BackgroundMedical oaths and ethical codes play a crucial role in guiding physicians through their professional responsibilities. This study extends prior research on ethical codes created by students at the Medical School for International Health (MSIH) by analysing codes from the years 2007 to 2022.ObjectiveThe objective of this study is to evaluate changes in the ethical principles emphasised by MSIH students over time and to compare these with previous cohorts.MethodsEthical codes from MSIH classes (2007–2022) were analysed (...) using the framework developed by Baker. This framework categorises oaths into four sections: preamble, covenant, code of duties to patients and peroration. The focus was primarily on the code of duties to patients. Quantitative analysis was used to assess the prevalence of specific ethical principles.ResultsThe study found an increased emphasis on principles such as ‘respect for patients’ and ‘cultural competence/sensitivity’, while traditional values like ‘benevolence’ and ‘honesty’ were mentioned less frequently. New themes, including ‘patient autonomy’ and ‘cultural competence’, emerged, reflecting a shift towards patient-centred care and justice, though emerging issues like artificial intelligence ethics were not addressed.ConclusionsMSIH students’ ethical codes have evolved to emphasise patient respect and cultural competence. The findings suggest a maturation in the ethical perspectives of medical students, though gaps remain in addressing contemporary challenges. Future studies should explore how ethical codes can incorporate emerging issues in healthcare. (shrink)

In this paper, we will consider the role of oaths and codes of ethics in undergraduate medical education. Studies of ethics syllabi suggest that ethics educators typically use well-known bioethics texts such as Beauchamp and Childress. Yet, many issues that medical students will face are addressed by codes of ethics and oaths. We will first provide a historical survey of oaths and codes and then address how these sources of ethical guidance can be effectively (...) used in ethics education of medical students. Oaths and codes can be engagingly taught using a range of techniques including visual narrative. Excerpts from television and film can be used to highlight challenging ethical dilemmas in a variety of settings, taking the learning from the theoretical to the more applied while offering context. (shrink)

While there has been much discussion about the role of oaths in medical ethics, this discussion has previously centered on the content of various oaths. Little conceptual work has been done to clarify what an oath is, or to show how an oath differs from a promise or a code of ethics, or to explore what general role oath-taking by physicians might play in medical ethics. Oaths, like promises, are performative utterances. But oaths are generally characterized (...) by their greater moral weight compared with promises, their public character, their validation by transcendent appeal, the involvement of the personhood of the swearer, the prescription of consequences for failure to uphold their contents, the generality of the scope of their contents, the prolonged time frame of the commitment, the fact that their moral force remains binding in spite of failures on the part of those to whom the swearer makes the commitment, and the fact that interpersonal fidelity is the moral hallmark of the commitment of the swearer. Oaths are also distinct from codes. Codes are collections of specific moral rules. Codes are not performative utterances. They do not commit future intentions and do not involve the personhood of the one enjoined by the code. Recent attacks on oath-taking by physicians are discussed. Two arguments in favor of oath-taking are presented: one on the basis of the nature of medicine as a profession and the other on the basis of rule-utilitarian considerations. No attempt is made to define which oath a physician should swear. (shrink)

While the consequences of mathematically-based software, algorithms and strategies have become ever wider and better appreciated, ethical reflection on mathematics has remained primitive. We review the somewhat disconnected suggestions of commentators in recent decades with a view to piecing together a coherent approach to ethics in mathematics. Calls for a Hippocratic Oath for mathematicians are examined and it is concluded that while lessons can be learned from the medical profession, the relation of mathematicians to those affected by their work is (...) significantly different. There is something to be learned also from the codes of conduct of cognate but professionalised quantitative disciplines such as engineering and accountancy, as well as from legal principles bearing on professional work. We conclude with recommendations that professional societies in mathematics should sponsor an (international) code of ethics, institutional mission statements for mathematicians and syllabuses of ethics courses for incorporation into mathematics degrees. (shrink)

In a perfect world, physicians and drug producers would have only one goal: to advance the health of their patients. Unfortunately, ours is not a perfect world. While every physician’s prime responsibility—by oath and by law—is to the patient, every pharmaceutical producer’s first and foremost obligation, by design, is to shareholders and employees. Their ultimate objectives are diagonally diverse. This situation calls for a code of ethics to govern the marketing and prescription of pharmaceuticals. This paper attempts to identifythe business (...) practices prevailing in the Indian pharmaceutical industry, in order to provide a basis for constructing an appropriate code of ethics. The research is based on surveys or in-depth interviews of physicians, patients, retail pharmacists, and drug manufacturers. (shrink)

The Hippocratic Oath and the Declaration of Geneva of the World Medical Association are compared in terms of content and origin. Their relevance for current medical practice is investigated. The status which is ascribed to these documents will be shown and the status which they can reasonably claim to have will be explored. Arguments in favor of the Hippocratic Oath that rely on historical stability or historical origin are being examined. It is demonstrated that they get caught up in paradoxes. (...) Should doctors swear the Hippocratic Oath or the Declaration of Geneva? The Hippocratic Oath is a remarkable historic document, which contains important elements still relevant for medical ethics today. Its interpretation as a timeless, still valid medical code is unfounded. The historical arguments, that should justify its validity, are untenable. The Declaration of Geneva, and not the Hippocratic Oath, can legitimately claim to come close to representing the most important principles of professional medical conduct in today’s globalised world. (shrink)

I graduated from, medical school in 1972. According to orders signed at the Kremlin by the Chairman of the Supreme Soviet of the USSR, I was obliged, along with every graduating medical student, to swear to a new professional code, “The Oath of the Soviet Physicians.” This was the second year the oath was used. Incorporated in the oath were promises to “conduct all my actions according to the principles of the Communist morality, to always keep in mind … the (...) high responsibility I have to my people and to the Soviet government” I felt no discomfort joining with my friends in repeating words about the communist morality which by that time had already become a ritualized and meaningless official decoration of our life. The text of this oath fit into the political and medical ideology of that time. Not surprisingly, “The Oath of the Soviet Physicians” died along with the Soviet Union. (shrink)

Professions typically formulate codes of ethics. Medical students are exposed to various codes and often are expected to recite some.

The first code of professional ethics must: (1)be a code of ethics; (2) apply to members of a profession; (3) apply to allmembers of that profession; and (4) apply only to members of that profession. The value of these criteria depends on how we define “code”, “ethics”, and “profession”, terms the literature on professions has defined in many ways. This paper applies one set of definitions of “code”, “ethics”, and “profession” to a part of what we now know of the (...) history of professions, there by illustrating how the choice of definition can alter substantially both our answer to the question of which came first and (more importantly) our understanding of professional codes (and the professions that adopt them). Because most who write on codes of professional ethics seem to take for granted that physicians produced the first professional code, whether the Hippocratic Oath, Percival’s Medical Ethics, the 1847 Code of Ethicsof the American Medical Association (AMA), or some other document, I focus my discussion on these codes. (shrink)

From the Hippocratic Oath on, deontological codes and other professional self-regulation mechanisms have been used to legitimize and identify professional groups. New technological challenges and, above all, changes in the socioeconomic environment require adaptable codes which can respond to new demands.We assume that ethical codes for professionals should not simply focus on regulative functions, but must also consider ideological and educative functions. Any adaptations should take into account both contents (values, norms and recommendations) and the drafting process (...) itself.In this article we propose a process for developing a professional ethical code for an official professional association (Colegio Oficial de Ingenieros Industriales de Valencia (COIIV) starting from the philosophical assumptions of discursive ethics but adapting them to critical hermeneutics.Our proposal is based on the Integrity Approach rather than the Compliance Approach. A process aiming to achieve an effective ethical document that fulfils regulative and ideological functions requires a participative, dialogical and reflexive methodology. This process must respond to moral exigencies and demands for efficiency and professional effectiveness.In addition to the methodological proposal we present our experience of producing an ethical code for the industrial engineers’ association in Valencia (Spain) where this methodology was applied, and we evaluate the detected problems and future potential. (shrink)

A new Turkish Penal Code came into effect on 1 June 2005. Article 280 concerns health care workers’ failure to report a crime. This article removes the responsibility from health care workers to maintain confidentiality, but also removes patients’ right to confidentiality. It provides for up to one year of imprisonment for a health care worker who, while on duty, finds an indication that a crime might have been committed by a patient and who does not inform the responsible authorities (...) about it. This forces the health care worker to divulge the patient’s confidential information. A patient who thinks he or she may be accused of a crime may therefore not seek medical help, which is the universal right of every person. The article is therefore contrary to medical ethics, oaths taken by physicians and nurses, and the understanding of patient confidentiality. (shrink)

From the Hippocratic Oath on, deontological codes and other professional self-regulation mechanisms have been used to legitimize and identify professional groups. New technological challenges and, above all, changes in the socioeconomic environment require adaptable codes which can respond to new demands.We assume that ethical codes for professionals should not simply focus on regulative functions, but must also consider ideological and educative functions. Any adaptations should take into account both contents (values, norms and recommendations) and the drafting process (...) itself.In this article we propose a process for developing a professional ethical code for an official professional association (Colegio Oficial de Ingenieros Industriales de Valencia (COIIV) starting from the philosophical assumptions of discursive ethics but adapting them to critical hermeneutics.Our proposal is based on the Integrity Approach rather than the Compliance Approach. A process aiming to achieve an effective ethical document that fulfils regulative and ideological functions requires a participative, dialogical and reflexive methodology. This process must respond to moral exigencies and demands for efficiency and professional effectiveness.In addition to the methodological proposal we present our experience of producing an ethical code for the industrial engineers’ association in Valencia (Spain) where this methodology was applied, and we evaluate the detected problems and future potential. (shrink)

This book is a collection of essays which originate from two, mainly European, workshops in 1996 on ethics codes before, and especially after, the appearance of the Nuremberg code in 1947. The book has previously been published in German, and a number of contributions have been translated from the original German and French manuscripts. The majority of the 26 papers cover the development of ethics codes from the Hippocratic oath to the present time, but some papers look at (...) possible codes for new areas such as predictive medicine and resource allocation in health care, …. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:A Brief History of Medical Ethics Code in PolandJacek A. Piątkiewicz (bio)On March 15, 1934 a Parliamentary Act authorized the General Medical Chambers, a body incorporating all Polish physicians, to establish general rules of medical ethics. These rules governed medical conduct in Poland until 1950, when the Communist government dissolved the General Medical Chambers.From 1950 to 1989 the only medical organization in Poland tolerated by the Communist government was (...) the Polish Medical Association, which included about 30% of the country's physicians. In 1967 this group produced the "Collection of Ethico-deontological principles of the Polish Physician" which constituted a kind of code of medical ethics. This collection was a compromise between objective ethical principles and the demands of the Communist regime. For example, Principle 1 of the Collection stated that the physician "had to observe the ethico-deontological principles obligatory in socialist society."During round-table talks in early 1989 with representatives of the Communist government, the Solidarity movement argued for the revival of autonomous medical organizations like the Medical Chambers. On May 17, 1989 an Act of Parliament re-established the group. The Act (article 33, part 1) also stipulated that the National Congress of Physicians, the legislative body of Medical Chambers, establish rules of medical ethics. The Act (article 15, part 1) also states that all practicing Polish physicians are obliged to observe these rules.When the revived Chambers began its work in January 1990, its governing body—the General Medical Council—created a Commission to prepare a draft of a medical ethics code. After a year and a half of work, the Commission completed its draft, which received preliminary acceptance by the General Medical Council. [End Page 361]On December 13-14, 1991 the Extraordinary Second National Congress of Physicians was held in Bielsko-Biala (South Poland) and one of the main items on the agenda was the Code. Every article of the Code was discussed exhaustively throughout the second day of the meeting, and close to midnight the Code, including the Physician' Oath, was approved by an overwhelming majority (449 for, 75 against, 58 abstaining).Some of the liveliest discussion centered on Article 37, which relates to abortion. The delegates realized that the Code was inconsistent with a 1956 Act on abortion then under discussion in the Parliament which was not as restrictive as the Code. They decided to defer implementation of the Code for five months, until May 3, 1992. As described in the following text by Robert Baker, Article 37 has now been appealed and a decision resolving the discrepancy would have to come from Poland's Constitutional Tribunal or its Parliament. [End Page 362]Jacek A. Piątkiewicz Jacek A. Piątkiewicz, M.D., Ph.D., is Chairman of the Legislative Commission of the General Medical Council of Poland in Warsaw.Copyright © 1993 The Johns Hopkins University Press... (shrink)

The origins of professional ethical codes and oaths are explored. Their legitimacy and usefulness within the profession are questioned and an alternative ethical source is suggested. This source relies on a commonly shared, naturally knowable set of principles known as common morality.

This chapter provides a brief introductory history of biomedical practitioners’ efforts at self-regulation though oaths, codes, and statements of ethical principle, tracing them from ancient oaths through the nineteenth-century transition to codes of medical ethics. The more recent foundation for modern biomedical ethics was laid in post-World-War II oaths and codes written in the aftermath of the Holocaust, and later modified in response to animal rights and patients’ rights movements that promoted principles and practices (...) enforced by semi-self-regulatory acronym-laden ethics committees— HECs, IACUCs, IRBs/REBs/RECs. The last section of this chapter discusses the modern origins of self-regulatory ethical principles for benchside biomedicine and biomedical publications. (shrink)

Background of the study: Physiotherapists in Nigeria renewed their practicing license annually through the regulatory body and are provided with the professional code of ethics which stipulate the appropriate conduct, behaviour to guild and regulate the practice of their profession however, the level of knowledge, attitude and application of the ethical guidelines by Nigerian physiotherapists need to be investigated. Aim of Study: This study assessed the knowledge, attitude and perception of Nigerian physiotherapists in relation to the ethics of their professional (...) practice. Methodology: The cross-sectional study recruited 117 licenced Physiotherapists working in various health institutions in Nigeria. They were recruited for the study during the 2018 annual scientific conference of clinical and academic physiotherapists in Nigeria. Data on demographic, work experience, knowledge, attitude and perception of ethics of professional practise were obtained using a self-administered questionnaire. Data were summarized using a descriptive statistics of percentage and frequency distribution. Results: All the participants 117 (100%) had copies of code of ethics and oath of professional practise. 74.6% of participants had good knowledge of code of professional ethics while 25.39% had poor knowledge. Only 40.8% (48) of the respondents demonstrated good attitudes toward code of professional ethics. Similarly, only 43.4% (51) of the respondents demonstrated good attitude towards oath of professional practise. 57.0 % of the respondents have heard about ethical misconduct among colleagues while only 13.60% have been involved in ethical misconduct with respect to colleagues or patients. Greater proportion of the respondents (78.2%) considered ethics in physiotherapy as very important while 43.4% supported the introduction of physiotherapy ethics as a course to physiotherapy students in year three of their undergraduate training. Conclusion: Majority of Nigerian physiotherapists have good knowledge of professional code of ethics and oath of professional practise, however, their attitudes towards periodic updating their knowledge on code of ethics and professional oath remain poor. Clinical implication and recommendation: Ethical matter are very important to the practise of physiotherapy, however the poor attitudes of physiotherapy toward updating their knowledge on ethical matters calls for the need for the regulatory body and the professional association to organise seminars and workshops on ethics in physiotherapy and introduce pre-renewal test on ethics before annual licence renewal. (shrink)

The AHP Code of Ethics requires members to serve the best interests of their clients, be clear and honest with them, and keep their secrets confidential. Members pledge to represent their skills and qualifications honestly and to make appropriate referrals to others more qualified when out of their depth.AHP stands for “Associated Hair Professionals,” or hair stylists, but their Code of Ethics looks a lot like the Hippocratic Oath and the current Principles of Medical Ethics of the American Medical Association. (...) All of these ethics statements emphasize honesty, confidentiality, competence, serving patients’ best interests, and willingness to refer to other qualified professionals. But it’s not just doctors and hair professionals who have Codes of Ethics. The SPCP — Society of Permanent Cosmetic Professionals —requires its members to “maintain high professional standards consistent with sound practices,” “conduct business relationships in a manner that is fair to all,” and avoid false or misleading statements to the effect that the application of permanent makeup is not tattooing, not permanent, and not painful. (shrink)

Humanity entered the twenty-first century with revolutionary achievements in biomedical research. At the same time multiple “dual-use” results have been published. The battle against infectious diseases is meeting new challenges, with newly emerging and re-emerging infections. Both natural disaster epidemics, such as SARS, avian influenza, haemorrhagic fevers, XDR and MDR tuberculosis and many others, and the possibility of intentional mis-use, such as letters containing anthrax spores in USA, 2001, have raised awareness of the real threats. Many great men, including Goethe, (...) Spinoza, J.B. Shaw, Fr. Engels, J.F. Kennedy and others, have recognized that liberty is also a responsibility. That is why the liberty to decide now represents an acknowledged necessity: biomedical research should be supported, conducted and published with appropriate measures to prevent potential “dual use”. Biomedical scientists should work according to the ethical principles of their Code of Conduct, an analogue of Hippocrates Oath of doctors; and they should inform government, society and their juniors about the problem. National science consulting boards of experts should be created to prepare guidelines and control the problem at state level. An international board should develop minimum standards to be applicable by each country. Bio-preparedness is considered another key-measure. (shrink)

The Hippocratic Oath is a code of ethics defining correct behaviour by physicians they are required to commit themselves to before being accepted into the profession. It was the first code of ethics for any profession. While originating in Ancient Greece, it subsequently evolved, but the current code still embodies many of the core injunctions of the original code. The most widely accepted current form is the 2006 The Declaration of Geneva by the World Medical Association to be taken before (...) being admitted as a member of the medical profession. The most important of its injunctions are: ‘The health of my patient will be my first consideration’ and ‘I will maintain the utmost respect for human life’. The first is a rewording of the injunction from Epidemics, Book I, of the Hippocratic school: ‘Practice two things in your dealings with disease: either help or do not harm the patient.’ This was later simplified to the most basic precept of the Hippocratic Oath: ‘First, do no harm.’ It is one of the principal precepts of bioethics that all students in healthcare that, given an existing problem, it may be better not to do something, or even to do nothing, than to risk causing more harm than good. The development of neurotechnology could be subsumed with little modification under the Geneva formulation of the Hippocratic Oath, extending this precept to a commitment not to damage people’s psychological health. (shrink)

In presenting the case for professional economic ethics over the past two years, since the publication of The Economist's Oath, I've encountered more scepticism among heterodox economists on the left than from those on the right. Left-leaning economists argue inter aliathat the project to establish a field of professional economic ethics is naive, since economists are hardly to be dissuaded from doing wrong by the existence of a code of conduct; off target, since professional ethics doesn't address the main failures (...) of economics and economists; and as a consequence of all that, that professional economic ethics is wrong-headed, at least for heterodox economists, since it deflects our attention away from the real problems in our profession. The left's scepticism regarding professional economic ethics, while not lacking merit, is mistaken in central respects. Not least, heterodox economists hold too narrow a view of the scope of professional economic ethics; and they tend to conflate the field with a code of conduct. Once we correct these errors, we come to see that heterodox economists should be at the forefront of the push for professional ethics in economics. The paper concludes by examining what professional economic ethics might imply for economic pedagogy. Read the Open Peer Discussion on this paper » Read the discussion on this paper on the WEA's Ethics conference ». (shrink)

This book is a comprehensive and unique text and reference in medical ethics. By far the most inclusive set of primary documents and articles in the field ever published, it contains over 100 selections. Virtually all pieces appear in their entirety, and a significant number would be difficult to obtain elsewhere. The volume draws upon the literature of history, medicine, philosophical and religious ethics, economics, and sociology. A wide range of topics and issues are covered, such as law and medicine, (...) truth-telling by the physician, research, population policy, genetics, abortion, dying, and individual rights in medical care. The selections span the centuries, beginning with material from the works of Hippocrates, continuing through Thomas Percival, John Stuart Mill, and Claude Bernard, down to modern commentators like Henry K. Beecher, Walsh McDermott, David L. Bazelon, Paul Freund, H. L. A. Hart, John Rawls, Paul Ramsey, Richard McCormick, Rashi Fein, and Bernard Barber. The text has eight major divisions, beginning with sections on the ethical dimensions of the physician-patient relationship in history; the moral bases of medical ethics; and regulation, compulsion, and protection of the consumer in clinical medicine and public health. Each of these sections includes key essays that appear for the first time. All of the book's major divisions contain primary documents: codes such as the Hippocratic Oath, Medieval Law for the Regulation of Medicine, and the first as well as the most recent code of the American Medical Association; court decisions, including those on Karen Quinlan and on abortion in the United States and West Germany; government documents such as the statement of the National Commission on the Protection of Human Subjects, the Tuskegee Syphilis Report, the British Parliamentary debate on euthanasia, and the Council of Europe on rights of the sick and dying; and various published guidelines such as the Harvard Medical School brain death criteria, the American Hospital Association on patient's rights, and Pope Pius XII on the prolongation of life. Cases that illustrate moral dilemmas are provided for discussion purposes. Each section is preceded by a succinct editor's introduction. The documents and essays are of practical value for practitioners and students in medicine, law, ethics, and counselling, and for individual patients and groups concerned with medical care. Through encompassing divergent viewpoints, the essays and primary documents were selected to encourage humane practices and deepen understanding of the multiple traditions that shaped and do shape the development of medicine. (shrink)

The ancient art of healing and practical argumentation are closely linked, and this link points to three substantial issues: that physicians enjoy certain social status, that medicine is recognized as a special area of knowledge and that the art of healing is a profession. We use the analogy between the medicine and the judiciary for demonstrating these issues. The analogy involves two groups of norms governing the activities of judges – the norms of competence and the norms of conduct which (...) we interpret as the actional and the practical aspects of the ancient art of healing. The actional aspect is similar to the norms of competence of a judge and sets the goal for the art of healing – restoring patient’s health, and defines a physician as a person who is publicly allowed to pursue this goal in his professional activities. The practical aspect is reminiscent of the judges’ norms of conduct and it outlines the terms and techniques which lead to achieving this goal by those who are considered physicians, according to the norms of competence. In order to become a real tekhne, it is necessary and sufficient for the art of healing to secure its actional and practical aspects in the body of theoretical knowledge, on the one hand, and in the appropriate professional code, on the other. Practical argumentation serves as the tools of this implementation, for it allows to combine the norms and actions in a set of strategies of conduct, aimed at restoring patient’s health, of which the physisian is now free to chose the one that appear to be the most effective. (shrink)

When militaries mention loyalty as a value they mean loyalty to colleagues and the organisation. Loyalty to principle, the type of loyalty that has a wider scope, plays hardly a role in the ethics of most armed forces. Where military codes, oaths and values are about the organisation and colleagues, medical ethics is about providing patient care impartially. Being subject to two diverging professional ethics can leave military medical personnel torn between the wish to act loyally towards colleagues, (...) and the demands of a more outward looking ethic. This tension constitutes a test of integrity, not a moral dilemma. (shrink)

"Consists basically of medical prayers, oaths, pledges, ethical aphorisms and codes, and covenants of physicians throughout the ages, in various civilizations."--Intro. Published 1973.

Not only the direct physical experiences of deployment can severely harm soldiers’ mental health. Witnessing violations of their moral principles by the enemy, or by their fellow soldiers and superiors, can also have a devastating impact. It can cause soldiers’ moral disorientation, increasing feelings of shame, guilt, or hate, and the need for general answers on questions of right and wrong. Various attempts have been made to keep soldiers mentally sane. One is to provide convincing causes for their deployment, which (...) risks an “end justifies the means” way of thinking. The good cause can provide a moral justification for horrible atrocities. Another method, introduced in the USA, Canada, and Australia, aims to strengthen military personnel’s resistance by promoting and maintaining a happy, optimistic state of mind through the use of positive psychology. Alongside making soldiers “morally fit” for all kinds of situations, the focus could also be on moral recovery and forgiveness. Such a care-based military ethics approach, aimed at mutual understanding and interdependence, could help soldiers handle the emotional impact of moral conflicts. This demands that military units reflect on their organizational culture and rethink oaths and codes of conduct that focus mainly on efficiency and readiness, as well as the soldierly self-image with its seemingly still deeply rooted warrior ethos. Today, resilience and positive psychology in the military is apparently mainly geared to assuring its soldiers’ readiness. An appropriate set of virtues and understanding of virtue ethics that are less centered on self-perfection and autonomy could point to a different form of character-building and lead to a better understanding of others. (shrink)

Suppose that a very large number of people, say one billion, will suffer a moderately severe headache for the next twenty-four hours. For these billion people, the next twenty-four hours will be fairly unpleasant, though by no means unbearable. However, there will be no side-effects from these headaches; no drop in productivity in the work-place, no lapses in concentration leading to accidents, no unkind words spoken to loved ones that will later fester. Nonetheless, it is clearly desirable that these billion (...) people avoid the headaches. Even though the headaches are moderate, they are impervious to pain-killing drugs, acupuncture, transcendental meditation, and just about any other remedy. In fact, there is only one way in which the headaches can be avoided. In a remote South American village, a young woman, Agnes, is suffering from a fever. A simple dose of antibiotics will save her life, otherwise she will die. If, and only if, she dies, the billion headaches will be prevented. You just happen to be passing through the village, in full knowledge of the circumstances. Although not a doctor (and therefore not bound by codes of professional ethics, Hippocratic oaths, etc.), you possess the requisite dose of antibiotics, for which you have no other use, and which will become useless, if not used in the next two hours. (shrink)

Numerous grounds have been offered for the view that healthcare workers have a duty to treat, including expressed consent, implied consent, special training, reciprocity (also called the social contract view), and professional oaths and codes. Quite often, however, these grounds are simply asserted without being adequately defended or without the defenses being critically evaluated. This essay aims to help remedy that problem by providing a critical examination of the strengths and weaknesses of each of these five grounds for (...) asserting that healthcare workers have a duty to treat, especially as that duty would arise in the context of an infectious disease pandemic. Ultimately, it argues that none of the defenses is currently sufficient to ground the kind of duty that would be needed in a pandemic. It concludes by sketching some practical recommendations in that regard. (shrink)

This paper examines confidentiality and its nature and analyses the guidelines laid down by the Hippocratic Oath as well as the British and World Medical Associations for maintaining such confidentiality between doctor and patient. There are exceptions to practically any code of rules and this is true also for confidentiality. Some of these exceptions make it appear that very little is confidential. The three values implicit in confidentiality would seem to be privacy, confidence and secrecy. Each of these values is (...) discussed and developed in this paper. In conclusion, the question is suggested that maybe in the face of death, doctor and patient need to re-examine the pre-suppositions of privacy, confidence and secrecy on which the confidential relationship is based. (shrink)

Background The aim of the study is to assess the knowledge, attitudes and practices among healthcare professionals in Barbados in relation to healthcare ethics and law in an attempt to assist in guiding their professional conduct and aid in curriculum development. Methods A self-administered structured questionnaire about knowledge of healthcare ethics, law and the role of an Ethics Committee in the healthcare system was devised, tested and distributed to all levels of staff at the Queen Elizabeth Hospital in Barbados (a (...) tertiary care teaching hospital) during April and May 2003. Results The paper analyses 159 responses from doctors and nurses comprising junior doctors, consultants, staff nurses and sisters-in-charge. The frequency with which the respondents encountered ethical or legal problems varied widely from 'daily' to 'yearly'. 52% of senior medical staff and 20% of senior nursing staff knew little of the law pertinent to their work. 11% of the doctors did not know the contents of the Hippocratic Oath whilst a quarter of nurses did not know the Nurses Code. Nuremberg Code and Helsinki Code were known only to a few individuals. 29% of doctors and 37% of nurses had no knowledge of an existing hospital ethics committee. Physicians had a stronger opinion than nurses regarding practice of ethics such as adherence to patients' wishes, confidentiality, paternalism, consent for procedures and treating violent/non-compliant patients (p = 0.01) Conclusion The study highlights the need to identify professionals in the workforce who appear to be indifferent to ethical and legal issues, to devise means to sensitize them to these issues and appropriately training them. (shrink)

Physicians in Islamic countries might be requested to participate in the Islamic legal code of qiṣāṣ, in which the victim or family has the right to an eye-for-an-eye retaliation. Qiṣāṣ is only used as a punishment in the case of murder or intentional physical injury. In situations such as throwing acid, the national legal system of some Islamic countries asks for assistance from physicians, because the punishment should be identical to the crime. The perpetrator could not be punished without a (...) physician’s participation, because there is no way to guarantee that the sentence would be carried out without inflicting more injury than the initial victim had suffered. By examining two cases of acid throwing, this paper discusses issues related to physicians’ participation in qiṣāṣ from the perspective of medical ethics and Islamic Shari’a law. From the standpoint of medical ethics, physicians’ participation in qiṣāṣ is not appropriate. First, qiṣāṣ is in sharp contrast to the Hippocratic Oath and other codes of medical ethics. Second, by physicians’ participation in qiṣāṣ, medical practices are being used improperly to carry out government mandates. Third, physician participation in activities that cause intentional harm to people destroys the trust between patients and physicians and may adversely affect the patient–physician relationship more generally. From the standpoint of Shari’a, there is no consensus among Muslim scholars whether qiṣāṣ should be performed on every occasion. We argue that disallowing physician involvement in qiṣāṣ is necessary from the perspectives of both medical ethics and Shari’a law. (shrink)

Our shared moral framework is negotiated as part of the social contract. Some elements of that framework are established (tell the truth under oath), but other elements lack an overlapping consensus (just when can an individual lie to protect his or her privacy?). The tidy bits of our accepted moral framework have been codified, becoming the subject of legal rather than ethical consideration. Those elements remaining in the realm of ethics seem fragmented and inconsistent. Yet, our engineering students will need (...) to navigate the broken ground of this complex moral landscape. A minimalist approach would leave our students with formulated dogma—principles of right and wrong such as the National Society for Professional Engineers (NSPE) Code of Ethics for Engineers—but without any insight into the genesis of these principles. A slightly deeper, micro-ethics approach would teach our students to solve ethical problems by applying heuristics—giving our students a rational process to manipulate ethical dilemmas using the same principles simply referenced a priori by dogma. A macro-ethics approach—helping students to inductively construct a posteriori principles from case studies—goes beyond the simple statement or manipulation of principles, but falls short of linking personal moral principles to the larger, social context. Ultimately, it is this social context that requires both the application of ethical principles, and the negotiation of moral values—from an understanding of meta-ethics. (shrink)

The view from inside : gendered embodiment and the medical representation of sex / Shelley Wall -- The politics of medico-legal recognition : the terms of gendered subjectivity in the UK Gender Recognition Act / Sarah Burgess -- Journeys of choice? : abortion, travel, and women's autonomy / Christabelle Sethna and Marion Doull -- The code of ethics in medicine : intertextuality and meaning in Plato's Sophist and Hippocrates' oath / Twyla Gibson -- Sleeping ethics : gene, episteme, and the (...) body politic / Deborah Lynn Steinberg -- The last temptation of Marion Woodman : the anorexic remainder in bone : dying into life / David L. Clark. (shrink)

This baseline study was conducted to find out the knowledge, attitudes and practices of medical ethics among the undergraduate medical interns who did not have structured ethics curriculum in their course. A descriptive, cross-sectional study was carried out using a self-administered structured questionnaire among the medical undergraduate interns of Maharajgunj Medical Campus, the pioneer medical college of Nepal which enrols 60 students in a year. A total of 46 interns participated in the study. The most common source of knowledge on (...) ethics was lectures/seminars (35.7%) followed by experience at work (24.5%), training (21.4%) and own reading (17.3%). The main contents of Hippocratic Oath were known to 98.8% while 60.9% knew the main contents of Nepal Medical Council (NMC) code of ethics. Great majority (91.3%) regard ethics as very important in medical profession. “Doctors know the best irrespective of patients’ opinion” was disagreed by only 39.1% indicating the paternalistic attitude. However, 78.3% were in favour of adhering to the patient’s wish. None of the participant agreed to abandon confidentiality. Only about one-fourth (26.1%) claim to encounter ethical dilemma every day while the highest number (43.5%) had once in a month. To deal with the situation of ethical dilemma, majority approached to immediate supervisor followed by head of the department and colleagues. Eighty-seven percent of participating interns were involved in research activities involving human subjects. Only one of the participants had encountered the ethical issue on end-of-life and it was do-not-resuscitate consent in a terminally ill patient. On implementation of the curriculum on medical ethics focus should be - principles of biomedical ethics, sensitive ethical dilemmas like end-of-life care and practical experiences with participation in deliberations of the ethics committee. (shrink)

Magna Carta Libertatum or the Great Charter of the Liberties is a historical document of great significance for the constitutional history and human rights and liberties development. Although at its initial version it addressed a limited number of liberties and principles, it represented a solid foundation for the evolution of the principles of the rule of law, right to justice, right to a fair trial, just and reasonable sentencing, limitation of powers, etc. Namely, article 20 of the Charter states: A (...) freeman shall not be amerced for a slight offense, except in accordance with the degree of the offense; and for a grave offense he shall be amerced in accordance with the gravity of the offense, yet saving always his “contenement”; and a merchant in the same way, saving his “merchandise”; and a villein shall be amerced in the same way, saving his “wainage” if they have fallen into our mercy: and none of the aforesaid amercements shall be imposed except by the oath of honest men of the neighborhood. An analysis of this article undoubtedly leads us to the basic principles of the contemporary systems of fine, namely the daily-fine system introduced in the Macedonian Criminal Code in 2004 according to which the fine will be calculated and pronounced according to the gravity of the offence and the financial state and condition of the perpetrator. As one can notice, the gravity of the offence and the saving of the perpetrators “contenement” from the abovementioned article of the Great Charter refer to the aforesaid principles. In this article, a comparison will be made on the meaning of the term “amercement” and its similarities and differences with the modern financial penalties and measures in the criminal law from comparative perspective, to find which one corresponds to the latter: fine, assets forfeiture or compensation of damages made with the criminal offence. (shrink)

The profession of medicine has developed codes of ethical conduct for thousands of years. From the Hippocratic Oath of ancient Greece onward to modern times, a universal and central element of such codes has expressed the imperative that a physician shall “Do no harm.”.

While ancient in origin, the principle, "Do No Harm," continues to occupy a prominent place in many present-day medical ethics codes. Of all the versions of the principle two distinct varieties can be distinguished. These parallel two ethical traditions. This paper develops the contrast between the two versions, relates them to the two ongoing ethical traditions, and then uses insights from contemporary ethical theory to demonstrate the significance of one of the versions. Finally it suggests some contemporary applications for (...) a medical ethic and medical education. Keywords: Hippocratic Oath, harm, intention, agency CiteULike Connotea Del.icio.us What's this? (shrink)

The ¿scrutiny of all the laws¿ that Andocides invokes in his defence On the Mysteries is usually interpreted as a recodification with the aim of barring prosecution for the crimes of civil conflict. This article advances four theses against that traditional reading: (1) In Andocides¿ argument the Scrutiny was designed for a more practicable purpose, not to pardon crimes unpunished but to quash any further action against former atimoi, those penalized under the old regime but restored to rights in 403. (...) In context, coming close upon the summary of Patrocleides¿ decree, ¿all the laws¿ means all laws affecting atimoi. (2) The other evidence from inscriptions and literary testimony, for the Athenian Amnesty and similar agreements, supports this reading: the oath that closed the covenants, mê mnêsikakein, functions as a rule of estoppel or ¿no reprise¿; it was not in itself a pledge of ¿political forgiveness¿. In regard to the Scrutiny, as in Patrocleides¿ decree, the oath means that old penalties, now cancelled, can never again be enforced. (3) The Scrutiny itself was a reauthorization of the old laws for summary arrest and other standard remedies against atimoi who trespass or violate their restrictions. As a corollary to this re-enactment, the statute of limitations was introduced, ¿to apply the laws from Eucleides¿: the rules punishing the disfranchised cannot be used against those whose liabilities were incurred before 403. (4) Teisamenus¿ decree for new legislation was prior to this revision; it is not the decree that Andocides read to the court as a document of the Scrutiny. An ancient editor simply inserted the wrong document. Teisamenus envisioned no alteration of the ¿Solonian Code¿; the decree for Scrutiny was an unforeseen but necessary correction. These measures were successive reforms sorting out the new hierarchy of rules, a process whose complexity is attested in Diocles¿ law. (shrink)

Roman Law is an important legal systematic that contains important codings of world law history. This legal system not only affected Continental Europe, but also the Near East, which was a period under its domination. Especially in the Justinian period, the law collection that emerged as a result of the legal studies starting from the East Roman capital is considered as a monumental work by many historians and jurists. Researchers who praise Corpus Juris Civilis are right. However, this selection, which (...) is one of the most effective law coding, is far from being practical. For this Leo III prepared his law book called Ecloga. Referred to as the first Christian law book, this work was later expanded with some additions. Ecloga was given its final shape during the period of Empress Irene. Irene is one of the strongest female figures in Roman history. Emperor Constantine V married his son Leo (who is from his first wife Çiçek Hatun, the Caspian Princess) to Irene. Irene was the daughter of an ordinary family. She was Athenian as origin. However, Athens was not a city as flashy as it was in ancient times. At the same time, the Athenians were against icon-breaking, which was the official ideology of the empire. It was really interesting that Irene was chosen by Constantine V as wife for his son Leo. After the death of Constantine V, Leo IV acceded to the throne without any problems. The fact that Leo IV had chronic tuberculosis prevented him from state administrations. Actually, it was Irene who filled in this gap. After the early death of Leo IV, due to the aforementioned disease, his 10-year-old son Constantine VI became officially regent. After killing her son by abacina-tion Irene became the sole owner of the throne. In the ongoing process, she abused law and religion to maintain her power. Irene’s first law supplement was on oaths. There were many references to the Holy Book in the annex of this law. It was mentioned that it is not a sin to swear in the Old Testament, but it is now forbidden to swear with the New Testament. In addi-tion, the law stipulates that the oath is the way to deny God precisely after lying. However, it was claimed that the oath tradition to the Roman society passed through the Hebrews. Un-doubtedly, Irene used the text of this law to prove that the oath of devotion of the majority of the eastern Roman army, allegedly to her son Constantine VI, was invalid. Because in the Ro-man army, fulfilling the necessary oath and loyalty to the emperor were in front of everything. It was possible for the empress to take over the throne with this proclaimed law article that the vows of the soldiers who swore in order to remain committed to Constantine VI within the army were void. It is obvious that Irene was trying to prevent a possible coup attempt within the army. The empress’ second annex to the law concerns those who married for the third time. The law was titled “About those who illegally contract to third or later marriages and about those who marry their own slaves”. In Christianity, it was allowed to marry for the sec-ond time after the death of one of the spouses. There were certain phrases that marriages to be held for the third time in the Holy Book were forbidden. It is clear that Irene had a political benefit in reminding this ban. Because her power was based on her marriage with Leo, who was the son of Constantine V from his first wife. Their rivals were the sons of Constantine V from his third marriage. Therefore, with this law, she eliminated her political rivals. (shrink)

The article is focused on the profession of faith and the oath of fidelity, as has been formulated in 1989 by the Congregation of Faith. Catholic clergy as well as Catholic theologians are obliged to profess the Catholic faith and to take the oath before assuming an ecclesiastical office or function. The analyses and reflections are from the point of view of canon law. A retro prospective view makes clear that the profession and oath belong to the disciplinary tradition of (...) the Church. The Council of Trent offered the first more or less systematic regulation. The profession and the oath intend to guarantee that ecclesiastical ministers and Catholic theologians are in full communion with the Catholic Church. The three additional paragraphs of the profession and the text of the oath are condensed formulations of canons of the Code of Canon Law. In that way the profession and the oath are indirectly a part of the disciplinary corps of the Code. Their canonical disciplinairy significance has been investigated. The article ends with some general conclusions and considerations. (shrink)

This chapter contains sections titled: Medical Ethics Nursing Ethics Bioethics References.

This chapter contains sections titled: References.

Arguing that ecological thinking can animate an epistemology capable of addressing feminist, multicultural, and other post-colonial concerns, this book critiques the instrumental rationality, hyperbolized autonomy, abstract individualism, and exploitation of people and places that western epistemologies of mastery have legitimated. It proposes a politics of epistemic location, sensitive to the interplay of particularity and diversity, and focused on responsible epistemic practices. Starting from an epistemological approach implicit in Rachel Carson’s scientific projects, the book draws, constructively and critically, on ecological theory (...) and practice, on (post-Quinean) naturalized epistemology, and on feminist and post-colonial theory. Analyzing extended examples from developmental psychology, from medicine and law, and from circumstances where vulnerability, credibility, and public trust are at issue, the argument addresses the constitutive part played by an instituted social imaginary in shaping and regulating human lives. The practices and examples discussed invoke the responsibility requirements central to this text’s larger purpose of imagining, crafting, articulating a creative, innovative, instituting social imaginary, committed to interrogating entrenched hierarchical social structures, en route to enacting principles of ideal cohabitation. (shrink)

The arguments in this book are informed at once by the moral-political implications of how knowledge is produced and circulated and by issues of gendered subjectivity. In their critical dimension, these lucid essays engage with the incapacity of the philosophical mainstream's dominant epistemologies to offer regulative principles that guide people in the epistemic projects that figure centrally in their lives. In its constructive dimension, ____Rhetorical__ ____Spaces__ focuses on developing productive, case-by-case analyses of knowing other people in situations where social-political inequalities (...) create asymmetrical patterns of epistemic power and privilege. (shrink)