The development of medical ethics -a sociological analysis.

IT IS A curious fact that despite the rapidly growing volume of literature on the professions, little work has been done by sociologists on the development of professional ethics. This omission becomes doubly curious when one considers the central importance attributed to professional ethics in much of the literature on professions; given this situation one can hardly aspire to an adequate sociological analysis of the development of professional occupations which does not include an analysis of the development of professional ethics. This paper aims, in a modest way, to help fill this gap by analysing the origins and early development of modem medical ethics. The most famous of all codes of medical ethics is probably the Hippocratic Oath, which Edelstein dates from the fourth century B.C." From time to time, slightly modified forms of the oath were developed, for example to allow Christians to take what was originally a pagan oath, and although there was no body which enforced the ethical rules contained in the Hippocratic Oath, it appears to have had some influence on medical practice. Thus Chauncey D. Leake has pointed out that prior to the end of the eighteenth century, "the medical profession tried generally to handle its ethical problems on the basis of the Greek tradition of good taste and personal honor".2 However, ifwe wish to understand the development of specifically modem codes of medical ethics, we must look not to ancient Greece, but to nineteenthcentury England, and in particular, to the work of Thomas Percival, whose Medical ethics, published in 1803, marks an important break-point between ancient and modem medical ethics. As Leake has pointed out, it was Percival who, more than any other person, effected the "transition from the broad principles of Greek medical ethics to the current complicated system".3 This view of Percival as the founder of modem codes of medical ethics is shared by most medical men. Thus Forbes has referred to Percival's work as a "prominent landmark in the progress and evolution of medical ethics", and adds that "No later work has modified in any material degree the precepts and practice defined by Percival for the conduct of a physician".4 Barton has written that Percival "compiled the first modem code of medical ethics"," while McConaghey comments that the "rules of conduct of modem times stem from the small book published in 1803 by Thomas Percival".6 While it is difficult to over-estimate the importance of Percival's book, it would be quite wrong to see it, in an almost asocial sense, purely as the work of a gifted individual, for Percival's work is simply the most famous of a number of publications by *Ivan Waddington, B.A., is Lecturer in Sociology, University of Leicester.