Friedlander W J
Soc Sci Med. 1982;16(1):115-20. doi: 10.1016/0277-9536(82)90432-4.
Ninety-four percent of U.S. and 63% of Canadian medical schools administered an oath to their graduating students in 1977. This making a 'profession' of the values of the medical profession has undergone a continuous and striking increase since at least 1928. The only factors which may be related to a U.S. school not giving an oath are its being located in a North Central State and its having a large number of basic science doctoral students (perhaps a reflection of the school's commitment to basic science research). It is argued that it may be legitimate to consider that those values which are more frequently noted in the oaths are those which are held to be more important than those which are less frequently mentioned. Based on this assumption, a comparison of the oaths given in 1958 with those given in 1977 suggests that there has been a decline in the importance that medical schools and/or graduating students hold certain values which have been traditionally ascribed to physicians-in-service-to-others (e.g. confidentiality, welfare of patient, and avoidance of injury) while at the same time there has been no change in the importance of values associated with physicians-in-relation-to-the-medical--profession (e.g. concern with the status of the physician and respect for teachers). This, then, raises the possibility of there existing the interesting paradox that, although at this level of the medical profession, the profession is talking more, they are promising less.
1977年，94%的美国医学院和63%的加拿大医学院为其毕业生举行了宣誓仪式。至少自1928年以来，将医学职业价值观“职业化”的做法一直在持续显著增加。与一所美国医学院不举行宣誓仪式可能相关的唯一因素是，它位于中北部州，且有大量基础科学博士生（这或许反映了该校对基础科学研究的投入）。有人认为，可以合理地假定，那些在宣誓词中更频繁被提及的价值观，被认为比那些较少被提及的价值观更重要。基于这一假设，对1958年和1977年的宣誓词进行比较表明，医学院和/或毕业生对某些传统上赋予在职为他人服务的医生的价值观（如保密、患者福利和避免伤害）的重视程度有所下降，而与此同时，与医生相对于医学职业的价值观（如关注医生地位和尊重教师）的重要性则没有变化。那么，这就引发了一种有趣的悖论存在的可能性，即尽管在医学职业的这个层面上，这个职业说得更多，但他们承诺得却更少。
