There is definitely a decline in ethics in the field of Medicine and in the society as a whole. We read the chapter on ethics and its almost restricted only to the books. The factors would be the greed to become rich. money always becomes a priority nowadays than moral values. Being ethical, following strict moral values doesn't make you rich and sometimes doesn't allow you to progress in the profession too. So, its like you are forced to be become unethical in the present generation which is so competitive. There can be times where you are forced to be unethical since the top management is.

However, those who don't follow ethics maybe rich and be successful but the conscience will haunt them forever. “There are two types of people in this world, good and bad. The good sleep better, but the bad seem to enjoy the waking hours much more.” ― Woody Allen. Ultimately peace of mind is very important for a person than loads of money. “There may be times when we are powerless to prevent injustice, but there must never be a time when we fail to protest.”

― Elie Wiesel

I hope we all start to think from our heart than from our brain and be ethical and provide quality service in the field of medicine and be a good person and not cheat your conscience.

Researchers are lacking in reproducibility of the results and attracted toward the publication rather than innovation.

#OBJECTION!

Hi ,

See the lovely quote of the great scientist :

By academic freedom I understand the right to search for the truth and to publish and teach what one holds to be true. This right also implies a duty; one must not conceal any part of what one has recognized to be true. It is evident that any restriction of academic freedom serves to restrain the dissemination of knowledge, thereby impeding rational judgment and action."

- Albert Einstein

The meaning of ethics is very simple "difference between right and wrong" and always  the truth and right alone prevails"

Ethical values seem to be declining pretty much across the board in modern society.  Integrity is now wherever you find it---and it's getting harder and harder to find!  Anyone who has been around for more than 50 or 60 years (I'm moving into year 74 now) knows this very well.  A man or woman used to be known by their word.  Now, Big Pharma tricks people into believing that this or that drug will "cure" them.  And then, that same drug is found to be harmful to health and is pulled off the market.  What is that all about?  Integrity?  Or corporate greed?  Big Pharma "owns" modern medicine.  Big Corporate "owns" this world.  It all has to do with the official "religion" now dominating our consciousness: scientific materialism.  So, science has to "grow up" and shed itself of this domination theme, this ridiculous fixity in gross materialism, this denial of all the various layers of consciousness that are natural to our being.

There is definitely a decline in ethics in the field of Medicine and in the society as a whole. We read the chapter on ethics and its almost restricted only to the books. The factors would be the greed to become rich. money always becomes a priority nowadays than moral values. Being ethical, following strict moral values doesn't make you rich and sometimes doesn't allow you to progress in the profession too. So, its like you are forced to be become unethical in the present generation which is so competitive. There can be times where you are forced to be unethical since the top management is.

However, those who don't follow ethics maybe rich and be successful but the conscience will haunt them forever. “There are two types of people in this world, good and bad. The good sleep better, but the bad seem to enjoy the waking hours much more.” ― Woody Allen. Ultimately peace of mind is very important for a person than loads of money. “There may be times when we are powerless to prevent injustice, but there must never be a time when we fail to protest.”

― Elie Wiesel

I hope we all start to think from our heart than from our brain and be ethical and provide quality service in the field of medicine and be a good person and not cheat your conscience.

There are, of course, deeper reasons to be moral, kind and loving.  You may never be wealthy in a worldly sense, but in a karmic sense, at a level of Spiritual development, you could be thriving.  That, of course, is for the Divine to determine.  Meanwhile, yes, we can sleep at night knowing we have done right.  And, as Elie Wiesel suggests, we absolutely must stand up and holler when we see injustice.  These days, such injustice is all around us.  So, it is not hard to find!  Money comes and goes, but integrity is far more valuable---and, alas, these days, increasingly hard to find.  

Currently, I am spending much more time with my patients.  There is not as much money in this, much less, but they are getting far better service.  They deeply appreciate the time I give them.  We get things handled, too.  We get them healthy.     

When financial considerations enter into medical decisions, ethics is always brought into question.  There's a reason the saying, "money is the root of all evil", never draws much question.  The entire structure of "evidence-based" as a practice appropriateness criteria itself creates an ethical crisis.  It is much easier to randomize and blind studies of one drug or another than to test the efficacy of human self oriented treatments vs. high money value external technology based therapies.  Why are there so many more studies of drug therapies to treat vascular disease than the use of dietary or other lifestyle change modalities?   The entire debate around statin use ubiquity is an ethical opera, and a tragedy at that!  There are a lot of evil roots in medicine.

Money, self aggrandisement, cynicism, corruption, the undermining of faith in medical research are to name but a few reasons why medical ethics are in the state they appear to be.

To be fair though they have never been quite the beacon of piety that the mission statements claim.  I was always touched by the idea that Imhotep, the father of medical ethics, the architect and physician to Old Kingdom Pharaoh Djosser managed to be the first person also to breach them.  Carrying out experiments on trauma victims injured while building the step pyramid at Saqaara. Talk about a conflict of interest!  

Good call, Mark!  It's time for us to stand up and let ourselves be heard.  Many are feeling the same way.  We have to get back to integrity-based medicine, which allow for all modalities, each in their own best place.  I have spent so much of my career helping people get off drugs.  We have to teach them (the Pt) how to live a conscious, intelligent, responsible life, a life-positive lifestyle and a diet of high-raw or all-raw vegetarian food.  And I didn't come to this understanding overnight.  It too years of observing those that were least healthy and those who were healthiest.  Many of my favorite habits and dietary preferences had to be dropped--at least on any regular basis.  I had to live what I was teaching.  And the Pt respects this.  I worked with professionals in other areas of practice.  We healers must be open-minded.  You use drugs when needed, but for the most part, they're unnecessary.  Make demands on the Pt.  They got themselves into this mess and only they can get themselves out.  We are their help, the one who shows them how.  But, how many physicians know how?  

Maybe a return to the Code of Hammurabi might help. It provides an interesting set of sanctions for those who break this, one of the first written codes of law and medical ethics.

All Nice, but the main reason of the decline is:

1. The mistrust and sew culture (USA) of lawyers

2. The dictatorship of guidelines and the transformation from guidelines into strickt laws

3. The above kill creativity in medicine and thus the ability of doctors to help their patients

Yes, Jan, good call!  Speaking of codes of ethics, some years ago I did some research into these various codes.  Finally, it felt like a new code was being suggested.  So,we at Grand Medicine put one together.  Here is a copy of The Universal Healer's Code of Ethics.

Hi Everyone.

I am joining this subject of interest since I am writing a book on the lack of ethics. For now I have a blog on it with collection of articles that will add to it: http://cluelessdoctors.com/ which does not implicitly state "ethics" yet but will once all information is compiled. I am also getting many horror stories from people by email that will be added. 

For ethics, and why the field of medicine is less ethical these days, I have several thoughts. I am a researcher myself. I have to (had to.. took early retirement to get out of politics) get all kinds of ethics committee approval for any experiment I ran and had to attend all kinds of ethical education lectures. It could easily take over a year to get approval for an experiment (in university setting). 

I see several very important problems that add to the falling of ethics when it comes to the medical field, particularly in hospital and medical office setting:

1) off-label prescriptions. This is a subject I will attack. The FDA approves it since it approved the medicine but it approved it to illness X and it is used for illness Y without knowing the consequences, without written and informed consent by the patient, without the findings adding to the actual research data based on which the FDA approved the drugs

2) In just one illness, serotonin syndrome, 85% of the doctors (as per NIH) do not recognize the symptoms and would not know what to do with it. This incompetence then becomes an ethical question since doctors must treat patients for something... my mother had serotonin syndrome and she was treated for UTI because as the doctor put it "we have no such illness that we can mark for the administration"... Thus this has become an issue of ethics where the illness had to be changed to fit the list rather than enlarge the list to fit the illness

3) I am still sticking with serotonin since I had much experience with that. Not one of the doctors I talked to knew what serotonin syndrome was in 5 hospitals. Not one of the pharmacies knew they prescribed serotonin when they did--one was Sertraline (Zoloft), an SSRI, and Mirtazapine (Remeron) a Tetracyclic antidepressant containing serotonin. They actually got into a fight with me that these were not serotonin! Pharmacies!

4) The patient (my mother in this case) wore on her wrist an allergy band and on every page they noted that she was "allergic to" serotonin, which I added given that I diagnosed her with serotonin syndrome. Doctors completely without ethical considerations and without any tests decided that she did not have serotonin syndrome and gave her serotonin. They killed her of course. How can a doctor override allergies written without testing?

5) Hair dressers, nail polishers, beauticians, realtors, insurance agents, etc., all must take classes each year AND a test to pass and be able to renew their licenses. Doctors can just pay $30 and it is renewed. Even the classes they are supposed to be taking are by a scout who collects new info and then presents that to them in a room where the doctors are surfing the internet... 

6) Doctors ignore power of attorneys... why do we have them? No one cares and they just go on without any permission.

7) Although I have so far had luck with the Department of Health in citing several of the facilities and even finding one "doctor" actually being a PA saying he was a doctor and working without a license (6 months delinquency), prescribing psychotropics that requires special permission, I found that it is a fight because they are programmed to protect the medical industry and not the patient.

8) One medical facility was cited for treatment (a) by the Dept. of Public Health but the doctor who provided said treatment (a) was let go by the Board of Medicine saying "he did a professional job" but for the same professional job the Department of Health said "the hospital provided treatment (a) inappropriately"... so the left hand does not know the right hand because the Board of Medicine gets annual licensing fees from the doctors and so their loyalty is with the doctors and not the patients, whereas the Dept of Health is not "paid off" by the doctors.

I have much more but I do not want to overwhelm the discussion with more. But as you can see there are serious issues relating to ethics that come from the lack of accountability and lack of responsibility of the doctors and hospitals since no one seems to enforce them and patients don't know any better--nor can the dead complain!

Talk about ethics problems, check this out: http://www.youtube.com/watch?v=dbLGZw-SciU&feature=youtube_gdata_player.  It's 9 minutes long and sheer dynamite.  We have long known there were problems with the CDC, but this adds a whole new dimension.  Everyone in the health field should see this.  

Fascinating Leonard! Thanks for the video. I have some more to add to autism since that too was part of my research... amazing coincidence here.

I was working with Oxytocin [OT] (it is used as Pitocin to induce labor when epidural is used) and as I studied up on it, I bumped into C. Sue Carter and her studies (http://www.uic.edu/depts/neurosci/faculty/profiles-training/carter.html you will find some of her work there). She and I discussed autism and potential OT connection so she ran tests in her lab. She had three groups of the social voles (little mouse like animal; one type is social and the other not), all ready to give birth. One group of moms she induced with pitocin, another with placebo and the third went natural. She sacrificed all the pups and analyzed the OT receptors in the brain.

The group induced with pitocin all had their OT receptors burn up whereas the placebo and the untouched had no problems. In the next experiment she had the same three groups but this time she did not sacrificed the pups, only watched their behavior. Every single one became unsocial (hallmark 1 for autism), none produced babies, and all were very timid and spent their lives in a corner facing the wall. 

OT is the hormone for socialization, generosity, trust, love, etc. Autistic children have lots of OT in their blood but have no receptors to accept them.

I have contacted several hospitals asking for their records of pitocin and autism numbers so I could generate a correlation to see if there was indeed the same with humans--as it probably is--but was refused every time.

Instead we changed autism to be "autism spectrum disorder" into which just about everyone fits. So now we muddied up what it means to be autistic to cover up the fact that doctors wanted to be home for dinner or had theater tickets--some blatantly actually said that to nurses who reported this to me.

We have a major problem!

Programs on TV and news are starting to show up but not enough. Here is one: http://abcnews.go.com/Health/study-pitocin-harm-babies/story?id=19148043

Mainly  'Greed' is the reason. Even moneyed people have indulged in this practice and it is a disgrace.

The moral value need to be inculcated early childhood to be above that kind of behavior. That may improve ethical behavior.

There is no kind of science or education which can give you returns like business. The person practicing should understand this and also the people around shouldn't be judging ones success with the amount of money and assets. 

Before you claim that there is a historical trend ("ethics is getting worse"), you need some reasonable way to measure the trend--the way you can, for example, tell that health is getting better by counting early death from disease. Without some reasonable measure, the claim is empty.  A point Charles Dickens made in the opening sentences of Tale of Two Cities.

I don't agree that there is a decline in ethics, but I believe that the predominate ethics are changing and becoming more complex. Personally, I like some of the changes and don't like others. I tend to think of the changes that I personally dislike as being declines. Others may think of the same changes as improvements.

The question aims at an important topic that is receiving increasing attention from both philosophers and healthcare administators and professionals.  I suggest that a serious moral problem in medicine is the decreasing ability to maintain the accountability and moral responsibility of health care providers, particularly, physicians, to individual patients as well as to the public in general.

One reason for this is the marked trend toward increasing specialization, with a number of separate medical specialists often being involved in a single patient's treatment.  Typically, there is little or no communication between specialists attending to the same patient, and when things do go wrong, it is difficult or impossible to trace the lines of accountability and responsibility.  In the US, medical tort law is, unfortunately, a blunt instrument in cases of negligence and harmful consequences.

Another reason for the decreasing ability to maintain accountability and moral responsibility in medicine is organizational, and it has to do with flawed institutional structures in hospitals, which can lead to medical mistakes and also obsures individual moral responsibility.  Dennis F. Thompson (Harvard) recommends the establishment of ethics oversight committees in hospitals.  (See his Restoring Responsibility: Ethics in Government, Business, and Healthcare, Cambridge [2005])  Another approach is organizational (i.e., collective) moral responsibility in which the hospital as an entity is held morally responsibility.

Another useful source is the anthology, Responsibility in Health Care (Springer), published by Philosophy & Medicine, vol. 12, 1982.  (In this volume, see especially the article: The Concept of Responsibility in Medicine, pp 53-73, by George J. Agich, who cites my paper, Power and Collective Responsibility).

Indeed there is an increasing decline in ethical values in the field of medicine. In developing or low middle income countries, the main factors for the decline are illiteracy and poverty among patients (which doctors/clinicians take advantage of), lack of political will to enhance ethical standards  among doctors/clinicians in public hospitals, lack of adequate medical ethics training especially among clinicians and nurses and lack of awareness about ethics (ethical principles such as respect for autonomy, beneficence/non-maleficence and justice) among patients.

If I may add several additional comments, I would first like to respond to Angela Stanton's comments regarding seretonin.  Seretonin is a neurotransmitter found naturally in the brains of all humans and some other animals.  It is travels between receptors in the brain, and like dopamine for example, its functions are associated with mood regulation.  The drugs you mentioned, such as mirtazapine and several SSRI's, increase the level of free seretonin in the brain by inhibiting the reuptake of seretonin by thousands of receptors on one side of the synaptic gap.  This mechanism is thought to be associated with lifting depression.  But, the drugs in question are not themselves sertonin.  Having said this, I'm not clear what exactly is the nature of the moral problem you see these drugs as raising.

Regarding earlier remarks, another trend in healthcare, at least in the US, has exaserbated the dificulties in holding healcare professionals responsible for the consequences of treatment.  Particularly in primary care specialties, such as internal medicine and family practice, group practices have become the norm.  This means that a patient's treatment over time is likely to be delivered by different physicians and PA's on different ocassions.  Particularly regarding ommissions (eg., failing to order a test which good practice would require to be ordered) that contribute to harming a patient, it is difficult if not impossible to hold any one person individually responsible.

Research has shown that healthcare professionals who actually apologize to patient's for harm done and/or mistakes made are less likely to be sued than those who do not apologize (which is the norm).  Unless the mistake made is malicious, rather than merely negligent, the patient will most often forgive the healthcare professional.

I agree with the David T.Risser comments on the Serotonin and its mechanism, yes the healthcare professionals have to be very transparent in dealings with the patients, respect their rights and as well their families, a bond of trust is paramount importance. Never defend too much when you are sure there is a mistake committed on your part, as nowadays the patients have an excellent knowledge of basic concepts of diseases due to the advent of technology and bioinformatics.

I suppose added some points to discussion.   

Sultan Salah makes a very good point concerning the duty of healthcare professionals to be transparent in dealings with patients.  Otherwise, they risk becoming paternalistic towards patients.  Kant considered paternalism to be a particularly destructive kind of tyranny.

David, SSRIs increase serotonin levels. For someone who just had serotonin toxicity (serotonin syndrome) giving SSRI or anything that increases serotonin in the brain in any way is deadly. It was. She died.

And she did so because of ethical issues: the doctor overriding the diagnosis of serotonin syndrome without test to prove otherwise and forcing serotonin without patient (or in this case the durable power of attorney holder, who refused serotonin and SSRI is any shape and form) consent, verbal or written.

This is an ethical issue--currently already under investigation and I am not able to say more for gag order.

I am well aware of how SSRIs work: http://cluelessdoctors.com/2014/06/05/ssri-danger-for-migraine-and-depression-sufferers/  and for your information, serotonin helps only 30% of depression cases because depression may be caused by factors other than missing serotonin.

SSRIs also cause impotence: http://cluelessdoctors.com/2014/07/27/ssri-and-impotency-hahahaha-i-knew-more-bad-stuff-would-come-to-the-surface/  (sorry, I found that funny hence the title).

Serotonin also has a huge role in digestion and too much of it can cause IBS--which it does for most on SSRI.

I think all this info I have just now provided, I provided more than 85% of psychiatrists and doctors know as per an NIH article I can provide after I returned from the Labor Day holiday. That article states that 85% of doctor across the board cannot diagnose a serotonin syndrome and in 2012--the last reported data--showed that the 15% who do recognize reported nearly 80,000 cases in the US of which nearly 8,000 were very serious and nearly 100 died. This represents the 15%...

Add  to this the 85% who calls the death "hospital induced delirium" or "drug induced delirium" or "sudden onset of dementia" or "sudden onset of schizophrenia" as the cause of death and you will get a picture of nearly 500,000 people getting the syndrome in 2012 of which close to 700 died.

Not a number to miss and disregard. 

I hope you all have a wonderful Labor Day weekend!

There has not been a decline

(I can elaborate, but the question did not ask that)

Yes Jai Joshi ,you can go ahead with your elaboration to state that there is no decline.

Do elaborate Jai. Very curious to read what your take on it is.

I would also question whether there has been a decline in medicine, but that's because this is a very broad question due to two very broad terms: "ethics" and "medicine." Firstly, you have to be clear about what you mean by ethics, Are you talking about systems of rules that are communicated to result in ethical behaviour? Because we've seen more of this in medicine for sure. Bioethicists are brought on board to consult at hospitals, research ethics boards govern most research that is done, and medical practitioners are taught to tread carefully around issues related to consent, autonomy and privacy.  

However, we also see healthcare delivery systems being sped up and made more efficient so as undercut workers' abilities to show humanistic care for their patients. In that sense, we're seeing a less ethically sound environment because it is designed in a way that ends up increasing the suffering of both workers and clients. 

Medicine is also a very broad term and covers everything from the manufacturing of drugs, to the set up of for-profit hospitals, and then over to the attitudes of practitioners on the ground floor. I doubt very much that ground floor practitioners have become less ethical, in fact, as I suggest above, they're probably getting more of an education in ethics than the workers that came before them, meanwhile, from what I've seen in my work, a great many care very much about providing decent care to their patients. 

I agree Marnina, the question may not be well defined enough for all to mean the same. When I answered, here is what I meant:

Ethics in drug testing: researchers go through years of permission form various ethical boards yet doctors prescribe medicines off-label... is that not experimenting without patient consent? I believe it is. Who the ethics rests upon is questionable since the FDA permits off-label prescriptions--for now.. a lawsuit is already under way.

Ethics in medicine: PAs acting like doctors and prescribe medicines that require special permits, yet they are delinquent in their own license... and to catch them, someone must die. I caught one but yes, my mother died. Ethics? Whose? Several people are involved in this one, including the institution where he could work without being checked out.

Ethics in medical care: doctors who do not know what the drugs do that they prescribe. I found several. Whose ethics? Board of Medicine but then they will not bite the hand that feeds them and each doctor pays their annual licensing fees... so doctors are getting off the hook even if they have no clue what they are doing.

Ethics: pharmacies don't know the medicines they prescribe. One argued with me that Mirtazapine (Remeron) was not a serotonin.. really? Whose ethics? Those who allow pharmacies who are clueless about their prescription filling

Ethics in hospitals: patients wearing red allergy bands should be not given drugs that are on that band. Are they? You bet. My mom was one of them but I hear of a lot of other cases. Whose ethics? The doctor, the hospital, and also the pharmacy.

I just gave you a reduced "short list" if you will where the ethics of the medical system are in the dirt. I can give you more but I don't want to bore you. I think the message is clear.

C'mon, people!  Drugs are palliatives.  They were never meant to cure, only to treat symptoms.  Most of them are unnecessary.  Only some are actually temporarily useful.  How many people die in hospitals and otherwise from these "legal" concoctions every year?  How many more hundreds of thousands are maimed?  Can you read the official statistics?  And what about the Pts who come to your office?  I'm speaking from 42 years of hard clinical experience.    

Who teaches the Pt to be well via pure raw diet, fasting and life-positive lifestyle?  Anyone with half a brain knows that this is the main way real healing takes place.  Is this allowed or promoted in hospitals?  Who brings herbs into hospitals and uses them to aid in Pt wellness?  Who is allowed to prescribe traditionally-proven plants or even nutritional / vitamin substances?  Definition of "ethics" and "medicine"?  ARE YOU KIDDING ME?  The CDC is caught lying about their knowledge of the MMR causing autism and you're quibbling about terms?  (http://vimeo.com/user5503203/review/103711143/91f7d3d4d8)  GIVE ME A BREAK!  What planet are you living on?  Where is your common sense?  People are dying out there from the crimes of Big Pharma and you're involved in polite bantering?

I very much appreciate Leonard's response. It is not just greed.

A doctor prescribing a depression pill for anxiety is downright ignorance and incompetence mixed with lack of ethical considerations (here is my latest article on that: http://cluelessdoctors.com/2014/09/05/antidepressants-for-anxiety-why/ ).

Leonard is very right. We have patients dying in hospitals from misdiagnosis, mistreatment, mismanagement, all of which could be avoided and prevented if more ethical considerations were considered and the proper medications (or no medications, as Leonard suggests!) were used.

There are now medications for getting fat, medications to reduce fat... medications to wake up and medications to go to sleep... I talk to patients who take many medications, some of which increase blood pressure and others reduce blood pressure. What the heck are we doing? 

It is also generic versus brand name drugs. I started a big fight on that (here is another article on that and if you follow to the article following that, you will see some of my early wins and it is still continuing:

http://cluelessdoctors.com/2014/07/18/brand-name-versus-generic-drugs-are-you-in-danger-of-clueless-doctors/ ).

Our ethical values are sinking fast. Time to stop and look back. 

I do not think it is just money. I think it is also the relaxed ethical rules where off-label prescriptions are OK but researchers using the same for their experimenting requires over a year of ethical approval. Does that make sense to any of you? These are ethical shortcoming and I must say that yes, we are falling in ethical values when it comes to medicine! Big time!

Good work, Angela!  I just read the first paper (5Sep14) and I like it.  Of course, this is (as you describe) only one of many examples of a decline in ethical values we could note.  The field of medicine is fairly peppered with them.  One could easily conclude that in some real sense modern medicine is rotten to the core.  It needs a major overhaul.  

Consider: "The gross physical body is a food body.  The quality and quantity of the food we eat largely determines the health of the gross physical body--and the sense mind and emotions.  Therefore, the first treatment for any disease of the gross physical body is and rightly should be a food treatment."  (--Adi Da Samraj)  

It took me many years of clinical practice to come to this conclusion before I came across this quote from the book, Green Gorilla.  In the process, I saw what you mention in your paper, Angela---example after example of mis-prescribed drugs.  I also witnessed the differences in those Pt's who took diets of varying percentages of raw natural food, so that those who had the higher percentages were less likely to be sick.  And those who switched to very high percentages got well quicker.  Eventually, I came to the conclusion that unless the Pt was unwilling to follow protocol, or unless they were in a terminal stage, virtually all chronic degenerative diseases could be ameliorated or disappeared altogether via some form of raw diet---especially via periods of raw liquids.  

So, why is this not discussed in hospitals?  Why do so few MD's want to even talk about this?  Altho I believe the number is actually increasing, the preponderance are still---as you suggest---clueless, brainwashed by the directions given them in med school about drugs as remedy.  Where is the Pt education here?  Where is the integrity regarding the real benefits to the Pt?  It's just drug 'em and keep 'em there.  It's a dark dynasty that has to end.  

You're right about the money, too, Angela. It's not just that.  It's about power, maintaining power over the profession.  So, yes, Angela, keep telling people about your discoveries.  Tell everyone.  Get people educated to what is real in health care.  This will help us break away from this "disease care" system that works consciously to keep people ignorant of what it really takes to get and be healthy.  And finally to be health self-responsible and un-exploitable.  

Angela, Sorry I missed the main point of your "seretonin toxicity" answer.  But, whether or not there is a decline in ethical values in the field of medicine generally, and I have agreed above that there is, will depend upon a large number of such egregious cases across the various specialities in medicine. 

David, the main point is that 85% of the doctors (as of 2013 as per NIH) do not know what that is and cannot recognize it when they see one. They treat the patient for all kinds of unrelated illnesses and when the patient dies, the cause is something silly like "hospital delirium"... what kind of a cause is that. 

The ethical point is: one is not a doctor until one does not recognize a common disease. how many people today take serotonin medications? How many of those take more than one? I know hundreds... some take as many as 4 different types of serotonin medications that are surely going to cost their lives and the doctors will not know what killed them.

The head doctor in one of the hospitals where my mother was and had serotonin syndrome no one accepted that she had it--I caught her having the worst of it and being a scientist I was able to stop it but it has aftereffects, all of which were misdiagnosed and mistreated. I faced the head doctor and asked him if he had every heard of "serotonin syndrome"... this is the director of this hospital.. he said "serotonin what?" 

This is an ethical problem. We can solve this by further education with an annual test for doctors. They are fighting that with tooth and nail saying it takes too much time. How much time is a life worth?

Good call, Angela!

To answer the question, NO. Medics have not been the most ethical members of our society for a long time. Almost all may be, but history has a long list of those who weren't. Think Jenner and vaccination for example.

It is a continuing demand on us to force our medics to behave ethically, just like our bankers and our lawyers. Don't expect the problem to go away. Nuremburg and Helsinki didn't solve everything. Tuskegee wasn't stopped until long after both.

Part of the problem - a major part - is that medical ethics is deemed to be the preserve of medics rather than ethicists. Medical ethics tends to be taught to would-be medics by medics, not ethicists, ethics review boards (which give the green light to medical experiments on humans) are overwhelmingly manned (and yes manned is the right word) by medics, often those who do the same sort of experiments and so have a personal interest in the controls being 'gentle'.

If there is an ethicist on an IRB, what chance has s/he (usually having no science background) to understand the mountains of scientific gibberish that are presented, let alone prevail against the senior medics of a university hospital? Indeed, what chance has s/he to be able to do her/his daytime job as an ethics teacher/researcher and also read and understand all the ethics approval applications submitted to the IRB (perhaps a thousand a year or more)?

Medics hold a special, privileged position in our society - they are permitted to act in ways that otherwise would simply be criminal (assault, poisoning, murder, etc) Ethical oversight of medics is crucial, but is fiercely resisted.

And, before you ask, as an attorney I'm about as far from being an ethicist as is possible

Angela , your point is valid  there  is re-certification process for the doctors to continue practice in many countries and also there is a mandatory CME (Continuing Medical Education) some countries made it mandatory say up-to 50 credit hours for doctors to get their licence renewed. So it is up to to the respective health authorities to implement these stringent measures to make the health practice safe.

@Sultan, we also have the same but there is no testing. Have you seen any of these doctor re-educations? Doctors sit around a large table, all browsing the internet and answering emails while one poor doctor is doing his/her best to detail new findings. No one is paying attention. My hair dresser, realtor, insurance agents, etc., all need to attend classes each year AND they have to test.. why don't we test doctors? The license fee for doctors to renew is $30... give me a break... and no test.

I also found one of this docs who could not even care to renew his license and practiced without it for 6 months! These are facts. Ignorance at its highest.

We can blame whoever we want; I am not sure who is to blame. But the system is broken and ethics have fallen.

@Julian, I am very glad to see an attorney in this group because I have a question for you. Off-label prescriptions. It is legal according to the FDA? Why? How dare they? What gives doctors the right to prescribe a drug that was created for X to treat Y that has not been tested for Y and is not approved for Y? Where is the law there? Law considers (in the US) only precedents--I am familiar with law on the constitutional level only since I had to have that as part of my doctorate on human rights with medical experimenting.

I pocked fun of one ruling of the case of Moore in the book Patenting Lives Chapter 5, title: Forfeited Consent: Body Parts in Eminent Domain. (Ashgate). In that one the patient Moore had an illness that came with a special blood that provided infinite replicability, if I recollect well, and the doctor--whose name by now I forgot--stole his blood without patient knowledge, then after surgery of the spleen stole the spleen and rather than sending it to pathology for a quick exam and then disposal, he kept it to extract its ability to make blood. Patented the patient's blood and sold it to pharmaceuticals, all without the patient's knowledge and consent.

Then one day the doctor needed the consent and handed the patient the paperwork for the consent and the patient denied the doctor's right for the experimenting and refused to sign the consent! This went to court and the patient lost! It lost everywhere except in the CA Appeal court somewhere.. forget the details now but the point is: the patient's body part (his blood and spleen) were experimented on without his consent; the doctor made millions of dollars on it as did the pharmaceutical company without patient knowledge and consent and consent was expressly revoked by the patient and the patient still lost the case!

This is today's precedent for legal judgments over medical ethical conduct. Where the hell are the REAL lawyers who can change the law by changing the correctness of the precedent? Where is justice served if not by the law? Where does one turn today for ethical values in a society where the legal precedents provide unethical values for the medical and legal fields?

@Angela - There isn't much you can do about off-label, unless it goes wrong, in which case you can have a go, if you are still breathing. FDA is about the industry not the medics. Anyhow, you know me and I know you, so, if you have time, email me and I'll try to give my opinion (which is more like yours than you might think). Moore was a travesty, but largely because of what Moore and his attorneys were trying to achieve (a slice of the pie). [email protected]

@Julian, I sent you an email. :)

Thanks Ali for your links. I read all three but unfortunately I did not find any reference to our change in ethics topic. I found what ethics should be but not what is.

In fact one of the articles is from Mayo Clinic and I had to laugh because one of my "patients" (not really a patient but I consult her), has just recently had an amazing unethical experience at Mayo Clinic with a doctor. Let me quote part of what she wrote:

"I won't go into details because its a long story about sitting with a doctor for 45 minutes of him telling me that I am basically a hypochondriac because I have sought so many specialists, and I have been diagnosed with every health issue that really has no meaning (gastrointerologist/IBS, Gynecologic/endometriosis, neuro/migraine, & now him, rheumatoid/fibro). He said I needed a pschycologist more than anything. ...He said all of my tests came back fine so he is going to "say" that it's fibro. He then went on to say that there was one test they didn't do, & he would draw for it, for entertainment sake. I could expect a call from him if it came back positive, but he really doubts that it will be positive. I most likely am suffering from fibro and need to learn how to manage the stressors in my life so that they don't manifest themselves physically.

Well... My test came back POSITIVE!!!!!!!!! AND HE DIDNT CALL.

I am beyond annoyed with him."

So... shall we talk about ethics a bit on a "per experience" basis as opposed to what ethics is in the books? Because obviously the two do not have much in common.

I agreed ethical impression in health information system

Profit, too much dependence on technology, lack of humanism in medical education

What you are addressing in your question, is it the: