Queenstown GP's change to oath approved

New Zealand doctor Sam Hazledine's amendment to the Hippocratic Oath, sworn by all doctors, has been ratified unanimously by the World Medical Association.

Physician leaders at the WMA’s annual General Assembly in Chicago on Saturday (local time) approved the Queenstown GP's revisions to the Declaration of Geneva, which was adopted by the association in 1948.

The WMA said the revised Declaration, to be called a pledge, refocuses the text to reflect changes over the decades in the relationship between physicians and their patients and between physicians themselves.

Sam Hazledine and the phrase that will be added to the Hippocratic Oath. Photo: Still Vision Photography
Sam Hazledine and the phrase that will be added to the Hippocratic Oath. Photo: Still Vision Photography

The new pledge makes specific reference for the first time to respecting the autonomy of the patient, which is not included in the current text. 

It also includes a new obligation for respect between teachers, colleagues and students. The present Declaration says students must respect their teachers, but there is no reciprocity.

There is a new obligation on physicians to share medical knowledge for the benefit of their patients and the advancement of healthcare.

Also added is a requirement for physicians to attend to their own health, well-being and abilities in order to provide care of the highest standard.

Dr Hazledine said the change was a positive step for the medical profession and a fundamental shift in thinking. He told the Otago Daily Times the line was "more than just words".

Research showed burnout and stress in the profession could lead to patient harm.

"Our first core principle in our profession is ‘Do no harm’, but we are harming them [patients] by the way we are being and the way we are working.

"We are not de-prioritising the patient; rather, we are saying, ‘this is one of the most important things for the patient’."

Dr Yoshitake Yokokura. Photo: WMA
Dr Yoshitake Yokokura. Photo: WMA

The current Declaration of Geneva is used worldwide, the WMA said. In many countries it was part of the medical professional code and in some it was legally binding. However, in other countries it was either not used at all or is adapted in some way.

The WMA said it expected that the revised pledge, agreed following a two-year revision process, including a period for public consultation, would become a global ethical code for all physicians.

"The new wording respects the unique character and significance of this Declaration, but focuses more on important ethical principles not in the current version and not expressed explicitly, WMA president Dr Yoshitake Yokokura said on Saturday.

‘The life of physicians today is completely different to what it was in 1948 when the original Declaration of Geneva was adopted. Since then, the Declaration has become a core document of medical ethics and a modern version of the 2500-year old Hippocratic Oath.

"We hope that the Declaration approved today will be used by all physicians around the world to strengthen the profession’s determination to maintain the highest standard of health care for patients," Dr Yokokura said.

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