ETHICS is a philosophical discipline that studies morality and ethics. The term was introduced by Aristotle, who understood ethics as the philosophy of moral behavior of people. MEDICAL ETHICS is the doctrine of the role of moral principles in the activities of medical workers

In his famous oath, Hippocrates (Hippocrates was born around 460 BC on the island of Kos in the eastern Aegean Sea) articulated the duties of a doctor to his patient. The oath has not lost its relevance and is the standard for constructing many ethical documents.

In the model of Paracelsus (g.g.), “pater nationalism”, the emotional and spiritual contact of the doctor with the patient, acquires primary importance. The entire essence of the doctor-patient relationship is determined by the doctor's beneficence.

Modern medicine, biology, genetics and corresponding biomedical technologies have come close to the problem of predicting and managing heredity, the problem of life and death of the body, control of the functions of the human body at the tissue, cellular and subcellular level

There are two main elements in informed consent: 1. Provision of information; 2. Obtaining consent The physician is obligated to inform the patient: 1. About the nature and purposes of the proposed treatment 2. About the significant risks associated with it 3. About possible alternatives to this treatment

In the initial period of formation of the doctrine of informed consent, the main attention was paid to the provision of information to the patient. In recent years, scientists and practitioners have become more interested in the problems of patient understanding of the information received and achieving agreement on treatment.

The main goal of modern medicine is the well-being of the patient, and restoration of health is subordinated to this goal. Respect for the autonomy of the individual is one of the fundamental values ​​of a civilized way of life. Any person is interested in making decisions that affect his life independently. Thus, today the self-determination of the individual is the highest value, and medical care should be no exception.

“I swear by Apollo the physician, Asclepius, Hygieia and Panacea and all the gods and goddesses, taking them as witnesses, to fulfill honestly, according to my strength and my understanding, the following oath and written obligation: to honor the one who taught me the art of medicine on an equal basis with my parents, shares with him with his wealth and, if necessary, help him with his needs; ...instructions, oral lessons and everything else in the teaching to communicate to your sons, the sons of your teacher and students bound by obligation, but to no one else. I will direct the treatment of the sick to their benefit in accordance with my strength and my understanding, refraining from causing any harm or injustice. I will not give anyone the deadly means they ask from me and I will not show the way for such a plan; in the same way, I will not give any woman an abortion pessary. I will conduct my life and my art purely and immaculately...

Whatever house I enter, I will enter there for the benefit of the sick, being far from everything intentional, unrighteous and harmful. Whatever, during treatment, as well as without treatment, I see or hear regarding human life that should never be disclosed, I will keep silent about it, considering such things a secret. May I, who inviolably fulfill my oath, be given happiness in life and in art and glory among all people for eternity; to the one who transgresses and takes a false oath, let the opposite be done to this.”

For two and a half millennia, this document remains the quintessence of physician ethics. Its authority is based on the name of the ancient Greek physician Hippocrates, the “father” of medicine and medical ethics. Hippocrates proclaimed the eternal principles of the art of medicine: the goal of medicine is to treat the patient; healing can only be learned at the patient's bedside; experience is the true teacher of a doctor. He justified an individual approach to each patient. However, if Hippocrates himself saw healing primarily as an art, then later one of Hippocrates’ followers, the ancient Roman physician Galen, approached medicine as a science and as hard work. In the Middle Ages, Avicenna gave an excellent poetic description of the personality of a doctor. He said that a doctor should have the eyes of a falcon, the hands of a girl, the wisdom of a serpent and the heart of a lion.

There is a widespread belief in society that after graduating from college and taking the canonical Hippocratic Oath, young doctors are legally considered doctors. In fact, it was no longer possible to swear by pagan gods in the Middle Ages. The texts spoken by medical graduates of that time were very different from the traditional Hippocratic Oath. In the 19th century The era of scientific medicine has arrived, the text has been completely replaced. Nevertheless, the basic principles (non-disclosure of medical confidentiality, “do no harm”, respect for teachers) were preserved.

“Fulfill your medical duty honestly, devote your knowledge and skills to the prevention and treatment of diseases, preserving and strengthening human health; be always ready to provide medical care, maintain medical confidentiality, treat the patient with care and attention, act exclusively in his interests, regardless of gender, race, nationality, language, origin, property and official status, place of residence, attitude to religion, beliefs, affiliation to public associations, as well as other circumstances; show the highest respect for human life, never resort to euthanasia; remain grateful and respectful to your teachers, be demanding and fair to your students, and promote their professional growth; treats colleagues kindly, turns to them for help and advice if the interests of the patient require it, and never refuses help and advice to colleagues; constantly improve your professional skills, protect and develop the noble traditions of medicine.”

Medical ethics is a type of professional ethics. Historically, professional ethics developed primarily in medicine and law; pedagogical professions, in which the central place is occupied by helping a specific person and, therefore, interaction with him, as with a patient, client, student (student). The specificity of moral assessments and moral regulation in these areas is determined by the fact that in such interactions the most significant values ​​are directly affected: human life and health, his fundamental freedoms, rights, etc.

In the process of mastering the principles and norms of professional ethics, doctors simultaneously comprehend the mission of their profession in society. The full professional thinking of a doctor, nurse, or pharmacist always includes an ethical component. At the same time, professional medical ethics, which is integral to practice, is designed to ensure the prevention of damage that may be caused to an individual or society, as well as to the authority of the medical profession itself as a result of incompetent, careless or reprehensible actions of any of its representatives.

Medical ethics of Hippocrates

The history of medical ethics available to us in written monuments goes back more than three thousand years. In ancient India, doctors took an oath as early as 1500 BC. e.

The ethics of the ancient Greek doctor are of enduring importance for European medicine. Hippocrates(c. 460-370 BC), especially his famous "Oath". After in the sixteenth century. In different countries (Italy, Switzerland, Germany, France) the printed works of Hippocrates (“Hippocratic Corpus”) were published; the growth of his authority among European doctors can be figuratively called the “second coming” of Hippocrates. Already at that time, doctors receiving a doctorate in medicine at the Faculty of Medicine of the University of Paris were required to give a “Faculty Promise” in front of a bust of Hippocrates. It is known that when F. Rabelais received his doctor of medicine diploma in Montpellier, according to the custom of that time, he was not only given a gold ring, a gold-embossed belt, a cloak of black drape and a crimson cap, but also a book of the works of Hippocrates. In the second half of the 19th century. The “Faculty Promise,” which is based on the “Hippocratic Oath,” was introduced at medical faculties of Russian universities. By analogy with the “Hippocratic Oath” at the beginning of the 20th century. The nursing "Oath of Florence Nightingale" was drawn up, named after the founder of the independent nursing profession, who opened the world's first school of nursing in England in 1861. In the second half of the twentieth century, especially since the formation of bioethics at the turn of the 60s-70s, many provisions of the “Hippocratic Oath” (and the “Hippocratic Corpus” as a whole) found themselves at the epicenter of heated philosophical, theological, and legal disputes, which largely determines today's heightened interest in Hippocratic ethics.

The ethical views of the great physician are set out in the books of the “Hippocratic Corpus”: “Oath”, “Law”, “On the Doctor”, “On Decent Behavior”, “Instructions”, “On Art”, “Aphorisms” and others. Historians have long been arguing over which of these books belonged to Hippocrates himself. Thus, a fairly widespread point of view, first proposed by the American historian L. Edelstein, according to which the “Oath” was created by the Pythagorean school. One of the arguments in favor of this statement is that the “Oath” puts forward significantly stricter standards than those proclaimed in Greek legislation, in the ethics of Plato or Aristotle, and those that were characteristic of medical practice at that time. Although the question of Hippocratic authorship is of great scientific value, the content of the books of the Hippocratic Corpus, their significance and role for the history of medical ethics, as well as their general cultural significance can be considered independently of the resolution of this question.

The first part of the “Oath” contains a description of the relationship within the medical profession, in particular, between teacher and student. Anyone entering the profession has effectively become an adopted member of the teacher's family, and his strongest obligations relate specifically to the teacher and the teacher's family. The primary requirements are to prohibit the disclosure of medical knowledge to those who have not taken the oath, and to protect the ranks of professionals from the penetration of unworthy people. The medical community that existed at that time appears to us as a very closed social organization, which could be designated by words such as order or clan. hippocrates medical humanity

In the area of ​​doctor-patient relationships, Hippocrates proclaimed the principles of humanity, philanthropy, and mercy. The basis of ethics is the idea of ​​respect for a sick person, a patient, the mandatory requirement that no treatment causes him harm: “I... will refrain from causing any harm...”, says the “Oath”. Modern medicine has a huge arsenal of means and methods, the irrational or careless use of which can cause serious damage to the health (iatrogenic pathology) and, in general, to the well-being of the patient. For clarification, we note that these circumstances prompted the famous domestic clinician E.M. Tareev to conclude that the ancient rule “first of all, do no harm” gives way to the requirement of the modern principle of well-calculated risk. In modern clinical medicine, the requirement of Hippocratic ethics still remains mandatory: the benefit expected from a medical intervention must exceed the risk associated with the intervention. Moreover, the importance of this principle of medical ethics increases as the aggressiveness of medical interventions in the sphere of human health increases.

The ideas of humanity and respect for the human dignity of the patient are concretized in many instructions of the Hippocratic Corpus, in particular, in those that relate to the family life of the patient. Particular attention should be paid to the ethical prohibition of intimate relations between a doctor and a patient. The “Oath” says: “Whatever house I enter, I will enter there for the benefit of the sick, being far from everything intentional, unrighteous and harmful, especially from love affairs with women and men, free and slaves.” In the books “About the Doctor” and “On Decent Behavior” one can find a development of this topic: “A doctor has a lot of relationships with his patients; after all, they put themselves at the disposal of doctors, and doctors always deal with women, with girls and with property a very high price, therefore, in relation to all this, the doctor must be abstinent." “When visiting a sick person, you should remember... about external decency,... about brevity, about... sitting down to the patient right away, showing attention to him in everything.”

Healing, which in certain situations presupposes the need for visual and even tactile examination of a patient by a doctor of the opposite sex, seems to destroy the corresponding moral barriers and “neglects” the cultural context of gender relations in society. It is this aspect of medical practice, as well as the special depth of emotional contact, the doctor’s influence on the patient (and even power over him) that contains the possibility of abuse.

The problem posed by Hippocrates retains its practical relevance for modern medicine. For example, in 1991, the Committee on Ethical and Legal Issues of the American Medical Association, having considered the ethical aspects of the relationship between doctors and patients, made a special decision: intimate contacts between a doctor and a patient that occur during the period of treatment are classified as immoral.

The most famous commandment of Hippocrates' ethics is his prohibition on disclosing medical confidentiality. This ethical requirement is contained in the “Oath”: “Whatever during treatment - and also without treatment - I see or hear regarding human life that should never be disclosed, I will keep silent about it, considering such things a secret ". In the book “About a Doctor,” the enumeration of a doctor’s moral qualities begins with “prudence,” the first (and even self-evident) confirmation of which is the ability to remain silent. And this fragment of the book “About the Doctor” ends with a summary: “So, with these soul virtues... he should be distinguished.” This attribution of medical confidentiality to the “valor of the soul” seems especially valuable in the context of the entire subsequent history of medical ethics, especially those stages when attempts were made to abandon the rule of confidentiality altogether.

Perhaps none of the ideas of Hippocratic ethics arouses today, in the 21st century, more interest (not only in the professional medical environment, but also in society as a whole) than the idea of ​​respect for human life. The entire vast modern literature devoted to the problems of euthanasia and abortion, in a certain sense, comes down to polemics between supporters and opponents of the position of Hippocrates: “I will not give anyone the lethal means they ask from me and will not show the way for such a plan; in the same way, I will not give any woman an abortifacient.” pessary". This provision of the “Oath” does not allow the doctor to interrupt the life of the patient, even if he is terminally ill and doomed. In modern literature on bioethics, this problem is referred to as “active euthanasia.” Hippocrates was also fundamentally opposed to the practice of “assisted suicide,” a topic that has been extremely widely discussed in recent years.

The “oath” contains a ban on the participation of a doctor in performing an abortion. However, Hippocrates himself, judging by some sources, was sometimes forced under pressure to allow deviations from this norm. Thus, considering the issue of providing medical care to slaves in Ancient Greece, antiquity researcher T.V. Blavatsky in one of her works mentions the story of Hippocrates about how he terminated the pregnancy of a young slave flute player. In general, the historical evidence available today suggests that the actual medical practice of the times of Hippocrates was more tolerant of abortion and euthanasia than the prescriptions of the Oath. American medical historian D. Amundsen argues that both prohibitions, as a rule, are not enshrined in ancient medical and ethical literature

Hippocrates' interpretation of the topic of informing patients is of undoubted interest. In the book “On Decent Behavior,” a young doctor is given advice: “Everything ... must be done calmly and skillfully, hiding much from the patient in his orders ... and without telling the patients what will happen or has happened, because many patients for this reason reason, i.e. through the presentation of predictions about what comes or happens after, will be brought to an extreme state." In the book “Instructions” the last thought is clarified: “But the sick themselves, due to their deplorable situation, in despair, replace life with death.” It is with this that Hippocrates argues for the requirement to hide the true state of affairs from the patient if it is very deplorable and, even more so, hopeless: the doctor should not take away the patient’s hope for recovery. The further course of the disease is often unpredictable and unknown even to the doctor, and Hippocrates knew about the influence of a person’s mental state on his recovery: often the strength of spirit and confidence in recovery allows the patient to cope with the most serious illnesses, and despair deprives him of strength and creates favorable conditions for the aggravation of the disease.

As we see, many essential features of the “paternalistic model” of the relationship between doctor and patient developed back in the time of Hippocrates. The fatherly, patronizing style of the physician is recommended by many other passages in the Hippocratic Corpus.

The doctor's attention and affection should be combined with persistence and rigor. In some cases, the doctor does not trust the patient (after all, “many have often been deceived in accepting what was prescribed to them”), and therefore Hippocrates recommends assigning a sufficiently experienced student to the patient, “who would observe that he fulfills the instructions on time.” The conclusion of the book “On Decent Behavior” contains the following advice: “Announce everything that is done in advance to those who should know it.” Thus, the paternalistic position here receives its completeness: the restriction on informing the patient himself is complemented by the requirement to inform third parties, and without the consent of the patient himself.

Hippocrates devotes a significant place in his ethical writings to the regulation of the relationships of doctors with each other: “There is nothing shameful if a doctor, who has difficulty in some case with a patient... asks to invite other doctors.” At the same time, “doctors examining a patient together should not quarrel with each other or ridicule each other.” It is not fitting for doctors to be like “neighbors in their profession on the square”; “a doctor’s judgment should never arouse the envy of another.” When faced with a colleague’s mistake, you need to remember that you are also a person, and you too can make mistakes, “for in every abundance there is a lack.” Professional dialogue should not turn into mutual accusations, it should be constructive, business-like in nature, and its goal should always be the good of the patient, and not the doctor’s own ambitions.

The theme of a doctor's attitude to his profession runs like a red thread through the ethical writings of the Hippocratic Corpus. Concern for the authority of the medical profession leaves a unique imprint on the pedagogy of medicine and determines the direction of efforts to educate and self-educate a doctor. Here is the beginning of the book “On the Physician”: “The physician is informed by authority if he is of good color and well-fed, according to his nature, for those who themselves do not have a good appearance in their body are considered by the crowd to be unable to have the right concern for others.” Further, the young doctor is given advice to “keep yourself clean, have good clothes,” which should be “decent and simple” and dressed “not for excessive boasting,” but in order to make a pleasant impression on the patient and his relatives and instill confidence in them to the doctor. The doctor’s face should not be stern, but the opposite extreme should also be avoided: “The doctor who bursts out laughing and is overjoyed is considered heavy.”

The moral and ethical instructions of Hippocrates instruct the doctor to keep under moral control not only his professional activities, but also his entire lifestyle: in private life, he must follow moral rules, since he is a public person. Hippocrates places such high moral demands on a doctor that the question arises whether such a thing is feasible for a person. Good reputation in medicine comes at a price, at the cost of constant self-control and self-restraint: “I will lead my life purely and immaculately.” “To me, who inviolably fulfills the oath, may be given... glory to all people for all eternity.” Hippocrates proclaims the high authority of the medical profession: “Medicine is truly the noblest of all arts.”

The problem of the authority of medicine has another very important aspect for Hippocrates - this is the assessment and criticism of the activities of “pseudo-doctors”. In the book “The Law” he writes about doctors: “There are many of them by rank, but in reality there are as many as possible.” The book “On Decent Behavior” talks about those who, “possessing professional dexterity, deceive people... Anyone can recognize them by their clothes and other decorations.” As for true doctors, having many positive qualities (“they are demanding of debaters, prudent in making acquaintances with people like themselves,” etc.), they also “give into general information everything that they have received from science.” However, in light of the text of the “Oath”, we are apparently talking about a narrow circle of selected professionals.

Let's consider the moral aspects of the real relationship between the doctor and society in ancient Greece. Society highly valued and encouraged the dedication of doctors. Historical sources have brought to us many examples of contempt for dangers and personal courage of doctors during epidemics, wars, and earthquakes. Some of the doctors died. However, another thing is equally important: how fairly such work-service was assessed. In churches, steles were erected in honor of doctors, listing their merits. When a decree was issued in honor of the special merits of a “foreign” doctor, a copy of the decree was sent (sometimes with a solemn delegation) to his native city. Various gifts and generous rewards to doctors in such cases are mentioned in many historical sources.

The selflessness of doctors stood very high on the scale of social values ​​in ancient Greek society. More than once, doctors who were in the public service, in difficult times for the policy, refused completely or for a certain period of time the salary due to them. It is appropriate to remember here that in ancient Greek mythology, a characteristic feature of the patron of medicine, Asclepius, was philanthropy. And if we now return to one of the most important ideas of Hippocratic ethics, according to which the life of a doctor should correspond to his art, then we can better understand this idea: not only the professional activity of a doctor, but also his life itself should be characterized by philanthropy.

We have come to an interesting and important problem - healing and rewards for it. The work of a doctor was highly paid in Ancient Greece (better, for example, than the work of architects). The bulk of doctors lived off fees received from patients. The author of the “Instructions” advises his student: “If you first deal with the matter of remuneration - after all, this is relevant to our whole business - then, of course, you will lead the patient to the idea that if an agreement is not made, you will leave him or you will treat him carelessly and will not give him advice at the moment. You should not worry about establishing remuneration, since we believe that paying attention to this is harmful for the patient, especially in case of an acute illness: the rapidity of the disease, which does not give an opportunity for delay, makes a good doctor seek not profit, but rather the acquisition of glory. It is better to reproach those who are saved than to rob those in danger in advance."

Here an attempt is made to resolve the eternal dilemma: on the one hand, the doctor’s work must be fairly paid, and on the other, the humane nature of the medical profession is emasculated if the relationship between the doctor and the patient is reduced exclusively to money. The relationship between doctor and patient cannot be characterized in economic categories alone because it is very difficult for the patient to assess the quality of the services offered to him. Enrichment cannot be not only the only, but also the most significant motivation for professional activity. When the author of the book “On Decent Behavior” says that medicine and wisdom are closely interrelated (and even identical), then he calls the first manifestations of a doctor’s wise life position “contempt for money, conscientiousness, modesty.”

The words “contempt for money” must, however, be understood taking into account the entire context of the ethical writings of the Hippocratic Corpus. Thus, the author of the “Instructions” advises his student, when it comes to fees, to take a differentiated approach to different patients: “And I advise that you do not behave too inhumanely, but that you pay attention to the abundance of funds (the patient) and their moderation , and sometimes he would treat for nothing, considering a grateful memory higher than momentary glory. If the opportunity presents itself to provide help to a stranger or a poor person, then it should be especially delivered to such people..."

The fairness of society's attitude towards the activities of doctors has another side. In Ancient Greece, there was a special punishment only for doctors: “adoxia” (dishonor). We are talking about doctors who have committed serious professional errors or are guilty of abuse. According to T.V. Blavatsky, historical sources did not preserve factual information about the adoxia procedure itself or its consequences. But there is reason to believe that this punishment was quite severe and effective in the policy’s fight against false doctors and ignoramuses. At a minimum, adoxia meant a loss of trust and respect from fellow citizens. It probably also meant the loss of practice, the loss of a source of income for the doctor. Perhaps it was even accompanied by a partial loss of the rights of the unscrupulous doctor.

To summarize all that has been said, we note that Hippocratic ethics is a system of moral commandments, requirements, prohibitions that regulate the practice of healing and determine the doctor’s attitude towards the patient, towards other doctors, towards his profession as a whole, as well as the doctor’s attitude towards society. Its main principle is the principle “first of all, do no harm” (primum non nocere). She had a huge influence on the moral consciousness of physicians in Ancient Greece and Rome.

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Introduction

The history of medical ethics available to us in written monuments goes back more than three thousand years. For European medicine, the ethics of the ancient Greek physician Hippocrates (460 - 370 BC), especially his famous medical “Oath,” remains relevant to this day. After in the 16th century. The first printed works of Hippocrates (“Hippocratic Corpus”) were published in Europe; the growth of his authority among European doctors can be figuratively called the “second coming” of Hippocrates. Already at this time, doctors receiving their doctorate of medicine at the Paris Faculty of Medicine were required to give a “Faculty Promise” in front of a bust of Hippocrates.

The purpose of this study is to explore the basic ideas underlying Hippocratic ethics, historically the first European form of medical ethics.

In this regard, it seems necessary to consider the following questions:

Consider the Hippocratic oath and analyze its provisions on the basic values ​​and immoral norms of the relationship between doctor and patient;

Show how the ideas of Hippocrates were developed in Europe in the works of Paracelsus and Percival;

Show the role of Hippocratic ideas in modern medicine.

1. The Hippocratic Oath about the basic values ​​and moral standards of the relationship between doctor and patient

Around 400 BC. e. Hippocrates, an ancient Greek physician who is called the father of medicine, compiled the text of a medical oath, expressing the fundamental moral and ethical principles of a doctor’s behavior.

Hippocrates believed that the medical oath has special significance. As one of the founders of medicine, Hippocrates asked doctors to swear:

“I swear by Apollo the physician, Asclepius, Hygieia and Panacea and all the gods and goddesses, taking them as witnesses, to honestly fulfill, according to my strength and my understanding, the following oath and written obligation: to honor the one who taught me on an equal basis with my parents, to share with him my wealth and, if necessary, help him in his needs; consider his offspring as their brothers, and this art, if they want to study it, teach them free of charge and without any contract; communicate instructions, oral lessons and everything else in the teaching to his sons, the sons of his teacher and students bound by an obligation and oath according to the medical law, but to no one else. I will direct the treatment of the sick to their benefit in accordance with my strength and my understanding, refraining from causing any harm or injustice. I will not give anyone who asks me a deadly drug and will not show the way for such a plan; Likewise, I will not give any woman an abortion pessary. I will conduct my life and my art purely and immaculately. In no case will I perform sections on those suffering from stone disease, leaving this to the people involved in this matter. Whatever house I enter, I will enter there for the benefit of the sick, being far from everything intentional, unrighteous and harmful, especially from love affairs with women and men, free and slaves.

So that during treatment - and also without treatment - I neither see nor hear about human life that should never be disclosed, I will remain silent about it, considering such things a secret. May I, who inviolably fulfill my oath, be given happiness in life and in art and glory among all people for eternity; to the one who transgresses and swears a false oath, let the opposite be done to this” 1 .

The god Apollo mentioned here is the patron saint of doctors in ancient Greece and Rome (and the god of music, poetry, divination and the founding of cities). Asclepius, the son of Apollo, was considered a special god - the patron saint of doctors. Hygieia (Hygiene) - goddess of health, Panacea (Panacea) - goddess-healer of all diseases - daughters of Asclepius.

The philosophy reflected in this document is more likely to correspond to the ideas of the Pythagoreans of the 4th century BC. BC, who preached the sanctity of life and were known as opponents of surgical intervention 2.

The basis of the Hippocratic Oath is the idea of ​​respect for the sick, the patient, the mandatory requirement that any treatment does not cause him harm.

Medical ethics requires a specialist not only to not cause harm, but also to perform good deeds. “Whatever house I enter, I will enter there for the benefit of the sick,” says the Hippocratic Oath.

A curious aspect of the oath is the prohibition of intimate relations between the doctor and the patient.

The most famous commandment of Hippocrates' ethics is his prohibition on disclosing medical confidentiality. The medical community thus appears to us as a very closed social organization, which could be designated as an order or clan.

Finally, it should be noted that society in ancient Greece highly valued and encouraged the dedication and selflessness of doctors. In ancient Greek mythology, the patron of medicine, Asclepius, was philanthropic. The work of a doctor was highly paid in Ancient Greece (better, for example, than the work of architects). But Hippocrates advises his student, when it comes to fees, to take a differentiated approach to different patients: “And I advise that you do not behave too inhumanely, but that you pay attention to the abundance of funds (the patient) and their moderation, and sometimes treat would be for nothing, considering grateful memory higher than momentary glory. If the opportunity arises to provide assistance to a stranger or a poor person, then it should be especially delivered to such people” 3 .

Hippocrates saw the deviation in the moral behavior of a doctor from the everyday practice of human relations primarily in the fact that it should not be focused on the personal individual good of the doctor and the search for ways to achieve this good (whether it be material, sensual, etc.).

The doctor’s behavior, both from the point of view of his internal aspirations and from the point of view of his external actions, must be motivated by the interests and welfare of the patient. “Whatever house I enter, I will enter there for the benefit of the sick, being far from everything intentional, unrighteous and harmful,” wrote Hippocrates.

He rightly noted the direct relationship between philanthropy and the effectiveness of a doctor’s professional activity. Philanthropy is not only a fundamental criterion for choosing a profession, but also directly affects the success of medical practice, largely determining the measure of medical art. “Where there is love for people,” said Hippocrates, “there is love for one’s art.”

2. Development of the ideas of Hippocrates in European medicine of the 16th-18th centuries.

2.1. Paracelsus’ model of medical ethics

The second historical form of medical ethics after Hippocrates was the understanding of the relationship between doctor and patient, which developed in the Middle Ages. Paracelsus (1493-1541) was able to express it especially clearly. C. Jung wrote about Paracelsus: “In Paracelsus we see not only the founder in the field of creating chemical medicines, but also in the field of empirical mental treatment” 4.

The Paracelsian model is a form of medical ethics in which the moral attitude towards the patient is understood as one of the most important components of the doctor’s therapeutic behavior strategy. If in the Hippocratic model of medical ethics, first of all, social trust of the patient’s personality is won, then in the Paracelsian model the emphasis is on taking into account the emotional and mental characteristics of the individual, recognizing the importance of mental contact with the doctor and the inclusion of such contact in the treatment process.

Within the boundaries of Paracelsus' model, paternalism (from the Latin pater - father) is fully developed as a type of relationship between doctor and patient. The real meaning of the paternalistic approach is that the connection between the doctor and the patient reproduces not only the best examples of consanguineous relationships, which are characterized by positive psycho-emotional attachments and socio-moral responsibility, but also a certain “divine healing” of the contact between the doctor and the patient 5.

This “divine healing” is determined and given by the good deeds of the doctor, the direction of his will towards the good of the patient. It is not surprising that the main moral principle that is formed within the boundaries of this model is the principle of do good, goodness, or create love, beneficence, mercy.

Paracelsus taught: “The power of a doctor is in his heart, his work must be guided by God and illuminated by natural light and experience; the most important basis of medicine is love.”

2.2.Features of Percival’s medical ethics

In 1803, the English physician T. Percival published the book “Medical Ethics, or a Set of Established Rules for the Professional Conduct of Physicians and Surgeons” (surgeons in those days were not classified as doctors) 6 . If you get acquainted with these rules, you can see that they can be used for official instructions to doctors and nurses of the 20th century:

“Hospital doctors and surgeons must provide care to the sick in such a way that they are given the impression of the importance of their service; that the peace, health and life of those entrusted to their care depend on their skill, attention and devotion. They must also learn that their demeanor should combine tenderness with firmness, condescension with authority, so as to awaken in the minds of their patients feelings of gratitude, respect and confidence.The feelings and emotions of patients in critical circumstances should be known and taken into account no less than the symptoms of their illness. an incorrect assessment can intensify a real evil (disease) or create an imaginary one, no discussions about the essence of the disease are allowed in the presence of patients, either with a doctor (surgeon), or with hospital students or other physicians invited to the hospital. In large wards of a hospital, patients should speak about their complaints in such a tone of voice that it cannot be heard by others. Secrecy, when special circumstances require it, must be strictly observed. And women should be treated with the most scrupulous delicacy. It is cruel to neglect or laugh at their feelings... No precautions in the admission of patients suffering from incurable diseases, or contagious in nature, or tending to be aggravated in an unclean atmosphere, can eliminate the evil that cramped rooms and false economy bring. The delineation of diseases for which they are admitted to the hospital, the state of the air, nutrition, cleanliness, medications - all this should be carefully checked at certain periods of time" 7 .

If in Hippocratic ethics the doctor must put the needs of the patient above his own personal interests, serve the patient day and night with all his heart and soul; do not allow yourself to commit crimes, drunkenness and adultery; keep professional secrets secret. Then in Percival’s ethics we see a slightly different attitude towards patients. Percival's doctor acts as a philanthropist, bringing benefit to them and receiving appropriate gratitude from them. In his opinion, a doctor should behave with patients “delicately, balancedly, condescendingly and authoritatively.”

Percival was the first to recognize the physician's obligations not only to his patients, but also to society.

3. The role of Hippocrates’ ethical ideas in modern medicine

The principles of modern medical ethics for the most part remain adequate to the ethics of Hippocrates: non-harm, mercy, justice, but with recognition of patient autonomy.

In Hippocratic ethics, the “doctor-patient” relationship was built on the basis of “strong” and “weak”, laying down a model of a paternalistic approach in medicine. The dilemma of paternalistic and non-paternalistic is now “cross-cutting” in the ethics of modern medicine. The paternalistic model is based on the asymmetric nature of the moral relationship between the doctor and the patient - the doctor assumes all (or almost all) full responsibility for making clinical decisions. On the contrary, the non-paternalistic model of the relationship between the doctor and the patient is based on the priority of the patient’s moral autonomy, due to which the category of the patient’s rights becomes the key category of this approach 8 .

The basic moral principle of modern medicine is the principle of respect for human rights and dignity. Under the influence of this principle, the solution to the main issue of medical ethics is changing - the issue of the relationship between the doctor and the patient. Today, the issue of patient participation in medical decision-making is acute. This - far from being secondary - participation is formalized in a number of new models of the relationship between doctor and patient. Among them are informational, deliberative, and interpretive. Each of them is a unique form of protecting human rights and dignity.

In Russia, the overwhelming majority of doctors still adhere to the traditional paternalistic model of relationships with patients, in particular, professing the belief in the ethical justification of the doctrine of the “holy (saving) lie” in the conditions of healing. When Sigmund Freud learned from his doctor that he had cancer, he whispered: “Who gave you the right to tell me about this?” The great fighter against all self-deception in the field of sex did not find the strength to face another biological truth - inevitable death. Is it possible to reveal a “terrible” diagnosis to a patient or family or should it be kept secret? Is it advisable to tell the patient a less traumatic diagnosis, and what should be the measure of truth? We often prefer not to know the details of the treatment ahead of us and the risks associated with it. According to surveys, the number of patients who are not interested in receiving information on these topics reaches 60% in Russia 9 .

However, even in America, where for most people knowing the truth about their condition is a self-evident right, doctors take cultural factors into account. A young doctor tells a 68-year-old Chinese patient that he has cancer. From the doctor’s point of view, he is doing everything right - realizing the patient’s right to truthful and accurate information about his condition. But the patient’s son is outraged: he believes that the doctor should have first talked with the patient’s family members, and then they themselves would have decided whether to tell their relative the truth and in what form. In Chinese culture, the ethical basis for decision-making is Confucianism and Buddhism, which emphasize the values ​​of consent and submission to authority. This tradition is directly opposed to the Western model of independent personality, in which concealment of information is seen as a violation of fundamental individual rights 10 .

Description

The history of medical ethics available to us in written monuments goes back more than three thousand years. For European medicine, the ethics of the ancient Greek physician Hippocrates (460 - 370 BC), especially his famous medical “Oath,” remains relevant to this day. After in the 16th century. The first printed works of Hippocrates (“Hippocratic Corpus”) were published in Europe; the growth of his authority among European doctors can be figuratively called the “second coming” of Hippocrates. Already at this time, doctors receiving their doctorate of medicine at the Paris Faculty of Medicine were required to give a “Faculty Promise” in front of a bust of Hippocrates.

Content

Introduction 3
1. The Hippocratic Oath about the basic values ​​and moral standards of the relationship between doctor and patient 4
2. Development of the ideas of Hippocrates in European medicine of the 16th-18th centuries. 7
2.1. Paracelsus’ model of medical ethics 7
2.2.Features of Percival’s medical ethics 8
3. The role of Hippocrates’ ethical ideas in modern medicine 10
Conclusion 13
References 15

For the sick person, the patient, the mandatory requirement is that any treatment brings him benefit and does not cause harm: “I... will refrain from causing any harm...”, says his “Oath”. Modern medicine has a huge arsenal of means and methods, the irrational or careless use of which can cause serious damage to the health (iatrogenic pathology) and, in general, to the well-being of the patient. This circumstance prompted the famous domestic clinician E.M. Tareev to draw the following conclusion: “The old rule of primum ne noceas gives way to the requirement of the modern principle of a well-calculated risk.” It seems that E.M. Tareev is only partly right. In modern healing practice there is a direct deviation from the commandment “First of all, do no harm!” only in cases of mutilation on a “living donor”. In general, in clinical medicine, of course, the discussed requirement of Hippocratic ethics remains mandatory: the benefit (good) expected from a medical intervention must exceed the risk associated with this intervention (i.e., ultimately the maxim “Do no harm”). !" remains unshakable). Moreover, in a certain sense, the importance of this principle of medical ethics is increasing - as the “aggressiveness” of medical interventions in the sphere of human health increases. Of course, the social embodiment of the ethical ideal of humanity in the medical practice of Hippocrates and many generations of doctors after him was not free from contradictions. On the one hand, the book "Epidemics" in the "Hippocratic Corpus" contains case histories of both free citizens and slaves. In the same spirit is the testimony of a historian about a certain doctor Diomiades, who, according to what was published in his honor in the city of Gythia in 70 BC. e. decree, equally treated all those who turned to him, poor and rich, slaves and free. On the other hand, Plato (a younger contemporary of Hippocrates) testifies that slaves were mainly treated by slave doctors, whom he disparagingly classified as the second category of doctors. In fact, only in the 20th century, after the Second World War, did the ideas of protection and guarantees of human rights begin to dominate in social thinking, which, in particular, was reflected in many international documents on medical ethics, in which one of the central places adopted a ban on any discrimination in the provision of medical care. And only from this time on, the principle of humanity, respect for the human dignity of each patient becomes a truly universal ethical principle. However, this last circumstance only emphasizes that in its original, primordial, so to speak, form in European medicine, this principle was formulated by Hippocrates. Humanity in relation to the sick, the patient requires the doctor to be aware of the special mission of the medical profession in society, to develop in the process of education and self-education a high consciousness of professional duty and, no less important, to confirm in practice this fidelity to professional duty. Healing was understood in the Hippocratic school as a service. What are the sources that fed the professional consciousness of such a doctor? First, let us recall one of the most popular thoughts of the entire “Hippocratic Corpus”, set forth in the book “On Decent Behavior”: “After all, a physician-philosopher is equal to God. And indeed there is little difference between wisdom and medicine, and everything that is sought for wisdom is also found in medicine..." Hippocrates was only a few years younger than Socrates, who taught that the main task of philosophy is essentially ethical - to justify, to justify, how a person should live. Hippocrates turned out to be not just a contemporary of the greatest ancient Greek philosophers - Socrates, Plato and Aristotle - he was not just their contemporary in spirit, he was their congenial contemporary. When they say that Hippocrates is the “father of medicine,” they mean at least two things. He finally (more convincingly than before) contrasted scientific, rationalistic (and after this - secular, purely professional) medicine with sacred, temple, priestly medicine. Further: he created professional medical ethics, which reflected in specific ethical principles and norms the then level of ethical (philosophical) consciousness of ancient Greek society. Now we understand the hidden meaning of the instruction from the book “On the Physician”: “let him have a face full of reflection.” Secondly, the doctor of the Hippocratic school, as a citizen of the ancient Greek polis (city-state), had a highly developed civic consciousness. When Hippocrates, in his instructions to a young doctor, told him what “virtues of soul and body” he should possess, the “seeds,” so to speak, fell on well-prepared soil. The entire system of polis democracy, the entire moral atmosphere of this society determined that a warrior must be brave, a legislator must be wise, and a doctor must be humane and skillful. The principle of humanity and respect for the patient’s human dignity is concretized in many instructions of the Hippocratic Corpus, in particular those relating to the family life of the patient. Particular attention should be paid to the ethical prohibition of intimate relations between a doctor and a patient. The “Oath” says: “Whatever house I enter, I will enter there for the benefit of the sick, being far from everything intentional, unrighteous and harmful, especially from love affairs with women and men, free and slaves.” In the books “About the Doctor” and “On Decent Behavior” one can find a development of this topic: “a doctor has a lot of relationships with patients; after all, they put themselves at the disposal of doctors, and doctors always deal with women, girls and with property of a very high value, therefore, in relation to all this, the doctor must be abstinent"; “When visiting a sick person, you should remember... about external decency,... about brevity, about... sitting down to the patient right away, showing attention to him in everything.” The frankness with which Hippocrates discusses the topic of sexual relations between a doctor and a patient may lead some of our contemporaries into confusion. The explanation for this fact should be sought in our past spiritual and social experience. Thus, an authoritative researcher of the problem of sexuality in the context of the history of society and culture says that official Christian morality was ascetic and “anti-sexual”, and, discussing the state of affairs in our country, writes that “for many years, Soviet society has been hypocritical claimed to be absolutely non-sexual and even sexless" [b]. Of course, doctors have always stood apart here. Medical practice itself, which often requires a physical examination of a patient by a doctor of the opposite sex, seems to destroy the corresponding moral barriers and “neglect” the cultural context of gender relations in society. It is this aspect of medical practice, as well as the depth of emotional contact, the doctor’s influence on the patient (and even power over him) that contains the potential for abuse. It is appropriate to say here that in 1991, the Committee on Ethical and Legal Affairs of the American Medical Association, having considered the ethical side of sexual contacts between doctors and patients, came to the conclusion that: 1) intimate contacts between a doctor and the patient that arise during the treatment period are immoral, 2) an intimate relationship with a former patient may in certain situations be considered unethical, 3) the issue of intimate relationships between a doctor and a patient should be included in the training program for all medical workers, 4) doctors must certainly report violations of medical ethics by colleagues. The most famous commandment of Hippocrates' ethics is his prohibition on disclosing medical confidentiality. First of all, this ethical requirement is contained in the “Oath”: “Whatever during treatment - and also without treatment - I see or hear regarding human life that should never be disclosed, I will keep silent about it. considering such things a secret." In the book “About a Doctor,” the enumeration of a doctor’s moral qualities begins with “prudence,” the first (and even seemingly self-evident) confirmation of which is the ability to remain silent. And this fragment of the book “About the Doctor” ends with a summary: “So, these are the virtues of the soul... he should be distinguished.” This clear definition of medical confidentiality as a “valor of the soul” seems especially valuable in the context of the entire subsequent history of medical ethics, especially those stages when attempts were made to abandon the principle of confidentiality altogether. It is necessary to note the close connection between such concepts of Hippocratic ethics as “medical confidentiality” and “first of all, do no harm.” Keeping medical confidentiality means not harming the patient’s peace of mind, not harming his honor and dignity, not injuring his moral well-being, or, in general, his well-being. The family side of the patient’s life is under special patronage, special protection of the institution of medical confidentiality. Disclosure of medical confidentiality is a purely moral evil. And since the commandment to maintain medical confidentiality is contained in the “Oath,” the doctor who breaks it becomes an oathbreaker. Knowing how frivolously (ethically irresponsibly) some modern doctors sometimes dispose of confidential information about their patients, you ask a reasonable question: why is this impossible to imagine in the time of Hippocrates? Let us leave aside for now the pedagogical side of the matter (the worthy example of the Teacher, many years of education from early youth, the elitist rather than mass nature of professional training, etc.) and pay attention to the most important social aspects of healing in ancient Greek society. Historians note that the overwhelming majority of patients here (we are talking primarily about free citizens) were quite intellectually developed: “Wise by rich social experience, the free Greek easily caught the mistakes or negligence of doctors.” What was said especially concerned the doctor’s violations of ethical requirements. Further. A polis is a miniature (by today's standards) social entity: any doctor was “in full view” here, that is, he was under strict control of public opinion. Particularly indicative are the working conditions of doctors who were in public service. This activity was the most difficult, but also the most prestigious. The doctor worked under a contract with government authorities. Inviting a doctor and approving him to the position by the people's assembly was already an assessment of his business qualities. If the doctor deserved it, then at the end of the contract the authorities issued a decree praising him, which played an important role in the doctor’s future career. As we can see, the high ethical level of the medical profession here was associated with its high prestige in society, as well as with effective state and public control. No provision of Hippocratic ethics arouses today, at the turn of the 21st century, more interest (not only in the professional medical community, but also in society as a whole) than the principle of respect for human life. The entire vast modern literature devoted to the problems of euthanasia and abortion, in a certain sense, comes down to polemics between supporters and opponents of the position of Hippocrates: “I will not give anyone the lethal means they ask from me and will not show the way for such a plan; in the same way, I will not give any woman an abortifacient.” pessary" ("pessary" is a linen bag filled with a pharmacologically active substance. - (A.I.)). The term “euthanasia” (literally: a good, easy death) is not found in the vocabulary of Hippocrates, but the above provision of the “Oath” clearly does not allow, prohibits the moral choice of a doctor in relation to a dying patient, which (choice) in modern literature on medical ethics called "active euthanasia". The physician is also prohibited from using the tactic of “assisted suicide,” which has been extremely widely discussed in the American literature on biomedical ethics in recent years. Against the backdrop of 50 million induced abortions performed annually throughout the world, the corresponding ban on the Hippocratic Oath only emphasizes the intransigence of the struggle between defenders and opponents of abortion, whose positions are based on diametrically opposed priorities - “a woman’s right to free choice” and “the right of the fetus to life.” . However, Hippocrates himself, it seems, was also sometimes forced to allow deviations in his ethics under the pressure of social necessity. For example, when considering the issue of providing medical care to slaves in Ancient Greece, T. V. Blavatsky mentions the story of Hippocrates about how he terminated the pregnancy of a young slave flute player. The Hippocratic Corpus contains instructions on the attitude of a doctor to a hopeless, dying patient. We are talking about the book “On Art” (experts, however, claim that there is no reason to attribute its authorship to Hippocrates himself). The goals of medicine here are defined as follows: “it completely frees patients from illness, dulls the power of illness, but it does not extend its hand to those who have already been overcome by illness.” The justification for the latter position boils down to the following considerations: 1) there are diseases that are “stronger than the most powerful remedies”, 2) the therapeutic possibilities of medicine are, in principle, limited (“if anyone thinks that art has power in what is not art.. . he reveals ignorance"), 3) in such cases, the very hope of a cure is groundless (“if such an evil befalls a person that exceeds the means of medicine, then one should not even hope that this evil can be defeated by medical art.” ), 4) doctors who think this way are true doctors (“people truly experienced in the art”), while others are doctors “only in name,” ignoramuses, 5) blaming medicine for the fact that “doctors, they say, do not want to give helping hands to those who are completely conquered by illness,” are not just ignorant, but close to madness, 6) the approach when medicine “does not stretch its hands to those diseases that can no longer be corrected” is fair, and the medical art itself is innocent. The last phrase contains the actual ethical meaning of these polemically pointed, logically sophisticated arguments. In fact: it is pointless to treat incurable patients, because it is impossible to cure them. But it is very simple to get out of this vicious logical circle: yes, it is impossible to cure such patients, but the doctor is still obliged to help them, and this is his professional duty. However, the author of the book “On Art” is more concerned about something completely different - working with incurable, neglected patients can undermine the reputation of medicine. This position contradicts the humanistic spirit of Hippocratic ethics (it is no coincidence, apparently, that experts express doubts about the authorship of this book). In this form, the professional ethics of a doctor degenerates into “corporate ethics”, losing touch with genuine moral values. The main thing is that such “ethics” dominated among doctors not only in Ancient Greece, but also much later, and in a residual form it is present in the psychology (often on a subconscious level) of a considerable part of modern doctors. Related to the topic of the doctor’s attitude towards the dying is the topic of informing patients. In the book “On Decent Behavior,” a young doctor is given advice: “Everything... must be done calmly and skillfully, hiding much in one’s orders from the patient... and without telling the patient what will happen or has happened, for many sick people for this very reason, that is, through the presentation of predictions about what is coming or will happen afterwards, will be brought to an extreme state.” In the book “Instructions,” the last thought seems to be clarified: “But the sick themselves, due to their deplorable situation, in despair, replace life with death.” As we see, many essential features of the “paternalistic model” of the relationship between doctor and patient developed back in the time of Hippocrates. The fatherly-patronizing style of the doctor’s behavior is evident in many other pieces of advice and instructions from the Hippocratic Corps. “Attention” and “affection” should be combined with “perseverance” and “rigor” by the doctor. In some cases, the doctor does not trust the patient (after all, “many were often deceived in accepting what was prescribed to them”), and therefore it is advisable to assign a sufficiently experienced student to him, “who would observe that the patient complies with the instructions on time.” As for the problem of information, the conclusion of the book “On Decent Behavior” contains the following advice: “about everything that is being done, announce in advance to those who should know it.” Thus, the paternalistic position here receives its completeness: the restriction on informing the patient himself is complemented by the requirement to inform third parties (without the patient’s consent!). An integral part of Hippocratic ethics consists of moral precepts regarding the relationship of doctors with each other: “There is nothing shameful if a doctor, who has a problem with a patient in some way... asks to invite other doctors.” At the same time, “doctors examining a patient together should not quarrel with each other and ridicule each other.” It is not fitting for doctors to be like “neighbors in their profession on the square”; “a doctor’s judgment should never arouse the envy of another.” When faced with a colleague’s mistake, you must at least keep in mind that you are also a person and you too can make mistakes, “for in every abundance there is a lack.” The theme of a doctor’s attitude to his profession runs like a red thread through the ethical writings of the Hippocratic Corpus. Concern for the authority of the medical profession leaves a unique imprint on the pedagogy of medicine in Hippocrates and, as it were, directs all efforts to educate and self-educate a doctor. Here is the beginning of the book “On the Physician”: “A physician is informed by authority if he is of good color and well-fed, according to his nature, for those who themselves do not have a good appearance in their body are considered by the crowd to be unable to have the right concern for others.” Further, the young doctor is given advice: “keep yourself clean, have good clothes,” which should be “decent and simple” and dressed “not for excessive boasting.” The doctor’s face should not be stern, but the opposite extreme should also be avoided: “The doctor who pours out laughter and is overjoyed beyond measure is considered heavy.” Particular emphasis should be placed on the instructions given to a young doctor, requiring such self-control from him when the object of concern is his own professional dignity (take, for example, this advice: “hasty and excessive readiness, even if they are very useful, are despised”). The ethical category “dignity” reflects the moral strength of the individual as a whole. And a person’s personality correlates with his lifestyle. The moral and ethical instructions of Hippocrates order the doctor to keep under ethical control not only his professional activities, but also his entire lifestyle. Yes, this is such a high ethics that the question arises -. Is this feasible for a human doctor who takes an oath: “I will lead my life purely and immaculately”? And the fact that the “Oath” not only had the meaning of a solemn initiation into the profession, but also performed a direct practical-regulatory function at that time, confirms a similar moral requirement in the book “About the Doctor,” where the doctor is required to be prudent in all “ a properly ordered life,” in which “the doctor must be abstinent.” We can only assume that the professional consciousness of the doctor of the Hippocratic school, the entire constitution of his personality, was characterized by an amazing moral discipline, some kind of special “moral straightness”. Here, in particular, at what price is given “good fame” in medicine: “To me, who inviolably fulfills the oath, be given... glory among all people for all eternity.” This is the real meaning contained in the words (only at first glance - arrogant): “Medicine is truly the noblest of all arts.” The problem of the authority of medicine has another very important aspect for Hippocrates - this is the assessment and criticism of the activities of “pseudo-doctors”. The author of the book “The Law” states about doctors: “there are many of them by rank, but in reality there are as many as possible.” The book “On Decent Behavior” talks about those who, “possessing professional dexterity, deceive people. .. Anyone can recognize them by their clothes and other decorations" 2). As for true doctors, having many positive qualities (“they are demanding of debaters, prudent in making acquaintances with people like themselves,” etc. ), they also “give into general information everything that they have accepted from science.” It is quite logical to think of the last words as follows: “pseudo-doctors,” unlike true doctors, mainly rely on the so-called “esoteric” (understandable only for initiates) knowledge. And favorable conditions for their practice even at that time were created by patients (as Hippocrates notes in his “Instructions”, some patients prefer “what is unusual and mysterious”).

The name of Hippocrates is associated with the idea of ​​high moral character and ethical behavior of a doctor. And this is no coincidence, because it was he who invented and wrote down the oath, which, despite a history of several thousand years, has not yet been forgotten and is one of the factors determining the appearance of a modern medical worker.

The Oath is the first composition of the Hippocratic Corpus. It contains several principles that a doctor must follow in his life and professional activities:

1. Commitments to teachers, colleagues and students:

“Consider the one who taught me this art as equal to my parents, share with him the means and, if necessary, help him in his needs, accept his offspring as brothers and, at their request, teach them this art, free of charge and without a contract; instructions, oral lessons and everything else. in teaching to communicate to my sons, the sons of my teacher and students who are bound by an obligation and have taken an oath according to the medical law, but to no one else.”

2. The principle of non-harm:

“I will direct the treatment of the sick to their benefit, according to my strength and understanding, refraining from causing any harm or injustice.”

3. Refusal of euthanasia and abortion:

“I will not give anyone the requested lethal means and will not show the way to such a goal, just as I will not give any woman an abortifacient pessary.”

4. Refusal of intimate relationships with patients:

“Whatever house I enter, I will enter there for the benefit of the sick, being far from everything deliberately unrighteous and harmful, especially from love affairs.”

5. Maintaining medical confidentiality:

“Whatever during treatment, as well as outside treatment, I see or hear about people’s lives that should not be talked about, I will keep silent about that, considering all this shameful for disclosure.”

Hippocrates, in his famous oath, substantiated one of the main professional and moral requirements of medical deontology - to help people strengthen and protect their health, regardless of social and property status, social, national and racial background. This “Oath” has been the main ethical document in medicine for more than 2 thousand years, and it also became the basis of the oath of pharmacists.

Conclusion

Based on all of the above, we can safely say that Hippocrates was one of the most prominent and significant figures in the scientific world of antiquity. And his name remains familiar to modern people. This is due not only to the fact that Hippocrates was an outstanding doctor, created invaluable scientific works, and took important steps in the history of medicine and pharmacy. The reason for this is also that Hippocrates had a great influence on the appearance of the modern doctor, became the founder of a set of principles for a medical professional, and at one time determined the right paths for the development of medicine and pharmacy in the future. It is in this regard that he received the nickname “father of medicine” and to this day is the most famous positive example of a medical worker.