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Medical Ethics


Jackson Professor of Clinical Medicine in Harvard Medical School, Boston.

The subject of my remarks this evening is not of my choice. It was assigned me by the higher powers for reasons I do not presume fully to understand. I cannot believe that you are peculiarly in need of instruction in medical ethics, and I know that I am not specially qualified to give it; but having from my youth been brought up in habits of obedience I cannot break away from early and long training, and-you must take the consequences.

Of several definitions of ethics in the Century Dictionary, I have selected the following as perhaps best meeting our requirements of the evening as I conceive of them. "Ethics is the doctrine of man's duty in respect of himself and of the rights of others." Ethics thus formulates right conduct and aids us to see the light; but we must constantly strive to be led by it. Intellect and character are very different qualities, too rarely coexistent in their higher degrees in the same person. One or the other may be highly developed, or less or more atrophied, congenitally, from disuse, or both. He whose unclouded vision sees things just as they are, including the right and wrong of almost any and every question may, allowing himself to be dominated by love, ambition, avarice or some other passion, with open eyes choose a low Per contra, he whose intellect, which may be acute though narrow, fails to grasp the true relation of things, may,


An address to the students of Western Reserve University Medical College and the Academy of Medicine of Cleveland, April 25, 1968




subduing all passion and apparent self-interest, act nobly, even if, with a mind more logical than clear, false premises lead to false conclusions. History affords examples of either extreme, as well as a few of that harmonious balance of intellect and character, which, in General Washington, has so impressed the world, and as long as man works upward must remain a living force.

Standards of ethical conduct that is, conduct which not only tends to the development of individual character but also to that of the well-being of the race-have undergone considerable evolution, the most potent single influence which has been brought to bear upon them being Christianity. "An eye for an eye and a tooth for a tooth" of the Judaic, is supplanted by the offering of the other cheek to the smiter, of the Christian dispensation. Taking the world as a whole, even today, external standards vary enormously with the degree and kind of civilization and its lack-with the religion and organization of society, the physical peculiarities of a country, the density of population, means of communication and a thousand other things. With us a state of relative fixity has been reached. A homely illustration of the state of flux which obtains elsewhere is afforded by the war-like people of Portugese East Africa, the Masai, dwindling in numbers and in power. When the white man first came into contact with them a few years ago their mode of friendly greeting was to spit in the face of the person greeted. This customand every custom has its ethical side-has now given way to the handshake of the European, so Patterson tells us. I have tried to find out the origin of handshaking; but nothing certain appears. There is plenty of theory, but the custom is evidently one of great antiquity and of unknown origin.

The more complex society becomes, the closer knit by applied science, the more organized gains on individual action, the more numerous are the restrictions which must be placed on the individual for the benefit of society as a whole. That which may be perfectly right and proper for the savage, or even for the civilized man in the wilderness, may be highly reprehensible under other conditions. All this may be trite-I shall not complain if you say too trite.

We are all agreed that as men we should so live as to cultivate our intellects, to enlighten our consciences, to strengthen and elevate our characters, and, in as far as in us lies, to promote the well-being of mankind. This is practical ethics. What, then, is medical ethics? Has an adjective any place in ethics?

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