An oath taken to confirm an agreement or, in a political situation, to confirm a treaty could not be lightly broken or taken back. We don't seem too faithful to our oaths these days, nor as a society do we seem to care too much. In a culture in which the majority of marriage vows are broken by either infidelity or divorce, employer-employee contracts are often dishonored, and perjury appears so common that it seems but a minor peccadillo, a broken pledge by a physician may seem but a trifling matter. Practitioners who violated the original Hippocratic oath called down upon themselves curses of disrespect, loss of enjoyment in life, and professional disgrace. Physicians who violate even the reduced requirements left over in most of today's Hippocratic oaths do not pledge to suffer anything no loss of practice, no censure among colleagues, not even professional embarrassment.
Most modern versions are penalty free.
Perhaps it is time for the medical community to revisit this matter in earnest. J R Coll Physicians Lond. J Clin Ethics. All rights reserved.