Explained: What do Charak Shapath and Hippocratic Oath say?

The dean of Madurai Government Medical College was on Sunday (May 1) removed from his post and put on the waiting list for administering the Maharshi Charak Shapath instead of the Hippocratic Oath to new students.

In February, the undergraduate medical education board – National Medical Commission (NMC) had recommended that the Maharshi Charak Shapath should replace the Hippocratic oath.

According to new guidelines, “Modified Maharshi Charak Shapath is recommended when a candidate is introduced to medical education.”

Union Health Minister Mansukh Mandaviya had said in Parliament that Maharshi Charak Shapath would be optional and not forced on medical students.

What is Charaka Shapath?

Charaka Shapath or Charaka oath, is a passage from the Charaka Samhita, a text on Indian traditional medicine Ayurveda in Sanksrit, from 1st-2nd centuries AD. It is a guideline, like dos and donts, by a teacher to fresh medical students.

According to the Journal of Vishwa Ayurved Parishad, the oath, from Charaka Samhita
Vimanasthana 8th chapter, includes “… There is no limit at all to the Science of Life, Medicine. So thous shouldst apply thyself to it with diligence. This is how thou shouldst act. Also thou shouldst learn the skill of practice from another without carping. The entire world is the teacher to the intelligent and the foe to the unintelligent. Hence, knowing this well, thou shouldst listen and act according to the words of instruction of even an unfriendly person, when his words are worthy and of a kind as to bring to you fame, long life, strength and prosperity’.”

What NMC said on Charak Shapath

The following is a brief transliteration of Maharshi Charak Shapath, as issued by NMC in a circular on March 3, 2022.

• “During the period of study I shall live a disciplined life with my teachers and peers. My action shall be guarded, service oriented and free from indiscipline and envy. In my dealings I shall be patient, obedient, humble, constantly contemplative and calm. I shall aim my full efforts and ability towards the desired goal of my profession.
• As a Physician, I shall always use my knowledge for welfare of mankind.
• I shall always be ready to serve patients, even if I am extremely busy and tired. I shall not harm any patient for the sake of monetary or selfish gains, nor shall I entertain a desire for lust, greed or wealth. immorality shall not emerge even in my thoughts.
• My dressing shall be decent yet impressive and inspiring confidence. My conduct shall always be appropriate, pleasant, truthful, beneficial and polite. I shall use my experience in actions appropriate for that time and place.
• I shall constantly endeavor to accomplish/ keep updated with the latest developments in the field and widen my knowledge.
• I shall treat patient of gender other than mine in presence of relatives or attendants.
  When examining a patient, my discretion, attention and senses shall be concentrated on the cure of the disease. I shall not divulge the confidentiality related to the patient or family inappropriately.
• Although an authority (in my subject), I shall not display my knowledge and skill with arrogance.”

What is Hippocratic Oath?

It is an oath of ethics taken by physicians and has been widely used. It is attributed to the Greek physician Hippocrates. It was written in Greek in the 4th-5th centuries BC.

The oath starts, “I swear by Apollo Physician and Asclepius and Hygieia and Panaceia and all the gods and goddesses, making them my witnesses, that I will fulfill according to my ability and judgment this oath and this covenant:

Further, it includes, “I will apply dietetic measures for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice.

“I will neither give a deadly drug to anybody if asked for it, nor will I make a suggestion to this effect. Similarly I will not give to a woman an abortive remedy. In purity and holiness I will guard my life and my art.

“I will not use the knife, not even on sufferers from stone, but will withdraw in favour of such men as are engaged in this work.”

What Vice President had said

In April 2018, Vice President M Venkaiah Naidu spoke about both Charaka Sapath and Hippocratic Oath while addressing the 20th convocation of the Rajiv Gandhi University of Health Sciences, in Bengaluru.

He said, “Let me remind you, as the Hippocratic oath states, ‘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.’ Clearly, your healing touch goes beyond your medical knowledge. Please master both the ‘art’ and the ‘science’ of medicine.”

“Charaka in his Charaka Samhitha has described the ideal medical student as one who is ‘of mild disposition, never mean in his acts, humble, with strong memory, devoted to truth and study, devoted to theory and practice, thoughtful and compassionate, seeking the good of all creatures’,” he added.

“Empathy, compassion and a caring attitude enhance your effectiveness. Ethical behaviour enhances your credibility and stature. As Charaka again says, ‘you must be reasonable in charging for your service and only do what is “calculated to do good to the patient” without any other ulterior motives’,” he told the students.

In February, Congress MP Shashi Tharoor supported both Charaka Shapath and Hippocratic Oath being there for students.

“Many doctors are expressing concern. I am all in favour of introducing Indian elements into Indian education, but not at the expense of universal values and standards. Why can’t the Charaka Shapath supplement, rather than supplant, the HippocraticOath that doctors worldwide take?” he had tweeted.

Many doctors are expressing concern. I am all in favour of introducing Indian elements into Indian education, but not at the expense of universal values and standards. Why can’t the Charaka Shapath supplement, rather than supplant, the HippocraticOath that doctors worldwide take? https://t.co/vRzn8GFaoZ

— Shashi Tharoor (@ShashiTharoor) February 11, 2022

The Kerala Congress had alleged that the BJP government was attempting to saffronise medical education with Charaka Shapath. “The National Medical Commission’s proposal to replace the ‘#HippocraticOath’ taken by medical students with ‘Charak Shapath’ is an attempt to saffronise medical education as per the wishes of #RSS. Hippocratic Oath that captures the universal ethics and values can’t be changed.”

The National Medical Commission’s proposal to replace the ‘#HippocraticOath’ taken by medical students with ‘Charak Shapath’ is an attempt to saffronise medical education as per the wishes of #RSS. Hippocratic Oath that captures the universal ethics and values can’t be changed.

— Congress Kerala (@INCKerala) February 11, 2022

Modern pledge

In 2017, a modern successor to the Hippocratic Oath for physicians around the world was approved by the World Medical Association (WMA). The physician leaders, who met at the WMA’s annual General Assembly in Chicago, approved revisions to the Declaration of Geneva, which was adopted by the association in 1948.

The revised Declaration, called a pledge, refocused the text to reflect changes over the decades in the relationship between physicians and their patients and between physicians themselves.

WMA President Dr. Yoshitake Yokokura had said: “The new wording respects the unique character and significance of this Declaration, but focuses more on important ethical principles not in the current version and not expressed explicitly.

“The life of physicians today is completely different to what it was in 1948 when the original Declaration of Geneva was adopted. Since then, the Declaration has become a core document of medical ethics and a modern version of the 2,500-year old Hippocratic Oath.

“We hope that the Declaration approved today will be used by all physicians around the world to strengthen the profession’s determination to maintain the highest standard of health care for patients’.”