Medical Ethics

CHAPTER I.. _of Professional Conduct Relative to Hospitals, or Other

Of Professional Conduct relative to Hospitals, or other Medical Charities.

§ 1. Duties of hospital Physicians and Surgeons.—Tenderness.— Steadiness.—Condescension.—Authority 27

§ 2. Choice of their attendant Physician or Surgeon, how far allowable to hospital patients ib.

§ 3. Feelings and emotions of patients, under critical circumstances, to be duly regarded 28

§ 4. No discussion concerning the nature of their case to be entered into before them ib.

§ 5. Delicacy in many cases particularly required; and secrecy sometimes to be strictly observed 29

§ 6. Moral and religious influence of sickness to be cherished and promoted 29

§ 7. Propriety of suggesting to patients, under certain circumstances, the importance of making their last will and testament 30

§ 8. Parsimony in prescribing wine and drugs of high price reprobated ib.

§ 9. Hospital affairs and occurrences not to be incautiously revealed 31

§ 10. Professional charges to be made only before a meeting of the Faculty ib.

§ 11. Proper discrimination between the Medical and Chirurgical cases to be strictly adhered to 32

§ 12. What circumstances authorize new remedies and new methods of Chirurgical treatment ib.

§ 13. Unreserved intercourse should subsist between the gentlemen of the Faculty; and an account of every case or operation which is rare, curious, or instructive, should be regularly drawn up and preserved ib.

§ 14. Scheme for hospital registers 33

§ 15. Advantages arising from the scheme 34

§ 16. Close and crowded wards reprobated 35

§ 17. Establishment of a committee of the gentlemen of the Faculty considered 36

§ 18. Importance of frequent consultations, and the mutual assistance of the Physicians and Surgeons ib.

§ 19-22. Rules to be observed in consultations ib.

§ 23. Rules to be observed respecting operations 38

§ 24. Hospital consultations ought not to be held on Sundays, except in cases of urgent necessity 39

§ 25. Stated days for operations often inconvenient and improper 39

§ 26. Dispensaries ib.

§ 27. Asylums for female patients labouring under syphilis.—Rules to be observed in Lock Hospitals 41

§ 28. Asylums for insanity 43

§ 29. Modes of acquiring knowledge in the treatment of insanity recommended 44

§ 30. Treatment of lunatics—tenderness—indulgence 45

§ 31. Boldness of practice sometimes required in cases of mania.—Hospitals for small-pox—inoculation, &c. &c., require no professional duties not already enumerated ib.

CHAPTER II.. _of Professional Conduct in Private or General Practice._

Of Professional Conduct in Private or General Practice.

§ 1. Moral rules of conduct, the same with those to be observed towards hospital patients 47

§ 2. The strictest temperance required ib.

§ 3. Proper conduct to be observed respecting prognostications, and the disclosure of circumstances to the friends of the patients 48

§ 4. Proper conduct respecting interference in cases under the charge of another 49

§ 5. Conduct to be observed towards a Physician formerly employed by the patient, but not now consulted 50

§ 6. Distinction between the provinces of Physic and Surgery to be steadily maintained ib.

§ 7. Consultations to be promoted in difficult or protracted cases 51

§ 8. Special consultation.—Conduct of the Physician called in 52

§ 9. Theoretical discussions to be avoided in consultations 53

§ 10. Rules for consultations the same with those prescribed to the Faculty attending hospitals.—Seniority, how determined ib.

§ 11. Education of Medical men—what influence it ought to have in the consideration of their brethren ib.

§ 12. Punctuality in visits of consultation—further rules to be observed 54

§ 13. Visits to the sick not to be unseasonably repeated 55

§ 14. Rules to be observed with regard to fees, when a Physician officiates in the absence, or at the request, of another ib.

§ 15. Importance of adopting some general rule respecting pecuniary acknowledgements 56

§ 16. Medical men and their families, when to be attended gratuitously 57

§ 17. Peculiar delicacy and attention often required in attendance upon them 58

§ 18. Attendance on clergymen in narrow circumstances ib.

§ 19. Consultation by letter 59

§ 20. Rules to be observed in furnishing certificates ib.

§ 21. Use of quack medicines to be discouraged 60

§ 22. The dispensing of nostrums reprobated 61

§ 23. Duty incumbent on individuals to promote the general reputation of the Faculty collectively ib.

§ 24. Rule to be observed in professional controversy and contention 62

§ 25. Giving advice gratis ib.

§ 26. Rule to be observed in visiting the patient of another Physician 63

§ 27. Another case of the same ib.

§ 28. Review of the treatment and progress of interesting cases recommended ib.

§ 29. Moral and religious advice to patients 64

§ 30. Observance of the Sabbath by Medical gentlemen considered 65

§ 31. Co-operation of young and aged practitioners ib.

§ 32. Period of senescence in Physicians considered 66

CHAPTER III.. _of the Conduct of Physicians to Apothecaries._

Of the Conduct of Physicians to Apothecaries.

§ 1. Connection between the Apothecary and Physician 69

§ 2. The Apothecary often precursor to the Physician, and commonly acquainted with the diseases of the family ib.

§ 3. Rule to be observed in the intercourse and co-operation of the Physician and Apothecary 71

§ 4. Duty and responsibility of the Physician ib.

§ 5. Particular directions to be observed in visiting country patients with the Apothecary 72

§ 6. Profits of Apothecaries 73

§ 7. Physicians visiting the patients of Apothecaries in their absence, not approved of 74

§ 8. Duty of Apothecaries in recommending Physicians to families 75

§ 9. Establishment of funds for the benefit of the widows and children of Apothecaries 76

CHAPTER IV.. _of Professional Duties in Certain Cases Which Require a

Of Professional Duties in certain Cases which require a Knowledge of Law.

§ 1. Medical gentlemen exempt from serving on inquests, juries, &c.; but frequently called upon to exercise duties which require juridical knowledge 78

§ 2. Duty of Physicians in cases of last will and testament—knowledge of law required 79

§ 3. Commissions of lunacy—appointment of a curator 83

§ 4. Treatment of lunatics as authorized by law 85

§ 5. Asylums for lunatics subject to strict regulations of law ib.

§ 6. Opinions given in cases of sudden death 87

§ 7. Justifiable homicide 88

§ 8. Excusable homicide 89

§ 9. Suicide 92

§ 10. Manslaughter—Murder 93

§ 11. Murder of bastard children 96

§ 12. Duelling 102

§ 13. Duty of Surgeons with respect to attending a duellist to the field of combat 106

§ 14. Private and personal duty of Physicians with respect to duel—true honour considered 108

§ 15. Homicide by poison—cases adduced 109

§ 16. Law in cases of rape 113

§ 17. Nuisances defined and considered 117

§ 18. Duty of Medical gentlemen when summoned to attend coroners, magistrates, and judges 120

§ 19. Importance to gentlemen of the Faculty of settling their opinions concerning the right of magistrates to inflict capital punishment.—The limits prescribed to the exercise of the right; and the duty of giving full efficiency to law 122

§ 20. Cautions relative to professional testimony in cases of peculiar malignity 125

NOTES AND ILLUSTRATIONS.

Note

I. Caution or temerity in practice 129

II. Temperance of Physicians 130

III. A Physician should be the minister of hope and comfort to the sick.—Enquiry, how far it is justifiable to violate truth for the supposed benefit of the patient 132

IV. The practice of a prior Physician should be treated with candour, and justified, so far as truth and probity will permit 141

V. Theoretical discussions should be generally avoided 142

VI. Regular academical education ib.

VII. Pecuniary acknowledgements 146

VIII. Public worship; scepticism and infidelity 150

IX. Union in consultation of senior and junior Physicians 166

X. [On Wills] 168

XI. Partial insanity, with general intelligence—Lucid interval 169

XII. [On the new Lunatic Act] 175

XIII. [Legal penalties on duelling] 181

XIV. Duelling.—Letter from Dr. Franklin ib.

XV. Punishment of the crime of rape 192

XVI. [Medical evidence at inquests] 194

SKETCH OF THE LIFE OF DR. PERCIVAL.

Thomas Percival was born at Warrington in Lancashire, Sept. 29, 1740. When only three years old, he had the misfortune to lose both his parents; and the care of his early education devolved upon his eldest sister. When of proper age, he was placed at a private academy in the neighbourhood of his native town; to the free grammar-school of which he was subsequently removed.

In 1757 his name was enrolled as the first student at the Warrington academy, then just instituted under the superintendence of Dr. Aikin. After having acquired a high reputation for diligence in classical and theological studies, he proceeded in 1761 to Edinburgh, where he applied himself with great assiduity to medical pursuits. He would, it appears, have gone either to Oxford or Cambridge, but for his scruples about subscription to the Thirty-nine Articles. Whilst in Edinburgh he became acquainted with Mr. Hume and Dr. Robertson; and during a visit to London contracted a close intimacy with Lord Willoughby de Parham, who made him his constant companion, and became his warmest friend and patron. He was indebted to this nobleman for an early introduction to the most eminent literary characters of the day; and through his recommendation became a Fellow of the Royal Society in 1765.

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