Medicine and morality in the ancient world : an analysis of Galen's medical and philosophical writings
The great power of the medical profession over the lives of men entails a wealth of moral problems in medical practice and lends particular importance to questions of the responsibility of the physician. We investigate the solutions offered by Galen, the most prolific medical author of classical Antiquity, in his medical and philosophical writings. Issues of ethics and moral psychology are discussed in numerous passages of Galen's works, and he even devoted a number of treatises exclusively to ethics. The main results of our analysis of these treatises and passages can be summarized as follows. Starting with his interpretation of a prominent Hippocratic maxim, we discuss possible motivations for Galen's re-definition of the relationship between physician and patient. For Galen, it was the physician, not the patient, who led the fight against the disease. This prominent position of the Galenic physician entailed particular obligations and responsibilities. But Galen also took the view that certain responsibilities resided with the patient, particularly that of selecting the right physician and keeping the prescribed diets. Moreover Galen thought that everybody ought to pursue the systematic liberation of the soul from passions and errors, guided by his ethical methodology. Galen gave disciplined care for one's health and acquisition of medical knowledge the status of moral duties for every educated person. For physicians, he provided a wealth of additional principles and rules of conduct, covering areas as diverse as experimentation with drugs, surgical risks, promulgation of knowledge on poisons, remuneration and other social impacts of medicine, and medical education, all of them inspired by respect for the health of man, the animal who topped the teleological hierarchy of creation, and medicine, the art whose task it was to preserve and restore man's health. Galen held medicine in exceptionally high esteem, even by the standards of physicians. His view of medicine as the divine art kat 'exochen is considered in the context of his high valuation of human life and health. Health assumed a high rank in the hierarchy of goods, for it provided the basis for all the other goods and virtues. For Galen, preservation and restoration of health could be attained only on the basis of a sound scientific methodology. He was reluctant to apply criteria external to medicine proper to its practice, and mostly judged the morality of medical activities by the adherence to the principles of a well-founded therapy and avoidance of undue harm.