In a new set of draft regulations for the professional conduct of doctors, the National Medical Commission (NMC), the regulatory body which looks into the functioning of medical education and professionals in the country, has proposed to introduce the “Physician’s Pledge”. The new recommendations come after a controversy erupted over replacing the Hippocratic Oath with the Charak Shapath in medical colleges. The new draft National Medical Commission Registered Medical Practitioner (Professional Conduct) Regulations makes no mention of the Hippocratic Oath or Charak Shapath.
The earlier regulations by the Medical Council of India, which predated the NMC, did not mention the Hippocratic Oath.
What is the Physician’s Pledge?
The Physician’s Pledge is part of the Declaration of Geneva as amended in 2017 by the World Medical Association (WMA).
It was adopted by the Second General Assembly of the WMA in September 1948 in Geneva, Switzerland and has been revised five times over the last 74 years to reflect the changes in medical care. The latest amendment was made by the 68th WMA General Assembly in the Chicago, United States in October 2017.
The pledge reads as follows:
As a member of the medical profession:
I solemnly pledge to dedicate my life to the service of humanity
The health and well-being of my patient will be my first consideration
I will respect the autonomy and dignity of my patient
I will maintain the utmost respect for human life
I will not permit considerations of age, disease or disability, creed, ethnic origin, gender, nationality, political affiliation, race, sexual orientation, social standing, or any other factor to intervene between my duty and my patient
I will respect the secrets that are confided in me, even after the patient has died
I will practice my profession with conscience and dignity and in accordance with good medical practice
I will foster the honour and noble traditions of the medical profession
I will give to my teachers, colleagues, and students the respect and gratitude that is due
I will share my medical knowledge for the benefit of the patient and the advancement of healthcare
I will attend to my own health, well-being, and abilities in order to provide care of the highest standard
I will not use my medical knowledge to violate human rights and civil liberties, even under threat
I will make these promises solemnly, freely, and upon my honour.
What does the NMC draft say?
The NMC draft regulations, released on 23 May, mention the Physician’s Pledge from the “Declaration of Geneva” at the end of its 14-point code of ethics.
According to the draft, the code of ethics will serve as the commitment of the registered medical practitioner toward patients, society, professional colleagues, and self. “NMC Code of Ethics is framed as a self-regulatory set of guidelines reflecting professional as well as social expectations,” it adds.
The NMC has posted the draft Registered Medical Practitioners (Professional Conduct) Regulations 2022 for comments from the public, experts, and stakeholders, reports The Times of India.
Why the Physicians Pledge over the Hippocratic Oath?
The NMC draft has proposed the Physicians Pledge because of the controversy over the other oaths.
The Commission, which replaced the Medical Council of India in 2020, had suggested to medical colleges in early February that the Hippocratic Oath in English be replaced by the Charak Shapath, a Sanskrit oath attributed to the ancient Indian sage Maharshi Charaka.
The proposal was welcomed by some medical practitioners but it did not go down well with the Indian Medical Association (IMA), which reported the matter to Union Health Minister Mansukh Mandaviya. The health minister assured the IMA that the Charak Shapath would be optional and would not be replaced with the traditional Hippocratic Oath.
In response to a question in Lok Sabha in March, the health ministry stated that the “NMC has not proposed replacement of Hippocratic Oath with Charak Shapath”. But soon after, the Commission published guidelines on its website for competency-based medical education which stated, “Modified ‘Maharshi Charak Shapath’ is recommended when a candidate is introduced to a medical education”.
According to a report in The Indian Express in February, undergraduates at AIIMS, India’s top health institute, have been taking the Charak Oath during their annual convocation for several years now The AIIMS Charak Shapath is: “Not for the self; Not for the fulfilment of any worldly material desire or gain, but solely for the good of suffering humanity, I will treat my patient and excel well.”
In May, the dean of a medical college in Madurai was suspended after students were administered the oath in Sanskrit.
Has the Hippocratic Oath always been administered in India?
The Hippocratic Oath is an ethical code undertaken by physicians across the world. It is believed to have been written by Greek physician Hippocrates.
In its original form, it requires a new physician to swear to several healing gods, to uphold specific ethical standards.
It is administered to medical students when they transition from pre-clinical to clinical subjects, during what is known as the white coat ceremony.
However, the Medical Council of India, which drafted the professional conduct regulations before the NMC, did not mention the Hippocratic Oath. What it had was the earlier, shorter and slightly modified version of the Geneva Declaration, reports The Times of India.
The earlier declaration in the MCI Ethics Regulation of 2022 stated “will practice my profession with conscience and dignity”.
How is the new recommendation different?
The new pledge includes respect for autonomy and dignity of patients and vows to attend to one’s own health and well-being in order to provide care of the highest standard. Unlike the older declaration which stated, “I will maintain the utmost respect for human life from the time of conception”, the new one says “will maintain the utmost respect for human life”.
With inputs from agencies
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