Explained: New line on Charak Shapath; what is it and what does it say?

The Dean of Madurai Medical College was deleted on Sunday (May 1) after a group of new students received an oath in Sanskrit attributed to ancient Indian sage Maharshi Charaka instead of the traditional Hippocratic oath in English.

Following the event, which was attended by Tamil Nadu Finance Minister Palanivel Thiaga Rajan and Trade Tax Minister P Moorthy, the Dean, Dr A Rathinavel, was placed on the ‘waiting list’ without no information on his next assignment.

What is the Charak Shapath Controversy?

The controversy started after the National Medical Commission (NMC), the regulator of medical education and practice (which replaced the Medical Council of India in 2020) suggested to the faculties of medicine on February 7 that the Hippocratic oath should be replaced by a “Charak Shapath”.

While some doctors welcomed the proposal, the Indian Medical Association (IMA), the national representative platform for modern medicine doctors, took up the issue with Health Minister Mansukh Mandaviya.

In a letter published in IMA News, the official publication of the IMA, the association’s national president, Dr Sahajanand Prasad Singh, said that during an “interactive meeting” with an IMA delegation on 21 February, Mandaviya had “assured that Charak Shapath will be optional and will not be forced to replace the Hippocratic Oath”.

Subsequently, on March 29, responding to a starless question from several MPs on “whether the government intends to replace the Hippocratic Oath with the Charak Shapath”, “whether it is a fact that the Medical Commission national government proposed to replace the Hippocratic oath with Charak Shapath”, and “if the government has met with representatives of the Indian Medical Association (IMA) to discuss their opposition to this proposal”, the Minister of State for Health and Family Welfare, Dr Bharati Pravin Pawar, told Rajya Sabha: “As informed by the National Medical Commission (NMC), there is no proposal to replace the Hippocratic Oath with Charak Shapath.

A few days later, however, on March 31, the NMC issued a circular on the “implementation of a new competency-based medical education for the undergraduate curriculum,” in which it was written: “ A modified “Maharshi Charak Shapath” is recommended when a candidate is introduced to medicine. education”.

Interestingly, like the Indian Express communicated in FebruaryUndergraduate students at the nation’s premier health institute, AIIMS, have for several years taken the Charak Oath at their annual convocation.

Dr. MC Misra, former director of AIIMS, earlier told The Indian Express that the Charak Shapath was already part of the annual convocation when he took office in 2013.

The AIIMS Charak Shapath is: “Not for oneself; Not for the fulfillment of any worldly material desire or gain, but solely for the benefit of suffering humanity, I will treat my patient and excel well.

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), roughly 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 pupil and Alexander the Great’s tutor, Aristotle.

The oath is a charter of ethical principles that doctors of all times have sworn to respect in the exercise of their profession. The earliest available fragments of what is believed to be the original oath date back to the late 3rd century AD, and a millennial version is kept in the library of the Holy See.

Hippocrates is credited with a collection of 70 medical books titled “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.

What does the Hippocratic oath say?

Two translations of the pagan oath from the original Greek, by WHS Jones (“The Doctor’s Oath”, Cambridge University Press, 1924) and Ludwig Edelstein (“The Hippocratic Oath: Text, Translation, and Interpretation”, Johns Hopkins Press, 1943) , are popular with academics. According to excerpts published in the BMJ, October 1998, the Oath says:

“I will use treatment to help the sick according to my ability and judgment, but I will never use it to hurt or harm them.

I will not give poison to anyone who is asked, nor will I suggest such a plan. Likewise, I will not give a woman a pessary to abort her. But in purity and holiness I will keep my life and my art.

I will not use the knife on the stone sufferers either, but I will give way to those who are craftsmen in it.

In all the houses I enter, I will do so to help the sick, keeping me free from all intentional mischief and evil, especially from fornication with a woman or a man, slave or free.

Anything I see or hear during practice (or even outside of my practice in Social Relations) that should never be published abroad, I will not divulge, but I will consider such things as holy secrets.

So is there a universally accepted version of the doctor’s oath?

There are not any. Modern codes of medical ethics such as those formulated by the American Medical Association (AMA) and the British Medical Association (BMA) are largely rooted in the Hippocratic Oath, but they also draw heavily from other sources.

Many medical schools around the world hold a ceremony in which graduating doctors swear by a broad charter of ethics that is sometimes personalized by individual institutions.

A version of the “doctor’s code of ethics” is commonly displayed in hospitals or clinics in most places, including India.

The AMA describes its code of medical ethics as a living document that has evolved as medicine and society have changed. The WADA Code was adopted in 1847 and has been updated in 1903, 1949, 1957 and 2008.

The World Medical Association (WMA) adopted an international code of medical ethics in 1949, which was amended in 1968, 1983 and 2006. In May last year, the WMA released a proposed modernized version of the international code, “describing the duties of physicians to their patients, other physicians, health care professionals, and society as a whole,” according to the WMA’s website.

According to the WMA, some of the duties of physicians in general are:

* always exercise independent professional judgment and maintain the highest standards of professional conduct;

* respect the right of a patient capable of accepting or refusing treatment;

* not allow judgment to be influenced by personal gain or unfair discrimination;

* undertake to provide a competent medical service with full professional and moral independence, with compassion and respect for human dignity;

* treat patients and colleagues honestly and report to the appropriate authorities physicians who practice unethically or incompetently or who commit fraud or deceit;

* certify only what he has personally verified;

* comply with local and national codes of ethics.

Who was Charaka and what is Charak Samhita?

Like several other sages mentioned in ancient Indian literature, Charaka’s historicity is uncertain. It is unlikely that the compendium of medicine that bears his name was the work of a single individual, and it is unlikely that it was all written at once.

The Charak Samhita is a medical pharmacopoeia and collection of commentaries and discussions on medical practices historically dated to the 1st-2nd centuries CE.

Along with the compendium of Susruta (circa 4th century AD), which deals with surgery, the Charak Samhita is considered the founding text of ancient Indian medicine, which was an evolved system of understanding and treating disease that was at several respects ahead of the Greeks.

The ancient Indian interest in physiology is believed 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 early Christian missionaries, and contact with Hellenic practitioners of medicine.

And what is the medical ethics of the wise Charaka?

The doctor was an important and respected member of ancient Indian society, and medical practice followed rules of professional conduct and ethical principles.

AL Basham (“The Wonder That Was India”, 1954) quotes part of the sermon that Charaka asks a doctor to preach to his students in a ceremony at the end of their apprenticeship.

“…You must fight 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 bad companions…You must be pleasant of speech…and thoughtful, always anxious to improve your knowledge.

“When you go to a patient’s home, you should direct your words, mind, intellect and senses only towards your patient and his treatment… Nothing that happens in the patient’s home should be said outside, nor the patient’s condition be told to any person who might injure by this knowledge the patient or others”.

This Charaka code of ethics is universal, and remains just as relevant and applicable today.

What else does the Charak Samhita say?

The Charak Samhita emphasizes the importance of the doctor’s prayer, “every day on rising and going to bed for the welfare of all beings”, (Basham) and that of debate and discussion among scholars.

A passage from the Charak Samhita, quoted in Wendy Doniger (“Of Hinduism”, “The Hindus”) describes a debate between sages invited by a king to determine the origin of the disease. The sages advanced their theories, which were in many cases the essence of the great philosophical and medical traditions of ancient India.

One said that the individual is born from the soul, therefore disease also must come from the soul; a second said that the spirit, overwhelmed by energy and torpor, engenders both the body and the pathological changes it undergoes; a third said that creatures and disease both come from rasa; a fourth maintained that since the individual is created from the six material elements of earth, water, fire, wind, space and soul, disease also arises from these same elements; a fifth argued that just as an individual must have a father and a mother, so too must disease; but the sixth refuted that while a blind person is not necessarily born of another blind person, all creatures are the product of karma, just like disease.

As the sages argued, one advised others not to take rigid positions – typical, says Doniger, of how all shastras strive to be open-minded and inclusive. . “It is only when you have rid yourself of the torpor of factionalism of what you want to know that true knowledge will emerge.”

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