Introduction Chinese medicine has a history of at least 2,000 years. The first explicit literature on medical ethics did not appear until the seventh century when a physician named Sun Simiao wrote a famous treatise titled "On the Absolute Sincerity of Great Gold.1 In this treatise, later called The Chinese Hippocratic Oath, Sun Simiao required the physician to develop first a sense of compassion and piety, and then to make a commitment to try to save every living creature, to treat every patient on equal grounds, and to avoid seeking wealth because of his expertise. Traditional Chinese medical ethics is the application of Confucianism in the field of medical care. Confucian ethics is a form of virtue ethics with a strong deontological basis. Its focus has been on the virtues that a moral agent should have and the ways they can be acquired. The starting point of this morality is the cultivation of one's character by becoming a person with compassion. All the requisites that a physician should meet, and all the maxims that he or she should follow without regard to consequences, are heavenly principles. In premodern China, medical ethical issues were addressed only in the preface of medical texts. All maxims, exhortations, admonitions, and warnings were personal advice or suggestions of well-known and prestigious physicians of that time. These guidelines were based on the personal experience of noted physicians but were not professional codes in any sense. There have never been medical professional organizations in traditional China, so codes would not have any binding power on physicians.2 Only on 1 January 1937 was "The Creed of Doctors" published by the Chinese Association of Doctors as the motto of modern medical practitioners in China.3 In 1949, after the founding of the People's Republic of China, the government cancelled the licensing system. Even though mistaken medical judgments were made after this time, the courts and lawyers were not allowed to become involved. Social control of medical practice relied mainly on regulations of health administrations and ideological education by the Communist Party Committee of Hospitals. Medical personnel were required to read Mao's article titled "In Memory of Comrade Norman Bethune" and to generate criticism, and self-criticism according to Mao's teachings before and during the notorious Cultural Revolution. Medical ethics has become one of the most flourishing disciplines in the PeoPhysicians" in his work The Important Prescriptions Worth a Thousand Pieces of
This is an extract from a paper to be published in Transcultural Dimensions in Medical Ethics (Copyright University Publishing Group), coedited by Edmund D. Pellegrino, Patricia Mazzarella, and Piettro Corsi. Cambridge Quarterly of Healthcare Ethics (1993), 2, 69-76. Printed in the USA.
Copyright © 1993 Cambridge University Press 0963-1801/93 $5.00 + .00
pie's Republic of China during the last decade. The current stage of Chinese medical ethics began with a conference on the philosophy of medicine, which was held in Canton in December 1979. At the plenary session of this conference, a report titled "Philosophical Issues of Medicine in the 1970V was made, part of which was devoted to medical ethics.4 After this conference the discussion of medical ethics focused on two issues: the concept of death and euthanasia and the delivery of medical care without discrimination.5 Before the publicity of two legal cases, one on active euthanasia and the other on artificial insemination by donor (AID),6 the discussion was circumscribed by academic and professional circles. These circles were comprised of physicians, philosophers, and healthcare administrators who were publishing in specialized journals and attending conferences or colloquia on philosophy of medicine or medical ethics. After the publicity about...