A medical faculty class believed the Hippocratic oath had stalled. In order that they wrote their very own script.
When Tito heard of the incident with the memorial, he was on the verge of his “white coat” ceremony – a tradition in which incoming students often take the historic Hippocratic oath and promise the highest ethics in their medical careers.
He said the incident had incriminated him and his classmates and made them think deeply about the Hippocratic oath to “do no harm” that new medical students across the country would take. The oath is, in part, a promise to treat the sick, protect a patient’s privacy, and pass medical knowledge on to the next generation.
At the suggestion of one of the medical school’s assistant deans, incoming students at the University of Pittsburgh Medical School decided to update their oath for the first time in the school’s 137-year history. When they paraphrased it, it became more explicitly incorporated into all humans, including those historically overlooked by the medical community. It was wholeheartedly accepted by the administration.
The oath taken by the entire 149-member class last month pays tribute to the lives lost to Covid-19, the murders of Breonna Taylor, George Floyd and Ahmaud Arbery, and the history of “fundamental shortcomings in our health care and political systems in service vulnerable communities. “
Students then pledged to “promote diversity in both medicine and society,” “to be an ally of those of low socio-economic status,” as well as black and other colored people, as well as the gay, transgender and other underserved communities Groups.
The oath is designed to restore the confidence of marginalized communities in healthcare professionals.
Tito, who previously worked as a researcher at the National Institutes of Health, said he helped paraphrase the oath because “when you look at the bigger picture, medical facilities are part of the racist system,” he said, adding minorities are often overlooked or denied adequate medical care.
Recent studies have shown racial differences in health care. Black women are 2.5 times more likely to die in childbirth than white women, and black newborns are more likely to survive childbirth if they are cared for by black doctors – even though only 5 percent of doctors in the US are black.
The racist effects of Covid-19 have been devastating: Black Americans are up to six times more likely to die from the coronavirus than white Americans.
Historically sanctioned abuses committed by blacks were also taken into account when writing the oath.
From 1932 to 1972, the U.S. Department of Health conducted the Tuskegee Study, in which 399 black men were left untreated for syphilis without their knowing so that doctors could monitor the disease. In the 1950s, Henrietta Lacks’ genes were known to have been used and her genome was sequenced without doctors seeking her family’s consent.
Tito said this and other atrocities led him to join his medical school’s oath committee so that he could “create the conditions for how medical students in their class should approach their education”.
He added, “As a black, I thought I had a necessary perspective.”
Medical students across the country often recite a variation of the Hippocratic oath upon graduation. Over the past two decades, it has become increasingly common for medical students to recite the oath in their white smock at their ceremony.
Almost all American medical schools take an oath at their white mantle ceremony or beginning – some use it on both. Some schools have a unique oath; others allow students to be part of the oath-writing process.
This marks the first time since its inception in 1883 that the University of Pittsburgh School of Medicine has updated its oath.
The idea of writing a new oath was suggested by Chenits Pettigrew, associate dean at the medical school. Soon after his proposal, an oath committee was formed and dozens of Zoom calls began.
“The taking of the oath was an exercise in expressing the values that we as doctors want to show,” said Tito. “We worked together, but sometimes we didn’t agree. We touched on issues that sparked for some but didn’t advance the status quo enough for others. We were diverse in the most collective sense. “
He said every word had been discussed, from the use of the BIPOC (black, indigenous and colored) to “people with different abilities” to “personal prejudice”. The students chose BIPOC because they wanted to separately highlight the institutional racism that black and indigenous peoples are exposed to.
Students chose “people with different abilities” to cover the range of skills and students chose “personal prejudices” to acknowledge that they have all led their own individual lives and developed their own prejudices.
After the oath committee prepared a draft, they distributed it to their entire medical class for feedback.
Ashley Whited, another freshman on the oath committee, stated that this process forced the committee to explain each of her word decisions and encouraged her to learn more about the pandemic.
“While this is a current crisis, the pandemic is changing medicine and the way we see it,” Whited said. “Its effects will be long-lasting and needed more than a brief mention.”
The oath was taken prior to the white mantle ceremony on August 23, when students introduced it to the medical school dean Anantha Shekhar and recited the oath as a class.
Tito said at the end that the class was proud of their oath. “We just used the past and present to clarify our future goals as doctors.”
“The oath is the first step in our ongoing commitment to repairing injustices against those historically ignored and abused in medicine: black patients, indigenous patients, skin-colored patients and all marginalized populations who are identified by their identities and limitations an inferior supply have received resources. “
The oath can be read here.
Nonny Onyekweli is a New York based attorney.