The development of medieval medical ethics
By Darrel W. Amundsen
PhD Dissertation, University of British Columbia, 1980
Abstract: In classical antiquity there were no restrictions on who could practise medicine. There were no enforceable professional standards. The physician sold his services at his own discretion to those who asked and paid for treatment; he exercised his art as he wished. In the early Christian centuries Christian charity and moral principles effected some significant changes in the perception of medical ethics and suggested a responsibility to exercise compassion and extend charity. Yet it is not until the late Middle Ages that we can speak of the development of a clearly-defined medical deontology and professional ethics resulting from two factors:
1) The development of licensure requirements (whether imposed by external authority or obtained by medical guilds) which reflects a fundamental change in the very basis for the practice of medicine from a right to a privilege, with specific obligations attached to that privilege.
2) The clear definition and expression by casuists of the moral responsibilities of physicians. During the late Middle Ages some physicians wrote treatises on medical etiquette and ethics. When the contents of these treatises are supplemented by guild and university ethics and the moral expectations of the casuists, as well as by the evidence of physicians’ conscientious response to the various outbreaks of pestilential disease in the late Middle Ages, the picture that emerges is of relatively high ethical standards circumscribed by, and in part the result of, clearly-delineated expectations of ecclesiastical authority and the secular community.