An Upgraded Hippocratic Oath Is Needed In The Digital And A.I. Era

[Excerpts] The Hippocratic Oath is the most famous text in Western medicine. It constitutes the ethical basis of the medical profession. For centuries, it has provided an overview of the principles of this noble mission and doctors’ professional behaviour. At the dawn of a new era in medicine, it is high time to rewrite the Oath so that it would reflect the state of technological development, changes in social structures and in general, the requirements of the 21st century. These are our [The Medical Futurist] suggestions.

1. Patient inclusion – The scientific community does not only consist of physicians: medical researchers, nurses and patients must be included – also symbolically. Doctors are not the sole repositories of medical knowledge, and the ivory tower of medicine is crumbling under the weight of the digital sphere, social media, empowered patients or the DIY movement. The Hippocratic Oath should reflect that.
   
2. Healthcare must shift from treatment to prevention – With the recent advances in precision medicine as well as the appearance of preventive and lifestyle health, healthcare should have responses for the ill and the healthy alike. Advising on how to stay fit and well for the healthy is just as important as recommending treatments for the sick. The appearance of health sensors, wearables, and health apps results in new ways of prevention. It also results in a massive chunk of data medical professionals should be able to use. This data will help analyse as well as predict trends in the health of individuals and populations, so the Oath should change accordingly.
   
3. Acknowledgment for technologies – Technologies also need to be reflected in such a pledge. Physicians need to acknowledge the raison d’etre of technologies in healing, and one of the means to assume its rightful place in medicine starts with its inclusion into the Hippocratic Oath. It has to acknowledge the transformative impact that medical technologies have on healthcare – traditional as well as digital solutions.
   
4. Recognition of life-long learning – Besides mentioning technologies, it’s also critical to use the latest innovations. That requires openness towards new concepts, ideas or medical devices, which seems to be evident for many physicians, but is not practised in the medical community as often as it should be. Maybe a kind reminder in the oath could give at least a symbolic boost to life-long learning.
   
5. The inclusion of equal-level partnership – Access to information and technologies is not a privilege of physicians sitting in the ivory tower anymore. Patients also have access to information about drugs, cures, methods online, and with a pinch of digital literacy, anyone can find curated and credible medical data online. This started to shift the hierarchical patient-doctor relationship into a collaborative partnership in the future.
   
6. Addressing privacy concerns – Respecting patients’ privacy is a primary passage in the Oath. However, there is no indication of data privacy anywhere. Sure, there was no need for it 2,000 years ago as Odysseus did not check in to Facebook day after day when heading home to Ithaca, but that’s not the case today.According to Statista, in 2018, about 2,314 exabytes of new data could be generated worldwide in 2020. The need for safeguarding that amount of information is paramount, so we need to include it in the Oath.
   
7. Artificial Intelligence In Medicine –  A.I. has a vast potential to automate processes in healthcare. We can expect dramatic changes in care, with A.I. systems to excel at a specific task and healthcare professionals to increasingly interact with them. But what we always highlight is that A.I. will never replace medical professionals. But those physicians who use and embrace A.I. will replace those that do not.

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