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The collocation of moral precepts for the instruction of beginners in medicine does not appear to have been attempted by any English-speaking people, until the question of its utility and necessity began to attract the attention of some wise physicians. It was undertaken toward the close of the eighteenth century, and was entrusted to a man almost as great in scholarship and erudition as he was in devotion and virtue. That lettered champion of truth and good morals was Doctor Thomas Percival, of Manchester, to whom the profession owes a vast debt of gratitude for his untiring labors in gathering, arranging, and editing, with such sound judgment, and ability, the rules of conduct best adapted to the physician, even of these days although published as far back as the early part (February) of the year 1803. The object of the author was to establish a system of rules, "that the official conduct and mutual intercourse of the Faculty might be regulated by precise and acknowledged principles of urbanity and rectitude." In a letter to his loved son who was about to enter the ranks of the medical profession, he said. "It is characteristic of a wise man to act on determinate principles; and of a good man to be assured that they are conformable to rectitude and virtue. The relations in which a physician stands to his patients, and to the public, are complicated and multifarious; involving much knowledge of human nature, and extensive moral duties. The study of professional morals, therefore, cannot fail to invigorate and enlarge your understanding; whilst the observance of the duties which they
enjoin, will soften your manners, expand your affections and form you to that propriety and dignity of conduct, which are essential to the character of a gentleman."
What an admirable syllabus of his whole work, and what a superb portraiture of the man's high character and noble aspirations!
Forty-four years after the publication of Doctor Percival's book, the American Medical Association was organized and at once appointed a special committee consisting of Doctors Bell, Emerson, and Hays, of Pennsylvania; Doctor Arnold of Georgia; Doctor Clark of New York; Doctor Dunn of Rhode Island; and Doctor Morris of Delaware; with instructions to frame a system of morals for the government of members of the Association and for the information of the whole profession and of the public. The committee, after examining many such systems emanating from local medical societies, and finding that they were derived from Doctor Percival's writings, determined to use the English moralist's method as the model for their splendid system of rules of conduct which was so wisely adopted by the National Association. The promulgation of the lofty principles embodied in that priceless instrument has had the much desired effect of greatly raising the standard of medical morals and thought throughout this vast land.
Like the Hippocratic oath and law, the national system of medical morals prescribes no penalties for violation of its provisions; the consequence of a violation being sting of conscience or disgrace. It aims, as said Doctor Austin
Flint, its able commentator, "solely at the influence of its rules on the mind, irrespective of any penalties. It is based on the principle that moral rectitude is promoted more by fostering upright sentiments than by the punishment of offenses." It tells with precision and lucidity what the physician shall do and what he shall not do, as well as what is derogatory to professional dignity. It prescribes rules of etiquette, and informs clients of their obligations to physicians. Therefore it is a system of laws for the government of physicians and of the people in their relations to physicians.
The honorable Committee of 1847 being imbued with the idea that the most acceptable system of good medical morals must necessarily be one consisting of a carefully arranged collection of the most exalted precepts and rules for the guidance of physicians, patients, the public, and the state, in their reciprocal relations, gave the amplest evidence of their great sagacity when they couched these precepts and rules in the elegant language which renders the perusal of the whole composition as attractive and entertaining as are its teachings instructive and edifying; for they knew well that any essay composed in good manner and pregnant with useful matter must give information in a style the most pleasing to the æthesis of the reader; whilst a slovenly, dryly and obscurely phrased discourse, though it contain excellent ideas would, in all likelihood, be cast aside half, if at all, read by the majority even of those anxious for information. The admirably pure and exact language of the moral production in question gives
it a peculiar charm which delights the scholar, while it serves as a model of excellence for the rising generation of medical writers. The influence it has exerted morally and intellectually upon the profession in this country is verily marvelous. Those least familiar with its provisions and aims have been its worst detractors who have thus given encouragement to designing charlatans who take every opportunity to tell the people that this system of medical morals is "a mouldy, antiquated, illiberal, intolerant, oppressive, inhuman composition of the old school." And the people will believe all this as long as kept in ignorance of the wise, liberal, humane, and salutary provisions therein contained, particularly those relating to the obligations of patients to their physicians and of the public to the profession.
THE PHYSICIAN AND HIS PATIENT
Relations and obligations of the physician to his patientsPrompt obedience to the calls of the sick—Attention, steadiness and fidelity-Indulgence to the caprices of the sickThe obligation of secrecy extending beyond the period of professional services—A physician obtaining information in his professional capacity not bound to reveal it in any court of justice-Of necessary and unnecessary visitations to the sick-Gloomy prognostications not to be made within hearing of patients-Conduct as regards attendance on incurable cases-The division of responsibility in the management of serious and difficult cases.
THE subjects of this and the next two conferences will have special relation to the reciprocal obligations of the physician and patient, of the physician and the profession, and the profession and the public. Thus, by the laws of medicine, physicians are bound in devotion to their patients, and patients are bound in obedience to the directions of their physicians. All physicians are bound to observe the laws enacted by the profession, and the profession is under obligation to enact such laws as are best adapted to the government of its members, and is bound to give these members due protection against unjust attacks. The profession is also bound to establish proper sanitary regulations for the weal of the public, and the