Commentary on the Code of Medical Ethics and Deontology

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Introduction

The knowledge of the Code of Medical Ethics and Deontology among Spanish doctors is neither extensive nor profound. Nor does the way in which its mandates and advice are complied with seem to be much better. As long as we do not have a serious research to measure the Degree of knowledge and acceptance of the Code, it seems most prudent to assume that many doctors are ignorant of it and few are inspired by it in their conduct. This is a pity, because, alongside precepts that could immunise us against certain practical errors, the Code encourages us to live ethical ideals that would help us doctors to grow in professional and human stature, and to treat our patients with more compassion and respect.

In Spain we have been suffering for more than fifteen years now from a regrettable gap in the deontological Education of medical students. Many young doctors have been deprived of this essential training, just when they needed it most. It is almost certain that they have never seriously discussed professional ethics among themselves. Perhaps no one has shown them what values and incentives are contained in the articles of the Code. Worse still, they have read somewhere that the Code is a vestigial residue of a way of understanding the profession, that deontology is something that is on its way to extinction.

In Spain, we need to intensify the presence of ethical reasoning in our hospitals and clinics. Few doctors and few healthcare institutions have a deep and sincere concern for living and discussing the ethics of the profession. In order to try to remedy this status and to dispel the widespread ignorance surrounding the Code, I have decided to put together in the following pages some comments on the text of the Code of Medical Ethics and Deontology, to serve as subject for the reflection of doctors, especially young doctors, and students on the course in medical ethics. I would like it to help them to become aware of their present or future professional responsibilities.

Perhaps these Commentaries can also be of use to practising physicians. guide Firstly, to those who have the Code as a valid ethical code of professional practice, but who consider that its content is so obvious that it does not need to be studied: to these colleagues, these Commentaries will remind them of some forgotten notions and they will discover that time does not pass in vain in medical ethics, that the Code is enriched by the contributions of contemporary biomedical ethics. Secondly, to those who have a dismissive or sceptical attitude towards the Code, so that they may examine their prejudices in the light of the contents of the Code and thus come to more reasoned and well-founded conclusions. It is also my hope that these Commentaries may serve as a support to the members of the Ethics Committees of the Colleges in their delicate and difficult task of judging conflicts with fairness and skill.

And I look forward to your comments and criticisms.

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It is only right that I record here my gratitude to those who, in different ways, have helped me in the preparation of this book. To my colleagues on the Central Ethics Commission of the committee General de Colegios de Médicos de España and the Ethics Commission of the committee Permanente de los Médicos de la CE, and of the School de Medicina of the University of Navarra, for I have learned a great deal from all of them. To my students who, year after year, maintain my hope that medical ethics will take root in Spain. Finally, to my collaborators at department de Bioética, especially Dr. Antonio Pardo, who took the care to turn a pile of pages into a book.

Pamplona, February 1992