- The Washington Times - Wednesday, February 6, 2002

Doctors dealing with medical advancements such as cloning and private health care now can seek answers in a new code of ethics a set of guidelines that will act as a supplement to what some medical officials call an outdated Hippocratic oath.

The authors of the new code said yesterday the "Charter on Medical Professionalism" will better help doctors meet the needs of patients in the 21st century and defend patients' access to medical care, an element not included in the more than 2,500-year-old oath.

It urges doctors to keep up with scientific advances such as technology improvements and work toward providing a fair distribution of health care resources.

Medical ethics long had been influenced by the Hippocratic oath, which was written by the Greek physician Hippocrates, the father of modern medicine.

Patient autonomy and choice are issues relevant to doctors today, but not during the life of Hippocrates, between 460 B.C. and 377 B.C.

"The Hippocratic oath offers good advice," said Dr. Troyen Brennan, chairman of the Medical Professionalism Project whose members wrote the charter. "But what we need now is more specific advice and this is what the charter sets out to do."

The Hippocratic oath has been used as a guide of conduct for the medical profession for centuries. It tells doctors, "You will exercise your art solely for the cure of your patients and will give no drug, perform no operation, for a criminal purpose."

The new charter calls for doctors to be honest with patients, provide them with choices on managing their health, improve access and quality of care for patients and avoid inappropriate financial or sexual conduct with patients.

George Alberti, president of the Royal College of Physicians in England, called the new charter "an aide-memoir to modern medical practice."

"This modern interpretation of what is expected of professionals in areas of patient confidentiality, access to health care and ethical conduct is much easier to understand than some of the other oaths and ethical codes in medicine," Dr. Alberti said. "We hope it will lead to a greater understanding of what it means to be a physician, particularly in a climate where many areas of professionalism are under attack from the media and politicians the world over."

The charter was composed over the last year by the American Board of Internal Medicine, the American College of Physicians-American Society of Internal Medicine, and the European Federation of Internal Medicine. The contents of the charter will appear in this week's editions of the Annals of Internal Medicine and the Lancet.

Members of the three groups said they wrote the charter because the medical profession today must contend with "complicated political, legal and market forces," and health standards are coming under threat in developed countries because of privatization of health care and uneven distribution of resources.

"Forces that are largely beyond our control have brought us to circumstances that require a reinstatement of professional responsibilities," said Dr. Harold C. Sox, editor of the Annals of Internal Medicine. "The challenge will be to live by these precepts and to resist efforts to impose a corporate mentality on a profession of service to others."

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