Sun Si Miao’s Code of Ethics

Sun Si Miao [581—682 A.D.] was a famous Chinese alchemist, scholar, and clinician. He is credited with the first code of ethics for doctors, less a formal code per se, and more of the philosophy of a virtuous physician and values that suggest an ethical practitioner. The principles primarily focus upon compassion, justice, beneficence, and humility, rather than physician truth-telling and self-importance.
To posterity, Sun Si Miao completed two, 30-volume medical works that would establish his place as a central figure in the field of Chinese [herbal] medicine. Here he is depicted in this wooden carving as the Medicine God seated on a tiger and holding a dragon above him.
• First develop compassion, not giving way to wishes, desires and judgments.
• She sympathizes in her heart with those who experience grief, as if she herself has been struck by it.

• She does not ponder her own fortune or misfortune above preserving life and having compassion for it.

• By no means should there arise an attitude of rejection. Sympathy, compassion and care should develop for whomever suffers from conditions looked upon with contempt by people.

• Treat all patients alike, whether powerful or humble, rich or poor, old or young, beautiful or ugly, resentful relatives or kind friends, locals or foreigners, fools or wise men.

• Neither dangerous mountain passes nor the time of day, neither weather conditions nor hunger, thirst nor fatigue should keep her from helping whole-heartedly.

• She makes a dignified appearance, neither luminous nor somber.

• It is not permissible to be talkative and make provocative speeches, to make fun of others, raise one’s voice, to decide right from wrong, and to discuss other people and their business.

• The wealth of others should not be the reason to prescribe precious and expensive treatments. The object is to help.

• It is inappropriate to emphasize one’s reputation, to belittle other physicians, and to praise one’s own virtue. Indeed, in actual life someone who has accidentally healed a disease then strides around with head held high, showing conceit, and announcing that no one in the entire world could have measured up to yield such results; underscoring one’s own merits and abilities. Such conduct has to be regarded as contrary to the teachings of magnanimity. In this respect, all physicians are evidently incurable!

Adaptation derived from review of related articles by Paul Unschuld, Subhuti Dharmananda, and S.Y. Tan, MD.

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