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If so, why? Cannot all practical ethics be summed up in the Golden Rule? Yes and no. It can be so summed up, but rules based on analysis are useful as short-cuts, promoting the rapidity of decision as to right conduct in concrete cases which may seem, or really be, complex. Every calling involves some peculiarities of relation to other persons, which adds to or modifies the restrictions imposed by general ethics. I have heard a stock-broker say that brokers, as a class, are the most honest men in the world, a simple word or nod being absolutely binding. But is not this due to the necessities of the business rather than to a sudden accession of spiritual grace which resides in and emanates from the seat in the brokers' board to each successive owner thereof? Were contracts thus apparently loosely made not inviolable, the business as at present conducted could not be transacted. The peculiarly intimate relations, especially with female patients, involved in the practice of medicine necessitate a very strict standard, lapses from which are less pardonable to the doctor than to men of any other calling save the priesthood. This has been recognized from very early times as we shall see later.

The French law, it would seem very properly, pronounces void a legacy from a patient devised during the illness to the physician in charge of him during the same. Neither in this country, England or Germany is there any such legal provision, and it seems to me to speak well for the integrity of our profession that physicians with us are so seldom legatees of their patients.

History tells us that everywhere in early times the priest and the physician were one, and so it is today among many primitive peoples. In the absence of knowledge superstition rules, and as long as illness is regarded as a demoniac possession the priest is naturally the medicine man and lays down the rules for his conduct. When the mind gets to the point of coldly collecting and collating facts and of recognizing that they are the masters, not the servants, in all matters open to observation and experiment, the care of the soul and of the body cannot remain in the same hands.

The Babylonian Code of King Hammurabi, 2287-2232 B. C., contains 282 sections. Nine of these apply to medicine, four to veterinary medicine. This is, however, a legal code, and the medical sections deal only with fees and penalties. The whole code reveals a remarkable state of civilization at the time, but



does not specially interest us here inasmuch as it is legal rather than ethical.

The most ancient statement on medical ethics of which I can get clear trace is the Hippocratic Oath, of about 460 B. C. This oath was taken on entering practice after the completion of the medical studies and runs as follows: "I swear by Apollo, the physician, by Aesculapius, by Hygeia, Panacea, and all the gods and goddesses, that according to my ability and judgment I will keep this oath and stipulation, to reckon him who teaches me this art equally dear to me as my parents, to share my substance with him and relieve his necessities if required, to look upon his offspring on the same footing as my own person, and to teach them this art if they shall wish to learn it without fee or stipulation, and that by precept, lecture and every other mode of instruction I will impart a knowledge of this art to my own sons, to those of my teachers and to disciples bound by a stipulation and oath, according to the law of medicine, but to no others. I will offer that system of regimen, which, according to my ability and judgment, I consider for the benefit of my patients, and abstain from whatever is deleterious and mischievous. I will give no deadly medicine to anyone if asked, nor suggest any such counsel, and in like manner I will not give a woman a pessary to produce an abortion. With purity and with holiness I will pass my life and practise my art. I will not cut persons laboring under the stone, but will leave this to be done by men who are practitioners of this work. Into whatever houses I enter, I will go into them for the benefit of the sick, and will abstain from very voluntary act of mischief and corruption, and further, from the seduction of females and males, of freemen and slaves. Whatever in connection with my professional practice, or not in connection with it, I see or hear, I will not divulge, as reckoning that all such things should be kept secret. While I continue to keep this oath inviolate, may it be granted to me to enjoy life and the practice of my art, respected by all men at all times; but should I trespass and violate this oath, may the reverse be my lot."

Charaka,1 dating probably, as I am informed by Professor Lanman, from about 100 A. D., deals at some length with medical ethics and the mutual relations of pupil and teacher. It is too long to give in full, but I permit myself to make some extracts, calling your attention to the fact that this ancient Indian oath

(1). Charaka-Sahmita, Calcutta, W. C. Samanta, 200 Cornwallis' Street.

was administered to the pupil about to enter on the study of medicine, not at the end of his pupilage. We note the stress which is laid on the physical perfection of the candidate, and remember that such, in a limited way, is a pre-requisite to admission to the Romish priesthood. After setting forth what constitutes a good treatise to select for minute study a list of the qualifications desirable in the preceptor are enumerated. "Approaching such a preceptor, the pupil desirous of courting him should attend on him with heedfulness like one revering one's sacrificial fire, or one's deity, or one's king, or one's father, or one's patron." A very proper attitude of pupil to teacher, not always observed at the present day.

Next come the qualities of the pupil:

"He should be of a mild disposition.

He should be noble by nature.

He should not be mean in acts.

His eyes, mouth and nasal line should be straight.

His tongue should be thin, red and unslimy.

His teeth and lips should have no deformity.
He should not have a nasal voice.

He should be possessed of intelligence.

He should be free from pride.

He should be endued with a large understanding.

He should have power of judgment and memory.

He should have a liberal mind.

He should belong to a family the members of which have studied the medical scriptures or followed medicine as a profession.

He should have a devotion for truth.

He should not be defective in respect of any limb.

He should have all his senses perfect.

He should be disposed for solitude.

He should be free from haughtiness.

He should be of a thoughtful disposition.

He should be free from those faults which go by the name of Vyasana. ''1

Then follow elaborate ceremonies which are gone through with, so interesting and curious that I wish we had time for them in full. And finally, the perceptor formulates, as it were, a code, the acceptance of which is a pre-requisite to pupilage.

"If thou desirest to achieve success of treatment, earn wealth, acquire celebrity, and win Heaven hereafter, thou (1.) Certain habits and acts go by the name of 'Vyasana.' They are hunting, gambling with dice, sleep during day time, speaking ill of others, infatuation for women, excessive addiction to singing, dancing and instrumental music, purposeless sauntering, and others of a similar nature. The Hindu Scriptures abound with exhortations to avoid them. In the case, especially, of a Brahmacharin (pupil living in the house of his preceptor), their avoidance is doubly incumbent.-T.



shouldst, reverencing kine and Brāhmanas above all, always seek, whether standing or sitting, the good of all living creat


Thou shouldst, with thy whole heart, strive to bring about the cure of those that are ill.

Even for the sake of thy life thou shouldst not drain those that are ill1.


Thou shouldst not, even in imagination, know another man's

Thou shouldst not, similarly, appropriate other people's possessions.

Thou shouldst not keep any connection with publicans, or sinful men, or with those that are abettors of sinful behaviour.

Thou shouldst speak words that are soft, unstained by impurity (obscenity) fraught with righteousness, incapable of giving pain to others, worthy of praise, truthful, beneficial and properly weighed or measured.

Thou shouldst always conduct thyself taking note of place and time.

While entering the family dwelling-house of the patient, thou shouldst do it with notice to the inmates and with their permission. Thou shouldst (at such times) be accompanied by some male member of the family. Thou shouldst cover thy person properly. Thou shouldst (while entering) keep thy face downwards. With thy wits about thee, thou shouldst, with understanding and mind properly fixed, observe all things. Duly conducting thyself in this way thou shouldst enter (the dwelling-house of the patient).

Having entered, thou shouldst not devote thy words, mind, understanding, and the senses to anything else than what is calculated to do good to the patient, or to any other subject connected with the patient (than his recovery).

Thou shouldst never give out (to others) the practices of the patient's house."

Please note specially the following:

* * *

"There is no end (to reach) of Medical Science. Hence, heedfully, thou shouldst devote thyself to it. Then, again, skillfulness of practice should be acquired from others, without feeling any humiliation.

(1.) I. e, suck out or extort their substance. A little may be taken, but not much.-T.

Unto men possessed of intelligence, the entire world acts as a preceptor.

Unto men destitute of intelligence, the entire world occupies the position of an enemy."

At the expense of chronology I will here give the oath which today must be taken in Egypt before entering into practice:

"I swear in the name of God, the Most High, and of his sublime prophet, Mohammed, whose glory may God increase, to be faithful to the laws of honor, honesty and benevolence in the practice of medicine. I will attend to the poor gratuitously and never exact too high a fee for my work. Admitted into the privacy of a house my eyes will not perceive what takes place. My tongue will guard the secrets confided to me. Ever respectful and grateful to my masters, I will hand on to their children the instructions which I have received from their fathers. May I be respected by men if I remain faithful to my vow. If not, may I be covered with shame and despised. God is witness to what I have said. The oath is finished."

In the Langobard Code, A. D. 650, we find: "Whosoever has inflicted wounds upon anyone, he shall supply him with attendance, and likewise pay the fee of the physician at a rate to be estimated by learned men." (Not by physicians, however). Physicians were made responsible for their want of skill. Their fees were stipulated in advance.

An old Germanic Legal Code dates from about 1400. A part relating to medicine reads as follows:

1. "No doctor can bleed a woman in the absence of her relatives. If he does so, he must pay 10 solidi (one solidus equals $2.25) to her husband or relatives, since it is not impossible that occasionally some sport may be associated with such an opportunity. (Carnal offenses were very severely punished, often by castration)....

3. Doctors must take charge of sick people under definite security.

4. Having done this, he must cure them. If death ensues, he shall not demand the stipulated fee, nor shall suit be instituted for it by either party.

6. If a doctor has injured a nobleman by bleeding him, he shall pay 150 solidi. If the patient dies, the doctor is delivered up to his relatives to be dealt with as they see fit." Realizing this state of affairs and the risks which they ran from this law, in all cases in which they thought that the patient might die, the physi

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