CODE OP ETHICS 
 
 0* TBS 
 
 CANADIAN MEDICAL ASSOCIATION, 
 
 ADOPTED SEPT., 1868. 
 
 -.,«"^'^' 
 
CODE OF MEDICAL ETEICS. 
 
 OP THE DUTIES OF PHYSICIANS TO THEIR PATIENTS AND OF THl 
 OBLIGATIONS OF PATIENTS TO THEIR PHYSICIANS. 
 
 Art. I. — Duties of physicians to their patients. 
 
 1. A physician should not only be ever ready to obey the calls of the 
 «ick, but his mind ought also to be imbued with the greatness of his mis- 
 sion, and the responsibility he habitually incurs in its discharge. These 
 obligations are the more deep and enduring, because ordinarily there is no 
 tribunal other than his own conscience to adjudge penalties for carelessness 
 or neglect. Physicians should, therefore, minister to the sick with due 
 impressions of the importance of their office ; reflecting that the ease, the 
 health, and the lives of those committed to their charge, depend on their 
 skill, attention, and fidelity. They should study, also, in their deport- 
 ment, so to unite tenderness with Jirmness, and cotidescensioii viith author- 
 ity, as to inspire the minds of their patients with gratitude, respect and 
 confidence. 
 
 2. Every case committed to the chaise of a physician should be treated 
 with attention, steadiness and humanity. Reasonable indulgence should 
 be granted to the mental imbecility and caprices of the sick. Secrecy 
 and delicacy, when required by peculiar circumstances, should be strictly 
 observed ; and the familiar and confidential intercourse to which physi- 
 cians are admitted in their professional visits, should be used with dis- 
 cretion, and with the most scrupulous regard to fidelity and honor. 
 The obligation of secrecy extends beyond the period of professional ser- 
 vices ; — none of the privacies of personal and domestic life, no infirmity 
 of disposition or flaw of character observed during professional atten- 
 dance, should ever be divulged by the physician except when he is im- 
 peratively required to do so. The force and necessity of this obligation 
 are indeed so great, that professional men have, under certain circum- 
 stances, been protected in their observance of secrecy by courts of justice. 
 
 3. Frequent visits to the sick are io general requisite, since they enabk 
 
the physician to arrive at a more perfect knowledge of the disease — to 
 meet promptly every change which many occur and also tend to preserve 
 the confidence of the patient. But unnecessary visits are to be avoided, 
 as they give useless anxiety to the patient, tend to diminish the authority 
 of the physician, and render him liable to be suspected of interested 
 motives. 
 
 4. A physician should not be forward to make gloomy prognostications, 
 because they savor of empiricism, by magnifying the importance of his 
 services in the treatment or cure of the disease. But he should not fail, 
 on proper occasions, to give to the friends of the patient timely notice of 
 danger when it really occurs; and even to the patient himself, if abso- 
 lutely necessary. This office, however, is so peculiarly alarming when 
 executed by him, that it ought to be declined whenever it can be asBigned 
 to any other person of sufficient judgment and delicacy. For, the phy- 
 sician should be the minister of hope and comfort to the sick ; that, by 
 such cordials to the drooping spirit, he may smooth the bed of death, 
 revive expiring life, and counteract the depressing influence of those 
 maladies which often disturb the tranquillity of the most resigned in 
 their last moments. The life of a sick person can be shortened not only 
 by the acts, but also by the words or the manner of a physician. It is, 
 therefore, a sacred duty to guard himself carefully in this respect, and to 
 avoid all things which have a tendency to discourage the patient and to 
 depress his spirits. 
 
 5; A physician ought not to abandon a patient because the case is 
 deemed incurable ; for his attendance may continue to be highly useful 
 to the patient, and comforting to the relative around him, even in the 
 last period of a fatal malady, by alleviating pain and other symptoms, and 
 by soothing mental anguish. To decline attendance, under such circum- 
 stances, would be sacrificing to fanciful delicacy and mistaken liberality, 
 that moral duty, which is independent of, and far superior to, all pecu- 
 niary consideration. V 
 
 6. Consultations should be encouraged in difficult or protracted cases, 
 as they give rise to confidence, energy, and more enlarged views in practice. 
 
 7. The opportunity which a physician not unfrequently enjoys of pro- 
 moting and strengthening the good resolutions of his patients, suffering 
 under the consequences of vicious conduct, ought never to be neglected. 
 His counsels, or even remonstrances, will give satisfaction, not offence, 
 if they be proffered with politeness, and evince a genuine love of virtue, 
 accompanied by a sincere interest in the welfare of the person to whom 
 they are addressed. 
 
'-»■■ 
 Art. II. — Obligations of patients to their physicians. ' *V 
 
 1. The members of the medical profession, upon whom is enjoined 
 the performance of so many important and arduous duties towards the 
 -community, and who are required to make so many sacrifices of comfort, 
 ease, and health, for the welfare of those who avail themselves of their 
 services, certainly have a right to expect and require, that their patients 
 should entertain a just sense of the duties which they owe to their medi- 
 cal attendants. ., >;;j: 
 
 2. The first duty of a patient is to select as his medical adviser one 
 who has received a regular professional education. In no trade or occu- 
 pation do mankind rely on the skill of an untaught artist; and in medi- 
 cine, confessedly the most difl&cult and intricate of the scienceSj the world 
 ought not to suppose that knowledge is intuitive. , .. 
 
 3. Patients should prefer a physician whose habits of life are regular, 
 and who is not devoted to company, pleasure, or to any pursuit incom- 
 patible with his professional obligations. A patient should, also, confide 
 the care of himself and family, as much as possible, to one physitian ; 
 for a medical man who has become acquainted with the peculiarities of 
 constitution, habits, and pre-dispositions of those he attends, is more 
 likely to be successful in his treatment than one who does not possess 
 that knowledge. 
 
 A patient who has thus selected his physician should always apply 
 for advice in what may appear to him trivial cases, for fatal results 
 often supervene on the slightest accidents. It is of still more importance 
 that he should apply for assistance in the early stage of violent dis- 
 eases ; it is to a neglect of this precept that medicine owes much of the 
 uncertainty and imperfection with which it has been reproached, 
 
 4. Patients should faithfully and unreservedly communicate to their 
 physician the supposed cause of their disease. This is the more impor- 
 tant, as many diseases of a mental origm simulate those depending on 
 external causes, and yet are only to be cured by ministering to the mind 
 diseased. A patient should never be afraid of thus making his physi- 
 cian his friend and adviser ; he should always bear in mind that a medi- 
 cal man is under the strongest obligations of secrecy. Even the female sex 
 should never allow feelings of shame or delicacy to prevent their disclos- 
 ing the seat, symptoms, and causes of complaints peculiar to them. How- 
 ever commendable a modest reserve may be in the common occurrences 
 life, its strict observance in medicine is often attended with the most 
 serious consequences, and a patient may sink under a painful and loath- 
 some disease which might have been readily prevented had timely intima- 
 tion been given to the physician. 
 
5. A patient should never weary his physician with a tedious detail of 
 events or matters not appertaining to his disease. Even as relate^ to his 
 actual symptoms, he will convey much more real information by giving 
 clear answers to interrogatories, than by the most minute account of hi» 
 own framing. Neither should he obtrude upon his physician the details 
 of his business nor the history of his family concerns. 
 
 6. The obedience of a patient to the prescriptions of his physician 
 should be prompt and implicit. He should never permit his own crude 
 opinions as to their fitness to influence his attention to them. A failure 
 in one particular may render an otherwise judicious treatment dangerous, 
 and even fatal. This remark is equally applicable to diet, drink, and 
 exercise. As patients become convalescent, they are very apt to suppose 
 that the rules prescribed for them may be disregarded, and t'.ie conse- 
 quence, but too often, is a relapse. Patients should never allow them- 
 selves to be persuaded to take any medicine whatever, that may be recom- 
 mended to them by the self-constituted doctors and doctresses who are so 
 frequently met with, and who pretend to possess infallible remedies for 
 the cure of every disease. However simple some of their prescriptions 
 may appear to be, it often happens that they are productive of much 
 mischief, and in all cases they arc injurious, by contravening the plan of 
 treatment adopted by the physician. 
 
 7. A patient should, if possible, avoid even ilui/rieiuU^ L-lsitsi>/ a phy- 
 sician who is not attending him — and when he d(K;s receive them, he 
 »''0uld never converse on the subject of his disease, as :\n observation may 
 b ^ made, without any intention of interference, wliicli may destroy his 
 confidence in the course he is pursuing, and induce him to neglect the 
 directions prescribed to him. A patient should never send for a consult- 
 ing physician without the express consent of his own medical attendant. 
 It is of great importance that physicians should act iu concert; for, 
 although their modes of treatment may be attended with equal success 
 when employed singly, yet conjuntly they are very likely to be productive 
 of disastrous results. 
 
 8. When a patient wishes to dismiss his physician, justice and com- 
 mon courtesy require that he slmuld declare his reasons for so doing. 
 
 9. Patients should always, when practicable, send for their physician 
 in the morning, before his usual hour of going out ; for, by being early 
 aware of the visits he has to pay during the day, the physician is able 
 to apportion his time in such manner as to prevent an interference or 
 engagements. Patients should also avoid calling on their medical adviser 
 unneces.sarily during the hours devoted to meals or sleep. They should 
 always be in readiness to receive tlie visits of their physician, as the 
 detention of a few minutes is often of serious inconvenience to him. 
 
10. A patient should, after his recovery, entertain a just and enduring 
 sense of the value of the services rendered him by his physician ; for 
 these are of such a character, that no mere pecuniary acknowledgment 
 can repay or cancel them. 
 
 OF THE DUTIES OF PHYSICIANS TO EACH OTHER, AND TO THE 
 
 PROFESSION AT LARGE. 
 
 Art. I. — Duties for the support of professional character. 
 
 1. Every individual, on entering the profession, as he becomes thereby^ 
 entitled to all its privileges and immunities, incurs an obligation to exert 
 his best abilities to maintain its dignity and honor, to exalt its standing, 
 and to extend the bounds of its usefulness. He should, therefore, 
 observe strictly such laws as are instituted for the government of its 
 members; — should avoid all contumelious and sarcastic remarks relative 
 to the faculty as a body ; and while, by unwearied diligence, he resorts 
 to every honorable means of enriching the science, he should entertain a 
 due respect for his seniors, who have, by their labors, brought it to the 
 elevated condition in which he finds it. 
 
 2. There is no profession, from the members of which greater purity 
 of character, and a higher standard of moral excellence are required, 
 than the medical ; and to attain such eminence is a duty every physi- 
 cian owes alike to his profession and to his patients. It is due to the 
 latter, as without it he cannot command their respect and confidence, 
 and to both, because no scientific attainments can compensate for the 
 want of correct moral principles. It is also incumbent upon the faculty 
 to be temperate in all things, for the practice of physic requires the 
 unremitting exercise of a clear and vigorous understanding ; and, on 
 emergencies, for which no professional man should be unprepared, a 
 steady hand, an acute eye, and an unclouded head may be essential to 
 the well-being, and even to the life, of a fellow-creature. 
 
 3. It is derogatory to the dignity of the profession to resort to public 
 advertisements, or private cards, or handbills, inviting the attention of 
 individuals affected with particular diseases — publicly offering advice and 
 medicine to the poor gratis, or promising radical cures; or to publish 
 eases and operations in the daily prints, or suffer such publications to be 
 made ; to invite laymen to be present at operations, to boast of cures and 
 remedies, to adduce certificates of skill and success, or to perform any 
 other similar acts. These are the ordinary practices of empirics, and are 
 highly reprehensible in a regular physician. [In the case however of a 
 physician or surgeon commencing the practice of his profession or 
 removing to another locality, a single announcement by an unobstrusive 
 card in the public prints is unobjectionable,] 
 
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 4. Equally derc^atory to professional character is it for a physician to 
 hold a patent for any surgical instrument or medicine , or to dispense a 
 ^secret nostrum, whether it be the composition or exclusive property of 
 himself or of others. For, if such nostrum be of real efficacy, any con- 
 cealment regarding it is inconsistent with beneficence and professional 
 liberality ; and if mystery alone give it value and in porta nee, such craft 
 implies either disgraceful ignorance or fraudulent avarice. It is also 
 reprehensible for physicians to give certificates attesting the efficacy of 
 patent or secret medicines, or in any way to promote the use of them. 
 
 Art. II. — Professional services of physicians to each other. 
 
 1. All practitioners of medicine, their wives, and their children while 
 under the paternal care, are entitled to the gratuitous services of any one 
 or more of the faculty residing near them, whose assistance may be 
 desired. A physician afflicted with disease is usually an incompetent 
 judge of his own case ; and the natural anxiety and solicitude which he 
 experiences at the sickness of a wife, a child, or any one who, by the ties 
 of consanguinity, is rendered peculiarly dear to him, tend to obscure his 
 judgment, and produce timidity and irresolution in his practice. Under 
 such circumstances, medical men are peculiarly dependent upon each 
 other, and kind offices and professional aid should always be cheerfully 
 and gratuitously afforded. Visits ought not, however, to be obtruded 
 officiously ; as such unasked civility may give rise to embarrassment, or 
 interfere with that choice on which confidence depends. But, if a distant 
 member of the faculty, whose circumstances are affluent, request atten- 
 dance, and an honorarium be offered, it should not be declined ; for no 
 pecuniary obligation ought to be imposed, which the party receiving it 
 would wish not to incur. 
 
 Art. III. — Of the duties of physicians as respects vicarious offices. 
 
 1 . The affairs of life, the pursuit of health, and the various accidents 
 and contingencies to which a medical man is peculiarly exposed, some- 
 times require him temporarily to withdraw from his duties to his patients, 
 and to request some of his professional brethren to officiate for him. 
 <!!ompliance with this request is an act of courtesy, which should alwa}-s 
 be performed with the utmost consideration for the interest and character 
 of the family physician, and when exercised for a short period, all the 
 pecuniary obligations for such service should be awarded to him. But 
 if a member of the profession neglect his business in quest of pleasure 
 and amusement, he cannot be considered as entitled to the advantages of 
 the frequent and long-continued exercise of this fraternal courtesy, with- 
 
out awarding to the physician who officiates, the fees arising from the 
 discharge of his professional duties. .... 
 
 In obstetrical and important surgical cases, which give rise to unusual 
 fatigue, anxiety, and responsibility, it is just that the fees accruing there- 
 from should be awarded to the physician who officiates. 
 
 Art. IV. — Of the duties of physicians in regard to consultations. 
 
 1. A regular medical education furnishes the only presumptive evi- 
 dence of professional abilities and acquirements, and ought to be the 
 only acknowledged right of an individual to the exercise and honors of 
 his profession. Nevertheless, as in consultations the good of the patient 
 is the sole object in view, and this is often dependent on personal con- 
 fidence, no intelligent regular practitioner, who has a license to practise 
 from some medical board of known and acknowledged respectability, 
 recognized by this Association, and who is in good moral and profes- 
 sional standing in the place in which he resides, should be fastidiously 
 excluded from fellowship, or his aid refused in consultation, when it is 
 requested by the patient. But no one can be considered as a regular 
 practitioner or a fit associate in consultation, whose practice is based on 
 an exclusive dogma, to the rejection of the accumulated experience of 
 the profession, and of the aids actually furnished by anatomy, physio- 
 logy, pathology, and organic chemistry, or who assumes any special title 
 but that of Physician or Surgeon. 
 
 2. In consultations, no rivalship or jealousy should be indulged ; can- 
 dor, probity, and all due respect should be exercised towards the physician 
 having charge of the case. 
 
 3. In consultations, the attending physician should be the first to pro- 
 pose the necessary questions to the sick ; after which the consulting phy- 
 sician or physicians should have the opportunity to make such further in- 
 quiries of the patient as may be necessary to satisfy him or them of the 
 true character of the case. They should then retire to a private place for 
 deliberation ; and the one first in attendance should communicate the direc- 
 tions agreed upon to the patient or his friends, as well as any opinions which 
 it may be thought proper to express. But no statement or discussion of 
 it should take place before the patient or his friends, except in the pre- 
 sence of all the faculty attending, and by their common consent ; and no 
 opinions or prognostications should be delivered which are not the result 
 of previous deliberation and concurrence. 
 
 4. In consultations, the physician in attendance should deliver his 
 opinion first ; and when there are several consulting, the junior physician 
 should deliver his opinion first and so on in the order of seniority. No deci- 
 
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 ■ion, however, should restiain the attending physician from making such 
 variations in the mode of treatment, as any subsequent unexpected change 
 in the character of the case may demand. But such variation, and the 
 reasons for it, ought to be carefully detailed at the next meeting in con- 
 sultation. The same privilege belongs also to the consulting physician if 
 he is sent for in an emergency, when the regular attendant is out of the 
 way, and similar explanations must be made by him at the next consul- 
 tation. 
 
 5. The utmost punctuality should be observed in the visits of physi- 
 cians when they arc to hold consultation together, and this is generally 
 practicable, for society has been considerate enough to allow the plea of a 
 professional engagement to take precedence of all others, and to be an 
 ample reason for the relinquishment of any present occupation. But, as 
 professional engagements may sometimes interfere, and delay one of the 
 parties, the physician who first arrives should wait for his associate a 
 reasonable period, after which the consultation should be considered as 
 postponed to a new appointment. If it be the attending physician who 
 is present, he will of course see the patient and prescribe ; but if it be 
 the consulting one, he should retire, except in case of emergency, or when 
 he has been called from a considerable distance, in which latter case he 
 may examine the patient, and give his opinion in wriling and under seal, 
 to be delivered to his assc-ciate, 
 
 6. In consultations, theoretical discussions should be avoided, as occa- 
 sioning perplexity and loss of time. For there may be much diversity 
 of opinion concerning speculative points, with perfect agreement in those 
 modes of practice which are founded, not on hypothesis, but on expe- 
 rience and observation. 
 
 7. All discussions in consultation should be held as secret and con- 
 fidentiiil. Neither l<y words nor manner should any of the parties to a 
 consultation assert or insinuate that any part of the treatment pursued 
 did not receive his assent. The responsibility must be equally divided 
 between the medical attendants — they must oijually share the credit of 
 success as well as the blame of failure. 
 
 8. Should an irreconcilable diversity of opinion occur when several 
 physicians are called upon to consult together, the opinion of the majority 
 should be considered as decisive ; but if the numbers be equal on each 
 side, then the decision should rest with the attending physician. It may, 
 moreover, sometimes happen, that two physicians cannot agree in their 
 views of the nature of a case, and the treatment to be pursued. This is 
 a circumstance much to be deplored, and should always be avoided, if 
 possible, by mutual concessions, as far as they can be justified by a coa- 
 
11 
 
 fcientious regard for the dictates of judgment. But in the event of its 
 •ccurrence, a third physician should, if practicable, be called to act as 
 umpire ; and, if circumstances prevent the adoption of this course, it must 
 be left to the patient to select the physician in whom he is most willing 
 to confide. But, as every physician relies upon the rectitude of his judg- 
 ment, he should, when left in the minority, politely and consistently 
 retire from any further deliberation in the consultation, or participation 
 in the management of the case. 
 
 9. As circumstanct i^oraetimes occur to render a special consultation 
 desirable, when the continued attendance of two physicians might be 
 objectionable to the patient, the member of the faculty whose assistance 
 is required in such cases, should sedulously guard against all future 
 unsolicited attendance. As such consultations require an extiaordinary 
 portion both of time and attention, at least a double honorarium may be 
 reasonably expected. 
 
 10. A physician who is called upon to consult, should observe the most 
 honorable and scrupulous regard for the character and standinii of the 
 practitioner in attendance ; the practice of the latter, if necessary, should 
 be justified as far as it can be, consistently with a conscientious regard 
 for truth, and no hint or insinuation should be thrown out which could 
 impair the confidence reposed in him, or affect his reputation. The con- 
 sulting physician should also carefully refrain from any of those extraor- 
 dinary attentions or assiduities, which are too often practised by the dis- 
 honest for the base purpose of gaining applause, or ingr;itiating themselves 
 into *ho favor of families and individuals. 
 
 Art. V. — Duties of physicians in cases of interference. 
 
 1. Medicine is a liberal profession, and those admitted into its ranks 
 fihould found their expectations of practice upon the extent of their qua- 
 lifications, not on intrigue or artifice. 
 
 2. A physician in his intercourse with a patient under the care of 
 another practitioner, should observe the strictest caution and reserve. No 
 meduiing inquiries should be made — no disingenuous hints given relative 
 to the nature and treatment of his disorder ; nor any course of conduct 
 pursued that may directly or indirectly tend to diminish tlie trust reposed 
 in the physician employed. 
 
 3. The same circumspection and reserve should be observed when, 
 from motives of business or friendship, a physician is prompted to visit 
 an individual who is under the direction of another practitioner. Indeed, 
 Euch visits should be avoided, except under peculiar circumstances, and 
 
•when they are made, no particular inquiries should be instituted relative 
 to the nature of the disease, or the remedies employed, but the topics of 
 conversation should be as foreign to the case as circumstances will admit 
 
 4. A physician ought not to take charge of or prescribe for a patient 
 "who has recently been under the care of another member of the faculty 
 in the same illness, except in cases of sudden emergency, or in consulta- 
 tion with the physician previously in attendance, or when the lai ter has 
 relinquished the case, or been regularly notified that his services are no 
 longer desired. Under such circumstances, no unjust and illiberal insi- 
 nuations should be thrown out in relation to the conduct or practice pre- 
 viously pursued, which should be justified as far as candor and regard for 
 truth and probity will permit ; for it often iiappens ^hat patients become 
 dissatisfied when they do not experience immediate relief, and, as many 
 diseases are naturally protracted, the want of success, in the first stage of 
 treatment, affords no evidence of a lack of professional knowledge and 
 skill. 
 
 5. When a physician is called to an urgent case, because the family 
 attendant is not at hand, he ought, unless his assistance in consultation 
 be desired, to resign the care of the patient to the latter immediately on 
 his arrival. 
 
 d. It often happens in cases of sudden illness, or of recent accidents 
 and injuries, owing to the alarm and anxiety of friends, that a number 
 of physicians are simultaneously sent for. Under these circumstances, 
 courtesy should assign the patient to the first who arrives, who should 
 select from those present, any additional assistance that he may deem 
 necessary. In all such cases, however, the practitioner who oflSiciates 
 should request the family physician, if there be one, to be called, and, 
 unless his further attendance be requested, should resign the case to the 
 latter on his arrival. 
 
 7. When a physician is called to the patient of another practitioner, 
 in consequence of tlie sickness or absence of the latter, he ought, on the 
 return or recovery of tlie regular attendant, and with the consent of the 
 patient, to surrender the case. 
 
 [The expression, '• patient of another practitioner," is understood to 
 mean a patient who may have been under the charge of another practi- 
 tioner at the time of the attack of sickness, or departure from home of 
 the latter, or who may have called for his attendance during his absence 
 or sickness, or in any other manner given it to be understood that he 
 regarded the said physician as his regular medical attendant.] 
 
 8. A physician, when visiting a sick person in the country, may be 
 desired to see a neighboring patient who is under the regular direction of 
 
13 
 
 another physician, in consequence of some sudden change or aggravftion 
 of symptoms. The conduct to be pursued on such an o.>casion is to give 
 advice adapted to present circumstances ; to interfere no further than is 
 absolutely necessary with the general plan of treatment ; to assume no 
 future direction, unless it be expressly desired ; and, in this last case, to 
 request an immediate consultation with the practitioner previously em- 
 ployed. 
 
 9. A wealthy physician should not give advice gratis to the affluent ; 
 because his doing so is an injury to his professional brethren. The 
 office of physician can never be supported as an exclusively beneficent 
 one ; and it is defrauding, in some degree, the common funds for its sup- 
 port, when fees are dispensed with which might justly be claimed. 
 
 10. When a ^ uysician who has been engaged to attend a case of mid- 
 wifery is absent, and another is sent for. if delivery is accomplished during 
 the attendance of the latter, he is entitled to the fee, but should resign 
 the patient to the practitioner first engaged. 
 
 Art. VI. — Of differPTires between physicians. 
 
 1. Diversity of opinion and opposition of interest may, in the medical 
 as in other professions, sometimes occasion controversy and even conten- 
 tion. Whenever such cases unfortunately occur, and cannot be imme- 
 diately terminated, they should be referred to the arbitration of a sufficient 
 number of physicians or a court-medical. 
 
 2. As peculiar reserve must be maintained by physicians towards the 
 public, in regard to professional matters, and as there exist numerous 
 points in medical ethics and etiquette through which the feelings of me- 
 dical men may be painfully assailed in their intercourse with each other, 
 and which cannot be understood or appreciated by general society, neither 
 the subject-matter of such di£ferences nor the adjudication of the arbitra- 
 tors should be made public, as publicity in a case of this nature may be 
 personally injurious to the individuals concerned, and can hardly fail to 
 bring discredit on the faculty. 
 
 Aet. VII. — Of pecuniary acknowledgments. 
 
 Some general rules should be adopted by the faculty, in every town or 
 district, relative to pecuniary acknowledgments from their patients, insu- 
 rance companies, &c., attendance upon United Benefit Societies, &c. 
 Neither should any physician compound with Mutual Benefit Societies, 
 to give his professional services for any fixed sum ; and it should be 
 deemed a pcint of honor to adhere to these rules with as much uni- 
 formity as varying circumstances will admit. 
 
OF THE DUTIES OF THE PROFESSION TO THE PUBLIC, AND OF THE 
 .. OBLIGATIONS OF THE PUBLIC TO THE PROFESSION, r 
 
 ' ■ ' • • Art. I. — IhUies of the profession to tJie piihlic. 
 
 1. As good citizens, it is the dutj of physicians to be ever vigilant for 
 tlie welfare of the community, and to bear their part in sustaining its insti- 
 tutions and burdens ; they should also be ever ready to give counsel to 
 the public in relation to matters especially appertaining to their profes- 
 sion, as on subjects of medical police, public hygiene, and legal medicine. 
 It is their province to enlighten the public in regard to quarantine regu- 
 lations — the location, arrangement, and dietaries of hospitals, asylums- 
 schools, prisons, and similar institutions — in relation to the medical 
 police of towns, as drainage, ventilation, &c. — and in regard to measures 
 for the prevention of epidemic ad contagious diseases ; and when pesti- 
 lence prevails, it is their duty to face the danger, and to continue their 
 labors for the jilleviation of the c^uffcring, even at the jeopardy of their 
 own lives. 
 
 2. Medical men should also be always ready, when called on by the 
 Ic^lly con!«titutcd authorities, to enlighten coroners' inquests and courts 
 of justice, on subjects strictly medical — such as involve questions relating 
 to sanity, legitimacy, murder by poisons or other violent means, and in 
 regard to the various other subjects embraced in the science of Medical 
 Jurisprudence. But in these cases, and especially where they are 
 required to make a j^ost-mortem examination, it is just, in consequence 
 of the time, labor, and skill required, and the responsibility and risk 
 they incur, that the public should award them a proper honorarium 
 Medical men should also be properly paid for attendance as witnesses in 
 •criminal cases. 
 
 3. There is no profession by the members of which eleemosynary ser- 
 vicos are more liberally dispensed than the medical, but justice requires 
 that some limits should be placed to the performance of such good offices. 
 Poverty, professional brotherhood, and certain of the public duties 
 relerred to in the first section of this article, should always be recognized 
 as presenting valid claims for gratuitous services ; but neither institu- 
 tions endowed by the public or by rich individuals, societies for mutual 
 l)enefit, for the insurance of lives (the certificates for which should be 
 considered by the Insurance Companies and Medical references as 
 strictly confidential, and to be paid for by the company whether for- 
 -warded by the Medical referee of the company or the family physician,) 
 or for analogous purposes, nor any profession or occupation, can be ad- 
 mitted to possess such privilege. Nor can it be justly expected of phy- 
 
fiicians to furnish certificates of inability to serve on juries, to perform 
 
 militia duty, or to testify to the state of health of persons wishing to 
 
 ensure their lives, obtain pensions, or the like, without a pecuniary 
 
 acknowledgment. But to individuals in indigent circumstances, such 
 
 professional services should always be cheerfully and freely accorded. 
 
 4. It is the duty of physicians, who are frequent witnessea of the 
 enoralties committed by quackery, and the injury to health and even 
 destruction of life caused by the use of quack medicines, to enlighten the 
 public on these subjects, to expose the injuries sustained by the unwary 
 from the devices and pretensions of artful empirics and impostors. Phy- 
 sicians ought to use all the influence v/hich they may possess, as profes- 
 sors in Colleges of Pharmacy, and by exercising their option in regard to 
 the shops to which their prescriptions shall be sent, to discourage drug- 
 gists and apothecaries from vending quack or secret medicines, or from 
 being in any way engaged in their manufacture and sale. 
 
 Art. II. — Ohligatijns of the puhlic to physicians. 
 
 1. The benefits accruing to the public, directly and indirectly, from the 
 active and unwearied beneficence of the profession, are so numerous and 
 important, that physicians are justly entitled to the utmost consideration 
 and respect from the community. The public ought likewise to enter- 
 tain a just appreciation of medical qualifications ; to make a proper dis- 
 crimination between true science and the assumptions of ignorance and 
 empiricism and to afford every encouragement and facility for the acqui- 
 sition of medical education.