S.J. Scheinman is president and dean and professor of medicine, Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania. P. Fleming was a fourth-year medical student, Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania, at the time this article was written. K. Niotis was a fourth-year medical student, Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania, at the time this article was written.
Acad Med. 2018 Sep;93(9):1301-1306. doi: 10.1097/ACM.0000000000002097.
The widespread use of oaths at medical commencements is a recent phenomenon of the late 20th century. While many are referred to as "Hippocratic," surveys have found that most oaths are modern, and the use of unique oaths has been rising. Oaths taken upon entry to medical school are even more recent, and their content has not been reported. The authors surveyed all Association of American Medical Colleges-member schools in the United States and Canada in 2015 and analyzed oath texts. Of 111 (70.2%) responses, full texts were submitted for 80 commencement and 72 white coat oaths. Previous studies have shown that while oaths before World War II were commonly variations on the original Hippocratic text and subsequently more often variations on the Geneva or Lasagna oath, now more than half of commencement ceremonies use an oath unique to that school or written by that class. With a wider range of oath texts, content elements are less uniformly shared, so that only three elements (respecting confidentiality, avoiding harm, and upholding the profession's integrity) are present in as many as 80% of oaths. There is less uniformity in the content of oaths upon entry to medical school. Consistently all of these oaths represent the relationship between individual physicians and individual patients, and only a minority express obligations to teach, advocate, prevent disease, or advance knowledge. They do not reflect obligations to ensure that systems operate safely, for example. None of the obligations in these oaths are unique to physicians.
在医学毕业典礼上广泛使用誓言是 20 世纪后期的一个新现象。虽然许多被称为“希波克拉底誓言”，但调查发现大多数誓言是现代的，独特誓言的使用正在增加。医学院入学誓言更是最近才出现的，其内容尚未有报道。作者在 2015 年调查了美国和加拿大的所有美国医学协会会员学校，并分析了誓言文本。在 111 所（70.2%）回应的学校中，有 80 所毕业典礼和 72 所白色外套誓言提交了完整的文本。以前的研究表明，在第二次世界大战之前，誓言通常是希波克拉底原文的变体，随后更常见的是日内瓦或拉沙格誓言的变体，而现在超过一半的毕业典礼使用的是该校独有的或由该班级编写的誓言。由于誓言文本的范围更广，内容元素的共享程度较低，因此只有三个元素（尊重保密性、避免伤害和维护专业的诚信）出现在 80%的誓言中。医学院入学誓言的内容也没有那么统一。这些誓言始终都代表着个体医生和个体患者之间的关系，只有少数誓言表达了教学、倡导、预防疾病或推进知识的义务。它们并没有反映出确保系统安全运行的义务。这些誓言中的义务没有一个是医生独有的。
