1-04 2 STATUTES REGULATING THE PRACTICE 2 OF PHYSIC AND SURGERY IN THE STATE OF NEW-YORK; THE BY-LAWS ICXL MEDICSL SOCIETY OF THE COUNTY OF NEW-YORK, ADOPTED IJtJLY FOURTEENTH, 1828. ALSO A SYSTEM MEDICAL ETHICS, AS ADOPTED BY THE NEW-YORK STATE MEDICAL SOCIETY. PUBLISHED BY ORDER OF THE SOCIETY. NEW-YORK: PRINTED BY J. SEYMOUR, JOHN-STREET. 1828. STATUTES REGULATING THE PRACTICE OF PHYSIC AND SURGERY , IN THE STATE OF NEW-YORK; AND THE BY-LAWS OF THE MEDICAL SOCIETY OF THE COUNTY OF NEW-YORK, * » * ADOPTED JULY 14, 1828. PUBLISHED BY ORDER OF THE SOCIETY. — T. SEYMOUR, JOHN-STREET. S28. 1228 AN ACT TO INCORPORATE MEDICAL SOCIETIES. THE PRACTICE OF PHYSIC AND SURGERY IN THIS STATE. INCLUDING AMENDMENTS TO JAN. 1828 Whereas well regulated Medical Societies have been found to contribute to the diffusion of true science, and particularly the knowledge of the heal- ing art: Therefore, I. Be it enacted by the people of the State of New- York, represented in Senate and Assembly, That it shall and may be lawful for the physicians and surgeons in the several counties of this state, now authorized by law to practise in their several professions, except in those counties wherein medical societies have been already incorporated, to meet together on the first Tuesday of July next, at the place where the last term of the court of common pleas next previous to such meeting was held in their respective counties; and the several physicians and surgeons so convened as aforesaid, or any part of them, being not less than five in number, shall proceed to the choice of a pre- sident, vice-president, secretary, and treasurer, who 4 shall hold their offices for one year, and until others shall be chosen in their places; and whenever the said societies shall be so organized as aforesaid, they are hereby declared to be bodies corporate and po- litic, in fact and in name, by the names of the Medi- cal Society of the county where 6iich societies shall respectively be formed; and by that name shall be in law capable of suing and being sued, pleading and being impleaded, answering, and being answered unto, defending and being defended, in all courts and places, and in all matters and causes whatsoever ; and shall and may have a common seal, and may alter and renew the same at their pleasure : Provided always, That if the said physicians and surgeons shall not meet and organize themselves at such time and place as aforesaid, it shall be lawful for them to meet at such other time as a majority of them shall think proper, and their proceedings shall be as valid as if such meeting had been at the time before specified. 2. And be it further enacted, That the medical soci- eties of counties already incorporated, shall continue to be bodies corporate and politic, in fact and in name, by the names of the Medical Society of the county where such societies have respectively bee ----- Rodgers John R. B. Rodgers John Kearney Rogers David Rogers David L. Rogers James H. Rogers J. Smyth Rhinelander John R. Riley Henry A. Seaman F. W. See John Simpson Archibald B. Smith Albert Smith Gilbert Smith J. Augustine Smith Joseph M. Smith T. L. Smith W. S. Saynisch Ludovich Stearns John Sterling John W. Stevens Alexander H. Stillwell William Sweeney Hugh Swift William Scott William S. Tomlinson David Townsend Peter S. Trenor John | Tuite---- Upson Hiram Underhill Richard Van Gelder Abraham Van Beuren Thomas Van Dorin Garrit Van Rensselaer Jeremiah Van Solingen Henry M. Van Arsdale Peter Van Arsdale Philip Ver Meule Richard Walker Richard L. Watts jun. John Weed John W. Wilson Abraham D. Willet Marinus Winthrop Egerton L. Wright Amaziah Wright Clark Wolfe Elias Wolf J. Leo Wood Isaac Williams A. V. i Yates Christopher (' A SYSTEM MEDICAL ETHICS. PREPARED BY THE STATE MEDICAL SOCIETY ADOPTED AND BEPnBUSHED BT THE MEDICAL SOCIETY OP THE COUNTY OF NEW-YORK. Testor, Apolliuem medicucu, et iEsculapiunj,------me quantum io me erit, et quantum ibgeoium tneniu valebit, bsc omnia observaturum ; vitam meam atque artem meam puran ■atque integraraservaturum Ev Hippocratti jurejurando. A SYSTEM OF MEDICAL ETHICS. A system of Medical Ethics comprises all the moral prin- ciples and regulations which should govern physicians and surgeons in the exercise of their professional avocations with the public in general, in private and confidential cases, as well as in their intercourse with other medical men, and before magistrates and courts of justice. Such a system may be reduced to the form of a code of medical police, exhibiting maxims and precepts in five re- spective divisions of medical ethics, under the following heads. 1st. Personal Character of Physicians. 2d. Quackery. 3d. Consultations. 4th. Specifications of Medical Police in Practice. 5th. Forensic Medical Police. Note.—Precepts and Articles of the code of Medical Police are seve- rally arranged under a series of numbers: FIRST DIVISION. PERSONAL CHARACTER OF PHYSICIANS. It would be difficult to determine which of the three learned professions in society requires the most virtue, or the most lo punt^, and perfection of personal character. Those only can judge who are themselves acquainted with the difficulties to be surmounted in the study of medicine and surgery, and the labour and extent of the long course of experimental ob- servation which it is necessary to pursue, before the confidence of the public can be attained. The life of a physician is, on the whole, a continued struggle against prejudices and erro- neous habitudes of the mind, and not unfrequently against ingratitude,* exclusive of the personal hazard among the sick, the fatigue, and the loss of ordinary comfort and rest which it necessarily involves. I. A physician cannot successfully pass through his career without the aid of much fortitude of mind, and a religious sense of all his obligations of conscience, honour, and hu- manity.f His personal character should, therefore, be that of a perfect gentleman, and above all, be exempt from vulga- rity of manners, habitual swearing, drunkenness, gambling, or any species of debauchery, and contempt for religious practices and feelings.J II. The confidence of the public cannot be awarded to a physician who has rendered himself notorious for felony or misdemeanour, or who has incurred penalties for crimes. * It unfortunately happens, that the only judges of medical merit art' those who have sinister views in concealing and depreciating it. [John Gregory, M.D. Led. I. on the Duties, fyc. p. 17. Lond. cd. t Hence appears the necessity of a physician having a large share ol good sense and knowledge of the world, as well as medical genius and learning. [J. Gregory, M.D. Led. J. page 17. ! The most celebrated physicians who to this day remain our models and masters were religious men. I know none among the living wbo can be judged greater than Stahl, Boerhaave, Linnaeus and Haller, who always beaded their works by an invocation to the Supreme Ruler. [F. E. Poderr. Vid. Diction, dessciences medicate*, art. Me/1, pol.icf 49 . III. A physician in indigent circumstances is not permitted to embrace or exercise any business which would degrade the character of his profession ; such as keeping a tavern, lottery- office, gambling, victualling, or play-house. Any low trade or servile mercenary occupation is incompatible with the dig- nity and independence of medical avocations. In such ex- treme and derogatory situations a physician forfeits the pri- vileges of his profession. SECOND DIVISION. The importance of the medical profession requires that it should be exercised with fidelity to its scientific principles and approved doctrines; with honour to all its members ; and with justice and humanity to the sick. A departure from the above principles constitutes quackery ; which degrades the medical character by ignorance, artifice, unapproved methods of practice, and by the use of remedies dangerous to health and life. IV. Any physician or surgeon who divides his responsibi- lity with a known quack, and associates with him in medical consultations, receiving a fee or the usual charges for such services, or practices with nostrums, secret medicines, or pa- tent remedies, is guilty of quackery. V. The right of a patent medicine being incompatible with the duty and obligation enjoined upon physicians to advance the knowledge of curing diseases, it constitutes quackery, and cannot be professionally countenanced. 7 50 VI. Public advertisements, or private cards, inviting cus- tomers afflicted with defined diseases; promising radical cures j engaging for no cure, no pay ; offering advice and medicines to the poor, gratis; producing certificates and signatures even from respectable individuals in support of the adverti- ser's skill and success, and the like ; are all absolutely acts of quackery, which medical institutions should always repress, and punish by the rejection or expulsion of those who commit them. THIRD DIVISION. CONSULTATIONS. All the individuals composing the Colleges and Medical Societies constituted by the legislature of this State, are by them, qualified Physicians and Surgeons. The two profes- sions of Medicine and Surgery are blended by the law, both in the schools and in practice. The examinations by the cen- sors of the county and state societies of candidates for the degree of license; and by the professors of colleges for the de- gree of doctor ; are equally directed to embrace in their ex- ercises the elements and doctrines of both sciences, establish- ing thereby the candidate's proficiency, not only in medicine, but in surgery. There are no degrees of qualifications, nor are different rights assigned to the members of the same pro- fession, but such as result from their individual choice, skill, and fitness. Practical surgery is more properly attended to by the younger members, but the more experienced should be deemed competent to direct or inspect either the theoretical or practical departments. These remarks are offered, to show that the distinction fre- quently adopted in practice, and especially in consultation, between physicians and surgeons, confining each other to sur- ■>1 gical or medical external or internal cases, has no foundation in propriety, and if adhered to, arises from the wish to in- dulge in personal or interested motives. It is admitted, how- ever, that when the question is merely to perform some ope- rative process, a practical surgeon should be selected in pre- ference ; but this exception is only applicable, when a physi- cian declines (on such accounts as he may think proper,) to perform a necessary operation, and by no means invalidates the principle established in the state of New-York, in confor- mity to Medical Ethics.* VII. A consultation of one or many physicians is like a deliberating committee, over which a senior in age or experi- ence presides, each one, however, being equally responsible for the trust assigned to him of the cure or relief of the pa- tient. The attending physician is exclusively charged with the execution of the treatment, from day to day, nor is any consulting physician ever allowed to .visit or inspect, unless it be with his colleagues, or by agreement, or in cases of emergency. When a surgical operation is required, it devolves upon the senior practitioner of surgery in the consultation, or on one especially appointed.f VIII. A diversity of opinion in consultation is to be re- gretted, for if unavoidable, it must cause much delay and * Among the moderns, the arts of physic and surgery have often been promiscuously practised by the same person : for example, Hildanus, Sc- verinus, Bartholine, and many others of distinguished genius and learning. ......The separation of physic from surgery in modern times has been productive of the worst consequences. [J. Gregory, Led. II. p. 44. f In consultations, the junior physician or (or the physician in ordinary) should deliver his opinion first, and the other, in the progressive order of ^enioritv. fT' Percival> Med' Etkie*< P- 1 p- ;iiany inconveniences before a medical umpire can be ob- tained. It is needless to point out what a correct sense of delicacy will in this ca«e require from a gentleman who in sj>it of his opposition, finds himsilf in the minority; he should politely retire from the consultation, and if he be the fa.T:ily physician, he should consistently resign his deliberative voU* IX. A great reserve, and even secrecy respecting the deli- berations of a consultation is indispensable. No communi- cation is to be made to the patient or friends but by unani- mous order and consent; because, whatever opinions are emitted, become subject to frequent alterations or inversions from mouth to mouth, and may become a source of contra- diction perhaps injurious to some of the physicians in atten- dance. X. It is the duty of a consulting physician to take care that hi= visits be not multiplied without necessity. He is, through courtesy, at liberty to decide when to discontinue his attendance. A consulting physician, however, cannot be dis- missed without the consent of the patient as well as of the attending physician. XI. Physicians are justly censurable if their patient be in danger and they do not, in time, procure advice and respon- sibility beside their own. Whoever be the motive that in- duces them to dispense with a consultation, they certainly may expose their reputation by an incorrect judgment or * Every physician must rest on his own judgment which appeals for its rectitude to nature and experience alone. [J. Gregory, Led. I. on the duties and qualities, SfC. Land, ed.p.14. But an obstinate adherence to an unsuccessful method of treating a dis- ease, is self-conceit—it generally proceeds from ignorance—it is a species of pride to which the lives of thousands have been sacrificed.—[lb. p. 28. misapprehension of their patient's case, and weaken the con- fidence reposed in them. And a physician does not acquit himself correctly toward his patient if he does not benefit him with the best advice that can be procured. Poverty or the narrowness of means to remunerate an additional practi- tioner is no reasonable excuse ; for he can scarcely deserve the name of a practising physician, who cannot find at least one medical friend to consult, when the life or limb of a fel- low creature is in jeopardy. FOURTH DIVISION. SPECIFICATIONS OF MEDICAL ETHICS IN PRACTICE. XII. It is not intended in this system of Medical Ethics to -instruct physicians and surgeons upon every felonious act of infanticide, murder, &c. for which the penal statutes of this country have made sufficient provision. It is incumbent upon medical authorities to consider, condemn, and punish as cri- minal, such acts of medical practitioners as offend the respec- tive obligations of married persons, or the chastity and mo- desty of the youth of both sexes. This restrictive definition is to be applied, 1st. To the personal conduct of medical men, who abuse the confidence of families, and become exposed to legal da- mages for crim. con. or seduction, fyc. 2d. To those who with a view of curing diseases or cor- recting certain natural imperfections, prescribe remedies or advise remedial means that must interfere with matrimonial rights and the observance of a chaste and moral life. The scope of opinion on this subject may be wide, and the pretexts in palliation numerous, but the dependence of the .Jl public upon our labours, for the preservation of health, and the cure of diseases, ought to be held sacred ; nor can confi- dence be granted to a profession that should allow any of its members to violate hospitality, to promote immorality, or to be accessary to vicious and criminal conduct. XIII. Honour and justice particularly forbid a medical practitioner's infringing upon the rights and privileges of another who is legally accredited, and whose character is not impeached by public opinion, or civil or medical authority ; whether he be a native, or a stranger settled in the country. There is no difference between physicians but such as results from their personal talents, medical acquirements, or their ex- perience ; and the public, from the services they receive, are the natural judges of these intellectual advantages. In all probability, every good physician would receive a merited share of patronage, were there not many who usurp a portion through artful insinuations, and slanders of others, or combi- nations against, or improper interferences with the more wor- thy practitioner. Any physician thus molested or injured, is justifiable in applying for redress to the county medical soci- ety to which he is attached. XIV. A physician is not to visit a patient placed under another practitioner's care, without previous and ostensible friendship or business, nor without first informing the attend- ing physician ; if then he thinks it proper to advise, he may do it, but it must be in conformity to the rules of consultation as above explained. XV. Libellous attacks among physicians are no doubt sub- ject to the same mode of redress by damages as the law points out to other citizens ; but we hold that matters of libel include professional and practical acts, whether true or false, pub- lished or stated to any person who is not a competent judge, with a view to injure the professional reputation of a physi- cian. This identical principal was adopted by the Supremp 65 Court of Pennsylvania in the trial of Benjamin Rush v. Wm. Cobbelt, alias Porcupine, in which a verdict of $4000 da- mages was awarded to the plaintiff for a libel founded in a malicious representation of the plaintiff's practice, made to the public by the defendant. XVI. If medical controversies are brought before the pub- lic in newspapers or pamphlets, by contending medical wri- ters, and give rise to, or contain assertions or insinuations injurious to the personal churacter or professional qualifica- tions of the parties, such papers are unquestionably disrepu- table to the medical community; for those who should be foremost in the pursuit of truth, ought to be the last to set an example of an illiberal, indecorous, and revengeful deport- ment, so contrary to what is expected from literary and scien- tific gentlemen. Such papers are therefore to be reported by the censors to their respective county medical societies, and the authors are liable to such punishment as the cases may re- quire. It is a matter of justice, necessity, and propriety, that the business of a physician and surgeon should be always consi- dered of a confidential nature. Even secrecy in certain cir- cumstances, as will be explained hereafter, is the privilege of the faculty, and inviolable even in a court of justice. In or- dinary practice, common sense, decency and delicacy should, in familiar conversation with females and persons uninstructed in medicine, always exclude such topics as patients, diseases, remedies, operations, and the like. A display of ternfic and wonderful relations of diseases, remedies, wounds, operations, and cures, is frequently indulged in, no doubt ad captandam, yet in most cases they produce but an equivocal admiration for the narrator, and prove beside, his very imperfect know- ledge of human nature. Those who are not fam.l.ar with the subjects of medical art and study, are liable to draw mis- taken and contradictory inferences from what they hear con- cerning them. Hence many people suppose that a physic.an ,nt is an uuteeling man ; and assimilate a good surgeon to a butcher. The more talk therefore, the more numerous the misrepresentations set afloat, and the greater the diffidence, distrust, or disrespect excited. XVII. The exposure of the nature of the complaint which a physician is called upon to judge or cure, subjecting the patient to public shame or impeaching his moral character, is an unpardonable breach of Medical Ethics. XVIII. " The poor," says Boerhaave, " are the best cus- tomers, because God will be the paymaster." Instead of fee, they give in exchange the benefit of experience, of useful ob- servation, and frequently the gratification of successful ad- vice, which is more exactly followed by them than by the rich, who too often spoil the best directions by their whimsical no- tions and love of comfort. The most lucrative and extended patronage a physician can enjoy, far from being an honoura- ble pretext for not affording some attention to the poor, stands as a proof of his selfishness or want of humanity. XIX. In urgent cases of sickness, or of injuries occasioned by accidents, a call for medical or surgical help should be obeyed immediately, unless such compliance be to the detri- ment of some other sufferers. It often happens in such cases that many physicians, and more than are required, meet on the spot. Courtesy then assigns the patient to the first phy- sician or surgeon who arrives, and if he should want assist- ance, he has a right to request it from a physician or practical surgeon present, according to the nature of .the case. But if the physician or surgeon who usually attends the family or patient be of the number, then the present urgent case is as- signed to him. In the event of the concurring attendance of many medical gentlemen, no fee is to be exacted for the trouble of coming, unless called up' n by <=ome authorized person. An accidental an injury is distress, and help for a fellow-being in distress is claimed by the laws of nature.* XX. The fees for the compensation of medical services are regulated by the value of currency and the price of necessa- ries in different countries and cities; by the customs approved and established among experienced and reputable practition- ers ; and sometimes by a recorded rate of charges, such as individuals belonging to any trade or profession adopt by general consent. It must be recollected however, that this last mode has been forbidden physicians and surgeons in their corporate capacity, by a resolution of the State Medical So- ciety of New-York, in the year 1817. This is in conformity to the common law of England, according to which, services rendered by advice cannot constitute a pecuniary debt, and much less in the medical profession, which " is too honoura- ble," said a chief justice of that country, (Lord Erskine) " to be subjected to a defined rate of charges." It follows from this, that medical services are not legally entitled to re- muneration, except for the employment of time, medicines, and personal labour in attending upon the sick. But public opinion in a civilized nation, and among the more enlightened classes of society, will always highly estimate and liberally compensate medical services. A strict sense of justice and honour towards each fellow- member of the profession, should prevent a physician from undervaluing his services, by items and charges in his bills, ' * Dr Gregory says, (p. 1*9) "that under such circumstances conside. ra Js o^^^enevoJc; humanity, and gratitude are wholly set as.de: for disputes arise, ^VS^'X^^ pubce.' H • W■*>'» hut„MemI!itJOI1l,fore>1penSCSoftraiii,port- 58 beneath the customary rate, with a view to draw patronage by exciting comparisons. A practitioner may settle his de- mands with his patrons on whatever terms he pleases, but he has no right to make the law or change an established usage to the prejudice of his brethren. The reputation of a cheap doctor, after all, is neither dignified nor enviable. Others will follow quite a contrary method. They will place an exorbitant value on their time and labour, and exact oppressive demands for their services. The conduct of such has a very injurious influence upon the lower and middling classes of society, who, needing medical aid, are deterred from applying to any physician, lest they should incur ruin- ous charges. These expensive doctors should be reminded that whenever a person pays a bill which he thinks extrava- gant and unreasonable, he easily repays himself, and gratifies: his vanity if not his resentment, by divulging how much mo- ney he has been willing to bestow ; what liberality he has ex- ercised ; or to what imposition he has been exposed ! Some physicians, more intent on acquiring wealth than a good name, exact from their patients their charges, whether great or small, with unrelenting severity, refusing time to procure the necessary means, often having recourse to law- suits, disregarding the plea of low circumstances, or absolute want, thus creating much distress. Such conduct is as disre- putable to the physician as it is disgraceful to humanity, for the highest aim of the profession, is to reach its utmost requi- sitions. These extortioners, as they dishonour the medical profession, by a single act of such oppression, deserve a pub- lic reprimand, if not a prompt expulsion from their county medical society. Whenever a physician is reduced to obtain his professional fees by compulsory measures, it is his duty first to propose, and then to prefer the settlement of the matter io contention by a reference to arbitrators. .V9 XXI. It is enjoined in the sacred obligation which Hippo- crates imposed upon the pupils of the noble science of medi- cine and surgery, which is also the model of the like engage- ment offered to the candidates for graduation in this and other countries ; that they shall respect and assist their preceptors and masters, their seniors by experience or age, and shall contribute as far as in their power, to the honour, improve- ment, and utility of their professions. According to this pre- cept, physicians and surgeons have something more to do, than to procure their livelihood. As they are indebted to the labours, talents, and experience of their predecessors in the healing art for all that constitutes its admirable body of doctrine ; so present and future generations look to them for some additional improvement, because much can yet be done to extend its usefulness. This obligation is unbecomingly violated by many physicians who pretend to eminence ; they estrange themselves from medical associations—never have any observation or improvement to communicate,—their de- gree of skill and exper ence always remains unknown and mysterious,—they screen themselves from scientific labours and controversies, and, as if incompetent, never contribute by any effort, however small, to the advancement of the medical character. Such practitioners, although they are frequently popular and wealthy, are, nevertheless, only comparable to drones in the bee-hive : medical associations should refuse to confer upon them offices, appointments, or even employments i« committees ; on the principle that proofs are wanting of their talents, zeal, judgment, and professional emulation. FIFTH DIVISION FORENSIC MEDICAL POLICE. XXII There are numerous accidents and offences, the na- ture and degree of criminality of which are determined by medical opinion. Human passions daily occasion acts of lid violence which fall under the cognizance of public justice ; and diseases of the mind, whether arising from vice, intem- perance, sickness, or accident, have also their share of influ- ence iu the commission of crime; and often lead their unfor- tunate victims to suicide and murder. Crime so originating could be perpetrated in ways so disguised as to conceal the authors or the means by which they were accomplished, were it not that juries can be assisted by medical men in evidence relating to physiology. A physician should always be in readiness to answer in thesejurisdictional inquisitions, and to give an opinion, on facts referred to his judgment, according to the approved doctrines of medicine and surgery, as far as these are ascertained. Ignorance, or an imperfect knowledge upon matters which place life, honour, and innocence in a fatal predicament, is unpardonable, and should subject any physician so illiterate, to disqualification for the privileges of his profession. XXIII. To well instructed physicians only two rules need to be recommended. The one relating to their conduct when they are called upon to give professional evidence ; and the other, to the nature and extent of the secrecy which they are bound to maintain in relation to their patients. 1st. When physicians engaged in the decision of a forensic question are unbiassed by the parties, and have no interest for plaintiff or defendant, (being well informed of all the facts alleged in evidence) they have only to decide by known medical principles, and can therefore rarely disagree. It is their duty to obtain every possible information upon the case, and before giving in their declaration, candidly and conscien- tiously to canvass each other's opinions, so that erroneous ideas may be removed, and information participated.* Two ; When two or more gentlemen of the faculty are to offer their opinions or testimony, it would sometimes tend to obviate contrariety if Ulev were to confer freely with each other before their publu; examination. [T i'ercival, Med. tithics, rh. 4, p. J07. bi or more physicians on one side of a question, should in the same manner freely communicate, in order to guard against versatile and contradictory declarations, for which the trivial sarcasm, " doctors differ," is no excuse, as they always inva- lidate their opinions, authority, decisions, and respectability. 2d. The second rule is that of secrecy upon facts with which physicians become professionally acquainted, or are invited to ascertain ; such as whether an apparent pregnancy be real; the gestation and birth of a child; its parentage, colour, and age ; the judgment and treatment of syphilitic and gonorrhceal diseases ; the able or disabled state of a per- son, in limb or constitution ; the fallacy of virginity and other circumstances, to the confession of which, a degree of shame, and the idea of exposure is attached, and which are never mentioned but with an engagement to secrecy. This duty has been defined by comparing it to that of the Catholic Confessional, which admits of no disclosures except in cases of treason or murder.* This inference has been ac- knowledged by the judiciary of New-York, and, in its appli- cation to medical matters, admitted by that of Philadelphia, in the year 1800 ;f and the Medical Society of the State of * The sacred duty or privilege of a catholic priest not compellable to disclose the secrets of auricular confession, was maintained by a decision of the court of sessions of New-Yqrk, 14th June, 1813. Id the case ot the Rev. Mr. K. refusing his testimony on a matter of felony. {Vide Cathol. Quest. Report, by Wm. Sampson, Esq. | The same secrecy was vindicated to a physician (by a superior court of Philadelphia, 1800) refusing the disclosure of his professional acts. aeainst a plaintiff suing for Divorce, on the plea of adultery. Manv persons would rather suffer or die, than be exposed to shame or disgrace from the complaints they are labouring under. It is a law of na- t«r°e that they should seek for cure or relief and be protec ed by profe, sional secrecv. even if a matter of persecution should arise therefrom. \\j07niwii'rr t.n New-York have adopted the same principle, so extended a* to include felony. But this great privilege of the medical profession ought to be limited by discretion and regulated by a strong sense of moral duty ; it should never be exercised to the injury of innocence, or the violation of the rights of justice, or when it might operate to the dishonour or distress of families. Note.—The following precept of Medical Police having been accidentally omitted in the Report of the Committer, and reinstated only after the adjournment of the State Medical Society, is here placed, under the authority which they have given for revision and notes. Physicians are often requested to declare to the patient his danger, and to urge his observance of religious and testamen- tary acts: but medical aid, in extremely dangerous cases, would seldom be of any avail, if in place of composing the mind of the sufferer, physicians were to doom it to despond- ency and despair. Such services are incompatible with their duty of administering hope and comfort, without the influence of which, many doubtful cases of disease might at once be- come positively fatal. To a christian minister alone, or to some other authorized person, therefore, appertains the task of disclosing to the pa- tient his alarming situation, and preparing his mind to meet with composure that event, which to his friends may appear inevitable. Physicians should not interfere in the final settlement of their patients' worldly affairs. These are eventually com- posed of various family claims and pretensions ; and a phy- sician's interference in their distribution may be taxed as G3 arising from interested motives, or be thought by those con- cerned to be a disgraceful violation of the confidence reposed on his humane functions as medical attendant. In order to protect himself, and to place his name beyond the reach of any implication, he should, 1st. Give timely and explicit information of the dangerous situation of the patient to those who have the best right to advise him in his religious and temporal concerns. 2d. He should inform them of a possibility of a change in the prognostic, in order to prevent any relaxation of care and attention on the part of nurses and others, that no chances of the patient's recovery be lost through neglect. 3d. The physician in such a case should continue his per- sonal attendance, which is the more proper, as he entertains or has acknowledged some hopes of a favourable change : should he be dismissed from pecuniary motives, his respon- sibility nevertheless requires a friendly or gratuitous atten- tion.* * " It is as much the business of a physician to alleviate pain and to smooth the avenues of death, when unavoidable, as to cure diseases." [Vide 7 Gregory's Lectures, Lond. ed. p. 35, and Benj. Rush's Ap- pendix on the Duties of a Physician, Art. XL J NATIONAL LIBRARY OF MEDICINE ii 111111 ii in 11111 ii 111 in Mil 11111 mi mi in in m in iin n Ni_n DmMaaTS t i *F/ - '-Pit':' 8b i$f < :i';v:-.