ABSTRACT

The treating physician seemingly had no concern apart from the care and cure of the patient; even as National Institutes of Health officials and other critics of research practices came to recognize that the bedrock principle of medical ethics–the doctor as advocate for his or her patients–did not fit with human experimentation, they did not doubt that it held in medicine itself. Medical ethics as conceptualized and written by physicians had a very practical bent, concerned not as much with discerning first principles as with formulating maxims for practice. "Medical economics", declared the American Medical Association policymakers, "has always rested fundamentally on medical ethics", whose principles were universal, not varying by time or place or type of government. "Such continuous persistence through so wide a diversity of environments", they argued, "seems to prove that judged by the 'survival test', medical ethics has demonstrated its essential social soundness".