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| Year : 2011 | Volume
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| Issue : 1 | Page : 1 |
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| Ethics - A need for graduating doctors |
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George Paul
Medical Director, Sharon Cancer Centre, Salem, Member Secretary, Ethi consult Services, Salem, India
Click here for correspondence address and email
| Date of Web Publication | 6-Mar-2012 |
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How to cite this article:
Paul G. Ethics - A need for graduating doctors. J Educ Ethics Dent 2011;1:1 |
The crux of ethics is goodness. Ethics also balance various other interrelated contradictions like right and wrong, or crime and punishment. Clearly, ethic can be regarded as an all-pervasive phenomenon that influences every aspect of our life, even death. Medicine, perhaps, has had the most tenuous relationship with ethics. It has revolutionized the way we learn, research and practice the profession. Ethics has largely influenced medicine, just as medical advancement has significantly impacted ethics. It has had a reciprocal relationship. To understand the changing concepts of ethical standards in medical science we must re-visit the oldest document on health ethics - The Hippocratic Oath.
Medical historians are more or less convinced that most of the writings in the Corpus Hippocraticum are actually the work of a number of different writers of that period. [1] The oath itself may have been drafted by the famous Hippocrates of cos circa 5 th century BC. Many of the dictates are obsolete and impractical. A sample of this from the original ionic Greek rendition can be read as follows: "I will not give a lethal drug to anyone if I am asked to" or "I will not use my knife, not even to the sufferers of stone." These promises would have effectively eliminated all pharmaceutical prescriptions and surgical activities (particularly urology). On the other hand, there are enduring principles that hold relevance even today, with the most important being "to do no harm". The oath also touches on issues of confidentiality and avoidance of doctor patient sexual misconduct.
Ethics is closely linked to morality and both mean the 'custom of life'. However, the difference lies in reference, one speaks of 'a moral act' and an 'ethical code.' [2] Most of us have seen the shifting goalpost in morality even within our life time. While fundamental morality of right, wrong, good and evil remains largely unchanged, moral judgments often change. Let us take a common experience that is easy to relate. Moral judgments about attire are constantly changing. In the early part of the twentieth century, in India, it would have been morally scandalous for a woman in our cities to bare their legs (although the tribal people did so without compunction and low caste women in the south were required by social norms to not cover their breasts). Today miniskirts in our urban centres do not even invite a single glance. It is the same with Ethics; however, in a reversed manner. When Edward Jenner 'vaccinated' contents of a cowpox pustule into a boy's skin, he neither explained the matter nor took the boy's or his parent's consent. It was not considered unethical then. In fact, that single act laid the foundation for the emergence of the small pox vaccine which has saved the lives of millions of people in today's times. If the same action was to be carried out by Edward Jenner today, it would be frowned upon as distinctly unethical on several counts. The reason for this sea change in attitude came about largely because of the abuse of ostensible medical research by the Nazi regime, giving birth to the Nuremburg Code (1946). This evolved into numerous national and International conventions and facilitated research. The Declaration of Helsinki in 1974 was a watershed in International research ethics. National policies including the Food and Drug Administration regulations and our own Indian Council of Medical Research guidelines have largely streamlined research by setting well defined guidelines. Today, clinical practice and research are theoretically guided by the principles of autonomy, beneficence, non malfeasance and confidentiality. And unfortunately, these are aspects we violate unknowingly every day.
Unfortunately, the medical and dental curriculum has largely ignored the teaching and practice of ethics. To most of us, ethics is an arcane set of ideals that have no relevance to our work. It is high time that the medical and dental curricula prescribe the independent study of Ethics as a mandatory requirement for graduating doctors. This will revolutionize medical care both for the care giver as well as the public. Medicine can once again have a humane touch in a rapidly commercializing environment.
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| 1. | Adams, Francis. The Genuine Works of Hippocrates, New York: William Wood and Company; 1891. 
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| 2. | Available from: www.philosophy-religion.org/handouts/pdfs/ch7-ethics.pdf [Last accessed on 2011 Sep. 18].
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| Authors | | |
Correspondence Address:
George Paul
Medical Director, Sharon Cancer Centre, Salem, Member Secretary, Ethi consult Services, Salem
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0974-7761.93405
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