Medical Ethics

Zhang Zhan, a famous scholar in the Eastern Jin Dynasty, said: “To master the classics of medicine is difficult and the difficulty is long-standing.” Nowadays diseases are sometimes interiorly the same but exteriorly different, and sometimes interiorly different but exteriorly the same. Thus it is difficult to examine the conditions of the five Zang-organs and the six Fu-organs as well as the circulation of the blood, nutrient Qi and defensive Qi simply by means of listening and observation. It is necessary that the pulse be taken to make an accurate diagnosis. However, the Cun, Guan and Chi divisions of the Cunkou (the pulsation of the radial artery) may be either floating, or sunken, or taut, or tense; the circulation of Qi and blood through the acupoints may be either upward, or downward, or shallow, or deep; the skin, muscle and bones may be either thick, or thin, or strong, or weak. Only those who are very cautious and conscientious can be discussed with such an abstruse theory.

However some unqualified doctors nowadays study such a profound and excellent theory with very simple and crude thinking. Is not it dangerous? If sthenia syndrome is treated with nourishing therapy, asthenia syndrome with purging therapy, incontinence with drainage therapy, constipation with blockage therapy, cold syndrome with cold therapy and heat syndrome with warm therapy, it will undoubtedly worsen the disease. Those quack doctors may hope to save the patients in such a way, but I believe that the patients treated will certainly die. That is why the knowledge of medicine and divination are very difficult to be mastered. Without the inspiration of the immortals, how could one understand the profound theory of medicine!

Nowadays some ignorant people who have studied medicine for just three years claim that no disease is incurable to them. However, after three years of practice, they have begun to realize that no prescriptions are applicable. So those who are ready to devote themselves to medicine must try to search for the origin of medicine and work hard in their studies. They should not believe hearsay. If they think that they have mastered all the knowledge of medicine, then they will surely mislead themselves.

When great doctors treat patients, they are usually calm and concentrated without any desire and avarice. They have great sympathy with the patients and are determined to save the people from suffering. If the patients come to ask for help, they would not treat them differently by seeing whether they are rich or poor, old or young, beautiful or ugly, enemy or friends, Chinese or foreigners and foolish or intelligent. They would treat all the patients like their close relatives. In treating patients, they would not think over and over for themselves and pay too much attention to the protection of their own life. Being doctors, they should regard patients’ suffering as their own and have deep sympathy with them. Confronted with danger, they should not try to avoid it. No matter in the daytime or night and in winter or summer, and no matter when they are hungry or thirsty and tired or exhausted, they should work for the patients heart and soul without any delay and contemplation for personal gain or loss. Only by doing so can one become a great doctor for the people. Otherwise he will surely become a scourge of the people.

From the ancient times, celebrated doctors treated patients by using the live animals. Although it is believed that animals are humble and human beings are noble. However in terms of the love for life, human beings and animals are the same. To kill one for the saving of another is regarded as a disaster even in the animal world, let alone human beings! To kill animals to save human beings actually deviates from the right way of saving life. That is why the prescriptions recorded in my book have excluded the use of live animals. Some insects, like horsefly and leech which were dead before being sold on the market, can be bought and used in prescriptions. This does not include in what is mentioned above. The only exception is the egg which is in chaos and can only be used under emergency as a last resort. Those who do not make use of it are the true great doctors. I myself can never come up to such a high standard. Sometimes patients are suffering from scabies or dysentery with foul smell and unpleasant sight appearing disgusted in the eyes of other people. But as a doctor, one should have deep sympathy with the patients and not be weary in any way. That is what I wish to do.

A great doctor should be easy in manner, quiet in spirit, strict in self-examination, noble in appearance, magnanimous in breadth of mind and neither supercilious nor obsequious in manner. In collecting pathological information and diagnosing disease, the doctor should pay great attention to distinguishing syndromes without any errors and deciding treatment with great accuracy. It is true that a disease must be treated as immediately as possible. However in actual practice, the doctor has to keep calm in emergency and takes all factors into consideration in making diagnosis and performing treatment. In dealing with the life of the patients, the doctor should try to avoid showing off and building up reputation for himself, because that is absolutely immoral. When entering into the patient’s home full of beautiful things, he should never cast his glance about. When the musical sound played around, he should not appear entertained; when delicious food is served, he should feel tasteless; and even when mellow wine is offered, he should keep undistracted. Why I emphasize this? Because one person’s suffering will make the whole family said, let alone the suffering of a patient which is constant. Under such a situation, if the doctor indulges himself in entertainment and appears self-important, he will be condemned by both human beings and the immortals. The great doctors with high morality never behave that way because this is just where medical tenets lie in.

Besides, being a doctor, one should never talk extravagantly, laugh uproariously, gossip at length, speak about others, show off oneself, slander other doctors and boast his own ability. Once accidentally curing a patient, one may put on airs, appear proud or feel unequalled. All that mentioned above is the most serious diseases that doctors tend to develop.

Therefore doctors should never try to use their techniques to make money for themselves, but always have great sympathy with the patients. When they have finally entered the other world, they will feel much happier. Furthermore, doctors should never prescribe the rich patients with precious drugs difficult to collect for the purpose of showing off his own talent. This behaviour, undoubtedly, does not agree with the ideas of humanity and virtue. Since I am determined to devote myself to saving the lives of the people, I have put forward some suggestions in the above for doctors to follow. I think that those who devote themselves to medicine will not regard what I have said as nonsense.

大医精诚英语翻译