Explanation of the Swiss Medical Oath

About the objectives

An oath/pledge contains a formula or a text of moral content in which one or more obligations are contained to which the person taking the oath or pledge professes. The taking of the oath or the execution of the pledge represents a solemn/public act in which the person taking the oath or pledge publicly commits to the content of what has been said. The "Swiss Medical Oath" is not only part of a written document, but should actually be taken in the respective institution. The act of taking the oath realizes a self-commitment - a binding of the conscience to the content of the oath or pledge. In the case of morally sensitive professions, after taking the oath or pledge, the person in question is expected to adopt attitudes ("virtues") that correspond to the duties expressed.

However, the act of taking an oath/pledge not only obligates the person in question, but also protects him or her from expectations, pressure or encroaching behavior on the part of third parties, which would violate the oath or pledge obligations or make their fulfillment impossible. In this respect, such an oath is not only a moral self-obligation of an individual, but also an obligation of the respective institution to allow its employees to decide and act in accordance with the oath.

On the question of voluntariness

The oath is based on voluntariness. However, successful implementation of the medical ethos contained in the oath/pledge requires that the respective institution in which the oath/pledge takers perform their work supports and promotes oath taking. For example, an institution may decide to make oath-taking part of the employment contract for new hires. Such an inclusion must not be understood as a sanction mechanism, but again serves to protect the person taking the oath: he or she is not a solitary person, but the representative of an institution which, for its part, is committed to the standards of the medical ethos and is willing to make this its own guiding principle.

To the contents

In the case of an oath/pledge for physicians, the oath contains those duties that are considered fundamental for the appropriate practice of the profession and as a guiding principle for the professional group. The oath/pledge is therefore taken vis-à-vis the professional group of physicians or as a member of this profession. Taking the oath today does not require any religious or ideological confession. Under today's conditions of a liberal and therefore pluralistic society, an oath/pledge cannot take a stand on all controversial moral matters associated with modern medicine, nor can it anticipate the specific trade-offs on the ground - in the clinic or in the practice.

An oath/pledge forms a kind of constitution of a virtue-ethical nature to which a professional group submits. The individual guidelines that follow from it are elaborated in the respective professional codes of conduct. These can be described - analogously to the concept of constitution - as laws. As in the reality of the political, the "constitution" (the oath/pledge) can urge corrections in the area of the "laws" (the professional codes of conduct). Not every obligation that is part of the text of the oath/pledge can be cast in the form of a rule or norm that has found expression in the codes of ethics.

On the relation of the oath of the World Medical Association

The Swiss Medical Oath presupposes and follows on from "The Physician's Pledge of the World Medical Association" of October 2017. This update of the "Declaration of Geneva" provides the general, global framework against which the Swiss Medicine Oath contains a higher degree of concretization and a clear focus on developments on the ground. In view of the strong tendency towards economization, the Swiss Medical Oath, by means of its patient-centeredness, is directed not at least towards ensuring and strengthening the integrity of the indication quality. The oath or pledge has the function to protect and strengthen the medical ethos, to defend the dignity of the medical profession and its responsibility towards patients, and in this way to make the humane signature of the profession visible.

The prohibition of instrumentalization contained in the oath protects patients from measures and treatments that have neither a direct nor an indirect benefit for them. The prohibition therefore does not constitute an obstacle to research, since research projects, if they are planned in accordance with the rules, are in any case subject to the aforementioned criterion of benefit, in addition to other ethical criteria.