With issues like euthanasia and genetic testing so prominent in the moral landscape of the early twenty-first century, any work whose title includes the words "medicine" and "ethics" is guaranteed attention nowadays. My hope as a reader of this volume by Schubert (S) was to find an enrichment of the historical approach to the question of the evolving role of medical deontology, in order to bring it in line with the current understanding of biomedicine as a frontier of politics,1 and/or an elaboration of the hermeneutical perspective on the art of healing that was advanced by none other than Hans-Georg Gadamer near the end of his very long life.2 Lawyers, doctors and medical journalists have contributed their share of intensely thought-provoking writings about medical ethics from sometimes perplexing points of view;3 could a classical scholar do something of this sort too? I am afraid that S's book leaves this question largely unanswered.
The Hippocratic oath is the subject of Chapters I-III. S offers a Greek text (with German translation) mainly based on P. Oxy. XXXI 2547 and Ambrosianus B113, sup. fol. 2, as established by Jouanna in the work cited by S.4 The Christian version of the oath (including a strengthening of the abstention from abortive practices) is presented separately, as the first of a long sequence of changes to the oath. The principles of Hippocratic medicine and the social standing of doctors in classical and Hellenistic times are discussed in Chapters IV and V, together with the name of Hippocrates as an agglutinating symbol of practices and writings that enabled the establishment of the medical profession as a largely self-regulated one. The latter discussion is an interesting one and picks up the unavoidable Hippocratic question in a sensible manner, albeit it in very brief compass. Readers interested in pursuing further questions such as the role of doctors like Scribonius Largus, Soranus or Galen and their different attitudes toward Hippocratic medicine will have to look elsewhere.5
With reference to the subtitle "Medicine and Ethics from Antiquity to the Present Day", I regret to report that the second part of the book (Chapter VI) is mainly a small collection of texts derived from the ancient oath. These texts are given without any introduction or commentary, other than the endnotes. Chronologically arranged, they culminate in the 1968 Geneva Pledge, formulated under the auspices of the World Medical Association (WMA), whose role is not discussed by S. The 2003 version of the pledge for German doctors is also given. In addition, the volume contains (also without introduction or commentary) the 1975 Helsinki-Tokyo Declaration on Biomedical Research and the 1981 Lisbon Declaration on the Rights of the Patient, both equally under the auspices of the WMA. I missed a more widely comparative approach and at least a brief discussion of the Helsinki Declaration as a living document that has managed to maintain focus on the ethical aspects of medical research (involving many professionals other than doctors) for almost half a century already, and of the several amendments that have been made to it after 1975, followed by a summary of what can be considered constant in the pledge of the medical profession, and perhaps a list of open questions. In my view, that would have been the minimum for a volume with the subtitle above, and such minimum is not met. Therefore, this may not be the first book to read in order to gain a historical perspective on medical ethics today.
1. On the political aspects of biomedicine, see e.g. Habermas, J., The Future of Human Nature, Cambridge: Polity Press, 2004.
2. Gadamer, H-G., The Enigma of Health: The Art of Healing in a Scientific Age, Stanford University Press, 1996.
3. For two definitely thought-provoking examples, see Gawande, A., Complications: A Surgeon's Notes on an Imperfect Science, New York: Henry Holt & Co., 2002, and Roach, M., Stiff: The Curious Lives of Human Cadavers, New York: W.W. Norton & Co., 2003.
4. Jouanna, J., "Un témoin méconnu de la tradition hippocratique: L'Ambrosianus Gr. 134 (B113 sup.), Fol. 1-2 (avec une nouvelle édition du Serment et de la Loi)", in Garzya, A. Garzya and Jouanna, J., Storia e Ecdotica dei Testi Medici, Naples 1995.
5. For a recent and fuller treatment of these non-textual aspects, see Nutton, V., Ancient Medicine, Routledge, 2004.