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Charak Shapath and the contraversy

  • Published
    2nd May, 2022
Context

The Dean of Madurai Medical College was removed recently after a batch of new students were administered an oath in Sanskrit attributed to the ancient Indian sage Maharshi Charaka instead of the traditional Hippocratic Oath in English.

About

About the controversy:

  • The controversy began after the National Medical Commission (NMC), the regulator for medical education and practices (which replaced the Medical Council of India in 2020) suggested to medical colleges that the Hippocratic Oath should be replaced by a “Charak Shapath”.
  • Indian Medical Association (IMA) later had “assured that Charak Shapath will be optional and will not be forced to replace the Hippocratic Oath”.
  • NMC again issued a circular on “Implementation of new Competency Based Medical Education for Undergraduate Course Curriculum”, in which it said: “Modified ‘Maharshi Charak Shapath’ is recommended when a candidate is introduced to medical education”.

Case Study

  • Undergraduates at the country’s premier health institute, AIIMS, have been taking the Charak Oath during their annual convocation for several years now.
  • The AIIMS Charak Shapath is: “Not for the self; Not for the fulfilment of any worldly material desire or gain, but solely for the good of suffering humanity, I will treat my patient and excel well.”

 

World Medical Association (WMA):

  • The World Medical Association (WMA) adopted an international code of medical ethics in 1949, which was amended in 1968, 1983, and 2006.
  • In May 2021, the WMA published a proposed modernised version of the international code, “outlining physicians’ duties towards their patients, other physicians, health professionals and society as a whole”, according to the WMA website.
  • According to the WMA, some of the duties of physicians in general are to:
    • always exercise his/her independent professional judgment and maintain the highest standards of professional conduct;
    • respect a competent patient’s right to accept or refuse treatment;
    • not allow his/her judgment to be influenced by personal profit or unfair discrimination;
    • be dedicated to providing competent medical service in full professional and moral independence, with compassion and respect for human dignity;
    • deal honestly with patients and colleagues, and report to the appropriate authorities those physicians who practice unethically or incompetently or who engage in fraud or deception;
    • certify only that which he/she has personally verified;
    • respect the local and national codes of ethics

What is the Hippocratic Oath that the Charak Shapath would replace?

  • The Hippocratic Oath is attributed to Hippocrates of the island of Kos, a Greek physician of the classical period (4th-5th centuries BC), broadly corresponding to the period from the death of the Buddha (486 BC) to the rise of the Mauryas (321 BC) in India.
  • Among the great contemporaries of Hippocrates, the so-called “father of modern medicine”, were the Athenian philosopher Plato and his teacher Socrates, and Plato’s student and a tutor of Alexander the Great,
  • The Oath is a charter of ethical principles that physicians over the ages have sworn to uphold in the practice of their profession.
  • The earliest available fragments of what is understood to be the original oath date back to the late 3rd century AD, and a millennium-old version is kept in the library of the Holy See.
  • To Hippocrates is attributed a collection of 70 books on medicine called ‘The Corpus Hippocraticum’; most scholars, however, agree that the Hippocratic Oath itself may not have been the work of the individual identified as the historical Hippocrates.

Who was Charaka and what is Charak Samhita?

  • The new oath of choice is in honour of Maharshi Charaka, considered one of the principal contributors to the ancient science of Ayurveda and the author of the medical treatise, 'Charaka Samhita'.
  • The Charak Samhita is a medical pharmacopoeia and collection of commentaries and discussions on medical practices that is dated to the 1st-2nd centuries AD.
  • Along with the compendium of Susruta (c. 4th century AD), which is about surgery, the Charak Samhita is considered the foundational text of ancient Indian medicine, which was an evolved system of understanding and treating disease that resembled that of Hippocrates and Galen (2nd century AD), and was in some ways ahead of the Greeks.
  • The ancient Indian interest in physiology is understood to have drawn from yoga and mysticism, and to have been enriched by the growth and spread of Buddhism to new lands, the arrival of the first Christian missionaries, and the contact with Hellenic practitioners of medicine.
  • In theory and praxis, ayurvedic medicine today remains broadly unchanged from these ancient Indian principles.

The medical ethics of Charaka

  • The physician was an important and respected member of ancient Indian society, and medical practice followed rules of professional conduct and ethical principles.
  • Charaka instructs a physician to preach to his pupils at a ceremony at the end of their apprenticeship.

“…You must strive with all your soul for the health of the sick. You must not betray your patients, even at the cost of your own life… You must not get drunk, or commit evil, or have evil companions… You must be pleasant of speech…and thoughtful, always striving to improve your knowledge.

“When you go to the home of a patient you should direct your words, mind, intellect, and senses nowhere but to your patient and his treatment… Nothing that happens in the house of the sick man must be told outside, nor must the patient’s condition be told to anyone who might do harm by that knowledge to the patient or to another.”

  • This ethical code is universal, and remains just as relevant and applicable today.
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