art – if they want to learn it – without wage and written covenant (to them), to make an imparting of the set of rules and lecture and all the rest of instruction to my sons and those of my teacher, and to those pupils who have been indentured and who have taken an oath according to the medical law, but to no one else. 

-I will use diets for the assistance of the sick according to my ability and discernment; but also to keep away injury of health and injustice. 

I will neither give any deadly drug, having been asked for it, nor will I guide the same advice. Similarly, I will not give an abortifacient pessary to a woman. In purity and in holiness I will maintain my life and my art. 

-I will not use the knife, not even on those suffering from the stone, but I will give way to those who are practitioners of this work.

And as many houses as I may go into, I will go in for the assistance of the sick, being free from all voluntary injustice and mischief and the rest, even abstaining from sexual pleasures of both female and male persons, both free and slaves. 

-That which I may see or hear during treatment, or even outside of treatment concerning the life of men, which must not in any way be divulged outside, I will not speak, regarding such things to be unutterable. 

And so may it be to me making complete my oath and not making it of no effect that I enjoy the benefits of my life and art and be honored by all men for time eternal; but may it be the opposite of this to me transgressing and swearing falsely. 

The Oath taken today has been revised from the above original text.  Although there are portions of the original Oath which are no longer applicable or sworn to by physicians, there are interesting parallels between certain standards in the original Oath and the present-day laws in the Ohio Revised Code (“ORC”), pertaining to Ohio physicians’ medical practice and behavior, the violation of which subjects a physician to disciplinary action by the State Medical Board of Ohio (“Ohio Medical Board”).

No Harm To Patients

The Oath provides: “I will use diets for the assistance of the sick according to my ability and discernment; but also to keep away injury of health and injustice.”  I interpret this provision generally to require the ancient Greek physician (i) to use dietary regimens to assist people who are sick, (ii) not to harm their patients, and (iii) not to do any injustice to their patients.

ORC §4731.22 authorizes the Ohio Medical Board to discipline a physician based acts would could result in patient harm including but not limited to:

ORC §4731.22(B)(2): Failure to maintain minimal standards applicable to the selection or administration of drugs, or failure to employ acceptable scientific methods in the selection of drugs or other modalities for treatment of disease;

ORC §4731.22(B)(3): Selling, giving away, personally furnishing, prescribing, or administering drugs for other than legal and legitimate therapeutic purposes;

ORC §4731.22(B)(6): A departure from, or the failure to conform to, minimal standards of care of similar practitioners under the same or similar circumstances (whether or not actual injury to a patient is established); and

ORC §4731.22(B)(18): Violation of any provision of a code of ethics of the American medical association; and/or

ORC §4731.22(B)(29): Failure to use universal blood and body fluid precautions established by Ohio Medical Board rule.

No Injustice To Patients

ORC §4731.22 also authorizes the Ohio Medical Board to discipline a physician based on an act which evidences an injustice to a patient including but not limited to:

ORC §4731.22(B)(1): Permitting one’s name or one’s certificate to practice or certificate of registration to be used by a person, group, or corporation when the individual concerned is not actually directing the treatment given;

ORC §4731.22(B)(5): Making a false, fraudulent, deceptive, or misleading statement in the solicitation of or advertising for patients; in relation to the practice of medicine and surgery;

ORC §4731.22(B)(7): Representing, with the purpose of obtaining compensation or other advantage as personal gain or for any other person, that an incurable disease or injury, or other incurable condition, can be permanently cured; and/or

ORC §4731.22(B)(8): The obtaining of, or attempting to obtain, money or anything of value by fraudulent misrepresentations in the course of practice.

Although the requirement of the Oath to, “keep away injury of health and injustice” is phrased more broadly than the specific requirements in the ORC, a parallel between the requirements of the Oath and the ORC is apparent.  The dictates imposed by both the ancient Greek caregivers and the Ohio legislature evidence important standards that a physician do no harm to the patient and promote the just (ie, honest and truthful) relationship between the physician and the patient.

Sanctity Of Life 

The Oath provides: “I will neither give any deadly drug, having been asked for it, nor will I guide the same advice. Similarly, I will not give an abortifacient pessary to a woman. In purity and in holiness I will maintain my life and my art.”  The requirements (i) not to give or recommend any deadly drug, (ii) not to induce an abortion, and (iii) for the physician to hold his or her own life in purity and holiness, individually and collectively, support the notion that ancient Greek physicians held human life as sacred.

ORC §4731.22(B)(3) authorizes the Ohio Medical Board to discipline a physician for selling, giving away, personally furnishing, prescribing, or administering drugs for other than legal and legitimate therapeutic purposes.  Additionally, assisted suicide is against public policy in Ohio (ORC §3795.02(A) and is required to be enjoined by a Court of Common Pleas (ORC §3795.02(B)).  Consequently, ORC §4731.22(B)(37) authorizes the Ohio Medical Board to discipline a physician for assisting suicide.

Subject to certain express conditions and exceptions in Ohio law beyond the scope of this article, ORC §4731.22(B)(23) authorizes the Ohio Medical Board to discipline a physician for performing or inducing an abortion upon a pregnant woman.

No Sexual Misconduct

The Oath provides: “And as many houses as I may go into, I will go in for the assistance of the sick, being free from all voluntary injustice and mischief and the rest, even abstaining from sexual pleasures of both female and male persons, both free and slaves.

OAC §4731-26-02(A) authorizes the Ohio Medical Board to discipline a physician for engaging in sexual misconduct with a patient.

Confidentiality 

The Oath provides: “That which I may see or hear during treatment, or even outside of treatment concerning the life of men, which must not in any way be divulged outside, I will not speak, regarding such things to be unutterable.”

ORC §4731.22(B)(4) authorizes the Ohio Medical Board to discipline a physician for willfully betraying a professional confidence.

Conclusion 

The standards in the Oath applicable to ancient Greek physicians to do no patient harm, to have a just patient relationship, to take no act contrary to human life, to abstain from sexual misconduct with a patient, and to protect patient confidential information, are reflected in present-day legal requirements applicable to Ohio physicians’ medical practice and behavior.

That the Oath is recited in medical schools even today (See: http://medicine.osu.edu/news/archive/2012/08/21/reciting-the-hippocratic-oath-a-family-centered-tradition.aspx) is a testament to the enduring verities contained in the Oath.

As always, if you have any questions about this post or the Ohio Medical Board in general, please contact Collis, Smiles & Collis, LLC or Beth Collis at 614-486-3909 or Beth@collislaw.com.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

This site uses Akismet to reduce spam. Learn how your comment data is processed.