or of accident, the first to arrive should be considered the physician in charge. How ever, as soon as the exigencies of the case permit, or on the arrival of the acknowledged family attendant or the physician the patient desires to serve him, the first physician should withdraw in favor of the chosen attendant; should the patient or his family wish some one other than the physician known to be the family physician to take charge of the case the patient should advise the family physician of his desire. When, because of sudden illness or accident, a patient is taken to a hospital, the patient should be returned to the care of his known family physician as soon as the condition of the patient and the circumstances of the case warrant this transfer. A COLLEAGUE'S PATIENT SEC. 7.-When a physician is requested by a colleague to care for a patient during his temporary absence, or when, because of an emergency, he is asked to see a patient of a colleague, the physician should treat the patient in the same manner and with the same delicacy as he would have one of his own patients cared for under similar circumstances. The patient should be returned to the care of the attending physician as soon as possible. RELINQUISHING PATIENT TO REGULAR ATTENDANT SEC. 8. When a physician is called to the patient of another physician during the enforced absence of that physician, the patient should be relinquished on the return of the latter. SUBSTITUTING IN OBSTETRIC WORK SEC. 9.-When a physician attends a woman in labor in the absence of another who has been engaged to attend, such physician should resign the patient to the one first engaged, upon his arrival; the physician is entitled to compensation for the professional services he may have rendered. ARTICLE V.-DIFFERENCES BETWEEN PHYSICIANS ARBITRATION SECTION 1.-Whenever there arises between physicians a grave difference of opinion which cannot be promptly adjusted, the dispute should be referred for arbitration to a committee of impartial physicians, preferably the Board of Censors of a component county society of the American Medical Association. ARTICLE VI.-COMPENSATION LIMITS OF GRATUITOUS SERVICE SECTION 1.-The poverty of a patient and the mutual professional obligation of physicians should command the gratuitous services of a physician. But institutions endowed by societies, and organizations for mutual benefit, or for accident, sickness and life insurance, or for analogous purposes, should be accorded no such privileges. CONTRACT PRACTICE SEC. 2. It is unprofessional for a physician to dispose of his services under conditions that make it impossible to render adequate service to his patient or which interfere with reasonable competition among the physicians of a community. To do this is detrimental to the public and to the individual physician, and lowers the dignity of the profession. SECRET DIVISION OF FEES CONDEMNED SEC. 3. It is detrimental to the public good and degrading to the profession, and therefore unprofessional, to give or to receive a commission. It is also unprofessional to divide a fee for medical advice or surgical treatment, unless the patient or his next friend is fully informed as to the terms of the transaction. The patient should be made to realize that a proper fee should be paid the family physician for the service he renders in determining the surgical or medical treatment suited to the condition, and in advising concerning those best qualified to render any special service that may be required by the patient. CHAPTER III The Duties of the Profession to the Public PHYSICIANS AS CITIZENS SECTION 1.-Physicians, as good citizens and because their professional training specially qualifies them to render this service, should give advice concerning the public health of the community. They should bear their full part in enforcing its PHYSICIANS SHOULD ENLIGHTEN PUBLIC- SEC. 2. Physicians, especially those engaged in public health work, should enlighten the public regarding quarantine regulations; on the location, arrangement and dietaries of hospitals, asylums, schools, prisons and similar institutions; and concerning measures for the prevention of epidemic and contagious diseases. When an epidemic prevails, a physician must continue his labors for the alleviation of suffering people, without regard to the risk to his own health or life or to finanical return. At all times, it is the duty of the physician to notify the properly constituted public health authorities of every case of communicable disease under his care, in accordance with the laws, rules and regulations of the health authorities of the locality in which the patient is. PUBLIC WARNED SEC. 3.-Physicians should warn the public against the devices practiced and the false pretensions made by charlatans which may cause injury to health and loss of life. PHARMACISTS SEC. 4. By legitimate patronage, physicians should recognize and promote the profession of pharmacy; but any pharmacist, unless he be qualified as a physician, who assumes to prescribe for the sick, should be denied such countenance and support. Moreover, whenever a druggist or pharmacist dispenses deteriorated or adulterated drugs, or substitutes one remedy for another designated in a prescription, he thereby forfeits all claims to the favorable consideration of the public and physicians. CONCLUSION While the foregoing statements express in a general way the duty of the physician to his patients, to other members of the profession and to the profession at large, as well as of the profession to the public, it is not to of medical ethics, or that the physician is be supposed that they cover the whole field besides these herein set forth. In a word, not under many duties and obligations it is incumbent on the physician that under all conditions, his bearing toward pashould be characterized by a gentlemanly tients, the public and fellow practitioners deportment and that he constantly should behave toward others as he desires them to deal with him. Finally, these principles are primarily for the good of the public, and their enforcement should be conducted in such a manner as shall deserve and receive the endorsement of the community. Code of Ethics of the Graduate Nurses' Association of the State of Pennsylvania Adopted by the Association in 1904 SECTION 1.-There is no profession open to women, from the members of which greater purity of character and a higher standard of moral excellence are required, than that of nursing, and every one who has entered the profession has incurred an obligation to maintain its dignity and honor. SEC. 2.-A nurse can best do honor to her Association by her personal conduct, and by the high character of her professional work. When a nurse becomes a member of the Association she tacitly admits that she owes it her allegiance. SEC. 3.-Every member of the Association should feel it her duty to further its interests, not only by attendance at the meetings and the payment of dues, but also by giving her hearty support to all work for the elevation and advancement of the Association, and by interesting the public in such work in all legitimate ways. SEC. 4.-A nurse as a good citizen should do all in her power to improve the hygienic conditions of the community in which she resides. The Code of Ethics of the National Dental Association ARTICLE I THE DUTIES OF THE PROFESSION TO THEIR PATIENTS SECTION 1.-The dentist should be ever ready to respond to the wants of his patrons, and should fully recognize the obligations involved in the discharge of his duties toward them. As he is in most cases unable to correctly estimate the character of his operations, his own sense of right must guarantee faithfulness in their performance. His manner should be firm, yet kind and sympathizing so as to gain the respect and confidence of his patients, and even the simplest case committed to his care should receive that attention which is due to operations performed on living, sensitive tissue. SEC. 2. It is not to be expected that the patient will possess a very extended or a very accurate knowledge of professional matters. The dentist should make due allowance for this, patiently explaining many things which may seem quite clear to himself, thus endeavoring to educate the public mind so that it will properly appreciate the beneficent efforts of our profession. He should encourage no false hopes by promising success when, in the nature of the case, there is uncertainty. SEC. 3. The dentist should be temperate in all things, keeping both mind and body in the best possible health, that his patients may have the benefit of that clearness of judgment and skill which is their right. ARTICLE II MAINTAINING PROFESSIONAL CHARACTER SECTION 1.-A member of the dental profession is bound to maintain its honor and to labor earnestly to extend its sphere of usefulness. He should avoid everything in language and conduct calculated to dishonor his profession, and should ever manifest a due respect for his brethren. The young should show special respect to their seniors; the aged, special encouragement to their juniors. SEC. 2. It is unprofessional to resort to public advertisement, cards, handbills, posters, or signs, calling attention to peculiar styles of work, lowness of prices, special modes of operating; or to claim superiority over neighboring practitioners; to publish reports of cases or certificates in the public prints, to circulate or recommend nostrums; or to perform any other similar acts. But nothing in this section shall be so construed as to imply that it is unprofessional for dentists to announce in the public prints, or by cards, simply their names, occupation, and place of business, or in the same manner to announce their removal, absence from or return to business, or to issue to their patients appointment cards having a fee bill for professional services thereon. SEC. 3.-When consulted by the patient of another practitioner the dentist should guard against inquiries or hints disparaging to the family dentist or calculated to weaken the patient's confidence in him; and if the interest of the patient will not be endangered thereby, the case should be temporarily treated, and referred back to the family dentist. SEC. 4.-When general rules shall have been adopted by members of the profession practicing in the same localities in relation to fees, it is unprofessional and dishonorable to depart from these rules, except when variation of circumstances require it. And it is ever to be regarded as unprofessional to warrant operations as an inducement to patronage. ARTICLE III CONSULTATIONS Consultations should be promoted in difficult or protracted cases, as they give rise to confidence, energy, and broader views in practice. In consultations that courtesy and just dealing should be especially observed. ARTICLE IV THE RELATIVE DUTIES OF DENTISTS AND PHYSICIANS Dental surgery is a specialty in medical science. Physicians and dentists should both bear this in mind. The dentist is professionally limited to diseases of the dental organs and adjacent parts. With these he The American Pharmaceutical Association, composed of Pharmaceutists and Druggists throughout the United States, feeling a strong interest in the success and advancement of their profession in its practical and scientific relations, and also impressed with the belief that no amount of knowledge and skill will protect themselves and the public from the ill effects of an undue competition, and the temptations to gain at the expense of quality, unless they are upheld by high moral obligations in the path of duty, have subscribed to the following Code of Ethics for the government of their professional conduct. ARTICLE 1.-As the practice of pharmacy can only become uniform by an open and candid intercourse being kept up between apothecaries and druggists among themselves and each other, by the adoption of the National Pharmacopoeia as a guide in the preparation of official medicines, and by the discontinuance of secret formulae and the practices arising from a quackish. spirit, and by an encouragement of that esprit de corps which will prevent a resort to those disreputable practices arising out of an injurious and wicked competition; Therefore, the members of this Association agree to uphold the use of the Pharmacopoeia in their practice; to cultivate brotherly feeling among the members, and to discountenance quackery and dishonorable competition in their business. ART. 2.-As labor should have its just reward, and as skill, knowledge and responsibility required in the practice of pharmacy are great, the remuneration of the pharmaceutist's services should be proportioned to these, rather than to the market value of the preparations vended. The rate of charges will necessarily vary with geographical position, municipal location, and other circumstances of a permanent character, but a resort to intentional and unnecessary reduction in the rate of charges among apothecaries, with a view to gaining at the expense of their brethern, is strongly discountenanced by this Association as productive of evil results. ART. 3.-The first duty of the apothecary, after duly preparing himself for his profession, being to procure good drugs and preparations (for without these his skill and knowledge are of small avail), he frequently has to rely on the good faith of the druggist for their selection. Those druggists whose knowledge, skill and integrity enable them to conduct their business faithfully, should be encouraged, rather than those who base their claims of patronage on the cheapness of their articles solely. When accidentally or otherwise, a deteriorated, or adulterated drug or medicine is sent to the apothecary, he should invariably return it to the druggist, with a statement of its defects. What is too frequently considered a mere error of trade on the part of the druggist, becomes a highly culpable act when countenanced by the apothecary; hence, when repetitions of such frauds occur, they should be exposed for the benefit of the profession. A careful but firm pursuit of this course would render well-disposed druggists more careful and deter the fraudulently inclined from a resort to their disreputable practices. ART. 4.-As the practice of pharmacy is quite distinct from the practice of medicine, and has been found to flourish in proportion as its practitioners have confined their attention to its requirements; and as the conduction of the business of both professions by the same individual involves pecuniary temptations which are often not compatible with a conscientious discharge of duty; we consider that the members of this Association should discountenance all such professional amalgamation; and in conducting business at the counter, should avoid prescribing for diseases when practicable, referring applicants for medical advice to the physician. We hold it as unprofessional and highly reprehensible for apothecaries to allow any percentage or commission to physicians on their prescriptions, as unjust to the public, and hurtful to the independence and self-respect of both parties concerned. We also consider that the practice of some physicians (in places where good apothecaries are numerous), of obtaining medicines at low prices from the latter, and selling them to their patients, is not only unjust and unprofessional, but deserving the censure of all high-minded medical men. ART. 5.-The important influence exerted on the practice of pharmacy by the large proportion of physicians who have resigned its duties and emoluments to the apothecary, are reasons why he should seek their favorable opinion and cultivate their friendship, by earnest endeavors to furnish their patients with pure and well-prepared medicines. As physicians are liable to commit errors in writing their prescriptions, involving serious consequences to health and reputation if permitted to leave the shop, the apothecary should always, when he deems an error has been made, consult the physician before proceeding; yet in the delay which must necessarily occur, it is his duty, when possible, to accomplish the interview without compromising the reputation of the physician. On the other hand, when apothecaries commit errors involving ill consequences, the physician, knowing the constant liability to error, should feel bound to screen them from undue censure, unless the result of a culpable negligence. ART. 6.-As we owe a debt of gratitude to our predecessors for the researches and observations which have so far advanced our scientific art, we hold that every apothecary and druggist is bound to contribute his mite toward the same fund, by noting the new ideas and phenomena which may occur in the course of his business, and publishing them, when of sufficient consequence, for the benefit of the profession. This code of ethics is evidently in need of revision. The following code is proposed for adoption at the annual meeting of the American Pharmaceutical Association in the autumn of 1922. Principles of Pharmaceutical Ethics Proposed by Charles H. LaWall for Adoption by the American Pharmaceutical Association at its Annual Meeting in 1922 CHAPTER I THE DUTIES OF THE PHARMACIST IN CONNECTION WITH HIS SERVICES TO THE PUBLIC Pharmacy has for its primary object the service which it can render to the public in safeguarding the handling, sale, compounding and dispensing of medicinal substances. The practice of Pharmacy demands knowledge, skill and integrity on the part of those engaged in it. Pharmacists are required to pass certain educational tests in order to qualify for registration under the laws of most of our states. These various states restrict the practice of Pharmacy to those qualifying according to the regulatory requirements thereby granting to them a special privilege which is denied other citizens. In return the states expect the Pharma |