We have thousands of laws, several chartae and bills of fundamental rights and 30 articles of Human Rights and of course hundreds of religious, moral and ethical norms. But all of them can be reduced to one single principle: “do not do to others what you do not want done to yourself”. Or expressed in positive: “behave towards others as you would like them to behave towards you”.
This so called golden rule is fund among old Egyptians, ancient Greek, Romans; in Christianity it is expressed by Jesus’ command: “love your next as yourself”, in Islam (“wish for your brother, what you wish for yourself”; Hadith by Muhammad), Buddhism, Hinduism and most Religions, but also in Humanism, Existentialism, Psychology, Economics or Anthropology.
Golden Rule and Hippocratic Oath
Patient experience is based on the same underlying logic of compassion, empathy and moral reciprocity and its first written expression in the context of healthcare is the Hippocratic Oath. It is true, that Hippocrates had apparently first his physician masters and second his pupils in mind and secondly the patients (as can be read in the original), but clearly within the spirit of reciprocity and empathy.
The longer introduction regarding his own craft has possibly to do with the fact that he addressed other physicians rather than patients and had, of course, no marketing intention. But this length is also due the very clear statements regarding patients: “I will take care that they suffer no hurt or damage”. There is no need to say more and in one sentence all of the spirit of patient centricity is resumed.
Modern versions of the oath
With the time, the Hippocratic Oath has suffered adaptions to new historical and social contexts. For instance the so called modern version or the Declaration of Geneva, written under the impact of Nazi horror.
The Lasagna Oath and patient centricity
Of all the modern versions, the one I find expresses best reciprocity with patients and seems to have patients first in mind is the Hippocratic Oath of Dr. Louis Cesare Lasagna the founder of clinical pharmacology. Louis Lasagna emphasized 1964 a holistic and compassionate approach to medicine. May the reader judge if it reflects the spirit of golden rule and what we know nowadays as patient centricity.
I swear to fulfill, to the best of my ability and judgment, this covenant:
I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.
I will apply, for the benefit of the sick, all measures [that] are required, avoiding those twin traps of overtreatment and therapeutic nihilism.
I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon’s knife or the chemist’s drug.
I will not be ashamed to say “I know not,” nor will I fail to call in my colleagues when the skills of another are needed for a patient’s recovery.
I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.
I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person’s family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.
I will prevent disease whenever I can, for prevention is preferable to cure.
I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.
If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.