Professional Medical Ethics: Grounds for Its Separateness and Position in Ethical Education of Physicians and Medical Students
Main Article Content
Abstract
In the article I prove the separateness of professional medical ethics in three ways: 1. By showing differences between the normative rank of responsibilities (conducts, values and virtues) within general and professional ethics. 2. By justifying affiliation of professional medical ethics within the appropriation model which is a type of applied ethics characterized by its unique properties. 3. By justifying historical professionalism as the ethics that is proper for the medical profession; for this kind of ethical internalism the content of professional ethics is the sole work of medical professional organizations as well as individual doctors.
In the final part of the article I reconstruct the actual and postulated relations between professional ethics and professionalism as well as between academic bioethics and public bioethics. The aim of this reconstruction is to indicate the optimal from the perspective of ethical education place of professional ethics within the ethics education system for professionalists.
Downloads
Article Details

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
By submitting his/her work to the Editorial Board, the author accepts, upon having his/her text recommended for publication, that Diametros applies the Attribution 4.0 International (CC BY 4.0) license to the works we publish. Under this license, authors agree to make articles legally available for reuse, without permission or fees. Anyone may read, download, copy, print, distribute or reuse these articles without asking prior permission from the publisher or the author, as long as the author and original source are properly cited. The author holds the copyright without any other restrictions. Full information about CC-BY: https://creativecommons.org/licenses/by/4.0/legalcode.
References
ABIM Foundation, ACP–ASIM Foundation, European Federation of Internal Medicine (2002), Medical Professionalism in the New Millennium: A Physician Charter, „Annals of Internal Medicine” 136 (3): 243–246.
View in Google Scholar
American Medical Association (1847), Code of Medical Ethics, URL = https://www.ama-assn.org/sites/default/files/media-browser/public/ethics/1847code_0.pdf [dostęp 10.06.2019].
View in Google Scholar
American Medical Association (1999), Principles of Medical Ethics, [w:] The American Medical Ethics Revolution, R.B. Baker, A. Caplan, L. Emanuel et al. (red.), Johns Hopkins University Press, Baltimore: 335–345.
View in Google Scholar
American Medical Association (1957), Principles of Medical Ethics, URL = https://www.encyclopedia.com/science/encyclopedias-almanacs-transcripts-and-maps/principles-medical-ethics-1957 [dostęp 20.06.2019].
View in Google Scholar
American Medical Association (1991), Code of Medical Ethics’ Opinions on Care at the End of Life, „Virtual Mentor” 15 (12): 1038–1040.
View in Google Scholar
American Medical Association (2001), Principles of Medical Ethics AMA, URL = https://www.ama-assn.org/sites/ama-assn.org/files/corp/media-browser/principles-of-medical-ethics.pdf [dostęp 20.06.2019].
View in Google Scholar
American Medical Association (2019), Opinions on Patient-Physician Relationships, URL = https://www.ama-assn.org/system/files/2019-01/code-of-medical-ethics-chapter-1_0.pdf [dostęp 10.06.2019].
View in Google Scholar
AMA Council of Ethical and Judicial Affairs (1992), Sexual Misconduct in the Practice of Medicine, URL =http://www.lifeinslowmotionblog.com/wp-content/uploads/2015/04/Sexual-Misconduct-in-the-Practice-of-Medicine.pdf [dostęp 10.06.2019].
View in Google Scholar
AMA Council of Ethical and Judicial Affairs (1999), Fundamental Elements of the Patient-Physician Relationship, [w:] The American Medical Ethics Revolution, R.B. Baker, A. Caplan, L. Emanuel et al. (red.), Johns Hopkins University Press, Baltimore: 360–361.
View in Google Scholar
Andre J.A. (2010), Moralność ról jako złożony przypadek zwyczajnej moralności, tłum. M. Strąkow, [w:] Moralność i profesjonalizm. Spór o pozycję etyk zawodowych, W. Galewicz (red.), Universitas, Kraków: 207–222.
View in Google Scholar
Anonim (2003), Kodeks nie całkiem etyczny, URL = https://www.wprost.pl/swiat/49417/Kodeks-nie-calkiem-etyczny.html [dostęp 01.09.2019].
View in Google Scholar
Arras J.D. (2001), A Method in Search of Purpose: The Internal Morality of Medicine, „Journal of Medicine and Philosophy” 26 (6): 643–662.
View in Google Scholar
Baker R.B. (1999), The American Medical Ethics Revolution, [w:] The American Medical Ethics Revolution, R.B. Baker, A. Caplan, L. Emanuel et al. (red.), Johns Hopkins University Press, Baltimore: 17–51.
View in Google Scholar
Baker R.B. (2002), Bioethics and History, „Journal of Medicine and Philosophy” 27 (4): 447–474.
View in Google Scholar
Baker R.B. (2013), Before Bioethics: A History of American Medical Ethics from the Colonial Period to the Bioethics Revolution, Oxford University Press, Oxford.
View in Google Scholar
Baker R.B., McCullough L. (2007), Medical Ethics’ Appropriation of Moral Philosophy: The Case of the Sympathetic and the Unsympathetic Physician, „Kennedy Institute of Ethics Journal” 17 (1): 3–22.
View in Google Scholar
Baker R.B., Caplan A., Emanuel L. et al. (1999), Introduction, [w:] The American Medical Ethics Revolution, R.B. Baker, A. Caplan, L. Emanuel et al. (red.), Johns Hopkins University Press, Baltimore: XXXII–XXXIX.
View in Google Scholar
Barański J. (2013), Wywiady i listy z etyką lekarską w tle, URL https://medium.dilnet.wroc.pl/pliki/medium/0813.pdf [dostęp 01.09.2013].
View in Google Scholar
Beauchamp T.L. (2001), Internal and External Standards for Medical Morality, „Journal of Medicine and Philosophy” 26 (6): 601–619.
View in Google Scholar
Beauchamp T.L. (2003), The Origins, Goals, and Core Commitments of The Belmont Report and Principles of Biomedical Ethics, [w:] The Story of Bioethics: From Seminal Works to Contemporary Explorations, J.K. Walter, E.P. Klein (red.), Georgetown University Press, Washington: 17–46.
View in Google Scholar
Beauchamp T.L. (2007), The „Four Principles” Approach to Health Care Ethics, [w:] Principles of Health Care Ethics, R.E. Ashcroft, A. Dawson, H. Draper et al. (red.), John Wiley&Sons Ltd., Chichester: 3–10.
View in Google Scholar
Beauchamp T.L. (2007a), History and Theory in “Applied Ethics”, „Kennedy Institute of Ethics Journal” 17 (1): 55–64.
View in Google Scholar
Beauchamp T.L., Childress J.F. (1996), Zasady etyki medycznej, tłum. W. Jacórzyński, Książka i Wiedza, Warszawa.
View in Google Scholar
Beauchamp T.L., Childress J.F. (2013), Principles of Biomedical Ethics, Oxford University Press, Oxford.
View in Google Scholar
Biegański W. (1899), Myśli i aforyzmy o etyce lekarskiej, Skład Główny w Księgarni E. Wendego i Spółki, Warszawa.
View in Google Scholar
Breakey H. (2016), Supply and Demand in the Development of Professional Ethics, [w:] Contemporary Issues in Applied and Professional Ethics, M. Grix, T. Dare (red.), Emerald Group Publishing, Bingley: 1–28.
View in Google Scholar
Caplan A.L. (1983), Can Applied Ethics Be Effective in Health Care and Should It Strive to Be?, „Ethics” 93 (2): 311–319.
View in Google Scholar
Cassell E.J. (2013), The Beginnings of Bioethics, [w:] The Development of Bioethics in the United States, J.R. Garrett, F. Jotterand, D.Ch. Ralston (red.), Springer, Dordrecht: 16–25.
View in Google Scholar
Chadwick R. (2009), What is ‘Applied’ in Applied Ethics?, „Journal of Applied Ethics and Philosophy” 1: 1–7.
View in Google Scholar
Chisholm A., Askham J. (2006), A Review of Professional Codes and Standards for Doctors in the UK, USA and Canada, URL = https://www.picker.org/wp-content/uploads/2014/10/A-review-of-professional-codes-...-UK-USA-and-Canada.pdf [dostęp 20.06.2019].
View in Google Scholar
Chyrowicz B. (2013), Etyka stosowana – rozwój czy kryzys refleksji etycznej?, [w:] Etyka stosowana. Metody i problemy, B. Chyrowicz (red.), Towarzystwo Naukowe KUL, Lublin: 11–40.
View in Google Scholar
Cruess S.R., Cruess R.L. (2004), Professionalism and Medicine’s Social Contract with Society, „Virtual Mentor” 6 (4): 185–188.
View in Google Scholar
Dryla O. (2018), Pojęcie doskonalenia w sporach o cele medycyny, Wydawnictwo Uniwersytetu Jagiellońskiego, Kraków.
View in Google Scholar
Dunn M. (2016), On the Relationship Between Medical Ethics and Medical Professionalism, „Journal of Medical Ethics” 42 (10): 625–626.
View in Google Scholar
Dzur A.W. (2008), Democratic Professionalism. Citizen Participation and the Reconstruction of Professional Ethics, Identity, and Practice, Pennsylvania State University Press, University Park.
View in Google Scholar
Editorial (1997), The Ethics Industry, „Lancet” 350 (9082): 897.
View in Google Scholar
Erde E.L. (2013), Professionalism vs. Medical Ethics in the Current Era: A Battle of Giants, [w:] The Development of Bioethics in the United States, J.R. Garrett, F. Jotterand, D.Ch. Ralston (red.), Springer, Dordrecht: 179–206.
View in Google Scholar
Foster Ch. (2017), Relationship Between Ethics, Law and Professionalism, [w:] Medical Ethics, Law and Communication at a Glance, P. Davey, A. Rathmell, M. Dunn et al. (red.), John Willey and Sons, Ltd., Chichester: 15–23.
View in Google Scholar
Fox R., Swazey J. (1984), Medical Morality Is Not Bioethics – Medical Ethics in China and the United States, „Perspective in Biology and Medicine” 27 (3): 336–360.
View in Google Scholar
Freedman B. (2010), Metaetyka moralności zawodowej, tłum. J. Malczewski, [w:] Moralność i profesjonalizm. Spór o pozycję etyk zawodowych, W. Galewicz (red.), Universitas, Kraków: 157–180.
View in Google Scholar
Gaie J.B.R. (2004), The Ethics of Medical Involvement in Capital Punishment, Kluwer Academic Publishers, Dordrecht.
View in Google Scholar
Galewicz W. (2010), W sprawie odrębności etyk zawodowych, [w:] Moralność i profesjonalizm. Spór o pozycję etyk zawodowych, W. Galewicz (red.), Universitas, Kraków: 9–119.
View in Google Scholar
Gawande A. (2009), The Checklist Manifesto: How to Get Things Right, Metropolitan Books, New York.
View in Google Scholar
Gielewska A. (2003), Po co ten kodeks?, URL = http://www.sluzbazdrowia.com.pl/artykul_mobilny.php?numer_wydania=3273&art=3 [dostęp 27.03.2020].
View in Google Scholar
Gillon R. (2003), Ethics Needs Principles – Four Can Encompass the Rest – and Respect for Autonomy Should Be “First Among Equals”, „Journal of Medical Ethics” 29 (5): 307–312.
View in Google Scholar
Izba Lekarska Warszawsko-Białostocka (1975), Projekt kodeksu deontologii lekarskiej, [w:] A. Tulczyński, Polskie lekarskie kodeksy deontologiczne, PZWL, Warszawa: 138–145.
View in Google Scholar
Karta Lekarza (2013), URL = https://www.mp.pl/etyka/dokumenty/86822,karta-lekarza [dostęp 15.06.2019].
View in Google Scholar
Koch T. (2012), Thieves of Virtue. When Bioethics Stole Medicine, The MIT Press, Cambridge.
View in Google Scholar
Kohn L.T., Corrigan J.M., Donaldson M.S. (1999), To Err Is Human. Building a Safer Health System, National Academy Press, Washington.
View in Google Scholar
Latham S., Emanuel L.L. (1999), Who Needs Physicians’ Professional Ethics?, [w:] The American Medical Ethics Revolution, R.B. Baker, A. Caplan, L. Emanuel et al. (red.), Johns Hopkins University Press, Baltimore: 192–203.
View in Google Scholar
Lawlor R. (2007), Moral Theories in Teaching Applied Ethics, „Journal of Medical Ethics” 33 (6): 370–372.
View in Google Scholar
Łuków P. (2012), Moralność medycyny. O sztuce dobrego życia i o sztuce leczenia, Wydawnictwo Naukowe Semper, Warszawa.
View in Google Scholar
Łuków P. (2017), Non-Adjectival Bioethics, „Ethics, Medicine and Public Health” 3 (4): 401–409.
View in Google Scholar
Łuków P. (2018), Bioethics, Policy Compromise, and Religious Pluralism, „Ethics, Medicine and Public Health” 5: 99–109.
View in Google Scholar
May W.F. (1975), Code, Covenant, Contract or Philanthropy, „Hastings Center Report” 5 (6): 29–38.
View in Google Scholar
McCullough L.B. (2006), John Gregory’s Medical Ethics and the Reform of Medical Practice in Eighteenth-Century Edinburgh, „Journal of the Royal College of Physicians of Edinburgh” 36 (1): 86–92.
View in Google Scholar
McCullough L.B. (2006a), The Ethical Concept of Medicine: Its Origins in Modern Medical Ethics and Implication for Physicians, [w:] Lost Virtue: Professional Character Development in Medical Education, N. Kenny, W.N. Shelton (red.), Elsevier Ltd., Oxford: 17–28.
View in Google Scholar
Michałowska M., Turek J. (2010), Pomoc i czyny obowiązkowe i ponadobowiązkowe w praktyce lekarskiej i bioetyce, „Etyka” 43: 125–142.
View in Google Scholar
Naczelna Izba Lekarska (1975), Zbiór zasad deontologii lekarskiej, [w:] A. Tulczyński, Polskie lekarskie kodeksy deontologiczne, PZWL, Warszawa: 145–154.
View in Google Scholar
Naczelna Izba lekarska (2004), Kodeks etyki lekarskiej, URL = https://www.diametros.iphils.uj.edu.pl/serwis/?l=1&p=cnf4&m=44&jh=1&ih=63 [dostęp 20.06.2019].
View in Google Scholar
Nadzwyczajny II Krajowy Zjazd Lekarzy (1991), Uchwała w sprawie Kodeksu etyki lekarskiej, URL = https://www.diametros.iphils.uj.edu.pl/serwis/?l=1&p=cnf4&m=44&jh=1&ih=2 [dostęp 20.06.2019].
View in Google Scholar
Paprocka-Lipińska A. (2016), Normy kodeksowe w Polsce na przestrzeni wieków, [w:] Etyka w medycynie. Między teorią a praktyką, A. Paprocka-Lipińska, R. Budziński (red.), Gdański Uniwersytet Medyczny, Gdańsk: 63–74.
View in Google Scholar
Pellegrino E.D. (1999), The Moral Status and Relevance of the AMA Code of Ethics, [w:] The American Medical Ethics Revolution, R.B. Baker, A. Caplan, L. Emanuel et al. (red.), Johns Hopkins University Press, Baltimore: 107–123.
View in Google Scholar
Pellegrino E.D. (2010), Zewnętrzne i wewnętrzne cele medycyny: jak je zdefiniować?, tłum. O. Dryla, [w:] Moralność i profesjonalizm. Spór o pozycję etyk zawodowych, W. Galewicz (red.), Universitas, Kraków: 333–349.
View in Google Scholar
Polskie Towarzystwo Lekarskie (1975), Zasady etyczno-deontologiczne Polskiego Towarzystwa Lekarskiego, [w:] A. Tulczyński, Polskie lekarskie kodeksy deontologiczne, PZWL, Warszawa: 171–176.
View in Google Scholar
Polskie Towarzystwo Lekarskie (1994), Zbiór zasad etyczno-deontologicznych polskiego lekarza, [w:] K. Szewczyk, Etyka i deontologia lekarska, Polska Akademia Umiejętności, Kraków: 161–168.
View in Google Scholar
Radziwiłł K. (2003), Wypowiedź na Ogólnopolskiej Konferencji O nowelizacji Kodeksu Etyki Lekarskiej, URL – https://izba-lekarska.pl/numer/numer-200308/ogolnopolska-konferencja-konstanty-radziwill-prezes-nrl/ [dostęp 20.06.2019].
View in Google Scholar
Radziwiłł K. (2004), Szanowna koleżanko? Szanowny Kolego, [w:] Naczelna Izba lekarska, Kodeks etyki lekarskiej, URL = http://www.pznamazowszu.ehost.pl/Kodeks%20Etyki%20Lekarskiej.pdf [dostęp 18.06.2019].
View in Google Scholar
Rhodes R. (2002), Two Concepts of Medical Ethics and Their Implications for Medical Ethics Education, „Journal of Medicine and Philosophy” 27 (4): 493–508.
View in Google Scholar
Rhodes R., Cohen D.S. (2003), Understanding, Being, and Doing: Medical Ethics in Medical Education, „Cambridge Quarterly of Healthcare Ethics” 12 (1): 39–53.
View in Google Scholar
Rhodes R., Smith L.G. (2006), Molding Professional Character, [w:] Lost Virtue: Professional Character Development in Medical Education, N. Kenny, W.N. Shelton (red.), Elsevier Ltd., Oxford: 99–114.
View in Google Scholar
Schicktanz S., Schweda M., Wynne B. (2012), The Ethics of ‘Public Understanding of Ethics’ – Why and How Bioethics Expertise Should Include Public and Patients’ Voices, „Medicine, Health Care and Philosophy” 15 (2): 129–139.
View in Google Scholar
Szewczyk K. (2009), Bioetyka, t. 2, Pacjent w systemie opieki zdrowotnej, Wydawnictwo Naukowe PWN, Warszawa.
View in Google Scholar
Szewczyk K. (2013), Komisje etyczne i konsultanci etyczni, [w:] Bioetyka, J. Różyńska, W. Chańska (red.), Wolters Kluwer, Warszawa: 545–557.
View in Google Scholar
Szewczyk K. (2016), Odpowiedzialność moralna lekarzy i bioetyka, [w:] Etyka w medycynie. Między teorią a praktyką, A. Paprocka-Lipińska, R. Budziński (red.), Gdański Uniwersytet Medyczny, Gdańsk: 24–62.
View in Google Scholar
Szewczyk K. (2018), Kurs pozaformalny w edukacji studentów medycyny i młodych lekarzy, „Diametros” 57: 61–87.
View in Google Scholar
Szewczyk K. (2019) Formy profesjonalizmu lekarskiego i ich przydatność w edukacji moralnej studentów medycyny i młodych lekarzy, „Diametros” 16 (62): 33–64.
View in Google Scholar
Tapper A., Millett S. (2014), Is Professional Ethics Grounded In General Ethical Principles?, „Theoretical and Applied Ethics” 3 (1): 61–80.
View in Google Scholar
Thomson J.J. (1982), Obrona sztucznego zapłodnienia, [w:] Nikt nie rodzi się kobietą, tłum. T. Hołówka, Czytelnik, Warszawa: 233–257.
View in Google Scholar
Tomaszewska P. (2017), Nadużycia seksualne i ich kwalifikacja w praktyce sądów lekarskich, „Medyczna Wokanda” 9: 179–189.
View in Google Scholar
Towarzystwo Warszawskie Lekarskie (1975), Zasady obowiązków i praw lekarzy, [w:] A. Tulczyński, Polskie lekarskie kodeksy deontologiczne, PZWL, Warszawa: 85–95.
View in Google Scholar
Tulczyński A. (1975), Polskie lekarskie kodeksy deontologiczne, PZWL, Warszawa.
View in Google Scholar
Umiastowski J. (1994), Wokół Kodeksu etyki lekarskiej, „Ethos” 1–2: 237–244.
View in Google Scholar
Wilson D. (2012), Who Guards the Guardians? Bioethics and the ‘Ideology and Accountability’ in British Medicine, „Social History of Medicine” 25 (1): 193–211.
View in Google Scholar
Wulff H.R. (1994), Against the Four Principles: A Nordic View, [w:] Principles of Health Care Ethics, R. Gillon (red.), John Wiley, Chichester: 277–286.
View in Google Scholar
Veatch R. (2010), Zawodowa etyka medyczna: fundament jej zasad, tłum. W. Galewicz, [w:] Moralność i profesjonalizm. Spór o pozycję etyk zawodowych, W. Galewicz (red.), Universitas, Kraków: 325–332.
View in Google Scholar
Zielonka T.M. (2000), Na marginesie Kodeksu etyki lekarskiej. Art. 31, URL = http://www.oil.org.pl/xml/nil/gazeta/numery/n2000/n200003/n20000328 [dostęp 30.05.2019].
View in Google Scholar
X Zjazd Lekarzy i Przyrodników Polskich (1975), Kodeks deontologii lekarskiej, [w:] A. Tulczyński, Polskie lekarskie kodeksy deontologiczne, PZWL, Warszawa: 108–118.
View in Google Scholar