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The Hippocratic Oath: Origin, History, and Modern Version

· Posted by Pick The Doc Team · Editorial policy

The Hippocratic Oath is the oldest surviving statement of medical ethics in the Western tradition, and easily the most misquoted. It is nearly 2,400 years old, it does not contain the phrase most often attributed to it, and the version sworn by most doctors graduating today was written in 1964.

This page sets out where the Oath came from, what the original actually says, how it changed, and what it means in practice when you sit down in front of a doctor.

Origin: who wrote it, and when

The Oath belongs to the Hippocratic Corpus, a collection of around sixty medical texts written in Ionic Greek and traditionally associated with Hippocrates of Kos (c. 460 – c. 370 BCE), the Greek physician often called the father of Western medicine.

The attribution is loose. The Corpus is the work of many authors writing across more than a century, and historians generally do not credit the Oath to Hippocrates personally. Most date it to the fifth or fourth century BCE. The earliest substantially complete manuscript that survives is far later still.

What made Hippocratic medicine distinctive was its founding premise: that disease has natural causes and can be studied, rather than being a punishment sent by the gods. The Oath sits on top of that idea. It is an attempt to define what a person practising this new, naturalistic craft owes to patients, to teachers, and to the profession.

What the original Oath actually says

The classical text is short, and its structure is worth noticing. It opens by swearing on the Greek healing deities, spends a substantial passage on obligations to one's teacher, and only then turns to patients.

I swear by Apollo the physician, and Asclepius, and Hygieia and Panacea and all the gods and goddesses as my witnesses, that, according to my ability and judgement, I will keep this Oath and this contract.

The substantive promises that follow can be grouped into five areas.

1. Obligations to one's teacher

The physician swears to regard his teacher as equal to his own parents, to share his livelihood with him, to relieve his financial needs, and to treat the teacher's children as his own brothers, teaching them the craft without fee. In the original this is the longest single section. Medicine was a guild, passed down within a closed lineage, and the Oath was partly an initiation into that lineage.

2. Benefit and non-maleficence

I will use those dietary regimens which will benefit my patients according to my greatest ability and judgement, and I will do no harm or injustice to them.

This is the clause most often paraphrased as "first, do no harm" — though, as explained below, that is not what it says.

3. Specific prohibitions

Three explicit refusals appear, and all three are historically striking.

4. Conduct in the patient's house

Into whatever homes I go, I will enter them for the benefit of the sick, avoiding any voluntary act of impropriety or corruption, including the seduction of women or men, whether they are free men or slaves.

This is an early and explicit prohibition on abusing the access that medicine grants — an obligation that survives, in modern form, in every professional-boundaries regulation today.

5. Confidentiality

The physician swears to keep secret whatever he sees or hears in the course of treatment, or even outside it, holding such things to be unutterable. This is the direct ancestor of doctor-patient confidentiality and, ultimately, of statutory privacy protections such as HIPAA.

The Oath closes with a self-imposed sanction: if he keeps it, may he enjoy life and art and be honoured; if he breaks it, may the opposite befall him.

"First, do no harm" is not in the Oath

The Latin phrase primum non nocere — "first, do no harm" — is the single most common thing attributed to the Hippocratic Oath, and it does not appear in it.

The Oath contains a related but differently framed pledge: to use treatment to help the sick according to ability and judgement, and to abstain from harm and injustice. The idea that avoiding harm comes first, ahead of doing good, comes from a separate text in the Hippocratic Corpus, Epidemics, which advises the physician to help, or at least to do no harm. The Latin formulation itself is far later, entering common medical usage in the nineteenth century.

The distinction matters more than it sounds. "Do no harm" read literally would forbid surgery, chemotherapy, and most vaccination. What modern ethics actually asks is proportionality: that the expected benefit of an intervention should outweigh its expected harm, and that the patient should be the one to weigh it.

History: how the Oath survived and changed

The Oath was never universal in antiquity. It appears to have been sworn by a minority of Greek physicians, and several of its prohibitions ran against mainstream ancient practice.

Its long survival owes a great deal to medieval adaptation. Christian, Jewish, and Islamic scholars preserved and copied it, revising the pagan invocation of Apollo and Asclepius into forms compatible with monotheism. A version beginning "Blessed be God, the Father of our Lord Jesus Christ" circulated widely in Christian Europe, and the Oath was transmitted through Arabic medicine alongside the rest of the Greek medical inheritance.

By the eighteenth and nineteenth centuries the Oath had become more symbol than practice. Its revival as a graduation ritual is a twentieth-century phenomenon, and a rapid one. In 1928, roughly a quarter of North American medical schools administered any oath at all. By the end of the century, essentially all of them did.

Two events drove that change. The first was the Nuremberg Doctors' Trial of 1946–47, which documented medical experimentation and killing carried out by physicians under the Nazi regime, and made the question of what a doctor may refuse to do unavoidable. The second was the resulting Declaration of Geneva, adopted by the World Medical Association in 1948 as a modern physician's pledge, and revised several times since — most substantially in 2017, when a clause on the physician's own wellbeing was added.

The modern version

The text used at most American and British medical school ceremonies today is not the classical Oath. It is a rewriting composed in 1964 by Louis Lasagna, then Academic Dean of the School of Medicine at Tufts University. It is widely reproduced and remains under copyright, so what follows is a summary of its substance rather than the full text.

Lasagna's version keeps the covenantal form and the core duties — respect for the knowledge of predecessors, confidentiality, avoidance of overtreatment, and a warning against therapeutic nihilism — while making several deliberate changes:

Many schools now go further still, using the Declaration of Geneva, an oath written by the graduating class itself, or a locally adapted text. There is no single oath that all doctors take.

Original and modern compared

Patient autonomy is now one of the central ideas behind informed consent. Thinking Paths explores the philosophical meaning of autonomy, including what makes a choice genuinely one's own and how information, institutions, and power can affect it.

What it means for you as a patient

The Oath is not law. No doctor has ever been disciplined for breaching it as such. Physicians are bound instead by state licensing boards, professional codes such as the AMA's Code of Medical Ethics, and statutes governing privacy and consent.

What the tradition does describe is a reasonable set of expectations for any consultation:

If a consultation falls short of that last point, it is worth reading our guide on what to do when a doctor dismisses your symptoms. Being taken seriously is not a courtesy; it is the substance of the tradition described on this page.

Frequently asked questions

Does the Hippocratic Oath say "first, do no harm"?
No. That phrase does not appear in the Oath. The Oath pledges to abstain from harm and injustice; the "first" formulation derives from Epidemics, a different text in the Hippocratic Corpus, and the Latin primum non nocere came into use far later.
Do doctors still take the Hippocratic Oath?
Most medical schools hold a swearing ceremony, but very few use the classical text. Most use a modern rewriting — commonly Lasagna's 1964 version, the Declaration of Geneva, or an oath written by the graduating class.
Is the Hippocratic Oath legally binding?
No. It is a professional and ethical tradition. Legal obligations come from licensing rules, medical board regulations, and statutes such as HIPAA.
Did Hippocrates write it?
Probably not. It forms part of the Hippocratic Corpus, a multi-author collection, and most historians decline to attribute it to Hippocrates himself.
Why did the original ban surgery for kidney stones?
Ancient medicine drew a firm line between physicians and those who cut. Lithotomy was a separate trade, and the clause is best read as a rule about staying within one's competence — an idea that survives today as scope of practice.
Does the Oath forbid abortion or euthanasia?
The classical text contains explicit prohibitions on giving a deadly drug and on providing an abortive pessary. Nearly all modern versions omit both, leaving these questions to law and to individual conscience.

Sources

This is not medical advice. This article is educational and historical only. It does not diagnose conditions and is not a substitute for professional medical care. In an emergency, call 911. Read our full medical disclaimer.

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