Med students write their own Hippocratic oath to fight racial injustice and inequality

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Future doctors from the University of Pittsburgh have vowed not only to "do no harm," but to actively fight against it. 

The School of Medicine's class of 2024 started a new tradition this year of writing and reciting their own Hippocratic oath alongside the traditional one penned by Greek physician and philosopher Hippocrates 2,400 years ago.

"I think what makes our oath unique is that we really boldly address what's going on in society right now," first-year student Sean Sweat told As It Happens host Carol Off

"Not simply the COVID-19 pandemic and how that wreaked havoc on a number of minority communities — but also addressing the racial injustice that has been brought moreso to light given the events surrounding Breonna Taylor, George Floyd and Ahmaud Arbery," she said referring to three Black Americans whose deaths have sparked widespread protests for racial justice. Both Taylor and Floyd were killed by police, while Arbery's shooting death involved a former law enforcement officer and his son.

Sweat wrote the oath alongside 11 of her new classmates, and they recited it at the end of their orientation. The students vowed to fight for equality in health care, combat medical misinformation and "dismantle the systemic racism and prejudice that medical professionals and society have perpetuated."

"At Pitt, we challenge our students to change the world — and the future of medicine — for the better. This class didn't wait," Anantha Shekhar, the university's senior vice-chancellor for the health sciences, said in a news release.

"Their class oath, the first of its kind in our program's history, speaks to the power and importance of clinical care and research in creating a more inclusive and just society, and I am excited to watch them put this promise into practice." 

'The role of a physician is even more complex now'

Sweat says there are elements in Hippocrates' pledge that are as important today as they were 2,400 years ago, such as doing no harm and respecting doctor-patient confidentiality.

"Those are fundamental values that we still hold ourselves to," she said. "But the role of a physician is even more complex now, and writing our own oath gave us a chance to reflect on what it means to be a physician in this day and age."

Sweat and her peers are entering medical school during a particularly intense moment in history where people are in the streets calling for racial justice, and the COVID-19 pandemic has shone a harsh light on the inequities that exist in the health-care system.

More than 235,000 Americans have died from COVID-19, and the disease has disproportionately impacted Black and Indigenous communities — both in the United States and Canada. 

"As an African-American woman, this pandemic has really hit my community very hard. African-Americans tend to have higher rates of pre-existing conditions such as diabetes, high blood pressure [and] asthma that can make a COVID-19 infection lethal," she said.

"And so you might wonder, why are these pre-existing conditions so prevalent in African-Americans? Well, it goes back to lack of access to health care."

If you can't afford insulin and a healthy diet, you won't be able to keep your diabetes under control, she noted. And if you don't have access to transportation to get your blood pressure routinely checked, that too can spiral out of control.

Then there's that fact that many people of colour work in front-line jobs and "don't have the luxury of working from home," Sweat said. 

"It comes down to either going into work as an essential worker and risking exposure, or simply not bringing home an income in order to provide for the family," she said. "That's the choice that many have had to make."

This type of context, Sweat says, is important to consider when developing a medical care plan for patients.

In fact, understanding where each individual patient is coming from is one of the key elements of the class of 2024's oath, which reads: "I will care for my patients' holistic well-being, not solely their pathology. With empathy, compassion and humility, I will prioritize understanding each patient's narrative, background and experiences while protecting privacy and autonomy."

That paragraph was particularly important for Sweat. 

"With such a diverse patient population nowadays, it's so important to be equipped to treat patients who don't look like you, and it's so important to understand how a patient's unique experiences and challenges affect them," she said.

I really strongly believe that we are leaders in our society and that we can use our roles as physicians to make changes not only in the form of medicine, but beyond.- Sean Sweat, medical student 

But the oath also calls on doctors to look beyond their own patients or practices, and embrace their roles as leaders in medicine and society at large. 

The students vowed to "advocate for a more equitable health-care system from the local to the global level," to "restore trust between the health-care community," to hold each other accountable, and to combat "misinformation in order to improve health literacy."

"As physicians, I really strongly believe that we are leaders in our society and that we can use our roles as physicians to make changes not only in the form of medicine, but beyond," Sweat said.

Written by Sheena Goodyear. Interview produced by Kate Cornick.