Kao Audiey C, Parsi Kayhan P
Ethics Standards Group, American Medical Association, 515 North State Street, Chicago, IL 60610, USA.
Acad Med. 2004 Sep;79(9):882-7. doi: 10.1097/00001888-200409000-00015.
Oath taking is an important aspect of professionalization that all physicians share. The authors conducted a content analysis of the medical oaths administered at all allopathic and osteopathic medical schools in the United States to evaluate variations in ethical content.
The authors collected medical oaths administered at all accredited allopathic and osteopathic medical schools (122 and 19, respectively) in the year 2000. Using a modified conceptual framework developed by Baker, the oaths were analyzed for differences in their substantive content. Content differences based on schools' characteristics were also analyzed.
Just over half (62 of 122) of the allopathic schools administered an oath other than the Hippocratic Oath or a modified version of it. Thirty allopathic schools administered an oath written by students and/or faculty, and 18 schools offered students more than one oath option. All 19 osteopathic schools used the Osteopathic Oath. Nearly all allopathic and osteopathic schools' oaths included content protecting patients' confidentiality (129 schools), but few cited the importance of avoiding sexual misconduct with patients (four schools). Although the Osteopathic Oath prohibits physician-assisted suicide or euthanasia, only six allopathic schools administered an oath with such a prohibition. One allopathic school's oath explicitly prohibited abortion. There were no major content differences in the oaths administered based on a school's ownership status, religious affiliation, or use of white coat ceremony.
Many medical schools' oaths differ in substantive content. The impact of using a nonstandardized medical oath on physicians' professionalism and the inculcation of common ethical values and principles remains unknown.
宣誓是所有医生共同经历的职业化的一个重要方面。作者对美国所有对抗疗法和整骨疗法医学院所采用的医学誓言进行了内容分析,以评估伦理内容的差异。
作者收集了2000年所有经认可的对抗疗法和整骨疗法医学院(分别为122所和19所)所采用的医学誓言。使用由贝克开发的经过修改的概念框架,对誓言的实质内容差异进行了分析。还分析了基于学校特征的内容差异。
略超过一半(122所中的62所)的对抗疗法医学院采用了除希波克拉底誓言或其修改版本之外的誓言。30所对抗疗法医学院采用了由学生和/或教师撰写的誓言,18所学校为学生提供了不止一种誓言选择。所有19所整骨疗法医学院都使用整骨疗法誓言。几乎所有对抗疗法和整骨疗法医学院的誓言都包含保护患者隐私的内容(129所学校),但很少提及避免与患者发生不当性行为的重要性(4所学校)。虽然整骨疗法誓言禁止医生协助自杀或安乐死,但只有6所对抗疗法医学院采用了有此类禁止规定的誓言。一所对抗疗法医学院的誓言明确禁止堕胎。基于学校的所有权状态、宗教归属或是否举行白大褂仪式所采用的誓言在主要内容上没有差异。
许多医学院的誓言在实质内容上存在差异。使用非标准化医学誓言对医生职业化以及灌输共同的伦理价值观和原则的影响尚不清楚。