The COS Declaration

October 1992

We, who work in many different sectors in the fields of medicine and health care, having come together in Greece, on the Asklepieion of Cos, the island of Hippocrates, on October 30th 1992,

conscious of what motivates our commitments and wishing to develop responsible medical practices,

aware of the possible dangers unleashed by political, economic, scientific, and technological powers on our work,

proclaim our determination to make no compromise on the following ethical positions:

In solidarity with the Universal Declaration of the Rights of Man, believing in the basic principle of respect due to every human being, we commit ourselves:

• never to forget that progress in our science requires us to listen to the person next to us. We walk side by side with him, accompany him, and discuss therapeutic options, doing everything possible to avoid having to impose solutions to health problems;

• to propose our services as one of the resources for all those who suffer, from whatever walk of life, without exception, and in full understanding of the respect due to their lifestyles, their cultures, and their beliefs. Health professionals exist to help all peoples find a way towards health which conforms the principle of life;

• to consider every expression of pain as legitimate, to proscribe none, our first duty being to discover pain's meaning and causes, whether they prove to be specific to the individual or social;

• to insist on access to health care for everyone and to fight for this right;

• to refuse to participate, even in a camouflaging effort, in activities which exclude, assassinate, or torture;

Whe also commit ourselves to making our own activities public, including our errors, to the community, on the condition that we do no harm to those who have confided in us.

• to transmit our knowledge, as, well as the progress in our disciplines and their uncertainties, in whatever situation we find ourselves, while always being aware of our own human limits;

• to participate in the development of preventative as well as healing medicine, while honouring the principles we have affirmed;

• to ensure that we are never responsible for the health market becoming more important than the goal of healing, just as we understand that the health of our fellow human beings is our end and not our means.

This declaration was jointly written at the conclusion of the sixth international meeting of the Open School for European Health (EDSE), which was held on the theme of "The possibility of a new Hippocratic Oath: the place of the subject in medical and social practices" in Cos (Greece), from October 25 to 30, 1992.

• to refuse to export harmful materials anywhere in the world. On the contrary, we commit ourselves to speaking out against those practices, so that everyone knows that they are taking place.

The meeting took place at the International Hippocratic Foundation of Cos and the accompanying text was read on the Asklepieion on October 30th, 1992.

One hundred and seventy people participated in the discussions. They came from ten countries: Algeria, Belgium, Britain, France, Germany, Greece, Italy, The Netherlands, Romania and Switzerland.

Given the symbolic significance of the site, the respect inspired by the Hippocratic Oath and its historic nature, heaving in mind also the diversity of the professionals involved, the conference participants chose to publish a statement of principles which would give voice to the problems confronting us today.

In (J. Carpentier & C. Mangin-Lazarus, eds.) Retrouver la médecine. Paris: Synthélabo, Collection Les Empêcheurs de Penser en Rond, 1996, pp.229-231.

Reedited by Marc Jamoulle, 2011