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June 19, 1996


Author Affiliations

Georgetown University Medical Center, Washington, DC

JAMA. 1996;275(23):1807-1809. doi:10.1001/jama.1996.03530470035021

Thirty years ago, at the inception of the era of contemporary bioethics, the Hippocratic oath and the moral precepts it embodies were the immutable bedrock of medical ethics. They bound physicians in a moral community that reached across temporal, cultural, and national barriers. They seemed impervious even to the powerful scientific and societal forces then emerging.

Today, those forces have made the oath and each of its precepts the subject of critical challenge. Revisionists judge them anachronistic and in need of radical revision or total abandonment. Traditionalists, as urgently, insist on their timelessness, restoration, and reaffirmation. On the eve of the 21st century, the future shape and the viability of the centuries-old tradition of medical ethics are seriously in question.

What is at issue is the credibility and authority of the moral covenants that are at the heart of the oath, ie, the promises to act primarily for the benefit