List the essence of China's traditional medical ethics?

"Great Medical Knowledge" and "Great Medical Sincerity"

For example, Lingshu Shi Zhuan specifically discusses the responsibility and conscience of doctors; "Shu Wu Guo pian" lists five kinds of medical mistakes and points out that doctors must have four kinds of medical ethics; The chapter "Zheng Suxiang Ross Film" specifically discusses four kinds of mistakes that doctors are prone to make in clinical diagnosis and treatment as a warning. These monographs on medical ethics became compulsory courses for doctors later. Huangdi Neijing has been written for more than 400 years. It summarized the medical ethics thought and practical experience before the Western Han Dynasty, which not only laid the embryonic form of China's ancient medical theory system, but also marked the initial formation of China's traditional medical ethics thought.

"Gao Zongji" records that "Fu" ... painted eight diagrams ... only tasted hundreds of medicines and got nine stitches to save his life; "Huai Nan Zi Xiu Wu Xun" records: "Shennong ... tasted the beauty of herbs and the ups and downs of water springs, making people know what to avoid. At this time, I encountered seventy poisons a day. " In these superficial methods of preventing and treating diseases, there has been a simple medical ethics thought of "saving the dead with kindness", and it has been initially realized that the purpose of medicine is to "save lives" and "make people know taboos", that is, the purpose of medicine is to save lives and make people understand the advantages and disadvantages of drugs.

Sun Simiao's "Thousand Women" and "Thousand Women's Wings" further developed China's ancient medical ethics, and gradually systematized it, forming a relatively complete system. Especially in the works such as Great Doctor Sincerity and Great Doctor Knowledge, the medical ethics problems such as the purpose, dedication, service attitude, learning attitude and moral cultivation of studying medicine are comprehensively discussed. He emphasized that doctors should be "precise" and "sincere". "Fine" refers to superb medical skills; "Honesty" refers to noble medical ethics. He clearly pointed out that medical students should first have kindness, compassion and virtue, and treat patients equally and wholeheartedly. Only "fine" and "sincere" doctors are "great doctors", that is, noble and excellent doctors.

Liu said in "Life-saving Collection: On the Original Road": "Those who take care of their own lives care about others, those who take care of their own lives care about others, and those who take care of their own lives care about others. In any case, it is man-made. " From this, it is clarified that people can control their own destiny, not by "heaven". This idea of respecting human dignity and value is the spirit of humanism and the new development of medical humanism.

Yu Chang (about 1585- 1664) is the author of Medical Law. The chapter "Treating Diseases" of this book discusses in detail the principles and norms of professional ethics that doctors should abide by. This book breaks through the tradition that doctors use proverbial preaching methods such as "Five Commandments" and "Ten Essentials" to discuss medical ethical principles, and regards the principles of four clinical diagnoses and eight basic principles of syndrome differentiation and treatment as the "rules" of the medical profession, and the prohibitive provisions made by common mistakes in clinical diagnosis and treatment as the "rules" of the medical profession. This exposition of putting medical ethics into medical practice is called "clinical ethics" by later generations, which is another major breakthrough in the history of medical ethics in China.

Characteristics and main contents of ancient medical ethics in China

Generally speaking, the characteristics of China's ancient traditional ethics are that morality and politics are closely combined to serve the patriarchal hierarchy; Legalization of morality, moralization of law; Pay attention to the unity of medical ethics and medical skills, and combine medical ethics norms with medical ethics practice; Emphasize the moral cultivation of the subject; Emphasize the unity of man and nature, harmonious interpersonal relationship and pay attention to the golden mean; Confucian ethics is deeply influenced by Confucianism and occupies a dominant position in ancient medical ethics in China.

Specifically, China ancient medical ethics has the following main contents:

1, respect and cherish the noble thought of life.

China's first medical classic, Huangdi Neijing, said: "Everything is ready, not expensive for people." The two chapters of Su Xiang in Neijing, namely, Guo Lun in the Book and the Theory of Zheng Luo, also mentioned that doctors should avoid five mistakes and four mistakes, and warned doctors to analyze the causes from pathological and psychological aspects to relieve patients' pain. In the Tang Dynasty, Sun Simiao's famous saying, "Life is the most important thing, and a thousand dollars is precious. One side helps it, and virtue does not stop there", which further illustrates the importance of attaching importance to the preciousness of life and medical ethics.

2. The medical purpose of "medicine is benevolence"

"Medicine is benevolence" means that medicine is the art of practicing benevolence and the perfect combination of Confucian benevolence and the essence of medicine. Chinese Confucian culture has always emphasized "being a prophet of Confucianism and rationality" and "only knowing medical science". Confucian medicine represents the close combination of general ethics and medicine, and benevolence is the core of general ethics and medical ethics. "Mencius Hui Liang Wang Shang" said: "Harmless is benevolence." Physicians in past dynasties regarded "medicine is benevolence" as the purpose of medical practice and the basic principle of medical ethics. Sun Simiao, a famous doctor in the Tang Dynasty, emphasized that doctors must "be merciful and compassionate first, and swear to save suffering with spirit". In Ming Dynasty, Gong Tingxian said in The Ten Essentials of Doctors in Recovering from All Diseases: "First, we should be kind, …… second, we should know Confucianism and Taoism, … third, we should know evil spirits, and … tenth, we should not pay attention to profit". In the article "Five Commandments and Ten Essentials for Physicians" in Authentic Surgery by Chen Shigong in the Ming Dynasty, it is proposed that the first "importance" is: being a Confucian prophet, then knowing medical science. The proposition that "medicine is benevolence" still has important practical significance even today, which suggests that medicine should adhere to the people-oriented principle at all times, combine "benevolence" with "medicine" and cooperate with doctors and patients.

3. The principle of "universal equivalence" in medical practice.

Starting from the moral concepts of "saving lives with kindness" and "treating doctors as benevolence", ancient physicians emphasized equal treatment of patients, "general equality" and "saving lives with one heart". Sun Simiao suggested: As a doctor, we should be "if someone comes to ask for help when he is sick, we should not ask him whether he is rich or poor, old or young, beautiful or beautiful, friends or friends, rich or poor, vulgar or vulgar." Min Zicheng, a doctor in the Ming Dynasty, was kind and generous, and beggars enjoyed it. Doctor Zhao Mengbi, a hundred miles away, knocked at the door in the middle of the night. Zhu Danxi was one of the four great physicians in Jin and Yuan Dynasties. When practicing medicine, "the four sides welcome the disease, and there is no virtual day", and Mr. Wang "goes without exception, even if it rains or snows, it will not stop." The servant complained of pain, and the gentleman said, "The patient is like one year old, but he wants to run away?" "People who want medicine are all the same, don't compensate. He who has no complaints in trouble does not wait for his move. Although it is a hundred miles away, it has a lingering fear. " Zhang Bing, a doctor in Song Dynasty, saved lives. "No questions, no questions, no questions." Liu Mian, a famous doctor in the late Yuan Dynasty and early Ming Dynasty, used to be too many doctors. In his medical practice all his life, he took "treating everyone equally" as his creed. He often said, "I am not greedy for the wealth of the rich, but I work tirelessly for the welfare of the poor." In the hierarchical feudal society, people's moral status is hierarchical. The doctor-patient relationship advocated by ancient doctors in China is very valuable.

4. Moral concept of valuing righteousness over profit.

According to legend, during the "Three Kingdoms" period, Dong Feng, a famous Jiangxi doctor, lived in seclusion in Lushan Mountain. He lives in the mountains and doesn't farm. He treats people every day and doesn't take money. Those who recovered from a serious illness planted five apricots and one light. A few years later, he got more than 100,000 apricots and became a forest. He uses apricots collected every year to help the poor who seek medical treatment. Today, the medical community still has the story of "Xinglin is warm in spring" to praise the virtue of doctors. Pan, a doctor in the Ming Dynasty, had a good medical skill and never charged for medicine. Although he has been practicing medicine for 30 years, he is still poor and has almost no land. After his death, the local people buried him in an empty lane to express their condolences and eternal memories. The story of "Xinglin is warm in spring" and the legend of "an empty alley" represent the typical moral concept of valuing righteousness over profit in ancient China.

5. Clean medical practice style

There are countless examples of honest and decent doctors in ancient China. For example, in the medical book Introduction to Pediatric Hygiene, it is emphasized that doctors should have good conduct and decent medical style. In the Ming Dynasty, Chen Shigong stipulated in the second commandment of "Five Commandments and Ten Essentials for Physicians" that anyone who treats women and widows and nuns must wait for the waiter to come before entering the room for consultation. If you have no company, don't look at yourself. Zhang Gao recorded in "The Theory of Medicine": "He Cheng, a physician in the Xuanhe period of the Northern Song Dynasty, and Ceng Zhi, a scholar, were ill for many years and could not be cured. His wife was sold because her husband was ill for a long time, and there was no medicine for her. She was willing to pay. He cheng immediately said seriously, madam, what is this statement! But don't worry, this is for adjustment and treatment, and don't use it to pollute each other! " The scholar finally recovered under the careful treatment of He Cheng. He Cheng's noble moral sentiments have been praised by all previous dynasties.

6. Respect the modesty of fellow travelers.

Sun Simiao discussed the relationship between doctors and colleagues in his masterpiece "Great Doctor Sincerity": "A husband is a doctor's law, not a joke, a joke, right and wrong, and a person. Show off your reputation, ruin the doctor, and be proud of yourself. " Chen Shigong's "Five Commandments and Ten Essentials of Physicians" advocates: "Anyone who is in the same position in the countryside ... is respected by elderly people, and some scholars learn from them. Proud people feel inferior, and those who feel inferior recommend pulling it out. " His colleague Fan Fengyi wrote in the preface of Authentic Surgery: "My colleague Chen Shigong has always been open-minded, kind-hearted, respectful and modest." Zhu Zhenheng (also known as Zhu Danxi), the founder of the Yin-nourishing School among the four great families in the Jin and Yuan Dynasties, once treated a woman suffering from tuberculosis. Her illness will recover, but there are two red spots on her cheeks. There was no other way to cure Zhu Danxi, so he wrote to the patient's family and asked Ge Kejiu of Jiangsu for treatment. Sure enough, the patient was completely cured. These examples are touching and thought-provoking.

7. Pay attention to moral self-discipline and self-cultivation.

Huangdi Neijing, as the first medical classic in China, marks the initial formation of the theoretical system of traditional Chinese medicine and is an important monograph on medical and medical ethics education in early China. Sun Simiao, as a "sincere doctor" respected by doctors in past dynasties, attached great importance to moral self-discipline and self-cultivation. He studied medicine because of illness as a teenager and devoted his life to medical and pharmaceutical research. The Sui and Tang emperors called him to be an official many times, but he refused to accept it and treated the people for life. In order to relieve the suffering of leprosy patients, he took more than 600 patients to live in the deep mountains and forests, not afraid of infection, personally cared for them, carefully treated them, recorded the changes of their condition and the treatment process in detail, and cured more than 60 people. Respected and respected, he is known as "Sun Zhenren" and "King of Medicine". Yang Quan of the Jin Dynasty said in "On Things": "Being a husband's doctor, a heartless person cannot be trusted; If you are not smart and sensible, you cannot be appointed; Dishonest, dishonest and untrustworthy. " That is, when appointing doctors in ancient times, people with good moral character must be chosen. In his book Deliberately Discussing Medicine, Lin Bu in the Northern Song Dynasty wrote another famous saying related to this, that is, "Those who keep morality are not allowed to be doctors". "The doctor is the key to life and death ..." This famous saying is still widely read today. Yu Chang, a famous doctor in the Qing Dynasty, not only greatly enriched and perfected the traditional theory of medical ethics evaluation in his masterpiece "The Law of Medical Door", but also made another important contribution to medical ethics, which initiated the self-reflection of doctors in medical ethics cultivation. He hopes that there are "doctors who sue themselves" in the world.

8. Be loyal to the dedication of the medical industry.

Many ancient medical furniture have the spirit of not fearing power, not seeking fame and fortune, not caring about personal gains and losses, and dedicating themselves to the medical cause and the people. In feudal society, doctors' status in China was very low, and they were often included in the list of "three religions and nine streams", belonging to the same class as fortune tellers who looked at geomantic omen, so they were called "medical astrology". But in order to save people, they abandoned their official positions and became people's doctors. Fan Zhongyan in Song Dynasty said: "If you are not a good doctor, you are a good doctor." . Hua Tuo, a famous doctor in the Eastern Han Dynasty, was brilliant in medical skills, but not as good as fame and fortune. He abandoned his official position three times in his life and insisted on practicing medicine among the people. Compendium of Materia Medica written by Li Shizhen in Ming Dynasty is an unprecedented masterpiece of pharmacology in China. It has 654.38+0.90 million words, 52 volumes, 654.38+0.892 kinds of drugs and 654.38+0.096 prescriptions. He spent 27 years before and after, read more than 800 books, interviewed four directions, revised the manuscript, systematically summarized the rich experience of Chinese medicine before16th century, and made important contributions to the development of Chinese medicine. Huangfu Mi of Jin Dynasty was born in poverty and worked as a farmer since childhood. At the age of 20, he was eager to learn. At the age of 42, he was paraplegic and deaf due to rheumatism. At the age of 54, he suffered from a serious illness due to cold stone powder and almost died. However, he did not give up his studies because of poor health, but devoted himself to the study of acupuncture. After years of unremitting efforts, he finally wrote a masterpiece of acupuncture, Huangdi Acupuncture Three Classics. This book is the earliest extant monograph on acupuncture in China, which systematically expounds the theoretical knowledge of acupuncture and lays a solid foundation for the development of acupuncture and moxibustion. He was called the father of acupuncture by later generations.

As an ancient civilization with a long history in the world, China is rich in ancient medical ethics, and the above introduction is only its main content or tradition. These excellent contents or traditions are still worthy of our inheritance and continuous development in combination with the characteristics of the times. It should be pointed out that China's ancient medical ethics also had its historical and class limitations. It is mainly manifested in two aspects: First, it is influenced by feudal patriarchal ideology, hierarchy and some feudal superstitions. For example, feudal moral concepts such as "three obedience and four virtues" and "three cardinal guides and five permanents" restricted women from seeking medical treatment through some rules and regulations. For example, in the Ming Dynasty, Li's "Introduction to Medicine and Standard for Learning Medicine" said: "When a woman gets a diagnosis, she must ask her close relatives about their color, tongue and diet, and then take gauze as the diagnosis, bed as the diagnosis, or door as she wishes. It is inconvenient to be poor at home, and doctors wear gauze. " In addition, the ethical concepts of loyalty, filial piety, benevolence, righteousness and propriety of the feudal ruling class also had a negative impact on medical ethics. For example, "a person's body is damaged, and parents dare not do it", and it is unfilial, unkind and unjust to ban autopsy, which seriously hinders the progress of autopsy research in China. In the requirements of ancient medical ethics in China, there are many manifestations of feudal patriarchal hierarchy in Confucianism. For example, it is recorded in the Book of Rites Quli: "If you have a disease, I will taste it first. If you are sick, try it first. " This is the manifestation of the feudal patriarchal hierarchy of "monarch, minister and son". Secondly, although there were relatively perfect medical ethics norms in ancient China, there was a lack of systematic ethical theory.