AMA Journal of Ethics^®

Abstract

In this image, 3 figures—Hippocrates, a plague doctor, and a modern physician—represent continuity of ethical standards in ancient, medieval, and contemporary medical communities.

 

Figure. Keepers of Oaths

Media

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Avoiding harm and expressing respect for privacy are central values of medicine, according to the Hippocratic Oath, represented here through the figure of Hippocrates and in a Greek scroll containing the oath, part of which reads:

Into whatsoever houses I enter, I will enter to help the sick, and I will abstain from all intentional wrong-doing and harm, especially from abusing the bodies of man or woman, bond or free. And whatsoever I shall see or hear in the course of my profession, as well as outside my profession in my intercourse with men, if it be what should not be published abroad, I will never divulge, holding such things to be holy secrets.¹

The Roman numerals to the left of the middle figure—a plague doctor—represent a 16-clause contract that Giovanni de Ventura negotiated with the community of Pavia, Italy, in 1479 to treat patients ill with bubonic plague. A seminal clause in the contract stated that “the doctor must treat all patients and visit infected places as it shall be found to be necessary.”² This clause underscores the ethical responsibility physicians have borne throughout the history of medicine. Like the figure, Italian plague doctors in the 1600s might have worn a cross to signify obedience to prevailing Church hegemony over daily life and would have worn a beak-like mask filled with fragrant substances to mitigate odors of illness and provide protection from infection.³ The numbers at the image’s bottom-right corner indicate enactment of the Health Insurance Portability and Accountability Act of 1996 (Public Law 104-191) by the 104th Congress⁴ and guide the work of the third figure in the image, a contemporary physician using her stethoscope. A common theme during eras of medicine represented in this image is ethical commitment to treating everyone in need without prejudice.