The controversial origin of the Hippocratic Oath

A quick reality check: “the Hippocratic Oath” isn’t one single thing

When people say “the Hippocratic Oath,” they often mean one of three things:

• The ancient Greek text usually called simply “Oath” (and preserved among writings linked to Hippocrates).
• A classical translation that’s been copied and recopied for centuries (sometimes with religious edits).
• A modern oath recited at medical graduationsoften rewritten, shortened, secularized, or customized.

These versions overlap, but they aren’t interchangeable. In fact, modern medical schools almost never use the original ancient text
verbatim, and many schools use oaths created by students and faculty to match contemporary values and realities.

Where it came from: a famous “Oath” inside a not-so-neat Hippocratic universe

The Hippocratic Corpus: one brand, many authors

The Oath sits inside what’s often called the Hippocratic Corpus (or Hippocratic Collection), a set of roughly sixty ancient Greek
medical works associatedsometimes looselywith Hippocrates. The catch: scholars generally treat the Corpus as a multi-author library
assembled over time, not a single person’s diary. Different treatises can even contradict each other on practice and principles.

Dating and setting: ancient, but not a time capsule

The Oath is usually placed around the classical period (often associated with the 5th–4th centuries BCE), but pinning down a precise
date and “home address” is hard. Ancient texts traveled, got recopied, and absorbed the values of the groups who used them.
The Oath we talk about today is less a snapshot from one moment and more a survivor of a long, complicated game of cultural telephone.

Controversy #1: Did Hippocrates actually write it?

The short answer is: there’s no solid proof he did. Many historians and medical scholars point out that the Oath bears Hippocrates’
name in tradition, but authorship is uncertain and may postdate him. That sounds like a scandaluntil you remember how ancient
“authorship” worked. Attaching a respected name to a text was a common way to give it authority, especially if the text reflected a
school or tradition associated with that figure.

In other words, “Hippocratic” can mean “from the Hippocratic tradition” rather than “written by Hippocrates’ own hand.”
That distinction matters, because it reframes the Oath as a community document: a statement of what some physicians wanted
medicine to be, not a universal law passed down from a single ancient superhero doctor.

Controversy #2: A possible Pythagorean “house style” hiding in plain sight

One of the most persistent scholarly debates is whether the Oath reflects Pythagorean influenceyes, the Pythagoras with the triangle,
plus a whole philosophical/religious movement that cared about purity, discipline, and moral rules.

Why would that matter? Because the Oath contains strict prohibitions and an intense teacher-student loyalty structure that can look
less like “general Greek medicine” and more like a specific ethical sect drawing boundaries: “This is who we are, and this is what we
don’t do.”

Some scholars (notably Ludwig Edelstein, discussed widely in later medical history writing) argued that these features make more sense
as the product of a particular philosophical community rather than a broad, mainstream medical code. Whether or not you accept the
strongest version of that argument, the controversy highlights a key point: the Oath may represent a subset of ancient medical
values, not a universal consensus.

It’s like assuming one band’s tour rider (“no green M&Ms”) reflects the entire music industry. The Oath may tell us a lotbut it may
tell us a lot about one group’s identity as much as about “medicine” in general.

Controversy #3: It reads like a contract, not a motivational poster

Modern readers often expect an oath to be broad and inspiring: “I will serve humanity,” “I will respect all patients,” “I will be brave,
kind, and well-rested.” (Okay, maybe not the last onethough modern students increasingly add self-care.)

The ancient Oath, by contrast, spends serious energy on:

• Teacher-student obligations (including teaching the art under defined terms).
• In-group boundaries (who is allowed to learn and under what conditions).
• Rules of practice (what the physician will and won’t do).
• Privacy and propriety (confidentiality and sexual boundaries).

That’s not accidental. In a world without standardized licensing boards and modern malpractice law, an oath could help define a
professional identity, protect a reputation, and establish trustespecially for a community trying to distinguish itself from
competitors, “quacks,” or rival healers.

Controversy #4: The lines that keep starting arguments (even 2,400 years later)

Myth-busting: “First, do no harm” isn’t literally in the Oath

If the Hippocratic Oath had a fan club slogan, it would be “First, do no harm.” The problem? The ancient Oath doesn’t actually contain
that exact phrase. The idea of avoiding harm shows up, but the famous wording is more of a later summary of Hippocratic ethics (and is
often linked to other Hippocratic writings rather than the Oath itself).

This is a classic case of a powerful concept becoming a quote people wish were in the originalbecause it fits on a poster, a
mug, and a TED Talk slide.

Abortion and euthanasia: medicine, morality, and translation battles

Two of the most debated prohibitions are the Oath’s rejection of giving a deadly drug if asked and its line about not providing an
abortive pessary. These clauses have been pulled into modern political and ethical debatessometimes as if they were a crystal-clear,
single-meaning manifesto.

But historians point out that ancient medical practice wasn’t monolithic. Even in antiquity, physicians disagreed about what should be
permitted, under what circumstances, and by whom. Add in translation issueswhat specific methods are referenced, how broad the ban is
meant to beand you get the recipe for centuries of argument.

This is part of why modern medical school oaths often omit or rewrite these lines: not necessarily because the issues are unimportant,
but because contemporary ethics usually addresses them through broader frameworks (patient autonomy, informed consent, legal standards,
professional guidelines) rather than a single ancient sentence.

“I will not cut”: the surgery clause and ancient specialization

Another head-turner is the line often summarized as “I will not cut,” traditionally understood as refusing certain surgical procedures
(especially stone cutting) and leaving them to specialists. Today, that can sound like a physician saying, “I’m here for the vibes, not
the scalpel.”

In context, it suggests boundaries and role differentiation: some practitioners specialized, and the Oath drew a line between types of
workpossibly for competence, reputation, safety, or guild-like division of labor.

Sexual boundaries and confidentiality: surprisingly modern concerns

The Oath’s emphasis on avoiding sexual misconduct and keeping patient information private can feel strikingly current. Even if the
social context was very different, the underlying professional point is recognizable: the physician has access to vulnerable people and
sensitive information, and that power demands restraint.

Ironically, modern analyses of medical school oaths suggest that while confidentiality is almost always included, explicit mention of
avoiding sexual misconduct is much rarer than you might expectproof that even “obvious” ethical points can get lost when traditions
evolve.

How it got famous: from ancient text to modern graduation ritual

Here’s another twist in the origin story: the Oath wasn’t always the universal graduation staple people assume it was. Over centuries,
it drifted in and out of prominence, got translated, adapted, and sometimes edited to remove references to pagan deities.

By the time modern medicine was professionalizing in Europe and the United States, medical ethics increasingly took the form of codes,
not just oaths. In the U.S., for example, the American Medical Association adopted a formal ethics code in the mid-19th centuryan early
effort to define professional standards in a rapidly changing medical landscape.

In the 20th century, especially after World War II, the global medical community paid renewed attention to ethics, professional duties,
and human rightsleading to newer pledges like the Declaration of Geneva. Meanwhile, many U.S. schools kept oath-taking as a rite of
passage but updated the language to match modern medicine’s realities.

Modern medical oaths: the Oath’s “influence,” not its exact wording, is the legacy

What U.S. medical schools actually do

If you picture every graduating doctor solemnly reciting the same ancient lines… you’re picturing a movie, not a survey result.
Studies of U.S. medical school oaths show wide variation: many schools use modified Hippocratic language, many use entirely different
oaths, and some allow students to choose among options.

Even so, certain themes keep showing upespecially confidentiality. In one content analysis of oaths used at accredited U.S. medical
schools around 2000, nearly all included promises about protecting patient privacy, while only a small minority included explicit bans
on abortion or euthanasia, and very few mentioned avoiding sexual misconduct.

The Lasagna oath: a very American remix

One of the best-known modern rewrites was crafted in 1964 by Louis Lasagna (then at Tufts), and it’s still used in many places. It’s
more secular, more focused on modern professional responsibilities, and more explicit about caring for the whole personnot just the
disease on a chart.

Students write their own (and Hippocrates would probably have questions)

Many schools now involve students in crafting or selecting their oath. Modern student-written pledges often incorporate concerns that
ancient texts couldn’t anticipate: systemic inequity, teamwork, burnout, research ethics, responsible technology use, and the reality
that medicine happens inside families, communities, and healthcare systemsnot just inside a physician’s head.

This trend doesn’t “betray” the Oath. It proves the Oath’s biggest idea still works: a profession should publicly define what it owes to
patients and society, and it should do that in language that people actually mean when they say it.

So what’s the real controversyand why should anyone care?

The controversy isn’t just “who wrote it.” The deeper controversy is this:
Was the Oath ever meant to be universal?

If it began as a boundary marker for a particular grouppossibly a philosophically influenced community with strict rulesthen the Oath
is less a timeless constitution and more a historical argument. It’s a record of people trying to answer:

• What counts as legitimate medical practice?
• Who belongs in the professional circle?
• What should a healer refuse to doeven if asked?
• How should knowledge be passed down?
• How do power and vulnerability shape medical relationships?

And here’s the uncomfortable truth: we’re still answering those questions. We just do it with ethics committees, professional codes,
court decisions, hospital policies, and long debate threads that start with “Respectfully…” and end with somebody muting the group chat.

Conclusion: the Oath’s origin is controversial because medicine is controversial

The Hippocratic Oath isn’t a perfectly preserved ancient rulebook. It’s a survivorrewritten, reinterpreted, and repurposed across
centuries. Its origin is controversial because it likely reflects a specific community’s attempt to define “good medicine” in a
competitive and morally complex world. Its endurance is controversial because modern medicine keeps changing, and no single text can
settle every ethical dispute.

But the Oath remains useful as a mirror. When we argue about who wrote it, what it meant, and what should be left out today, we’re
really arguing about who we want doctors to beand what we want healthcare to protect when the decisions get hard.

In that sense, the Hippocratic Oath is doing its job. It’s not giving us easy answers. It’s making us commitpubliclyto the kind of
profession we’re trying to build.

Experiences: how the Oath’s controversial origin shows up in real life

Talk to physicians and medical students long enough and you’ll notice something funny: almost nobody experiences “the Hippocratic Oath”
as a single, stable text. Instead, people experience it as a momentusually a ceremonyfollowed by years of ethical gray zones that
don’t fit neatly inside one paragraph of ancient Greek.

One common experience is the “first oath shock.” A student walks into a white coat ceremony expecting something like a sacred,
unchanging script. Then they discover the oath is modern, edited, or even written by their own class. Some feel relieved (“No pagan
gods, no awkward lines, thank you very much”). Others feel disappointed, like they showed up for a classic movie and got a reboot.
But that emotional whiplash is actually a lesson in the Oath’s history: it was always shaped by the community using it.

Another experience is the hallway debate that starts with history and ends with identity. A professor might mention that the Oath may
not be by Hippocrates, or that scholars have argued it reflects a specific philosophical group. Suddenly the room divides into
“tradition protectors” and “context realists.” The protectors say, “Even if it’s not by Hippocrates, it represents medicine’s moral
roots.” The realists say, “If it was a niche sect’s contract, let’s stop pretending it’s universal.” And then someone points out the
obvious: both sides are right about different things.

Clinically, the Oath’s controversies surface in moments when a patient’s request collides with a clinician’s limits. Not every conflict
is headline-grabbing. Sometimes it’s simple: a patient wants antibiotics for a viral cold, and the physician has to refusepolitely,
firmly, and with enough explanation to keep trust intact. That refusal is a tiny modern echo of an ancient idea: a healer is not just a
service vending machine. The clinician must decide what is beneficial, what is harmful, and what they will not doeven if asked.

Students also experience the Oath’s “contract energy” when they watch mentorship up close. The ancient text is unusually intense about
obligations to teachers and the transmission of knowledge. In modern training, that shows up in small rituals: a resident staying late
to teach a procedure, an attending emphasizing humility when a diagnosis is uncertain, or a team debriefing after a mistake with the
quiet message that competence and character are learned together. It can be inspiringand it can also be complicated when hierarchy
becomes unhealthy. That tension is part of why many modern oaths include language about respect, teamwork, and accountability.

Finally, there’s the experience of rewriting. Many graduating classes workshop their oath line by line, arguing about what belongs.
Should it mention justice? Patient autonomy? Burnout? Technology? Social responsibility? Every edit is a mini referendum on what medicine
should be in their era. That process can feel surprisingly emotional, because it turns “ethics” from an abstract subject into a public
promise made in front of family, mentors, and peers.

If the Hippocratic Oath’s origin is controversial, these experiences explain why: oaths aren’t just historical artifacts. They’re living
mirrors. Each generation sees its own dilemmas reflected backand then tries to write something it can actually stand behind when real
human lives are on the line.