Article
Ethics
4 min read

The expectations of an oath: lessons from Hippocrates

M. Çiftçi explores the evolution of a historic and contemporary commitment to protect the vulnerable.

M. Ciftci has a PhD in political theology from the University of Oxford. He is currently writing a book about church-state relations that will be published by Palgrave Macmillan. 

While surgeons operate in the background a digital display shows numbers in the foreground
Natanael Melchor on Unsplash.

A ‘casual acceptance of infanticide seems to have been not the exception but the rule among both Greeks and Romans in the centuries immediately preceding the birth of Christ.’ That shocking fact about the pagan world’s attitudes towards children, mentioned in David Albert Jones’ The Soul of the Embryo, has been brought to our attention again recently by Tom Holland’s Dominion. Since his book was published, much has been written, even in Seen & Unseen, about the radical alteration of our attitudes towards the weak and vulnerable, especially children, women, and slaves, by the Christian faith’s love for the weak over the strong. The depictions of Christ’s suffering humanity in crucifixes over centuries slowly worked to change the attitudes of even the strong and powerful.  

But to think that the Greco-Roman world was entirely callous towards the vulnerable is not true. There is a minority of voices revealing that, even then, there were some opposed to the killing of children in the womb or after birth. There were some who anticipated the revolution of values that the Judaeo-Christian tradition was about to inaugurate. Within that minority of pagan authors, the writings attributed to Hippocrates (who was roughly a contemporary of Socrates) and to his school, in particular, stand out. Translations of his writings from Greek into Syriac, Arabic, and Latin ensured their influence for centuries over Muslim and Christian physicians. The most well-known one, of course, is the Hippocratic Oath, which explicitly forbids causing an abortion using a pessary.  

Its description of the moral rules and humane ideals that physicians swear to obey, is partly responsible for the honour and prestige that is still, even today, attached to the medical profession. Medical schools around the world, including 70 percent of them in the UK, still use some version of the Oath in their graduation ceremonies, so that the new medics can make their promise to obey a short summary of the ethical ideal that should guide their practice. The revival of interest in the Oath more recently dates from the post-war period, when the appalling example of medical experimentation in the Nazi regime led the then newly founded World Medical Association to draft the Declaration of Geneva in 1948, since revised multiple times, which have in turn inspired many other versions of the Oath to be written. Some of them are banal and frankly silly, such as one version by the poet David Hart: ‘I will not knowingly do harm to those in my care, I will smile at them and encourage them to attend to their dreams and so hear the voices of their inner strangers’.  

Doctors today, in their day-to-day work, rely more often on complex documents detailing their professional obligations. So, what can we and they learn from the Oath? 

The Oath includes general promises to use treatments for the benefit of patients and to protect them from harm and injustice, but more specifically it also promises to not give a deadly drug to anyone if asked, nor to suggest giving one to a patient, including a pessary to cause an abortion as I’ve already mentioned. Later the Oath states:  

‘Into whichever houses I enter, I will go for the benefit of patients, keeping myself free of any intentional injustice or corruption, particularly in sexual matters, involving both female and male bodies, both of the free and of slaves.’  

Already, this tells us, there was an awareness that patients are vulnerable when in the care of another. The physician must not take advantage of their vulnerability, either sexually, or by euthanising them, or by enabling those in despair to commit suicide. A renewed commitment to these rules should be urged, since some doctors continue to abuse their power over patients in these ways, sometimes even with legal permission in countries that permit assisted suicide

That the Oath was written by a pagan points to the possibility of us all finding our way, without appeal to any holy book or revelation, to an agreement about some basic moral rules that should guide doctors. However, Christianity put its own spin on the Hippocratic Oath, as we can see from a Christian version of it dating from the early Middle Ages. Gone is the reference to swearing by Apollo and Asclepius, whose serpent-entwined rod remains a symbol of medicine today. But, more importantly, the Christian oath forbids causing an abortion by any means, making the promise more definite and explicit. This provides further evidence of the argument mentioned at the beginning of Christianity’s preoccupation with defending the most vulnerable from harm.   

Whereas the original Oath envisages belonging to a closely-knit circle of physicians, led by a teacher, from which outsiders are to be excluded, those sections are completely missing from the Christian version. According to W.H.S. Jones, this could be because creating ‘an inner circle of practitioners shows an aristocratic exclusiveness, which is in sharp contrast with the universal brotherhood of Christianity. The relief of pain and suffering … should be tied by no fetters and hindered by no trade-union rules. Christian benevolence should be universal.’ For that reason, Jones thought that the Christian Oath might have been originally written during the earliest centuries of Christianity, when Jesus’ healing missions and the Apostles’ practice of holding all possessions in common had not yet been ‘forgotten or neglected.’  

In Westminster Abbey, last year, we saw at the Coronation that the heart of our political system is an exchange of vows between monarch and his people, vows sworn in the belief that to remain faithful to what was promised are gifts given by something above us and beyond our ability to control. Similarly, the weighty responsibilities of marriage have inspired societies across generations to begin married life by pledging solemn promises. Why should we expect anything less from those who take us into their care when we are struck by disease, or facing death?  

Weekend essay
Creed
Ethics
7 min read

After the fall: the Post Office scandal and the search for justice

Falls from grace, like that of the Post Office’s CEO, prompt Graham Tomlin to dissect the problems of justice and mercy.

Graham is the Director of the Centre for Cultural Witness and a former Bishop of Kensington.

A tense-looking woman, sitting at  desk, stares into the middle disance.
Lia Williams as Paula Vennells in Mr Bates vs The Post Office.
ITV Studios/ITV.

It was November, and I was in Rome. With the new year on the horizon, newsagents were displaying calendars for 2024. One in particular seemed to show up in just about every street vendor available: the ‘Hot Priest Calendar’.  

It had pictures for every month of young, bronzed, good-looking priests, resplendent in brand new, ironed black clerical shirts, smouldering into the camera. I've no idea whether they were real priests or just models in clerical garb. I didn't buy one, but it did get me thinking of why they had produced it. Was this a recruitment drive for clergy in the Roman Catholic Church? Something for the nuns to put on the wall of the convent? It was hardly aiming to attract women by saying if you become a Catholic you could bag one of these hunky chaps, as priests are, well, supposed to be out of reach.  

I suspect it was just trying to tell the world that the Church is cool after all. That the church is for good-looking, shiny people, not just the regular ones with wrinkles and expanding waistlines.  

The embarrassment and shame are real and proper and yet there is, in my view, something at the heart of it which seems to be mistaken.

I was thinking of this recently while watching the story of the Post Office scandal unfold. This dreadful story is, to be frank, a bit of an embarrassment for the Church of England. This horrendous miscarriage of justice has its heart not just a Christian but a priest. I met Paula Vennells once. While I was Bishop of Kensington, we planned a big conference for all the vicars in the Diocese of London. At the time, Vennells’ star was rising in ecclesiastical circles. People had just noticed that the head of the Post Office not only went to church, but was also ordained, and so she was getting invited to speak at all kinds of conferences. She agreed to come and, to be fair, was gracious, unassuming, polite. There was nothing to suggest she was soon to become the object of public opprobrium that she is now. 

She would definitely not go on a Church Calendar these days. But then who would? The last decade has seen a succession of scandals and falls from grace – Harvey Epstein, Huw Edwards, Russell Brand, Philip Schofield - and Christian leaders are not exempt. Jean Vanier, Ravi Zacharias, Mike Pilavachi – the list goes on – and now Paula Vennells. We Christians hang our heads, as it seems such a deep failure - how can someone profess to be a Christian – even a vicar - and yet do such things? The embarrassment and shame are real and proper and yet there is, in my view, something at the heart of it which seems to be mistaken.  

Celebrities are celebrated because we believe they are different from us ordinary mortals. But sooner or later, it turns out they have the same temptations, their bodies sag, their flaws get exposed. 

Helmut Thielicke was a German theologian who opposed the Nazis during the Second World War and somehow survived. His was a crucial voice in the German church and nation as it struggled to its feet again after the trauma and destruction of those years. The big question Germany faced at the time was how a modern sophisticated Christian nation had been so easily seduced by evil? They also struggled with the question of shame. What were German Christians to do with the guilt that hung over them after the Nazi years? 

Thielicke was a brilliant preacher and drew huge crowds to his church in Hamburg. In one of his sermons he took as his text St Paul’s line, that Christians are “a letter from Christ, written not with ink but with the Spirit of the living God, on tablets of human hearts.” He asked his congregation the question: what kind of letter are you? Is a Christian meant to be an advert for God? Is the Christian a shiny product of divine handiwork so that God, like some marketing agent, says ‘Look at her – isn’t she is fine person? Wouldn’t you like to be like her?’ 

When she was being feted by all, we might have said that about Paula Vennells. But not any more. And that’s the problem of celebrity Christians, or celebrities of any kind for that matter. They are used as adverts for the brand they profess, religious or otherwise: “Use this shampoo, follow this diet, believe this religion, like this celebrity does, and you could be like them.”  

Celebrities are celebrated because we believe they are different from us ordinary mortals. But sooner or later, it turns out they have the same temptations, their bodies sag, their flaws tend to get exposed in the extra scrutiny they face in a gossipy age like ours. The hunky priests in the calendar may look good but I suspect their lives are as shadowy and compromised as the rest of us. Every now and again you find a life that is remarkable, but even then there are dark corners. Mother Teresa famously said that she rarely experienced the presence of God and struggled with lifelong depression. If we are meant to be adverts for God, we’re not very good ones. 

Thielicke’s point was that Christians are not meant to be adverts for God but letters from him. And the letter, written on the human heart, says something like this: “Here is a poor, weak human being with their own strengths and frailties, moments of courage and moments of great weakness, struggling to live a good life but failing much of the time. And yet, despite that failure, God still forgives, accepts, loves and stands by them.”  

And forgiveness is not an excuse. It doesn’t say ‘it didn’t happen’, but it says, ‘it did happen’ and it was bad, but a new start is always possible.

It sounds scandalous I know. Hearing about the Post Office scandal, all we want is for the perpetrators to be found guilty and punished. And rightly so. Justice must be done. Paula Vennells and her staff seems to have stuck stubbornly to the laughable view that the Post Office had been infiltrated by hundreds of criminal sub-postmasters, intend on defrauding the public purse. They lacked the sense or courage to question their own IT system, despite being warned it was faulty.  

Yet divine and human justice work in different ways. Not least because God, unlike human judges, sees the dodgy things we all do, not just those whose sins get found out because they are in the public eye. Human justice systems must take their course, crimes must be punished, and attempts made to turn around the lives of those caught in patterns of criminality. Yet underneath human justice lies divine justice, which promises an ultimate judgment, even for those who escape human justice. Yet at the same time, it offers not just justice, but mercy - the gift of a more profound and ultimate forgiveness, which, if accepted, does not override the penalties of human justice, but enables the possibility of redemption in the longer term. 

Martin Luther often used a Latin phrase to describe Christians – that they are simul iustus et peccator - ‘at the same time righteous and sinful’. Like an alcoholic who is never encouraged to say that were an alcoholic, but that they are a recovering one, an honest Christian doesn’t say ‘I was a chronic worrier, greedy, someone who struggles with lust,’ but ‘I am such things, and yet faith in Jesus makes a difference in helping me not to be.’ St Paul once said: ‘Christ Jesus came into the world to save sinners – of whom I am the worst.’  Not I was the worst, but I am. I remember Frank Bruno once saying “I’m not much of a Christian – I’ve been a sinner all my life.” He hadn’t quite understood - Christians are only ever recovering sinners.  

Paula Vennells and the others responsible for the Post Office scandal will have to face justice one day. It may, for some, even mean prison. But, as many in our prisons up and down the country know, lots of people find God in prison - not as a literal ‘get out of jail free card’ – the justice system doesn’t play Monopoly – but a realisation that however bad your crimes, however murky our misdemeanours or sly our sins, forgiveness is possible. And forgiveness is not an excuse. It doesn’t say ‘it didn’t happen’, but it says, ‘it did happen’ and it was bad, but a new start is always possible, and the love and forgiveness of God is available, even for the worst of people - for good-looking priests who struggle with temptation, for celebrities who fall from grace. Or even ordinary people like us.