Historical development of medical ethics

The Hippocratic Oath in the 4th century BC is the earliest medical ethics document. Its essence is that doctors should take measures beneficial to patients according to their own "ability and judgment" and keep patients' secrets.

The two ethical standards adopted by the World Medical Federation, namely 1948 Geneva Declaration and 1949 Medical Ethical Standards, have developed the spirit of the Hippocratic oath and clearly pointed out that the health of patients is the first concern of medical staff, and medical staff should keep patients' secrets, treat colleagues as brothers and stick to the medical profession without exception.

The ancient Indian Vedas in the 1 century and the Asaf Oath in the 7th century also put forward similar requirements for doctors. In the 7th century AD, China and Sun Simiao also wrote down the code of conduct of doctors in the article "Great Doctor Sincerity", such as "If a patient comes to ask for help, don't ask whether he is rich or poor, old or young, friendly or not, ignorant or not, vulgar or not, all of which are like the thoughts of his closest relatives; It is also not allowed to look ahead, worry about good or bad, protect one's life and so on.

Medieval western Catholic scholars discussed medical ethics from the perspective of Christian theological ethics and put forward the theory of double effect, that is, an action can cause intentional and direct effects, as well as unintentional and indirect effects; If it is not intentional, the indirect adverse effects brought by an action can be tolerated under certain conditions. Protestant scholars are very close to Catholicism, but they emphasize that patients should be informed and make decisions about their medical problems.

Non-religious medical ethics is developed on the ideological tradition of Locke, Jefferson and the Bill of Rights. Nuremberg Code 1940 is the embodiment of this tradition, which abandons the old concept that subjects are protected by researchers and replaces it with a new concept that subjects have the right to make their own decisions and thus need informed consent.

But by the end of the 20th century, there was a tendency to return to the Hippocratic tradition, thinking that patients' autonomy was not absolute, and everything should focus on patients' interests. The post-Hippocratic oath emphasizes the priority of patients' interests, but it also contains the content of respecting patients' values and rights that the original Hippocratic oath does not have.