Science as public culture: chemistry and Enlightenment in Britain, 1760–1820

does indeed discuss the duties of physicians earlier than Percival, but not in the distinctive form of a code. The code format-a numbered compilation of moral rules of conduct-was introduced into English-language medical ethics by Percival. Here, for example, is an excerpt from Percival's Rule I1.3, which deals with the ethics of diagnosing "incurable" conditions: "A physician should not be forward to make gloomy prognostications ... by magnifying the importance of his services in the treatment or cure of the disease. But he should not fail ... to give to the friends of the patient, timely notice of danger... and even to the patient himself, if absolutely necessary.... For the physician should be minister of hope and comfort to the sick; that by such cordials to the drooping spirit, he may smooth the bed of death." It is a pity that Albarracin chose to engage in spurious scholarship instead of analysing what Gregory and Percival actually said about the ethics of diagnosis. Darrel Amundsen's 'Some conceptual and methodological observations on the history and ethics of diagnosis' demonstrates the dangers of attempting to practise history a priori. Noting that "the ethics of diagnosis has not yet been isolated for special scrutiny as a circumscribed ethical category" in standard works on medical ethics, Amundsen asks "How. .. may the historian construct a meaningful history of ethics of diagnosis?" (p. 49). After a protracted analysis he hedges, but is essentially sceptical. He is misled, in part, by the expectation that diagnosis must deal with discrete diseases (as it has since the nineteenth century) rather than conditions (the norm from the Hippocratics through Percival). He is also deceived by the strong association between ethics and therapeutics in modem medicine. Knowing that, before the nineteenth century, medicine de-emphasized therapeutics and lacked a nosology with clearly delineated diseases, Amundsen is sceptical about the very possibility of a history of the ethics of diagnosis, a priori. In striking contrast, Lain-Entralgo approaches the question a posteriori. By reexamining the Hippocratic corpus he discovers injunctions governing diagnosis in the context of prognosis-and thereby uncovers an ethic that, as the rule from Percival's Medical ethics cited above illustrates, was still important in the early nineteenth century. The moral of this tale is that the history of medical ethics is a branch of history; it is thus inextricably wedded to empirical evidence-and even sceptical theories must be validated by such evidence. …