Content analysis of ethical codes written by medical students compared with other codes of medical ethics

Introduction: Swearing to a medical oath is a common practice in medical schools today. Students at the Medical School for International Health (MSIH) participate in an elaborate physician's oath ceremony held in the first year of studies. At this ceremony, students read a code of ethics written by their class, the content of which includes the ethical principles the class as a whole deems significant. Methods: 9 codes of ethics, written by students at the MSIH between 1998 and 2006, as well as the oaths of Hippocrates and Maimonides, were collected and the principles contained within them were analyzed and compared. The oaths were broken up into preamble, covenant, code, and peroration sections, each encompassing various content domains. Results: Principles discussed in both the oaths of Hippocrates and Maimonides, as well in two-thirds or more of the student-written codes, included loyalty to one's colleagues, the profession, and one's teachers, as well as acting with beneficence. Attributes including compassion, integrity, and honesty, were mentioned in two-thirds or more of the student-written codes but neither the oath of Hippocrates nor Maimonides. Controversial issues, such as abortion and discussing God were not included in codes written by students. Conclusions: Ethical codes written by students at the MSIH contained some similar principles to those contained within the traditional oaths; however, there was more emphasis on attributes that establish a good physician-patient relationship in the codes written by students. Future studies need to examine the content of other student-written codes.