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Medical Ethics

  Medical Ethics sets out to define the required code of behaviour between doctor and patient and the regulation of advertising. It has come to include a consideration of the wider social and economic factors which influence the public health.

The Hippocratic Oath has, since the 3rd century  BCE, been the defined basis for ethical behaviour of physicians. It is in part an assurance to maintain a family craft-guild. The physician would prescribe drugs and diet, but not wield a knife, leaving surgery to surgeons. Intentional injustice, including sexual relations with members of the patient\'s household is forbidden. Confidentiality is promised. Euthanasia and abortion are both forbidden, although they were morally and socially a part of Greek culture at the time of Hippocrates.

Medical ethics might usefully be considered under the following headings:

Primum non nocere, the classic exortation ‘not to do harm’. Although any treatment will be intended to do good to the patient, it has frequently to be balanced against risks of harmful effects.

Respect for the dignity and autonomy of the patient in decision-making about how to proceed in a given situation. This can be made difficult by lack of clear reasons to make choices, and by the attitude of paternalism traditional to, and expected of, doctors.

A regard for the quality of information. The idea of giving true and not false information to patients is desirable but not easy to maintain. Despite the promise and the expectation of the ‘scientific revolution’ the spectrum of medical knowledge still ranges from scientifically provable, through all points, to folkloric. In order to apear scientific, small fragments of information are often extrapolated into grander, but unsupportable theories.

The Law. The legal code is supposed to provide ethical guidelines but is also guided by fashions, public opinion, investigative journalism, vested interests, etc. TG

Further reading L. Edelstein, Ancient Medicine; , I. Kennedy, The Unmasking of Medicine.



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