REPORT ON A COMPLETE CODE OF MEDICAL ETHICS. THE undersigned, appointed by the American Institute of Homœopathy a committee to "prepare a complete code of medical ethics," respectfully present the following as the result of their labors. Considering it to be very desirable that the code of ethics adopted by the various associations of the physicians of our country should be uniform in scope and arrangement, and as nearly identical in language as possible, the Committee have used the arrangement, and, to a great extent, the language of the Code adopted by the American Medical Association, and published in vol. xvi, of their Transactions (for 1865), modifying it where changes seemed to be demanded by a proper regard for liberality and for justice, both to patient and to physician, or by a due concern for the freedom of medical education, opinion and action. Respectfully submitted, CARROLL DUNHAM, M.D., E. M. KELLOGG, M.D., G. W. BARNES, M.D., Committee on Medical Ethics. CODE OF MEDICAL ETHICS. SCOPE. THE scope of a Code of Medical Ethics comprises the reciprocal duties and obligations of physicians and patients; the duties and obligations of physicians to each other; and the reciprocal duties and obligations of physicians and the public. FUNDAMENTAL PRINCIPLES. The great principles upon which Medical Ethics are based are these: 1. The great end and object of the physician's efforts should be: "The greatest good to the patient." 2. The rule of conduct of physician and patient, and of physicians toward each other, should be the GOLDEN RULE: "As ye would that men should do to you, do ye also to them, likewise." The various articles of the Code are only special applications of these great principles. PART I. RECIPROCAL DUTIES AND OBLIGATIONS OF PHYSICIANS AND PATIENTS. Article 1. DUTIES OF PHYSICIANS TO PATIENTS. 66 II. DUTIES OF PATIENTS TO THEIR PHYSICIANS. PART II. II. III. DUTIES AND OBLIGATIONS OF PHYSICIANS TO EACH OTHER. Article I. DUTIES AS MEMBERS OF THE MEDICAL PROFESSION. PROFESSIONAL SERVICES TO EACH OTHER. VICARIOUS SERVICES. Article I. DUTIES OF THE PROFESSION TO THE PUBLIC. OBLIGATIONS OF THE PUBLIC TO PHYSICIANS. PART I. OF THE RECIPROCAL DUTIES AND OBLIGATIONS OF PHYSICIANS AND THEIR PATIENTS. Article I-Duties of the Physician to the Patient. SECTION 1. The physician should hold himself in constant readiness to obey the calls of the sick. He should ever bear in mind the sacred character of his calling and the great responsibility which it involves, and should remember that the comfort, the health and the lives of his patients depend upon the skill, attention and faithfulness with which he performs his professional duties. SEC. 2. The physician, in order that he may be able to exercise his vocation to the best advantage of the patient, should possess his respect and confidence. These must be acquired and retained by faithful attention to his malady, by indulgent tenderness towards the weaknesses incident to his condition, and by the exercise of a firm but kindly authority. The physician is bound to keep secret whatever he may either hear or observe while in the discharge of his professional duties, respecting the private affairs of the patient or his family. And this obligation is not limited to the period during which the physician is in attendance on the patient. The patient should be made to feel that he has, in his physician, a friend who will guard his secrets with scrupulous honor and fidelity. SEC. 3. The physician should visit his patient as often as may be necessary to enable him to acquire and keep a full knowledge of the nature, progress, changes and complications of the disease, and to do for the patient the utmost of good that he is able. But he should carefully avoid making unnecessary visits, lest he render the patient needlessly anxious about his case, or expose himself to the charge of being actuated by mercenary motives. SEC. 4. The physician should not give expression to gloomy forebodings respecting the patient's disease, nor magnify the gravity of the case. Bearing in mind the almost infinite resources of nature, he should be cheerful and hopeful, both in mind and manner. This will enable him the better to exercise his faculties and apply his knowledge for the patient's benefit, and will inspire the patient with confidence, courage and fortitude, which are the physician's best moral adjuvants. But it is the physician's duty to state the true nature and prospects of the case, from time to time, to some judicious friend or relative of the patient, and to keep this person fully informed of its changes and probable issue; and if the patient himself request the physician to disclose to him the nature and prognosis of his disease, it is his duty to state tenderly, but frankly, the whole truth,-provided the patient be of sound mind and strong enough to receive the disclosure without serious injury. The patient has a right to know the truth. If, moreover, facts within the physician's knowledge lead him to believe that it is of great importance, in relation to the patient's affairs, that he should be warned of the approach of death, it is the physician's duty to reveal to the patient's nearest friend, or to the patient himself, the true state of the case, and the importance of timely action. SEC. 5. Whether the case proceed favorably, or become manifestly incurable, it is the physician's duty to continue his attendance faithfully and conscientiously so long as the patient may desire it. He is not justified in abandoning a case merely because he supposes it incurable. SEC. 6. As the patient has an undoubted right to dismiss his physician for reasons satisfactory to himself, so, likewise, the physician may, with equal propriety, decline to attend patients, when his selfrespect or dignity seem to him to require this step; as, for example, when they persistently refuse to comply with his directions. SEC. 7. In difficult or protracted cases consultations are advisable. They tend to increase the knowledge, energy and confidence of the physician, and to maintain the courage of the patient. The physician should be ready to act upon any desire which the patient may express for a consultation, even though he may not himself feel the need of it. Nothing is so likely to maintain the patient's confidence as alacrity in this respect. Moreover, such a course is but just to him, for he has an indisputable right to whatever aid or counsel he may think likely to be of service to him. |