When were medical ethics created?
Medical Ethics (book)
Medical Ethics; or, a Code of Institutes and Precepts, Adapted to the Professional Conduct of Physicians and Surgeons is a medical book focused on public health and medical ethics. It was written by English physician Thomas Percival and published in 1803. The book is widely regarded as the first on public health and ethics in medicine. Prior to 1803 medical ethics was more focused on medical etiquette. "Medical Ethics" was the first book to coin the term "medical ethics". The book "adopts a holistic approach to patient care" and set the standard for many future textbooks.
Patient safety
Millennia ago, Hippocrates recognized the potential for injuries that arise from the well-intentioned actions of healers. Greek healers in the 4th century BC drafted the Hippocratic Oath and pledged to "prescribe regimens for the good of my patients according to my ability and my judgment and never do harm to anyone." 
Since then, the directive "primum non nocere" (“first do no harm) has become a central tenet for contemporary medicine. However, despite an increasing emphasis on the scientific basis of medical practice in Europe and the United States in the late 19th Century, data on adverse outcomes were hard to come by and the various studies commissioned collected mostly anecdotal events.
AMA Journal of Ethics
The AMA Journal of Ethics is a monthly open-access (no subscription or publication fees) publication that includes peer-reviewed content, expert commentary, podcasts, medical education articles, policy discussions, and cases. It is a MEDLINE-indexed, online-only ethics journal. It was established in 1999 as Virtual Mentor, obtaining its current name in 2015. It is published by the American Medical Association and the editor-in-chief is Audiey C. Kao. Themes are student- and resident-driven, and issue editors are selected annually to work with editorial staff and expert contributors.
Centre for Human Bioethics
The Centre for Human Bioethics is a research and teaching centre at Monash University, based in the Faculty of Arts. It focusses on the branch of ethics known as bioethics, a field relating to biological science and medicine. It was founded in October 1980 by Professors Peter Singer and Helga Kuhse, as the first centre in Australia devoted to bioethics, and one of the first in the world.
MacLean Center for Clinical Medical Ethics
MacLean Center research has been on the cutting edge of both medicine and ethics, with clinical research proceeding in tandem with medical advances. The MacLean Center was involved in the introduction of pediatric live-donor liver transplantation in 1989. This new procedure raised complex ethical questions about medical innovation, risk/benefit balancing, informed consent, and the protection of "living organ donors". The MacLean Center worked for two years with transplant experts at the University of Chicago to review the ethical issues, publish protocols, and encourage professional discussion of the procedure before it was first performed on a patient. The MacLean Center’s transplant work is one example of the wide range of ethics-related research projects undertaken by its faculty. The MacLean Center faculty publishes on subjects such as research ethics, health policy, health disparities, end of life care, surgical ethics, pediatric outcomes, genetics, and transplantation ethics. Current and former MacLean Center faculty and fellows have published more than 150 books in the field of medical ethics.
Cambridge Quarterly of Healthcare Ethics
The Cambridge Quarterly of Healthcare Ethics is a quarterly peer-reviewed academic journal in the field of bioethics. It was established in 1992 with the goal of exploring “the many implications of both the broader issues in healthcare and society and of organizational concerns arising in the institutions in which ethics committees are located.” Its primary focus, as indicated in its title, is healthcare ethics, understood as distinct from clinical ethics, medical ethics, and academic ethics insofar as it is inductive, interdisciplinary, and concerned with “the character and traditions of the institutions in question.” One of its primary goals has been to integrate “many disciplines as they apply to the work of healthcare ethics committees. In the pages of this journal will be found sections devoted to medicine, law, philosophy, economics, research, theology, education, behavioral and social sciences, and more — with a focus on practical applications in committee settings."
Medical ethics
James Childress and Tom Beauchamp in "Principle of Biomedical Ethics" (1978) identify beneficence as one of the core values of healthcare ethics. Some scholars, such as Edmund Pellegrino, argue that beneficence is the "only" fundamental principle of medical ethics. They argue that healing should be the sole purpose of medicine, and that endeavors like cosmetic surgery and euthanasia are severely unethical and against the Hippocratic Oath.
History of hospitals
English physician Thomas Percival (1740–1804) wrote a comprehensive system of medical conduct, "Medical Ethics; or, a Code of Institutes and Precepts, Adapted to the Professional Conduct of Physicians and Surgeons" (1803) that set the standard for many textbooks.
In the mid 19th century, hospitals and the medical profession became more professionalized, with a reorganization of hospital management along more bureaucratic and administrative lines. The Apothecaries Act 1815 made it compulsory for medical students to practice for at least half a year at a hospital as part of their training. An example of this professionalization was the Charing Cross Hospital, set up in 1818 as the 'West London Infirmary and Dispensary' from funds provided by Dr. Benjamin Golding. By 1821 it was treating nearly 10,000 patients a year, and it was relocated to larger quarters near Charing Cross in the heart of London. Its Charing Cross Hospital Medical School opened in 1822. It expanded several times and 1866 added a professional nursing staff.
Public Health Ethics
Public Health Ethics is a triannual peer-reviewed academic journal covering bioethics as it pertains to public health. It was established in 2008 and is published by Oxford University Press. The editors-in-chief are Angus Dawson (University of Sydney) and Marcel Verweij (University of Sydney). According to the "Journal Citation Reports", the journal has a 2016 impact factor of 1.259.
Yeshiva University
The Yeshiva University Medical Ethics Society (MES), is an undergraduate student-run organization of Yeshiva University which was founded by students in the fall of 2005 with the help of the Center for the Jewish Future toward the goal of promoting education and awareness of Jewish medical ethics in the university itself and the community at large. Since that time, MES working with the CJF has grown from a small group of students with common interests to running events with university-wide participation. In the first several years, they hosted a program of on-campus lectures by experts in the field of medical ethics and Halakha (Jewish law). Topics covered have included stem cell research, cloning, do not resuscitate orders, genetic testing, pre-implantation genetic diagnosis, and birth control. They also host genetic testing events to help combat the high incidence of various genetic diseases in the Jewish community. The Society hosts events throughout the year, including an annual conference focused on a chosen medical ethics topic. The events are open to all those who have an interest in learning more about Jewish medical ethics.
Raanan Gillon
Raanan Evelyn Zvi Gillon FRCP (born April 1941) was a professor of medical ethics at Imperial College London (1995–1999) where he now holds an emeritus chair. A general practitioner until his retirement in 2002, he edited the "Journal of Medical Ethics" from 1980 to 2001. Gillon is credited with making "a major philosophical contribution to critical thinking about moral issues raised by the practice of medicine" and with being "the leading British advocate and interpreter of Beauchamp and Childress's four principles approach" to moral reasoning in healthcare.
Diploma in the Philosophy of Medicine
The curriculum was created by Michael Lockwood in 1978, with assistance from Raanan Gillon. Its structure reflects philosophical developments as applied to medicine. It is the oldest philosophy and ethics of medicine and healthcare course in the UK. Previously, the diploma was earned after a two-year study period on alternating Saturdays, and was predominantly attended by graduates and medical students. After an extensive revision in 1993, the course was shortened to one year and opened up to a wider range of students.
Medical ethics
Since the 1970s, the growing influence of ethics in contemporary medicine can be seen in the increasing use of Institutional Review Boards to evaluate experiments on human subjects, the establishment of hospital ethics committees, the expansion of the role of clinician ethicists, and the integration of ethics into many medical school curricula.
Michigan State Medical Society
Formation of the Michigan State Medical Society took place June 5, 1866 in the Supreme Court Room of Odd Fellows Hall in Detroit, near Woodward and E. Jefferson Avenues. About 100 physicians from all areas in Michigan were present. The society pledged "to elevate professional and medical education and to cultivate the advancement of medical science." The society also adopted the code of ethics of the American Medical Association (AMA).
Professionalization
A publication in the 1840 "British Medical Journal" revealed an increase in professional consciousness from medical practitioners in England. Physicians in the 19th century came to have the features of modern professions. A major one was autonomy. This was further emphasized with the establishment of a controlling body of the profession. Competition and overcrowding (two or three decades after 1930) also put pressure on governments to establish a system of registration and requirements for those who wished to practice. This led to the Medical Act of 1840. In fact, this council consisted mostly of doctors. Therefore, they were in control of regulating their own profession. The act required their members to oversee medical education, keep track of the numbers of qualified practitioners, and regulate it for the government. Pg 688. It gave the qualified more power and set limitations on the unqualified. The exclusion from government service of the unqualified practitioners was the most influential policy. Along with the act, the qualified practitioners came to be known as the “officially recognized” healers, and as such had a competitive advantage in the job market.
To reduce competition, the Medical Act also raised the standards for qualifications in 1858. A modern codes of medical ethics were also implemented in the 19th century. Again, this proves the high degree of power that the profession had. As a result, many medical practitioners came to experience ethical problems. Unlike today, it was more the concern of the behavior of doctors towards each other, than towards their patients. It is suggested to be due by the changes of the medical world in the first half of the nineteenth century. Unlike the pre-industrial age, distinctions between say surgeons and physicians were greatly reduced, to replace a division of mostly consultants and general practitioners.
Mark Siegler
The MacLean Center for Clinical Medical Ethics at the University of Chicago has played a major role in creating, establishing, and expanding the field of clinical medical ethics. In 1983, the MacLean Center was established after receiving a naming gift from Dorothy Jean MacLean and the MacLean family. Inspired by the clinical models of William Osler and Alvan Feinstein, the MacLean Center has helped to change and expand American medical ethics by helping to bring ethics to the bedside. Regarding the MacLean Center, the Johns Hopkins Berman Institute of Bioethics stated: "the training program established by you, including more than 450 fellows across almost 35 years, has had a greater impact than any other clinical ethics training program in the world. Through generations of scholars, you have populated the field of clinical ethics in perpetuity."
Islamic ethics
Islamic ethics (أخلاق إسلامية), defined as "good character," historically took shape gradually from the 7th century and was finally established by the 11th century. It was eventually shaped as a successful amalgamation of the Qur'anic teachings, the teachings of the Prophet Muhammad, the precedents of Islamic jurists (see Sharia and Fiqh), the pre-Islamic Arabian tradition, and non-Arabic elements (including Persian and Greek ideas) embedded in or integrated with a generally Islamic structure. Although Muhammad's preaching produced a "radical change in moral values based on the sanctions of the new religion and the present religion, and fear of God and of the Last Judgment", the tribal practice of Arabs did not completely die out. Later Muslim scholars expanded the religious ethic of the Qur'an and Hadith in immense detail.
Media ethics
One theoretical question for media ethics is the extent to which media ethics is just another topical subdivision of applied ethics, differing only in terms of case applications and raising no theoretical issues peculiar to itself. The oldest subdivisions of applied ethics are medical ethics and business ethics. Does media ethics have anything new to add other than interesting cases?
British Medical Association
The Medical Ethics Committee provides guidance to the association on current and developing issues in medical ethics. It is widely seen as one of the foremost authorities on ethical issues in the UK and international medical field. The committee debates issues of principle including those touching on:Issues considered by the committee include abortion, organ donation and presumed consent, patient confidentiality, and the Mental Capacity Act.
Council for International Organizations of Medical Sciences
The "International Ethical Guidelines for Biomedical Research Involving Human Subjects", sometimes informally referred to as
"CIOMS Guidelines", is a set of ethical principles regarding human experimentation created in 1993 by CIOMS and updated in 2002. These 21 guidelines (15 in the original report) address issues including Informed consent, standards for external review, recruitment of participants, and more. The Guidelines are general instructions and principles of ethical biomedical research.. 
In 2016 new CIOMS ethical Guidelines titled "International ethical guidelines for health-related research involving humans" were published. These guidelines were prepared in collaboration with WHO and address additional topics. They stress the need for research that has scientific and social value, provide special guidance for health-related research in low-resource settings, detail the provisions for involving vulnerable groups in research, and describe under what conditions biological samples and health-related data can be used for research.
Engineering ethics
In the United States, the National Society of Professional Engineers released in 1946 its Canons of Ethics for Engineers and Rules of Professional Conduct, which evolved to the current Code of Ethics, adopted in 1964. These requests ultimately led to the creation of the Board of Ethical Review in 1954. Ethics cases rarely have easy answers, but the BER's nearly 500 advisory opinions have helped bring clarity to the ethical issues engineers face daily.
Shared decision-making in medicine
One of the first instances where the term "shared decision-making" was employed was in a report on ethics in medicine by Robert Veatch in 1972. It was used again in 1982 in the "President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research." This work built on the increasing interest in patient-centredness and an increasing emphasis on recognising patient autonomy in health care interactions since the 1970s. Some would even claim that a general paradigm shift occurred in the 1980s in which patients became more involved in medical decision-making than before. For example, a 2007 review of 115 patient participation studies found that the majority of respondents preferred to participate in medical decision-making in only 50% of studies prior to 2000, while 71% of studies after 2000 found a majority of respondents who wanted to participate.
Medical ethics
A common framework used in the analysis of medical ethics is the "four principles" approach postulated by Tom Beauchamp and James Childress in their textbook "Principles of biomedical ethics". It recognizes four basic moral principles, which are to be judged and weighed against each other, with attention given to the scope of their application. The four principles are:The principle of autonomy views the rights of an individual to self-determination. This is rooted in society's respect for individuals' ability to make informed decisions about personal matters with freedom. Autonomy has become more important as social values have shifted to define medical quality in terms of outcomes that are important to the patient and their family rather than medical professionals. The increasing importance of autonomy can be seen as a social reaction against the "paternalistic" tradition within healthcare. Some have questioned whether the backlash against historically excessive paternalism in favor of patient autonomy has inhibited the proper use of soft paternalism to the detriment of outcomes for some patients.
History of medicine
The history of medicine shows how societies have changed in their approach to illness and disease from ancient times to the present. Early medical traditions include those of Babylon, China, Egypt and India. The Indians introduced the concepts of medical diagnosis, prognosis, and advanced medical ethics. The Hippocratic Oath was written in ancient Greece in the 5th century BCE, and is a direct inspiration for oaths of office that physicians swear upon entry into the profession today. In the Middle Ages, surgical practices inherited from the ancient masters were improved and then systematized in Rogerius's "The Practice of Surgery". Universities began systematic training of physicians around 1220 CE in Italy.
Van Rensselaer Potter
In 1970, Dr. Potter coined the term "bioethics" to describe a new philosophy that sought to integrate biology, ecology, medicine, and human values. Bioethics is often linked to environmental ethics and stands in sharp contrast to biomedical ethics. Because of this confusion (and appropriation of the term in medicine), Potter chose to use the term "global bioethics" in 1988. Awarded the Pfizer Award in Enzyme Chemistry in 1947.
Edward Shotter
Shotter is most notable for founding the London Medical Group in the mid-1960s. This was a forum for the discussion of the ethical issues of medicine and grew out of his work with the Student Christian Movement, the Diocese of London and the London Medical Deaneries. This group was widely exported to other UK medical schools. The group, its activities and members presaged the Society for the Study of Medical Ethics, later the Institute of Medical Ethics, which set up the "Journal of Medical Ethics". Shotter continues to be involved with the IME. Despite being involved with the LMG and its descendant organisations for over four decades he never lectured on the any particular medical ethical topic. He only ever chaired two meetings of the LMG, once because of the last-minute cancellation of the arranged chair. Ensuring that LMG was not seen as a 'chaplaincy exercise' was important to its success; Shotter ensured its impartiality and an even-handed representation all parties in debates.
Hippocrates
The Hippocratic Oath, a seminal document on the ethics of medical practice, was attributed to Hippocrates in antiquity although new information shows it may have been written after his death. This is probably the most famous document of the Hippocratic Corpus. Recently the authenticity of the document's author has come under scrutiny. While the Oath is rarely used in its original form today, it serves as a foundation for other, similar oaths and laws that define good medical practice and morals. Such derivatives are regularly taken today by medical graduates about to enter medical practice.
MacLean Center for Clinical Medical Ethics
In 1981, under the auspices of the MacLean Center, Mark Siegler and Richard Epstein organized a yearlong interdisciplinary seminar series on Bad Outcomes after Medical Intervention. The success of that initial seminar program demonstrated that there was great interest at the University of Chicago in creating a sustainable interdisciplinary forum to discuss health-related subjects with colleagues from across campus. Since 1981, the MacLean Center has sponsored an annual seminar series that has examined the ethical aspects of one key health related issue each year. Previous topics have included: Organ Transplantation, Pediatric Ethics, End-of-Life Care, Global Health, Health Care Disparities, Medical Professionalism, Confidentiality, and Pharmaceutical Innovation and Regulation.
Charles Marriot Culver
Charles Culver (November 7, 1934 – February 24, 2015) was a medical ethicist and a psychiatrist. He was primarily known for his work in medical ethics and his contributions in founding the field of bioethics in the United States.
Medical humanities
The first category is bioethics, which includes the morals of healthcare. As science and technology develop, so does healthcare and medicine, and there is discussion and debate in society and healthcare committees that go over the ethics of these certain situations that pertain to medical humanities. For example, one of these cases involves the practice of body enhancements in which the ethics of this practice are questioned due to the fact that bio-medical and technological practices are making changes to a person’s body to improve the body and/or its appearance.
Thomas Percival
Thomas Percival (29 September 1740 – 30 August 1804) was an English physician, health reformer, ethicist and author, best known for crafting perhaps the first modern code of medical ethics. He drew up a pamphlet with the code in 1794 and wrote an expanded version in 1803, "Medical Ethics; or, a Code of Institutes and Precepts, Adapted to the Professional Conduct of Physicians and Surgeons" in which he coined the expression "medical ethics". He was also a pioneering campaigner for public health measures and factory regulation in Manchester.
Accounting ethics
In 1887, the American Association of Public Accountants (AAPA) was created; it was the first step in developing professionalism in the United States accounting industry. By 1905, the AAPA's first ethical codes were formulated to educate its members. During its twentieth anniversary meeting in October 1907, ethics was a major topic of the conference among its members. As a result of discussions, a list of professional ethics was incorporated into the organization's bylaws. However, because membership to the organization was voluntary, the association could not require individuals to conform to the suggested behaviors. Other accounting organizations, such as the Illinois Institute of Accountants, also pursued discussion on the importance of ethics for the field. The AAPA was renamed several times throughout its history, before becoming the American Institute of Certified Public Accountants (AICPA) as it's named today. The AICPA developed five divisions of ethical principles that its members should follow: "independence, integrity, and objectivity"; "competence and technical standards"; "responsibilities to clients"; "responsibilities to colleagues"; as well as "other responsibilities and practices". Each of these divisions provided guidelines on how a Certified Public Accountant (CPA) should act as a professional. Failure to comply with the guidelines could have caused an accountant to be barred from practicing. When developing the ethical principles, the AICPA also considered how the profession would be viewed by those outside of the accounting industry.
Jewish medical ethics
Jewish medical ethics is a modern scholarly and clinical approach to medical ethics that draws upon Jewish thought and teachings. Pioneered by Rabbi Immanuel Jakobovits in the 1950s, Jewish medical ethics centers mainly around an applied ethics drawing upon traditional rabbinic law (halakhah). In addition, scholars have begun examining theoretical and methodological questions, while the field itself has been broadened to encompass bioethics and non-halakhic approaches.
Thomas Percival
He was a prominent member of the Manchester Literary and Philosophical Society, he holds an important place in the history of epidemiology for his analysis of the Bills of Mortality from 1772–6, and for his code of medical ethics. The latter was initially circulated privately as a book on jurisprudence in 1794 and as a result of solicited comments from colleagues then published in an expanded form with a change in title to Medical ethics in 1803. Percival had been asked by the Manchester Royal Infirmary to help with an internal dispute and became particularly concerned with the divisions that had arisen among the different branches of the profession – the physicians, surgeons, and apothecaries with their different backgrounds of training (university, hospital, and apprenticeship respectively). But he did not merely concern himself with intraprofessional relationships: he also laid down a code for conduct towards patients, whether rich or poor, and his ideas were rapidly taken up by the USA, Australia, and Canada — in fact, the ethical code introduced by the newly formed American Medical Association in 1847 used several passages taken directly from his book.
Research ethics consultation
Analogous to clinical ethics consultation, Research Ethics Consultation (REC) describes a formal way for researchers to solicit and receive expert ethical guidance related to biomedical research. The first REC service was established at the National Institutes of Health (NIH) Clinical Center in 1997. Today, most REC services are found at academic institutions, and the majority of current services were originally launched in response to the 2006 NIH Clinical and Translational Science Award program, as applicants to that program were required to have procedures in place to address ethical concerns raised by their research.
Medical ethics
Culture differences can create difficult medical ethics problems. Some cultures have spiritual or magical theories about the origins and cause of disease, for example, and reconciling these beliefs with the tenets of Western medicine can be very difficult.
Rhetoric of health and medicine
Starting with references to medical care in ancient Greece, Plato's “Dialogues”, expressed that physician-patient communication should not include any “lively interactions” between the physician and patient. In the Age of Enlightenment, Dr. John Gregory began to emphasize patient-physician communication by introducing the idea of preventative care for “gentleman of a liberal education.” Few found his suggestive style of care useful, and the view that “physicians must assume sole responsibility for protecting the ignorant public from its folly” lived on for some time. As late as the 1980s, the American Medical Association still had not incorporated regulations into their Code of Ethics that required physicians to incorporate patient opinion into the decision-making process. It was not until 1996 when the Health Insurance Portability and Accountability Act (HIPAA) was created to protect patient rights and privacy. This law was intended to assure patients that their wishes would be considered in treatment decision-making.
Medical Act 1983
The Medical Act 1983 (c 54) is an Act of the Parliament of the United Kingdom which governs the regulation and credentials of the medical profession, and defines offences in respect of false claims of fitness to practice medicine.
The Act 
consolidated the Medical Acts 1956 to 1978 and with certain related provisions and amendments gave effect to recommendations of the Law Commission and the Scottish Law Commission.
Henry K. Beecher
Work in medical ethics
World Medical Association
Even after the adoption of these two documents, WMA was constantly being informed about violations of medical ethics, crimes committed by doctors in time of war, unethical human experimentation, among several other problems in the field of medical ethics and medical law. This information caused the Council to establish a permanent Committee on Medical Ethics in 1952, which has been working actively ever since, as one can see from the declarations or statements of the WMA and their continuous updates.
Alastair Campbell (bioethicist)
With Kenneth Boyd, Campbell was joint secretary of the Edinburgh Medical Group. These medical groups were forerunners of the Society for the Study of Medical Ethics, founded in 1975, and which later became the Institute of Medical Ethics. From 1975-1980 Campbell was the founding editor of the Journal of Medical Ethics.
Raanan Gillon
In the late 1970s, assisting Michael Lockwood who introduced him to Beauchamp and Childress's principles of medical ethics, Gillon taught on the Worshipful Society of Apothecaries' course, DPMSA, on philosophical medical ethics, possibly the first such course in the UK. In 1983 he set up Imperial College's one week intensive course in medical ethics, one of the first courses on the subject in the UK. As of September 2017, the course continues to run and is advertised as running in September 2018.
APA Ethics Code
The first version was published by the APA in 1953. The need for such a document came after psychologists were taking on more professional and public roles post-World War II. A committee was developed and reviewed situations submitted by psychologists in the field who felt they had encountered ethical dilemmas. The committee organized these situations into themes and included them in the first document which was 170 pages in length. Over the years, a distinction was made between aspirational principles and enforceable standards. Since, there have been nine revisions with the most recent published in 2002 and amended in 2010.
Islamic ethics
The first documented description of a peer review process is found in the "Ethics of the Physician" by Ishaq ibn 'Ali al-Ruhawi (854–931) of al-Raha, Syria, where the notes of a practising Islamic physician were reviewed by peers and the physician could face a lawsuit from a maltreated patient if the reviews were negative.
Hippocratic Oath
The Hippocratic Oath has been eclipsed as a document of professional ethics by more extensive, regularly updated ethical codes issued by national medical associations, such as the AMA Code of Medical Ethics (first adopted in 1847), and the British General Medical Council's Good Medical Practice. These documents provide a comprehensive overview of the obligations and professional behaviour of a doctor to their patients and wider society. Doctors who violate these codes may be subjected to disciplinary proceedings, including the loss of their license to practice medicine. Nonetheless, the length of these documents has made their distillations into shorter oaths an attractive proposition. In light of this fact, several updates to the oath have been offered in modern times, some facetious.
Business ethics
As an academic discipline, business ethics emerged in the 1970s. Since no academic business ethics journals or conferences existed, researchers published in general management journals and attended general conferences. Over time, specialized peer-reviewed journals appeared, and more researchers entered the field. Corporate scandals in the earlier 2000s increased the field's popularity. As of 2009, sixteen academic journals devoted to various business ethics issues existed, with Journal of Business Ethics and Business Ethics Quarterly considered the leaders.
Health care quality
In 1990, the National Committee for Quality Assurance (NCQA) was entrusted to offer accreditation programs for managed care organizations. The NCQA was established as an independent non-profit dedicated to improving health care quality through accreditation and performance measurement. In 1991, Dr. Don Berwick's non-profit Institute for Healthcare Improvement (IHI) was founded. Rather than only focus on national health care quality improvement, IHI campaigned but nationally and worldwide. Directing the focus onto the patient as a consumer, the National Patient Safety Foundation was established in 1996. In 1998, by presidential directive, the Quality Interagency Coordination Task Force (QuIC) was created to increase coordination of federal agencies that work toward improving quality care. When the IOM published "To Err is Human" in 1999, revealing high medical error mortality rates, the QuIC published a report that inventoried regulatory and legislative initiatives that sought to improve issues surrounding medical error. Also in 1999, the National Quality Forum was founded. The private, non-profit forum aims to standardize health care delivery and measurements of quality. In response to the patient safety concerns discussed in "To Err is Human", the United States enacted the Patient Safety and Quality Improvement Act in 2005.
Charles Marriot Culver
In 1975 Culver and Dartmouth College Stone Professor Bernard Gert, founded the Dartmouth Hitchcock Medical Center Ethics Committee. Its primary function was/and still is to provide thorough and in-depth ethic consultation at the hospital. The DHMC Ethics Committee was one of the first ever established in the world and can be said to have been one of Culver's greatest achievements. Due to its foundation, Dartmouth Medical School began requiring medical ethics courses in its curriculum.
Ethics in religion
More developed ethical works emanated from Hasidean circles in the Maccabean time, such as are contained in Tobit, especially in Chapter IV. Here the first ethical will or testament is found, giving a summary of moral teachings, with the Golden Rule, "Do that to no man which thou hatest!" as the leading maxim. There are even more elaborate ethical teachings in the "Testaments of the Twelve Patriarchs", in which each of the twelve sons of Jacob, in his last words to his children and children's children, reviews his life and gives them moral lessons, either warning them against a certain vice he had been guilty of, so that they may avoid divine punishment, or recommending them to cultivate a certain virtue he had practised during life, so that they may win God's favor. The chief virtues recommended are love for one's fellow man, industry, especially in agricultural pursuits, simplicity, sobriety, benevolence toward the poor, compassion even for the brute and avoidance of all passion, pride, and hatred. Similar ethical farewell monitions are attributed to Enoch in the Ethiopic Enoch (xciv. et seq.) and the Slavonic Enoch (lviii. et seq.) and to the three patriarchs.
American Medical Association
In 1847 after a report by physician Nathan Smith Davis, sometimes called the "father of the AMA", American physicians met in Philadelphia and formed the AMA as a national professional medical organization, the first of its kind in the world, going on to establish uniform standards for medical education, training, and practice, the world's first national code for ethical medical practice. Ever since, the AMA Code of Medical Ethics dictates professional conduct for practicing physicians.
Erik Enger
Enger was born in Oslo. He was professor of internal medicine at the University of Oslo, and worked as a physician at Ullevål Hospital from 1973 to 1995. He chaired the ethical council of the Norwegian Medical Association from 1974 to 1985, and contributed to the public debate on medical ethics and jurisprudence.
Medical ethics
Historically, Western medical ethics may be traced to guidelines on the duty of physicians in antiquity, such as the Hippocratic Oath, and early Christian teachings. The first code of medical ethics, "Formula Comitis Archiatrorum", was published in the 5th century, during the reign of the Ostrogothic king Theodoric the Great. In the medieval and early modern period, the field is indebted to Islamic scholarship such as Ishaq ibn Ali al-Ruhawi (who wrote the "Conduct of a Physician", the first book dedicated to medical ethics), Avicenna's Canon of Medicine and Muhammad ibn Zakariya ar-Razi (known as Rhazes in the West), Jewish thinkers such as Maimonides, Roman Catholic scholastic thinkers such as Thomas Aquinas, and the case-oriented analysis (casuistry) of Catholic moral theology. These intellectual traditions continue in Catholic, Islamic and Jewish medical ethics.
Medical ethics
Well-known medical ethics cases include:
Raanan Gillon
Gillon has been involved with the development of medical ethics in the UK since the 1970s and has been called the UK's leading advocate and interpreter of the four principles approach to medical ethics, pioneered by Beauchamp and Childress. Based on a series of articles written for the BMJ, Gillon's book "Philosophical Medical Ethics" has been reprinted 13 times and he is a member of the BMA's medical ethics committee. Between 1981 and 2001 he edited the "Journal of Medical Ethics" and he was a longstanding chairman of the Institute of Medical Ethics, where he is now honorary president. In 1986 he received a travel scholarship from the RCP to visit the United States and visit a number of centres that were teaching medical ethics.
Medical ethics
In 1815, the Apothecaries Act was passed by the Parliament of the United Kingdom. It introduced compulsory apprenticeship and formal qualifications for the apothecaries of the day under the license of the Society of Apothecaries. This was the beginning of regulation of the medical profession in the UK.
Henry K. Beecher
Beecher's influential 1966 article on unethical medical experimentation in the "New England Journal of Medicine" — "Ethics and Clinical Research" — was instrumental in the implementation of federal rules on human experimentation and informed consent. A 1999 biography—written by Vincent J. Kopp, M.D. of UNC Chapel Hill and published in an American Society of Anesthesiologists newsletter—describes Beecher as an influential figure in the development of medical ethics and research techniques, though he has not been without controversy. The prestigious Beecher Prize, named in honor of Henry K. Beecher, is awarded annually by Harvard Medical School to a medical student who has produced exceptional work in the field of medical ethics. The Henry K. Beecher Award by The Hastings Center was established in 1976 in honour of the famous anesthesiologist, who was also its first recipient.
Jewish ethics
Jewish medical ethics is one of the major spheres of contemporary Jewish ethics. Beginning primarily as an applied ethics based on halakhah, more recently it has broadened to bioethics, weaving together issues in biology, science, medicine and ethics, philosophy and theology. Jewish bioethicists are usually rabbis who have been trained in medical science and philosophy, but may also be experts in medicine and ethics who have received training in Jewish texts. The goal of Jewish medical ethics and bioethics is to use Jewish law and tradition and Jewish ethical thought to determine which medical treatments or technological innovations are moral, when treatments may or may not be used, etc.
American College of Physicians
The Center for Ethics & Professionalism seeks to advance physician and public understanding of ethics and professionalism issues in the practice of medicine in order to enhance patient care by promoting the highest ethical standards. The sixth edition of the "ACP Ethics Manual" was published in 2012.
General Medical Council
The GMC sets standards of professional and ethical conduct that doctors in the UK are required to follow. The main guidance that the GMC provides for doctors is called Good Medical Practice. This outlines the standard of professional conduct that the public expects from its doctors and provides principles that underpin the GMC’s fitness to practise decisions. Originally written in 1995, a revised edition came into force in November 2006, and another with effect from 22 April 2013. The content of Good Medical Practice has been rearranged into four domains of duties. Their most significant change is the replacement of a duty to, "Act without delay if you have good reason to believe that you or a colleague may be putting patients at risk," to a new duty to, "Take prompt action if you think that patient safety, dignity or comfort is being compromised". Alongside the guidance booklet are a range of explanatory guidelines, including a new one about the use of social media. The GMC also provides additional guidance for doctors on specific ethical topics, such as treating patients under the age of 18, end of life care, and conflicts of interest.
Hospital
English physician Thomas Percival (1740–1804) wrote a comprehensive system of medical conduct, "Medical Ethics; or, a Code of Institutes and Precepts, Adapted to the Professional Conduct of Physicians and Surgeons" (1803) that set the standard for many textbooks. In the mid-19th century, hospitals and the medical profession became more professionalised, with a reorganisation of hospital management along more bureaucratic and administrative lines. The Apothecaries Act 1815 made it compulsory for medical students to practise for at least half a year at a hospital as part of their training.
Ishaq bin Ali al-Rohawi
Al-Rohawi's most celebrated work is "Adab al-Tabib" ("Practical Ethics of the Physician" or "Practical Medical Deontology"), the earliest surviving Arabic work on medical ethics. Al-Rohawi regarded physicians as "guardians of souls and bodies". The work was based on Hippocrates and Galen and consisted of twenty chapters on various topics related to medical ethics.
Informed consent
When the American Medical Association was founded they in 1847 produced a work called the first edition of the "American Medical Association Code of Medical Ethics". Many sections of this book are verbatim copies of passages from Percival's "Medical Ethics". A new concept in this book was the idea that physicians should fully disclose all patient details truthfully when talking to other physicians, but the text does not also apply this idea to disclosing information to patients. Through this text, Percival's ideas became pervasive guidelines throughout the United States as other texts were derived from them.
MacLean Center for Clinical Medical Ethics
Since 1981, The MacLean Center has offered clinical ethics consultations to assist patients, families, physicians, nurses, and students. MacLean Center fellows and faculty wrote many of the early papers guiding the field of clinical ethics consultation. The Center developed the concept of "research ethics consultation" in 1987 and has continued to offer this service to translational researchers and to the IRB.
Animal ethics
Animal ethics is a term used in academia to describe human–animal relationships and how animals ought to be treated. The subject matter includes animal rights, animal welfare, animal law, speciesism, animal cognition, wildlife conservation, the moral status of nonhuman animals, the concept of nonhuman personhood, human exceptionalism, the history of animal use, and theories of justice. Animal ethics can be traced back as far as the 6th century BCE to the teachings of Pythagoras who believed that the souls of humans reincarnated into animals. European countries have taken a leading role in animal ethics with the first animal welfare group the Society for the Prevention of Cruelty to Animals, (SPCA) beginning in Great Britain in 1824. America’s first organization, the American Society for the Prevention of Cruelty to Animals, (ASPCA) began in New York in 1866.
Clinical peer review
The first documented description of a peer review process is found in the "Ethics of the Physician" written by Ishap bin Ali al-Rahawi (854–931) of al-Raha, Syria, who describes the first medical peer review process. His work, as well as later Arabic medical manuals, states that a visiting physician must always make duplicate notes of a patient's condition on every visit. When the patient was cured or had died, the notes of the physician were examined by a local medical council of other physicians, who would review the practising physician's notes to decide whether his or her performance met the required standards of medical care. If their reviews were negative, the practicing physician could face a lawsuit from a maltreated patient.
Medical Council (Ireland)
Setting ethical standards
Ruwen Ogien
He was working to develop an ethical theory he called "minimal ethics." This is an ethical anti-paternalistic theory which would give reason to minimize the areas of intervention of what he calls, following John Stuart Mill, the "moral police". Minimal ethics arose initially in the form of three principles:Subsequently, Ogien tried to reduce it to one: "Do not harm others, nothing more" following this reasoning:Finally, what Ogien called "minimal ethics" is an ethic that excludes moral duties to oneself and positive paternalistic duties towards others. It tends to be reduced to one principle of not harming others. In accordance with this general conception of ethics, it supports the freedom to do what one wants from his own life as long as we do not harm others, which implies that the decriminalization of drug use, all forms of sexual relations between consenting adults, and active assistance to die for those who make the request. A special issue of the "Journal of Theology and Philosophy" was devoted to minimal ethics.
Bioethics
One of the first areas addressed by modern bioethicists was that of human experimentation. The National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research was initially established in 1974 to identify the basic ethical principles that should underlie the conduct of biomedical and behavioral research involving human subjects. However, the fundamental principles announced in the Belmont Report (1979)—namely, respect for persons, beneficence and justice—have influenced the thinking of bioethicists across a wide range of issues. Others have added non-maleficence, human dignity and the sanctity of life to this list of cardinal values. Overall, the Belmont Report (1979) has guided research in a direction focused on protecting vulnerable subjects as well as pushing for transparency between the researcher and the subject. Research has flourished within the past 40 years and due to the advance in technology, it is thought that human subjects have outgrown the Belmont Report (1979) and the need for revision is desired.
Theoretical Medicine and Bioethics
Theoretical Medicine and Bioethics: Philosophy of Medical Research and Practice is a bimonthly peer-reviewed medical journal covering bioethics and the philosophy of medicine with a more theoretical outlook than other journals in this area. It was established in 1980 as Metamedicine and was renamed Theoretical Medicine in 1983, obtaining its current name in 1998. It is published by Springer Science+Business Media and offered at a reduced rate to members of the American Society for Bioethics and Humanities. The editors-in-chief are Lynn Jansen (Oregon Health & Science University) and Daniel Sulmasy (Georgetown University). According to the "Journal Citation Reports", the journal has a 2017 impact factor of 0.615.
Placebo-controlled study
From the time of the Hippocratic Oath questions of the ethics of medical practice have been widely discussed, and codes of practice have been gradually developed as a response to advances in scientific medicine.
The Nuremberg Code, which was issued in August 1947, as a consequence of the so-called Doctors' Trial which examined the human experimentation conducted by Nazi doctors during World War II, offers ten principles for legitimate medical research, including informed consent, absence of coercion, and beneficence towards experiment participants.
Medicine in the medieval Islamic world
Physicians like al-Razi wrote about the importance of morality in medicine, and may have presented, together with Avicenna and Ibn al-Nafis, the first concept of ethics in Islamic medicine. He felt that it was important not only for the physician to be an expert in his field, but also to be a role model. His ideas on medical ethics were divided into three concepts: the physician's responsibility to patients and to self, and also the patients’ responsibility to physicians.
Evidence-based medical ethics
Evidence-based medical ethics is a form of medical ethics that uses knowledge from ethical principles, legal precedent, and evidence-based medicine to draw solutions to ethical dilemmas in the health care field. Sometimes this is also referred to as argument-based medical ethics. It is also the title of the book Evidence-Based Medical Ethics: Cases for Practice-Based Learning by Drs. John E. Snyder and Candace C. Gauthier, published by Humana-Springer Press in 2008 (). While seen as a promising new approach to bioethical problem solving by many, it has also been criticized for misrepresenting ethical problems as problems that can be solved by appeal to the evidence as the "bottom line".
Resources for clinical ethics consultation
Medical Council of India code of ethics
Isaac Hays
Hays was among the founders of the American Medical Association, serving as its first treasurer and chairman of the Committee on Publications. He is also credited with the authorship of the AMA's first Code of Ethics.
Professional courtesy
In 1994, the American Medical Association issued a Code of Medical Ethics Opinion advising free of charge and reduced rate services was not an ethical requirement, and physicians should use their own judgment in deciding to extend such professional courtesy.
Seven Sins of Medicine
The Seven Sins of Medicine, by Richard Asher, are a perspective on medical ethics first published in "The Lancet" in 1949.
Chamber of Physicians and Dentists
The Medical Code of Ethics was passed at the 2nd General Medical Assembly in 1991. It was significantly amended at the 3rd General Medical Assembly in 1993 and at the 7th General Medical Assembly in 2003 in order to update the Code according to the current developments, e.g. new provisions on the relations between the physician and the medical industry were introduced.
The Polish Chamber of Physicians and Dentists is active in the works of the following international organizations of doctors and dental practitioners:
Thomas Percival
Percival's "Medical Ethics" served as a key source for the American Medical Association (AMA) code, adopted in 1847. Though hyperbolic in its recognition of Percival, the AMA itself states:
The most significant contribution to Western medical ethical history subsequent to Hippocrates was made by Thomas Percival, an English physician, philosopher, and writer. In 1803, he published his "Code of Medical Ethics". His personality, his interest in sociological matters, and his close association with the Manchester Infirmary led to the preparation of a scheme of professional conduct relative to hospitals and other charities from which he drafted the code that bears his name.
As one expert writes, "The Percivalian code asserted the moral authority and independence of physicians in service to others, affirmed the profession's responsibility to care for the sick, and emphasized individual honor." Percival was a devout Christian.
Charles Marriot Culver
Culver was a pioneer in medical ethics. Up until the 1970s, not much work was ever done in the United States regarding the subject. Culver first received much of his national attention after publishing his article "Basic Curricular Goals in Medical Ethics" in the "New England Journal of Medicine" later in 1985. This article is said to have been distinguished for prompting much emphasis on medical ethics curriculum in United States medical education.
Early Islamic philosophy
The ethical standards of Muslim physicians was first laid down in the 9th century by Ishaq bin Ali Rahawi, who wrote the "Adab al-Tabib" ("Conduct of a Physician"), the first treatist dedicated to medical ethics. He regarded physicians as "guardians of souls and bodies", and wrote twenty chapters on various topics related to medical ethics, including:Many medieval Muslim thinkers pursued humanistic, rational and scientific discourses in their search for knowledge, meaning and values. A wide range of Islamic writings on love poetry, history and philosophical theology show that medieval Islamic thought was open to the humanistic ideas of individualism, occasional secularism, skepticism and liberalism.
Hippocratic Oath
The Hippocratic Oath is an oath historically taken by physicians. It is one of the most widely known of Greek medical texts. In its original form, it requires a new physician to swear, by a number of healing Gods, to uphold specific ethical standards. The Oath is the earliest expression of medical ethics in the Western world, establishing several principles of medical ethics which remain of paramount significance today. These include the principles of medical confidentiality and non-maleficence. As the seminal articulation of certain principles that continue to guide and inform medical practice, the ancient text is of more than historic and symbolic value. Swearing a modified form of the Oath remains a rite of passage for medical graduates in many countries.
Medicine in the medieval Islamic world
The earliest surviving Arabic work on medical ethics is Ishaq ibn 'Ali al-Ruhawi's "Adab al-Tabib" ( "Adab aț-Ṭabīb", "Morals of the physician" or "Practical Medical Deontology") and was based on the works of Hippocrates and Galen. Al-Ruhawi regarded physicians as "guardians of souls and bodies", and wrote twenty chapters on various topics related to medical ethics.
MacLean Center for Clinical Medical Ethics
The MacLean for Clinical Medical Ethics at the University of Chicago offers the oldest, largest, and most successful clinical ethics fellowship in the world. Dr. Mark Siegler, the Founding Director of the MacLean Center, created the first clinical ethics fellowship in the nation in 1981. Since then, the MacLean Center faculty members have trained more than 320 fellows, many of whom have gone on to direct their own ethics programs. While most fellows are physicians, the center welcomes those interested in medical ethics from any perspective, including philosophy, theology, nursing, law, and the social sciences. The MacLean Center, with more than 45 faculty members from many disciplines, provides training in clinical medical ethics and specialized fellowships in surgical ethics and pediatric ethics. Prior to 2014, through a partnership with the United States Veterans Administration (VA) hospital system, two or three VA medical professionals per year are selected by the VA through a national search to participate in the MacLean Center ethics fellowship training program.
Dignity
In 1984, France set up the National Consultative Committee for Ethics in the Life and Health Sciences (CCNE) to advise the government about the regulation of medical practices and research. In 1986, the CCNE said, "Respect for human dignity must guide both the development of knowledge and the limits or
rules to be observed by research." The CCNE said that research on human embryos must be subject to "the rule of reason" and must have regard for "undefined dignity in its practical consequences." The CCNE insisted that, in research on human embryos, the ethical principles that should apply are "respecting human dignity" and respecting "the dignity of science."
Nuremberg Code
In May 1947, while the trials were being held, six points defining legitimate medical research were submitted to the Counsel for War Crimes. Three judges, in response to expert medical advisers for the prosecution, adopted these points and added four additional points. The 10 points constituted the "Nuremberg Code", which includes such principles as informed consent and absence of coercion; properly formulated scientific experimentation; and beneficence towards experiment participants. It is thought to have been mainly based on the Hippocratic Oath, which was interpreted as endorsing the experimental approach to medicine while protecting the patient.The Nuremberg Code was initially ignored, but gained much greater significance about 20 years after it was written. As a result, there were substantial rival claims for the creation of the Code. Some claimed that Harold Sebring, one of the three U.S. judges who presided over the Doctors' Trial, was the author. Leo Alexander, MD and Andrew Ivy, MD, the prosecution's chief medical expert witnesses, were also each identified as authors. In his letter to Maurice H. Pappworth, an English physician and the author of the book "Human Guinea Pigs", Andrew Ivy claimed sole authorship of the Code. Leo Alexander, approximately 30 years after the trial, also claimed sole authorship. However, after careful reading of the transcript of the Doctors' Trial, background documents, and the final judgements, it is more accepted that the authorship was shared and the Code grew out of the trial itself.
Bruce Weinstein
Weinstein published his first book in 1985 at the age of 25 while a graduate student at Georgetown University. "Ethics in the Hospital Setting" contains the papers presented at the first state conference devoted to the issue of what was then called hospital ethics committees, which are now known as institutional ethics committees. Weinstein is credited as the editor of the volume. Portions of Weinstein’s doctoral dissertation, "The Possibility of Ethical Expertise" (Georgetown University, 1989) were edited and published as the articles “What is an Expert?”[Theoretical Medicine and Bioethics (Vol. 14, No. 1), pp. 57–73] and “The Possibility of Ethical Expertise”[Theoretical Medicine and Bioethics (Vol. 15, No. 1), pp. 61–75.
APA Ethics Code
Revisions occurred over the years pertaining to many changes in society. Culture, politics, the legal system, the economy and the healthcare system have all been influential in the development of the past and current ethical codes. The case examples were also removed. Prior to 1981, there was no principle or standard that addressed conflict between law and ethics. One of the biggest changes occurred with the 1992 version of the code. Before this version, there was no distinction between principles and standards. This version was the first to make that distinction. The principles are considered to be aspirational while the standards are enforceable by agencies adopting them, including the APA.
Good governance
The Tuskegee Study from 1932 to 1972 led to the signing of the National Research Act. This law outlined basic ethical ways in which research is to be carried out. The Department of Health, Education, and Welfare (DHEW) made regulations that required voluntary agreements for anyone who was to take part in their studies. Governance is used in scientific studies to ensure that policies are safe and ethical when studies are being done on human subjects. After the National Research Act there have been other organization put in place such as the Ethics Advisory Board, which reviews biomedical research. Many federal agencies adopted the Federal Policy for Protection of Human Rights in 1991. In 1995 President Bill Clinton established the National Bioethics Advisory Commission led by the Department of Health and Human Services with the task of reviewing regulations and policies to ensure the safety of research volunteers.
Committee on Publication Ethics
COPE's first guidelines were developed after discussion at the COPE meeting in April 1999 and were published as Guidelines on Good Publication Practice in the Annual Report in 1999. On their basis, the first edition of Code of Conduct for Editors was published on the first COPE website in November 2004, with an Editorial in the BMJ.[5] The Code was replaced in 2017 with a simplified description of expectations as COPE's Core Practices, with links to COPE's detailed guidance, to aid editors and publishers in the fight against research and publication misconduct. (scientific misconduct).
Wilk v. American Medical Ass'n
Before 1980, 
Principle 3 of the AMA Principles of medical ethics stated: ""A physician should practice a method of healing founded on a scientific basis; and he should not voluntarily professionally associate with anyone who violates this principle."" In 1980 during a major revision of ethical rules (while the Wilk litigation was in progress), it replaced Principle 3, stating that a physician "shall be free to choose whom to serve, with whom to associate, and the environment in which to provide medical services." Also, up until 1974, the AMA had a Committee on quackery which challenged what it considered to be unscientific forms of healing. Wilk argued that this committee was established specifically to undermine chiropractic.
Islamic bioethics
Islamic bioethics, or Islamic medical ethics, ( "al-akhlaq al-tibbiyyah") refers to Islamic guidance on ethical or moral issues relating to medical and scientific fields, in particular, those dealing with human life.
Patient rights in New Zealand
In the medical profession, everybody must follow the code of ethics when they are practicing, this is on top of the code of rights, but also enforcing the purpose of those rights. This is like the ethics codes in other professional fields, treating clients ethically. Medical practitioners are expected to follow several principles of ethical behavior. The health and well-being of the patient are of first priority. The autonomy, freedoms, and rights are to be respected. Exploitation of the patient is to be avoided. Compassion, moral integrity, and respect for human dignity are to be exercised during the practice of medical science. With exceptions considering public interest or patient safety, the private information of the patient is to be protected throughout the lifetime and beyond. In order for the best possible advice and treatment to be offered to the patient, knowledge, and skills are to be improved. The limits of current knowledge are to be acknowledged whilst the scientific basis for medical practice is followed. The responsibilities of assisting in the protection and increased health of the community, the advocation for proper resources to maximise access to medical services across the community, and the maintenance and improvisation of professional standards are to be accepted.
Self-experimentation in medicine
The ethics of informed consent is relevant to self-experimentation. Informed consent is the principle that the volunteers in the experiment should fully understand the procedure that is going to take place, be aware of all the risks involved, and give their consent to taking part in the experiment beforehand. The principle of informed consent was first enacted in the U.S. Army's research into Yellow fever in Cuba in 1901. However, there was no general or official guidance at this time. That remained the case until the yellow fever program was referenced in the drafting of the Nuremberg Code. This was further developed in the Declaration of Helsinki in 1964 by the World Medical Association which has since become the foundation for ethics committees' guidelines.
Human subject research
Ethical guidelines that govern the use of human subjects in research are a fairly new construct. In 1906 some regulations were put in place in the United States to protect subjects from abuses. After the passage of the Pure Food and Drug Act in 1906, regulatory bodies such as the Food and Drug Administration (FDA) and institutional review boards (IRBs) were gradually introduced. The policies that these institutions implemented served to minimize harm to the participant's mental and/or physical well being.
Estonian Medical Association
The Estonian Medical Association (EMA) () is a professional association of medical doctors operating in Estonia. The association was established on 28 February 1921. EMA also has an established Ethics committee consisting of 4 members. The ethics committee is responsible for producing guidelines on bioethics dealing with problems of medical ethics within the association.
Abraham Verghese
Verghese became founding Director of The Center for Medical Humanities and Ethics at the University of Texas Health Science Center at San Antonio in 2002. His focus here was on medical humanities as a way to preserve the innate empathy and sensitivity that brings students to medical school but which the rigor of their training frequently represses. In San Antonio, besides developing a formal humanities and ethics curriculum that was integrated into all four years of the medical school program, he invited medical students to accompany him on bedside rounds as a way of demonstrating his conviction about the value of the physical examination in diagnosing patients and in developing a caring, two-way patient-doctor relationship that benefits not only patients and their families but also the physician. At San Antonio, he held the Joaquin Cigarroa Chair and the Marvin Forland Distinguished Professorship.
Kennedy Institute of Ethics Journal
The Kennedy Institute of Ethics Journal is a quarterly academic journal established in 1991. It is published by the Johns Hopkins University Press on behalf of the Kennedy Institute of Ethics and focuses on questions of bioethics such as those relating to the research of and therapeutic use of human embryonic stem cells, organ donation, and genetic manipulation, as well as issues of global justice, research in the developing world, environmental ethics, food ethics, and issues of governance and expertise in clinical research.
Formula Comitis Archiatrorum
Formula Comitis Archiatrorum is the earliest known code of medical ethics. It was written in the 5th century, during the reign of the Ostrogothic king Theodoric, and is preserved in the works of Cassiodorus. It demands from physicians that they widen and deepen their knowledge and enacts the consultation with other physicians.
Adab al-Tabib
Adab al-Tabib ( "Adab aț-Ṭabīb", "Morals of the physician") is the common title of a historical Arabic book on medical ethics, written by Al-Ruhawi, a 9th-century physician. The title can be roughly translated "Practical Ethics of the Physician". As the name suggests, it focuses on adab, the Islamic concept of etiquette and personal ethics, as it is defined in a medical context. One of the earliest texts on Islamic medical ethics, it has been called the "crowning achievement" of early works concerning "adab" in medicine.
Cicely Saunders
Saunders was instrumental in the history of UK medical ethics. She was an advisor to Andrew Mephem whose report led the Rev. Edward Shotter to set up the London Medical Group, a forerunner of the Society for the Study of Medical Ethics, later the Institute of Medical Ethics. She gave one of the first LMG lectures on the subject of pain, developing the talk into "The Nature and Management of Terminal pain" by 1972.
Hygiene
Most of these practices were developed in the 19th century and were well established by the mid-20th century. Some procedures (such as disposal of medical waste) were refined in response to late-20th century disease outbreaks, notably AIDS and Ebola.