Old ethics: new dilemmas.

MEDICAL ethics may be described as a code of behaviour accepted voluntarily by the profession, as opposed to statutes and regulations imposed by official legislation. In many instances these are synonymous; for example, ethical matters constituting "infamous conduct" have for over a century been guarded by an official body, the General Medical Council. Numerous aspects of medical practice still fall outside official legislation but are none the less relevant to the doctor's behaviour and conscience, the limits being set by the approbation or disapproval of his colleagues. Much of medical ethics consists of good manners and civilised behaviour in the general sense, but there are certain matters which are peculiar to the practice of the profession of medicine. In Britain those aspects of medical behaviour which fall outside formal legislation are largely left to the conscience of the individual doctor: but the British Medical Association through its ethical committee has a particular interest in codifying, publicising and enforcing these ethical considerations upon its members. The oldest code of medical ethics is the one well known to medical and lay persons alike, the Hippocratic Oath. Though now some twenty-five centuries old its basic tenets remain as valid as ever, but they are framed, in archaic language and formulation, and however historically attractive have become anachronistic, leading to its restatement in the Declaration of Geneva. Formerly the Hippocratic Oath was pledged by new doctors at graduation ceremonies, but sadly this is now rare; even so the newly admitted practitioner still accepts its spirit and intentions. Following the gross transgression of medical ethics during the Second World War, the World Medical Association (at the instigation of the British Medical Association) reconstituted the Hippocratic Oath in modern style, this being known as the "Declaration of Geneva." Upon this, an international code of medical ethics was based. The Declaration of Geneva states: