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!CODE OE ETHICS
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OF THE
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AMERICAN
MEDICAL ASSOCIATION,
ADOPTED MAY, 18 4-7.














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       CONCORD:


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   Syracuse, N.Y
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CODE OF ETHICS
OF THE
AMERICAN
MEDICAL ASSOCIATION,^^
ADOPTED MAY, 1847.
     CONCORD:
PRINTED BY ASA McFARLAND
       ' 1850. 
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                       CONT E NTS.
                 ARMED rORCES M    "A!  LIBRAKl
                         VVA^rUuv.iCi.. 0. C.

                            CHAPTER I.

Of the duties_of physicians  to their patients, and of the obligations
                 of patients  to their physicians.
    Akt. i.—Of the duties of physicians to their patients,  •           3
    Art. ii.—Of the obligations of patients to their physicians,   •     5

                          CHAPTER II.

Of the duties of physicians to each other, and to the profession  at
                 large.
    Art. i.—Of the duties of physicians for the support  of pro-
                 fessional character,.........     7
    Art. ii.—Of the duties of physicians in regard to professional
                 services to each other,........     >•
    Art. hi.—Of the duties  of physicians in regard  to vicarious
                 offices,............     n
    Art. iv.—Of the duties of physicians in consultations,    •   •     <i
    Art. v.—Of the duties of physicians in  cases of interference
                 with one another,.........    11
    Art. vi.—Of the duties of physicians when  differences  occur
                 between them,..........    i:s
    Art. vii.—Of the duties of physicians in regard to pecuniary
                 acknowledgments,.........    13


                          CHAPTER  III.

Of the duties of the profession to the public, and of the  obligations
                 of the public to the profession.
    Art. i.—Of the duties of the profession to the public,  ...    14
    Art. ii.—Of the obligations  of  the public to physicians,   •   •    15 
CODE  OF  MEDICAL  ETHICS.
                       CHAPTER I.


  OF THE DUTIES OF PHYSICIANS TO  THEIR PATIENTS,
   AM) OF THE OBLIGATIONS OF PATIENTS  TO THEIR
   PHYSICIANS.

  Art. 1.  Duties of Physicians to their Patients.
  § 1.  A Physician should not only be ever ready to obey the calls of
the sick, but his mind ought also to be imbued with the greatness of
his mission, and the responsibility he habitually incurs in its discharge.
Those obligations are the more deep and enduring, because there is
no tribunal, other than  his own conscience, to adjudge penalties for
carelessness or neglect.  Physicians should, therefore,  minister to
the sick with due impressions of the importance of their office; re-
flecting that the ease, the health, and the lives of those committed to
their charge, depend on their  skill, attention  and fidelity.  They
should  study, also, in their  deportment, so to unite tenderness with
firmness, and condescension  with authority, as to inspire the minds of
their patients with gratitude, respect and confidence.

  § 2.  Every case committed to the charge of a physician should be
treated with attention, steadiness and humanity.  Reasonable indul-
gence should be granted to the mental imbecility and caprices of the
sick.  Secrecy  and  delicacy, when required by  peculiar circum-
stances, should be strictly observed ; and the familiar and confidential
intercourse to which physicians are admitted in  their  professional
visits,  should be used with discretion,  and with  the  most scrupu-
lous  regard  to  fidelity and honor.   The  obligation  of secrecy
extends beyond the  period of  professional services;—none  of the
privacies of personal and domestic life, no infirmity of disposition or 
i
flaw of character observed during professional attendance,  should
ever be divulged by him except when he is imperatively required to
do  so.  The force and  necessity of this  obligation are  indeed so
great, that professional men have, under certain circumstances, been
protected in their  observance of secrecy, by courts of justice.

  § 3.  Frequent visits to the sick are in general requisite, since they
enable the physician to arrive at a more  perfect knowledge of  the
disease,—to meet promptly every change which may occur, and also
tend to preserve  the confidence of the patient.  But unnecessary
visits are  to be  avoided, as they give useless  anxiety to the patient,
tend to diminish the authority of the physician, and render him  lia-
ble to be suspected of interested motives.

  § 4.  A physician should not be forward to make gloomy prognosti-
cations, because  they savour of empiricism, by  magnifying the  im-
portance of his services in the treatment or cure of the disease. But
he should not fail, on proper occasions, to give  to the friends of  the
patient timely notice of danger, when it really occurs; and even to
the patient himself, if absolutely necessary.  This office, however, is
so peculiarly alarming when executed  by him,  that it  ought to  be
declined whenever it can be assigned to any other person of sufficient
judgment and delicacy.   For, the physician should be the minister of
hope and  comfort  to the sick ;  that, by such cordials to the drooping
spirit, he  may smooth the bed of  death, revive  expiring life, and
counteract the depressing influence of those  maladies which often
disturb the  tranquility of the  most  resigned, in their last moments.
The life of a sick  person can be shortened, not only by the acts but
also by the words  or the manner of a physician.  It is, therefore, a
sacred duty to guard himself carefully in this respect, and to avoid
all things which have a tendency to discourage the patient and to
depress his spirits.

  § 5.  A  physician ought not to abandon a  patient  because  the
case is  deemed  incurable ; for his  attendance  may continue to  be
highly useful to the patient, and comforting to the  relatives around
him, even in  the  last period of a  fatal malady, by alleviating pain
and  other symptoms, and by soothing mental anguish.  To decline
attendance, under such circumstances,  would be sacrificing to fanci-
ful delicacy and mistaken liberality, that moral duty, which is inde-
pendent of, and  far superior to  all pecuniary consideration.

  § 6.  Consultations should be promoted  in difficult or protracted
cases, as they give  rise to confidence, energy, and more  enlarged
views in practice.

  § 7.  The  opportunity which a physician not  unfrequently  enjoys 
0
of promoting and strengthening the good resolutions of his patients,
suffering under the consequences of vicious conduct, ought never to
be neglected.  His counsels, or even  remonstrances, will  give satis-
faction, not  offence, if they be proffered with politeness, and evince
a genuine love of virtue, accompanied by a sincere interest in  the
welfare of the person to whom they are addressed.


   Art. 2.   Obligations of Patients to their Physicians.
   § 1.  The  members of the medical profession, upon whom are  en-
joined  the performance of so many important and arduous duties
towards  the  community, and who are  required  to make so many
sacrifices of comfort, ease,  and health, for the welfare  of those who
avail themselves of their  services, certainly  have a  right  to expect
and require, that their patients  should entertain a just sense of the
duties  which they owe to their medical attendants.

   § 2.  The  first duty of a patient is, to select as his medical adviser
one who has received a regular  professional  education.  In no trade
or oecupation do mankind rely on the skill of an untaught artist;
and  in medicine, confessedly the most  difficult and intricate of the
sciences, the world ought not to  suppose that knowledge is intuitive.

   § 3.  Patients  should  prefer a physician whose habits of life  are
regular, and who is not  devoted to company, pleasure, or to any
pursuit incompatible with his professional obligations, A patient
should, also, confide the care of himself and family, as much as pos-
sible, to one physician ; for  a medical man who has become acquainted
with the peculiarities of constitution,  habits, and predispositions, of
those he  attends, is more likely to be successful in his treatment, than
one who does not possess that knowledge.
   A patient who has thus selected his physician, should always apply
for advice in what may appear to him trivial eases, for the  most fatal
results often supervene on  the slightest accidents.   It is of  still more
importance  that  he should apply for assistance in  the forming stage
of violent diseases.  It is to a  neglect of this precept that  medicine
owes much  of the  uncertainty  and imperfection  with which it  has
been reproached.

   § 4.  Patients  should faithfully and  unreservedly communicate to
their phvsician the supposed cause of their disease.   This is the more
important, as  many diseases  of  a mental origin simulate   those_ de-
pending on external  causes, and yet are only to be cured by minis-
tering  to the mind  diseased.  A patient should  never be afraid of
thus making his  physician  his friend and adviser; he should always
bear in  mind that a medical  man is under the strongest obligations
of secrec v.   Even  the female sex should never allow feelings of shame
                1 * 
G
or delicacy to prevent their disclosing the scat, symptoms and causes
of complaints peculiar to them.   However commendable  a modest
reserve may be in the common occurrences of life, its strict observ-
ance  in medicine  is often attended with  the  most serious conse-
quences, and a  patient may  sink under a painful  and  loathsome
disease, which might have been readily prevented had timely intima-
tion been given to the physician.

  § 5. A patient should never weary his physician  with  a tedious
detail of events or matters not appertaining to his disease.   Even as
relates to his actual symptoms, he will convey much  more real infor-
mation by giving clear answers to interrogatories, than  by the most
minute account of his own framing.  Neither should  he obtrude the
details of his business nor the history of his family concerns.

  § 6. The obedience of a patient to the prescriptions  of his physi-
cian should  be prompt  and implicit.  He should never permit his
own  crude opinions as to their fitness, to influence his attention to
them.  A failure in one particular may render an otherwise judicious
treatment dangerous, and even fatal.  This remark is equally appli-
cable  to diet, drink, and exercise.   As patients become convalescent,
they are very apt to suppose that the rules prescribed for them may
be disregarded, and the consequence but too often is, a relapse.  Pa-
tients should never allow themselves to be persuaded to take any
medicine whatever, that may be recommended to them by the self-con-
stituted doctors and doctresses who are so frequently met with, and
who pretend to possess infallible  remedies for the cure of every dis-
ease.   However simple some of their prescriptions may appear to be,
it often happens that they are productive of much mischief, and in all
cases  they are  injurious,  by contravening  the  plan  of  treatment
adopted by the physician.

  § 7. A patient should, if possible, avoid even the  friendly visits of
a physician who  is not attending  him,—and when he does receive
them, he should  never converse  on the  subject of his disease, as an
observation  may be  made, without  any intention  of  interference,
which may destroy his confidence in the course  he is pursuing, and
induce him to neglect the directions prescribed  to him.   A patient
should never send for a  consulting physician  without the  express
consent of his own medical attendant.  It is of great importance that
physicians should act in concert;  for, although  their modes of treat-
ment  may be attended with  equal success  when employed singly,
yet conjointly they are very  likely to  be  productive  of  disastrous
results.

  § 8. When a patient wishes to dismiss his physician, justice  and
common courtesy require that he should declare his reasons for so
doing. 
<
  § 9. Patients should always,  when practicable, send for their phy-
sician in the morning, before his usual  hour of going  out; for, by
being early aware  of the  visits  he has  to pay during the day, the
physician is able to apportion his time in  such a manner as to prevent
an interference of engagements.   Patients should also avoid calling
on their medical adviser unnecessarily during the hours devoted to
meals or sleep.  They should always be in readiness to receive the
visits of their physician, as the detention  of a few minutes is often of
Berious inconvenience to him.

  § 10.  A patient should, after his recovery, entertain a just and en-
during sense of the value of the services  rendered him by his physi-
cian ; for these are of  such a character, that no mere pecuniary ac-
knowledgment can repay or cancel them.
                       CHAPTER  II.

OF THE DUTIES OF PHYSICIANS TO EACH OTHER, AND TO
                THE PROFESSION AT LARGE.

  Art 1.  Duties for the support of professional character.
  § 1. Every individual, on  entering  the profession, as he becomes
thereby entitled to all its privileges and immunities, incurs an obliga-
tion to exert his best abilities to maintain its dignity and honor, to exalt
its standing, and to extend the bounds of its usefulness.  He should
therefore observe strictly such  laws  as are instituted for the govern-
ment of its members;  should avoid all contumelious and sarcastic re-
marks relative  to the faculty, as a body; and while, by unwearied
diligence, he resorts to  every honorable means of enriching the sci-
ence, he  should entertain a due respect for his seniors, who have,
by their labors, brought it  to  the elevated condition in which he
finds it.

  § 2. There is no profession, from the members of which greater
puritv of character, and a higher standard of moral excellence are
required, than  the medical f and to attain such eminence is a duty
even- physician owes alike to his profession and to his  patients.   It is
due to the latter, as without it he cannot command their respect  and
confidence ; and to both, because no  scientific attainments can com-
pensate for the want  of correct moral principles.   It is also incum-
bent upon  the  facultv to be temperate in all things, for the practice
of physic requires the unremitting exercise of  a clear and  vigorous
understanding; and,  on emergencies for which no professional man 
s
 should be unprepared, a steady hand, an acute eye, and an unclouded
 head may be  essential  to the well-being, and even  to the  life, of a
 fellow creature.

   § 3. It is derogatory to the dignity of the  profession to resort to
 public advertisements or private cards or handbills, inviting the atten-
 tion of individuals  affected with particular  diseases—publicly offer-
 ing advice and medicine to the poor gratis,or promising radical cures;
 or to publish  cases and operations in the daily prints, or sutler such
 publications to be made ;—to invite laymen to be present at opera-
 tions,—to boast of cures and remedies,—to adduce certificates of skill
 and success, or to  perform any other  similar acts.   These are the
 ordinary practices  of empirics, and  are highly reprehensible  in  a
 regular physician.

  § 4. Equally derogatory to professional character is it, for  a physi-
 cian to hold a patent for any surgical  instrument, or medicine; or to
 dispense a  secret nostrum, whether it  be the composition or exclusive
property of himself, or  of others.   For, if such nostrum be of real
efficacy, any concealment regarding it is inconsistent with beneficence
and professional  liberality; and, if mystery alone give it value and
importance, such craft implies either disgraceful ignorance, or fraud-
ulent avarice.  It is also reprehensible for physicians to  give certifi-
cates  attesting the  efficacy of patent or secret medicines, or in any
way to promote the use of them.
  Art. 2.   Professional services of Physicians to each other.
  § 1. All practitioners of medicine, their wives and  their children,
while under the paternal care, are entitled to the gratuitous services
of any one or more  of the faculty residing near them,  whose assist-
ance  may be desired.  A physician afflicted with disease is  usually
an incompetent judge of his own case ; and the natural  anxiety  and
solicitude which he  experiences at the sickness of a wife, a child, or
any one who by the  ties of consanguinity is rendered peculiarly dear
to him, tend to obscure his judgment, and produce timidity and irres-
olution in his practice.  Under such circumstances, medical men are
peculiarly dependent upon  each other, and kind offices  and profes-
sional aid should  always be cheerfully  and gratuitously afforded.
Visits ought not, however, to be obtruded officiously ; as such unasked
civility may give rise to embarrassment, or interfere with that choice
on which confidence depends.  But, if a distant  member of the  fac-
ulty, whose  circumstances  are affluent, request  attendance, and an
honorarium  be  offered, it should not be declined ; for no pecuniary
obligation ought to  be imposed, which the party receiving k would
wish not to incur. 
9
  Art. 3.   < >f the duties of Physicians as respects vicarious offices.
  § 1.  The affairs of life, the pursuit of health, and the various acci-
dents and  contingencies to which a medical man is  peculiarly  ex-
posed, sometimes require him temporarily to withdraw from his duties
to his patients, and  to  request some of his professional brethren to
officiate for him.  Compliance with this request is an act of courtesy,
which should always be performed with the utmost consideration for
the interest  and character  of the  family physician ; and when exer-
cised for a short period, all the pecuniary obligations for such service
should be awarded  to him.  Eut if a member of the profession neg-
lect his business  in quest of pleasure and amusement, he  cannot be
considered as entitled to the advantages of the frequent  and long-
continued exercise of this fraternal courtesy, without awarding to ihe
physician who officiates, the fees  arising  from the discharge  of his
professional duties.
  In obstetrical and important surgical cases, which give rise to unu-
sual fatigue, anxiety and responsibility, it is just that the fees accru-
ing therefrom should be awarded to the physician who officiates.

  Art. 4.   Of the duties of Physicians in regard to consultations.
  § 1.  A regular medical  education furnishes the  only  presumptive
evidence of professional abilities and acquirements, and ought to be
the only acknowledged right  of an individual to  the  exercise  and
honors of his profession.  Nevertheless, as in  consultations the good
of the patient is the  sole object in view, and this is often dependent
on personal confidence, no intelligent regular  practitioner, who has a
license to practice from some medical board of known and acknowl-
edged  respectability, recognized  by this association, and  who is in
eood moral and professional standing in the place in which he resides,
should be fastidiously excluded from fellowship, or  his  aid  refused in
consultation when it is requested by the patient.  But no one can be
considered as a regular practitioner, or a  fit associate in consultation,
whose  practice  is based on an exclusive dogma, to the rejection of the
accumulated experience of the profession, and of the aids actually
furnished by anatomy, physiology, pathology, and organic  chemistry.

  §  2.  In consultations, no rivalship or jealousy should be indulged ;
candor, probity, and all due  respect, should  be  exercised towards
the physician having charge of the  case.

  § 3.  In consultations, the attending physician  should be  the first to
propose the necessary  questions to the sick ; after  which the consult-
in<>-  physician should have the opportunity to make' such  farther in-
quiries of the patient as mav  be necessary to satisfy him of the  true
character of the ease.   Both phvsicians should then retire to a private
place for deliberation ; and the one first in attendance should commu- 
10
nicate the directions agreed upon to the patient or his friends, as well
as any opinions  which it may be thought proper to express.   But no
statement or discussion of it should take place before the patient or
his friends, except in the presence of all the faculty attending, and
by their common consent;  and no opinions or prognostications should
be delivered, which  are not the result of previous deliberation and
concurrence.

   § 4.  In  consultations, the physician in attendance should deliver his
opinion first;  and when there are several  consulting,  they should
deliver their opinions in the order in which the}' have been called in.
Xo decision, however, should restrain  the attending physician from
making such variations in the mode of treatment, as any subsequent
unexpected change  in the character of the case may demand.  But
such variation and the reasons for it ought to be carefully detailed at
the next meeting in  consultation.   The same privilege belongs also to
the consulting physician if  he is sent for in an emergency, when  the
regular attendant is out of the way, and similar  explanations must
be made by him at the next consultation.

   § 5.  The utmost punctuality should be observed in the visits of
physicians when they are  to hold  consultation together; and this is
generally  practicable, for society has been considerate enough to allow
the plea  of a professional  engagement  to  take precedence of all
others, and to be an  anrple reason for the relinquishment of any
present occupation.  But as professional engagements may sometimes
interfere,  and delay  one of the parties, the physician who first arrives
should wait for  his  associate a reasonable period, after which  the
consultation should be considered as postponed to a new appointment.
If it be the attending physician who is present, he  will of course see
the patient  and  prescribe ; but if it be the consulting one, he should
retire, except in case of emergency, or when he has been called from
a considerable distance, in  which latter case he  may examine the  pa-
tient, and give his opinion in writing and under seal, to be delivered
to his associate.

   § 6;  In  consultations, theoretical discussions should be  avoided, as
occasioning perplexity and loss of time.   For  there may be much
diversity of opinion  concerning speculative points, with perfect agree-
ment in those  modes of practice which are founded, not on hypothe-
sis, but on experience and observation.

   § 7.  All discussions  in consultation should be held as secret and
confidential.  Neither by words nor manner should any of the par-
ties to a consultation assert or insinuate  that any part of the treat-
ment pursued did not  receive his assent.  The responsibility must
be equally divided between the  medical  attendants,—they must
equally share the credit of  success as well as the blame of failure. 
11
  § 8.  Should an  irreconcilable diversity  of opinion occur  when
Beveral physicians arc called upon to consult together, the opinion of
the majority should be considered as decisive ; but if the numbers be
equal on each side, then the decision should rest with the attending
physician.  It may, moreover, sometimes happen that two physicians
cannot agree in their views of the nature of a  case and the treatment
to be  pursued.   This is a circumstance much to  be deplored, and
Bhould always be avoided,  if possible, by mutual concessions, as far
as they can be justified by a conscientious regard for the dictates of
judgment.  But in  the  event of its occurrence, a  third physician
should, if practicable, be called to act as umpire, and if circumstances
prevent  the  adoption of this course, it must be left to the patient to
select the physician in whom he is most willing to confide.   But as
every physician relies upon the  rectitude of his judgment, he should,
when  left in the minority, politely and consistently retire from any
further deliberation in the  consultation, or participation in the man-
agement of the  case.

   § !t. As circumstances sometimes occur  to render a special consul-
tation  desirable, when the  continued attendance of two physicians
might be objectionable  to  the patient, the member of the faculty
wliose assistance is required in  such cases, should sedulously guard
against all future unsolicited attendance.   As such consultations re-
quire  an extraordinary portion both of time  and attention, at least  a
double honorarium may  be  reasonably expected.

   § 10. iV physician who is called upon to  consult, should observe
 the most honorable and scrupulous regard for the character and stand-
ing of the practitioner in  attendance: the practice  of_the latter, if
 necessary, should be justified as far as it can be, consistently with
 a conscientious regard for truth, and no hint or insinuation should be
 thrown  out, which  could impair the confidence reposed in him, or
 affect his reputation.  The  consulting physician should also  carefully
 refrain from any one of those extraordinary  attentions or assiduities,
 which are too often practiced by the dishonest for the base purpose
 of gaining applause, or ingratiating themselves into the favor of fam-
 ilies and individuals.

    Art. 5.   Duties  of Physicians in cases of interference.
   § 1. Medicine is a liberal profession, and  those  admitted into its
 ranks should found their expectations of practice upon the extent of
 their qualifications, not on  intrigue or artifice.

   § 2. A physician, in his  intercourse with a patient under the care
 of another practitioner, should observe the strictest caution and re-
 serve. No meddling inquiries should be made ; no disingenuous hints
 given relative to the nature and treatment of his disorder; nor any 
12
course of conduct pursued  that  may directly  or indirectly tend to
diminish the trust reposed in the  physician employed.

   § 3. The same circumspection and  reserve  should be observed,
when, from motives of business or friendship, a physician is prompted
to visit an individual who is under the direction of another practi-
tioner.   Indeed, such visits  should be avoided, except under peculiar
circumstances; and when  they  are made, no  particular inquiries
should be instituted relative to the nature of the disease, or the rem-
edies  employed, but  the topics of conversation should be  as foreign
to the case as  circumstances will admit.

   § 4. A physician ought not to take charge  of, or prescribe for a
patient who has recently been under the  care  of another member of
the faculty in  the same  illness, except in cases of sudden emergency,
or in  consultation  with the physician previously in  attendance, or
when the latter has relinquished  the case, or been regularly notified
that his services are no longer desired.  Under such circumstances no
unjust and  illiberal insinuations  should be thrown out in relation to
the conduct or practice  previously pursued, which should be justified
as far as candor, and regard for truth and probity will permit;  for it
often  happens  that patients  become dissatisfied when they do not ex-
perience immediate  relief, and, as many  diseases are naturally pro-
tracted, the want of success, in the first stage of treatment, affords no
evidence of a  lack of professional knowledge and skill.

  § 5. When a physician is called to  an urgent  case, because the
family attendant is not at hand, he ought,  unless his assistance in con-
sultation be desired, to  resign the care of the patient to  the  latter
immediately on his arrival.

  § 6. It often happens, in cases of sudden illness, or of recent  acci-
dents  and injuries, owing to  the alarm and anxiety of friends, that a
number of physicians are simultaneously  sent for.  Under these cir-
cumstances courtesy should assign the patient to the first who arrives,
who should  select from  those present  any additional assistance that
he may deem necessary. In all such cases, however, the practitioner
who officiates  should request the  family physician, if there be one, to
be called, and, unless his further attendance be requested, should re-
sign the case to the latter on his arrival.

  § 7. "When a physician is  called to the patient of another practi-
tioner, in consequence of the sickness  or absence of  the latter, he
ought, on the return or recovery of the regular attendant, and with
the consent of the patient, to surrender the case.

  § 8. A physician, when visiting a sick person in the  country, may 
13
be desired to see a neighboring patient who is under the  regular  di-
rection of another physician, in consequence of some sudden change
or aggravation of symptoms.   The conduct to be pursued on such an
occasion is to give advice adapted to present circumstances; to inter-
fere no farther than is absolutely necessary with the general plan of
treatment; to assume no future direction, unless it be expressly  de-
sired ;  and, in this  last case, to request an  immediate  consultation
with the practitioner previously employed.

   § 9.  A wealthy physician should not give advice gratis to the afflu-
ent,  because his doing so is an injury to his professional brethren.
The office of a physician can never be supported as an exclusively be-
neficent one ; and it is defrauding, in some degree, the common funds
for its support, when  fees are dispensed with which might justly be
claimed.

   ij  10. When a physician who has been engaged to attend a  case
 of midwifery is absent, and another is sent for, if delivery is accom-
 plished during the  attendance of the latter, he is entitled to the  fee,
 but should resign the patient to the practitioner first engaged.


   Art.  6.   Of differences between Physicians.
   § 1. Diversity of opinion, and opposition of interest, may, in the
 medical, as in other  professions, sometimes occasion controversy and
 even  contention.  Whenever  such  cases unfortunately  occur, and
 cannot be  immediately terminated, they should  be referred to the
 arbitration of a sufficient number of physicians, or  a court-medical.
   As peculiar reserve must be maintained by physicians towards the
 public, in regard to professional matters, and as there exist numerous
 points in medical  ethics and etiquette through which the feelings of
 medical men may  be painfully assailed in their intercourse with each
  other, and which  cannot  be  understood  or appreciated  by general
  society, neither the  subject matter of such differences nor the  adju-
  dication of the arbitrators should be made public, as publicity in a case
  of this nature may be personally injurious to the individuals concern-
  ed, and can hardly fail to bring discredit on the faculty.

    Art. 7.   Of Pecuniary Acknowledgments.
    § 1. Some general rules should be adopted by the faculty, in every
   town or  district, relative to  pecuniary  acknowledgments  from  their
   patients; and it  should  be  deemed a point of honor to adhere to
   these rules with  as much  uniformity as  varying  circumstances will
   admit 
11
                       CHATTER  III.

 OF THE DUTIES OF THE PROFESSION TO  THE  PUBLIC,
   AND OF THE OBLIGATIONS  OF THE  PUBLIC  TO  THE
   PROFESSION.

  Art. 1.   Duties of the profession to the public.
  § 1.  As good citizens, it is the duty of physicians to be  ever vigi-
lant for the welfare of the community, and to bear their part  in  sus-
taining its institutions and burdens.   They should also be  ever ready
to give counsel to the  public in relation to matters especially apper-
taining to their profession,  as  on  subjects  of medical  police, public
hygiene, and legal medicine.  It  is  their province to enlighten the
public   in regard  to quarantine regulations,—the  location, arrange-
ment, and dietaries of hospitals, asylums, schools, prisons, and similar
institutions,—in relation to the medical  police of towns, as drainage,
ventilation, &c,—and  in regard  to  measures for  the prevention of
epidemic and contagious diseases; and  when pestilence prevails, it is
their duty to face the danger, and to  continue their labors  for the
alleviation of the suffering, even at the  jeopardy of their own lives.

  § 2.  Medical men should always be  ready, when called on by the
legally constituted authorities, to enlighten  coroners'  inquests  and
courts  of justice, on subjects strictly medical,—such as involve ques-
tions relating to sanity, legitimacy, murder by poisons or other violent
means, and  in  regard to the various  other subjects embraced in the
science of Medical Jurisprudence.  But in these cases, and especially
where  they  are required to make a post mortem examination, it is
just, in consequence  of the time, labor and  skill  required, and the
responsibility and  risk they  incur, that the public should award them
a proper honorarium.

  § 3.  There is no profession by the  members of which eleemosy-
nary services are more liberally dispensed, than the medical, but jus-
tice requires that some limits should  be placed to the performance of
such good offices.  Poverty, professional brotherhood, and  certain
public  duties, referred  to in section  1 of this chapter, should always
be recognized as presenting valid claims for gratuitous services; but
neither institutions endowed by  the public  or by rich individuals,
societies for  mutual  benefit, for the insurance of lives or for analo-
gous purposes, nor any profession or occupation, can be admitted to
possess such  privUege.   Nor can it be  justly expected of physicians
to furnish certificates of inability to serve on juries, to  perform mili-
tia duty, or  to testify to the state of  health of persons wishing to in-
sure their lives, obtain  pensions, or the  like,  without a pecuniary
acknowledgment.   But to  individuals in indigent  circumstances, 
15
such professional services  should  always be cheerfully  and freely
accorded.

  § 4. It is the duty of physicians,  who are frequent witnesses of the
enormities committed by quackery, and the injury to health and even
destruction of life caused by the use of quack medicines, to enlighten
the public on these subjects, to expose the injuries sustained by the
unwary from the devices and pretensions of artful empirics and  im-
postors.  Physicians  ought to use all the influence which they may
possess, as  professors  in Colleges  of Pharmacy, and by exercising
their option in regard to the shops  to which their  prescriptions shall
be sent, to discourage druggists and apothecaries from vending quack
or secret medicines, or from being in any way engaged in their man-
ufacture and sale.

  Art. 2.  Obligations of the Public to Physicians.
  § 1.  The benefits accruing to the public  directly and indirectly
from the activ.e  and unwearied  beneficence of the profession, are so
numerous  and  important, that  physicians are justly entitled to  the
utmost consideration and respect from  the community.  The public
ought likewise to entertain a just  appreciation  of medical qualifica-
tions ;—to make a proper discrimination between true science and
the assumptions of ignorance and  empiricism,—to afford every  en-
couragement and facility for the acquisition of  medical education,—
and no  longer to allow the  statute books to exhibit the anomaly of
exacting knowledge from physicians, under Hability to heavy penal-
ties, and of making them  obnoxious to punishment for resorting to
the only means of obtaining it.
ARMED TORCES M    ./UUBRArT1 
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