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evade legal restrictions governing the practice of medicine; or to dispense, or promote the use of, secret medicines, for if such nostrums are of real efficacy, any concealment regarding them is inconsistent with beneficence and professional liberality, and if mystery alone give them public notoriety, such craft implies either disgraceful ignorance or fraudulent avarice. It is highly reprehensible for physicians to give certificates attesting the efficacy of secret medicines, or other substances used therapeutically.
ARTICLE II. PROFESSIONAL SERVICES OF PHYSICIANS TO EACH OTHER.
Physicians Dependent on Each Other.
SECTION 1. Physicians should not, as a general rule, undertake the treatment of themselves, nor of members of their family. In such circumstances they are peculiarly dependent on each other; therefore, kind offices and professional aid should always be cheerfully and gratuitously afforded. These visits ought not, however, be obstrusively made, as they may give rise to embarrassment or interfere with that free choice on which such confidence depends.
Gratuitous Services to Fellow Physicians.
SEC. 2. All practicing physicians and their immediate family dependants are entitled to the gratuitous services of any one or more of the physicians residing near them.
Compensation for Expenses.
SEC. 3. When a physician is summoned from a distance to the bedside of a colleague in easy financal circumstances, a compensation, proportionate to traveling expenses and to the pecuniary loss entailed by absence from the accustomed field of professional labor, should be made by the patient or relatives.
One Physician to Take Charge.
SEC. 4. When more than one physician is attending another, one of the number should take charge of the case, otherwise the concert of thought and action so essential to wise treatment can not be assured.
Attention to Absent Physician's Patients.
SEC. 5. The affairs of life, the pursuit of health and the various accidents and contingencies to which a physician is peculiarly exposed sometimes require the temporary withdrawal of this physician from daily professional labor and the appointment of a colleague to act for a specified time. The colleague's compliance is an act of courtesy which should always
be performed with the utmost consideration for the interest and character of the family physician.
ARTICLE III. THE DUTIES OF PHYSICIANS IN REGARD TO CONSULTATIONS.
The Broadest Humanity in Emergencies Required.
SECTION 1. The broadest dictates of humanity should be obeyed by physicians whenever and wherever their services are needed to meet the emergencies of disease or accident.
Consultations Should Be Promoted.
Consultations should be promoted in difficult cases, as they contribute to confidence and more enlarged views of practice.
Punctuality in Consultations.
SEC. 3. The utmost punctuality should be observed in the visits of physicians when they are to hold consultations, and this is generally practicable, for society has been so considerate as to allow the plea for a professional engagement to take precedence over all others.
SEC. 4. As professional engagements may sometimes cause delay in attendance, the physician who first arrives should wait for a reasonable time, after which the consultation should be considered as postponed to a new appointment.
Good Feeling and Candor in Consultations.
SEC. 5. In consultations no insincerity, rivalry or envy should be indulged; candor, probity and all due respect should be observed toward the physician in charge of the case.
Unauthorized Statements or Discussions.
SEC. 6. No statement or discussion of the case should take place before the patient or friends, except in the presence of all the physicians attending, or by their common consent; and no opinions or prognostications should be delivered which are not the result of previous deliberation and
Attending Physician May Vary Treatment.
SEC. 7. No decision should restrain the attending physician from making such subsequent variations in the mode of treatment as any unexpected change in the character of the case may demand. But at the next consul
tation reasons for the variations should be stated. The same privilege, with its obligation, belongs to the consultant when sent for in an emergency during the absence of the family physician.
Attending Physician to Prescribe.
SEC. 8. The attending physician, at any time, may prescribe for the patient; not so the consultant, when alone, except in a case of emergency or when called from a considerable distance. In the first instance the consultant should do what is needed and in the second should do no more than make an examination of the patient and leave a written opinion, under seal, to be delivered to the attending physician.
Discussions in Consultation Confidential.
SEC. 9. All discussions in consultation should be held as confidential. Neither by words nor by manner should any of the participants in a consultation assert or intimate that any part of the treatment pursued did not receive his assent.
Conflicts of Opinion.
SEC. 10. It may happen that two physicians can not agree in their views of the nature of a case and of the treatment to be pursued. In the event of such disagreement a third physician should, if practicable, be called in. None but the rarest and most exceptional circumstances would justify the consultant in taking charge of the case. He should not do so merely on the solicitation of the patient or friends.
Consultant to Scrupulously Regard Rights of Attending Physician.
SEC. 11. A physician who is called in consultation should observe the most honorable and scrupulous regard for the character and standing of the attending physician, whose conduct of the case should be justified, as far as can be, consistently with a conscientious regard for truth, and no hint or insinuation should be thrown out which would impair the confidence reposed in the attending physician.
ARTICLE IV. DUTIES OF PHYSICIANS IN CASES OF INTERFERENCE.
Qualifications the Only Basis of Practice.
SECTION 1. Medicine being a liberal profession, those admitted to its ranks should found their expectations of practice especially on the character and the extent of their medical education.
Intercourse with Patients of Other Physicians.
SEC. 2. The physician, in his intercourse with a patient under the care of another physician, should observe the strictest caution and reserve; should give no disingenuous hints relative to the nature and treatment of the patient's disorder, nor should the course of conduct of the physician, directly or indirectly, tend to diminish the trust reposed in the attending physician.
Circumspection as Regards Visits.
SEC. 3. The same circumspection should be observed when, from motives of business or friendship, a physician is prompted to visit a person who is under the direction of another physician. Indeed, such visits should be avoided, except under peculiar circumstances; and when they are made, no inquiries should be instituted relative to the nature of the disease, or the remedies employed, but the topics of conversation should be as foreign to the case as circumstances will admit.
Duty as to Calls to Patients of Other Physicians.
SEC. 4. A physician ought not to take charge of, or prescribe for, a patient who has recently been under the care of another physician, in the same illness, except in case of a sudden emergency, or in consultation with th physician previously in attendance, or when that physician has relinquished the case or has been dismissed in due form.
Criticisms to be Avoided.
SEC. 5. The physician acting in conformity with the preceding section should not make damaging insinuations regarding the practice adopted, and, indeed, should justify it if consistent with truth and probity; for it often happens that patients become dissatisfied when they are not immediately relieved, and, as many diseases are naturally protracted, the seeming want of success, in the first stage of treatment, affords no evidence of a lack of professional knowledge or skill.
SEC. 6. When a physician is called to an urgent case, because the family attendant is not at hand, unless assistance in consultation is desired, the former should resign the care of the patient immediately on the arrival of the family physician.
Duty When Called with Other Physicians.
SEC. 7. It often happens, in cases of sudden illness, and of accidents and injuries, owing to the alarm and anxiety of friends, that several physi
cians are simultaneously summoned. Under these circumstances, courtesy should assign the patient to the first who arrives, and who, if necessary, may invoke the aid of some of those present. In such case, however, the acting physician should request that the family physician be called, and should withdraw unless requested to continue in attendance.
Case to be Relinquished to Regular Attendant.
SEC. 8. Whenever a physician is called to the patient of another physician during the enforced absence of that physician the case should be relinquished on the return of the latter.
Emergency Attention and Advice.
SEC. 9. A physician, while visiting a sick person in the country, may be asked to see another physician's patient because of a sudden aggravation of the disease. On such an occasion the immediate needs of the patient should be attended to and the case relinquished on the arrival of the attending physician.
Substitute Obstetric Work.
SEC. 10. When a physician who has been engaged to attend an obsteric case is absent and another is sent for, delivery being accomplished during the vicarious attendance, the acting physician is entitled to the professional fee, but must resign the patient on the arrival of the physician first engaged.
ARTICLE V. DIFFERENCES BETWEEN PHYSICIANS.
Arbitration of Differences.
SECTION 1. Diversity of opinion and opposition of interest may, in the medical as in other professions, sometimes occasion controversy and even contention. Whenever such unfortunate cases occur and can not be immediately adjusted, they should be referred to the arbitration of a sufficient number of impartial physicians.
Reserve Toward Public on Certain Professional Questions.
SEC. 2. A peculiar reserve must be maintained by physicians toward the public in regard to some professional questions, and as there exist many points in medical ethics and etiquette through which the feelings of physicians may be painfully assailed in their intercourse, and which can not be understood or appreciated by general society, neither the subject matter of their differences nor the adjudication of the arbitration should be made public.