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.

In the same year he took his degree of M.D. at Leyden, and afterwards visited Paris and Hamburgh. He then returned to Warrington; at which place, after a residence of a few months, he married the daughter of Nathaniel Bassnett Esq. In 1767 he settled at Manchester, where he passed the remainder of his life.

Dr. Percival held a distinguished rank both as a literary character, and a physician. In the latter capacity he displayed quick penetration, discriminating judgement, patient attention, and above all, says Abp. Magee, a deep sense of responsibility. As an author he obtained considerable reputation in the philosophical and religious world, particularly by his “Essays, Medical and Experimental,” and his last work entitled, “Medical Ethics,” in which, it is said, while delineating the requisites and qualifications of the medical practitioner, he has unconsciously displayed the most exact portraiture of himself. His other more important productions include “A Father’s Instructions;” “Moral and Literary Dissertations,” (which have rarely been surpassed by any didactic composition of a similar extent, for genuine feeling, refined taste, purity of style or aptness of illustration;) and several papers published in the Transactions of the Manchester Literary and Philosophical Society, of which he was an original member, and continued the president from its first foundation to the end of his life. He was the first who attempted to establish public lectures on mathematics, commerce, and the fine arts, in that town. In addition to his other honours he was a fellow of the Royal Society of Edinburgh, and a member of several foreign Societies. His correspondence was extensive, and embraced a variety of subjects: among his epistolary friends, were Archdeacon Paley, Dr. Priestley, Dr. Franklin, Dr. Beattie, and Hannah More. In one of his letters to the first of these celebrated characters, he avows himself a dissenter; but he rarely alludes to the fact elsewhere, and he is known to have entertained a sincere respect for the Church of England, of which his eldest son was a minister. He died at Manchester Aug. 30, 1804, in the sixty-fourth year of his age. A Latin epitaph by the Rev. Dr. Parr is inscribed on his tomb in the church at Warrington; and over the president’s chair, in the hall of the Manchester Philosophical Society, a mural tablet has been erected to his memory. His works were collected and published in 4 vols. 8vo., 1807, with a biographical memoir by his son Dr. Edward Percival, of Bath.

FOOTNOTES:

Taken, with a few alterations, from “the Georgian Era,” vol. ii.

TO SIR GEORGE BAKER, BART., PHYSICIAN TO THEIR MAJESTIES, FELLOW OF THE ROYAL SOCIETY, AND LATE PRESIDENT OF THE COLLEGE OF PHYSICIANS, &c. &c. THIS CODE OF PROFESSIONAL ETHICS, WHICH HE HAS HONOURED WITH HIS SANCTION, AND IMPROVED BY HIS COMMUNICATIONS, IS GRATEFULLY AND RESPECTFULLY INSCRIBED, BY HIS OBLIGED AND AFFECTIONATE FRIEND, THE AUTHOR. [1803.]

Quicquid dignum sapiente bonoque est.

(Horace, Ep. i. 4. 5.)

TO E. C. PERCIVAL.

Permit me, my dear Son, to offer to your acceptance this little manual of MEDICAL ETHICS. In the composition of it, my thoughts were directed towards your late excellent brother, with the tenderest impulse of paternal love; and not a single moral rule was framed without a secret view to his designation, and an anxious wish that it might influence his future conduct.

To you, who possess in no inferior degree my esteem and attachment, who are prosecuting the same studies, and with the same object, my solicitudes are naturally transferred: and I am persuaded, these united considerations will powerfully and permanently operate upon your ingenuous mind.

It is the characteristic of a wise man to act on determinate principles; and of a good man to be assured that they are conformable to rectitude and virtue. The relations in which a Physician stands to his patients, to his brethren, and to the public, are complicated and multifarious; involving much knowledge of human nature, and extensive moral duties. The study of professional Ethics, therefore, cannot fail to invigorate and enlarge your understanding; whilst the observance of the duties which they enjoin, will soften your manners, expand your affections, and form you to that propriety and dignity of conduct, which are essential to the character of a gentleman. The academical advantages you have enjoyed at Cambridge, and those you now possess in Edinburgh, will qualify you, I trust, for an ample and honourable sphere of action. And I devoutly pray, that the blessing of GOD may attend all your pursuits, rendering them at once subservient to your own felicity, and the good of your fellow-creatures.

Sensible that I begin to experience the pressure of advancing years, I regard the present publication as the conclusion, in this way, of my professional labours. I may, therefore, without impropriety, claim the privilege of consecrating them to you, as a paternal legacy. And I feel cordial satisfaction in the occasion of thus testifying the esteem and tenderness, with which, whilst life subsists, I shall remain,

Your affectionate friend,

THOMAS PERCIVAL.

Manchester, Febr. 20, 1803.

FOOTNOTES:

AUTHOR’S PREFACE.

The first chapter of the following work was composed in the spring of 1792, at the request of the Physicians and Surgeons of the Manchester Infirmary: and the substance of it constitutes the code of laws, by which the practice of that comprehensive institution is now governed. The Author was afterwards induced, by an earnest desire to promote the honour and advancement of his Profession, to enlarge the plan of his undertaking, and to frame a general system of Medical Ethics; that the official conduct and mutual intercourse of the Faculty might be regulated by precise and acknowledged principles of urbanity and rectitude. Printed copies of the scheme were therefore distributed amongst his numerous correspondents, by most of whom it was warmly encouraged, and by many of them was honoured with valuable suggestions for its improvement.

Whilst the Author was thus extending his views, and carrying on his work with ardour, he lost the strongest incentive to its prosecution, by the death of a beloved son, who had nearly completed the course of his academical education, and whose talents, acquirements, and virtues, promised to render him an ornament to the healing art. This melancholy event was followed, not many years afterwards, by a second family loss equally afflictive; and the design has ever since been wholly suspended. The Author now resumes it, animated by the hope that it may prove beneficial to another son, who has lately exchanged the pursuits of general science at Cambridge, for the study of Medicine at Edinburgh. He feels at the same time impressed with the conviction that the languor of sorrow becomes culpable, when it obstructs the offices of an active vocation. “I hold every man,” says Lord Bacon, “a debtor to his profession; from the which as men of course do seek to receive countenance and profit, so ought they of duty to endeavour themselves, by way of amends, to be a help and ornament thereunto. This is performed in some degree by the honest and liberal practice of a profession, when men shall carry a respect not to descend into any course that is corrupt and unworthy thereof, and preserve themselves free from the abuses wherewith the same profession is noted to be infected: but much more is this performed if a man be able to visit and strengthen the roots and foundation of the science itself; thereby not only gracing it in reputation and dignity, but also amplifying it in profession and substance.”

It was the Author’s original intention to have treated of the powers, privileges, honours, and emoluments of the Faculty. But he now conceives that this would lead him into a field of investigation too wide and digressive; and therefore chooses to confine himself to what more strictly belongs to Medical Ethics.

To these institutes he has annexed an Anniversary Discourse, delivered by the late Rev. Thomas Bassnett Percival, LL.B., before the President and Governors of the Infirmary at Liverpool. As it is an address to the gentlemen of the Faculty, the officers, the clergy, and the trustees of the charity, on their respective hospital duties, by one competent to the subject from his early studies, it cannot but be deemed sufficiently appropriate to the present work, exclusively of a father’s claim to the privilege of its insertion.

The aphoristic form of this code of Medical Ethics, though adapted to such an undertaking, forbids in a great measure all digression, and even precludes the discussion of many interesting points nearly connected with the subject. Supplementary Notes and Illustrations, therefore, are necessary to the completion of the Author’s plan: and he trusts the candid reader will grant him the liberty of thus stating his opinions more at large; of rectifying misconceptions, to which the brevity essential to the work may give rise; and of correcting whatever subsequent reflection, or the judicious observations of his friends, may discover to be erroneous.

A considerable portion of these sheets was communicated to the Rev. Thomas Gisborne, M.A., whilst engaged in the composition of his “Enquiry into the Duties of Men,” a work that reflects the highest honour on the abilities and philanthropy of the author, and which may be justly regarded as the most complete system extant of practical ethics. The chapter concerning Physicians contains a reference to these institutes, expressed in the most gratifying terms of friendship; and it treats so largely of the duties of the Faculty, as to seem, at first view, to supersede the use of the present manual. But the two publications differ not only in their plan, but in many of their leading objects; and it may be hoped they will rather illustrate than interfere with each other. The same remarks may be applied to the excellent “Lectures” of Dr. Gregory. Even the “Statuta Moralia” of the College of Physicians, whatever merit or authority they possess, are not sufficiently comprehensive for the existing sphere of Medical and Chirurgical duty; and by the few regulations which they establish, they tacitly sanction the recommendation of a fuller and more adequate code of professional offices.

Copies of the former unfinished impression of this work have been transmitted to the libraries of several infirmaries in different parts of the kingdom; and the Author has reason to hope that they have contributed to excite attention to the subject of hospital police. Amongst other pleasing proofs of this truth, he refers with peculiar satisfaction to the late publications of his friends, Sir G. O. Paul, Bart., and Dr. Clark, of Newcastle-upon-Tyne.

This work was originally entitled “Medical Jurisprudence;” but, some friends having objected to the term Jurisprudence, it has been changed to Ethics. According to the definition of Justinian, however, Jurisprudence may be understood to include moral injunctions as well as positive ordinances:—“Juris praecepta sunt haec; honeste vivere, alterum non laedere, suum cuique tribuere.” (Instit. i. 1. § 3.)

Manchester, Febr. 15, 1803.

FOOTNOTES:

In the preface to his Elements of the Common Laws of England. (Works, vol. iv. p. 9.)

MEDICAL ETHICS;

&c. &c.