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Sources of Medical Morals

Richard Thomas Barton, MD
JAMA. 1965;193(2):133-138. doi:10.1001/jama.1965.03090020047012.
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Rather than go through a long list of "rights" and "wrongs" as they pertain to medical practice, I am going to outline the genealogy of medicine and its ethical codes, and then sketch the philosophical sources of ethics in order to demonstrate the influence of the natural-law theory and the pragmatic and empirical theories on moral discipline. My purpose is to show the thinking behind today's moral issues and to present some guidelines.

History of Ethical Codes  Let us begin with the time-line seen in Fig 1. In the earliest periods of man's history, the "shaman" was the tribal leader who usually represented the mayor, the policeman, the priest, and the physician combined in one entity against a background of superstition and mysticism. From this shamanism of the most primitive cultural groups gradually developed a physician-priest or "medicine man" who was the decision-maker and healer of the community, while the


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