{"id":4294,"date":"2022-06-09T00:24:43","date_gmt":"2022-06-08T23:24:43","guid":{"rendered":"https:\/\/blogs.bmj.com\/medical-ethics\/?p=4294"},"modified":"2022-06-09T00:24:43","modified_gmt":"2022-06-08T23:24:43","slug":"should-doctors-be-held-to-higher-moral-standards-than-others","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/medical-ethics\/2022\/06\/09\/should-doctors-be-held-to-higher-moral-standards-than-others\/","title":{"rendered":"Should doctors be held to higher moral standards than others?"},"content":{"rendered":"

By Daniel Sokol<\/p>\n

In a highly publicised case, Dr Arora\u00a0 – a general practitioner – was suspended for a month after the Medical Practitioners Tribunal<\/a> deemed her dishonest for telling a medical colleague that she had been promised a laptop when no such promise had been made.\u00a0 The Tribunal noted that Dr Arora\u2019s exaggeration brought the medical profession into disrepute and that anything short of suspension would fail to promote and maintain proper standards of conduct for doctors.<\/p>\n

As well as raising concerns about gender and racial bias – Dr Arora was a female, ethnic minority doctor – the case prompted many<\/a> in the profession to wonder whether the moral standards expected of doctors were too high.\u00a0 Should the medical profession be held to a loftier standard than ordinary people?<\/p>\n

The irony is that these standards were not set by society but by doctors.<\/p>\n

The term \u2018medical ethics\u2019 first emerged in the medical literature in Thomas Percival\u2019s eponymous text, published in 1803<\/a>.\u00a0 Percival<\/a>, an English doctor, wrote in the Dedication addressed to his son \u2018the study of professional ethics\u2026will soften your manners, expand your affections, and form you to that propriety and dignity of conduct, which are essential to the character of a gentleman<\/em>.\u2019\u00a0 He instructed doctors to \u2018cautiously guard against whatever may injure the general respectability of the profession\u2019<\/em>.<\/p>\n

Al Jonsen, in his Short History of Medical Ethics<\/strong><\/a>, remarked that \u2018the serious efforts of physicians such as \u2026Percival to improve the manners and morals of the profession attest to the sorry state of the profession in their days.<\/em>\u2019\u00a0 The vast majority of doctors did not enjoy high status and pay.\u00a0 An old lady in Somerset Maugham\u2019s Of Human Bondage<\/strong><\/a>, published in 1915, recounted how in her youth in the 1850s no gentleman\u2019s son would consider a career in medicine.<\/p>\n

The historian Edward Shorter in Bedside Manners<\/strong><\/a> wrote that, around the turn of the 20th<\/sup> century, when medicine became more scientific and it began to be harder to get into medical school, \u2018the modern doctor began to think increasingly well of himself<\/em>\u2019.\u00a0 Doctors sought to act like English gentlemen, joining prestigious clubs and becoming pillars of society.\u00a0 Harley Street, in central London, housed 36 doctors in 1873.\u00a0 By 1900, it was close to 150<\/a>.\u00a0 The social and economic status of all doctors rose dramatically in the course of the 20th<\/sup> century.\u00a0 This brought with it some therapeutic benefits, particularly in improving the mental health of patients.\u00a0 Shorter<\/a> argued that \u2018once medical men began imagining themselves to be socially a notch or two above everybody else, their ability to cure psychological disease increased correspondingly.\u2019<\/em><\/p>\n

In 1958, Stephen Hadfield, a surgeon and Assistant Secretary of the British Medical Association, wrote in Law and Ethics for Doctors<\/strong><\/a>:<\/em><\/p>\n

\u2018They <\/em>[doctors] should at all times so conduct themselves as to justify an implicit trust and respect on the part of their patients.\u00a0 Such trust and respect will be vitiated by any doubtful or improper conduct outside the professional sphere as well as within.\u2019<\/em><\/p>\n

Doctors lamenting the high standards of conduct expected of them therefore have their predecessors to blame.\u00a0 If here today, what would these august doctors say in their defence?<\/p>\n

They would say that lowering the expectations of good conduct may save the skin of some doctors who would otherwise have been sanctioned or erased from the register, but that may in the fullness of time have knock-on effects on the medical profession and the health of patients.\u00a0 They would offer arguments based on self-interest and altruism.<\/p>\n

In terms of self-interest, they would point out that establishing and maintaining a high standard raised the status and income of the medical profession, reminding today\u2019s doctors reaping the rewards of past generations that it was not always so.\u00a0 It is possible, they might say, that lowering the standard may similarly reduce<\/em> the social status of doctors and eventually their income.\u00a0 If so, fewer bright young men and women would choose a career in medicine.<\/p>\n

In terms of altruism, they would point to the greater trust, faith and respect that most patients have in a profession held to very high standards of conduct and how this is likely to raise the confidence of patients in doctors\u2019 advice and improve their adherence to treatment.\u00a0 Lowering the standards – an event which may attract considerable press attention – could reduce this all-important trust and respect, and damage the health of patients.<\/p>\n

Finally, they might argue that the requirement for high standards of conduct forms part of the fabric of medical practice and that it is no coincidence that its origins can be traced back to Hippocrates<\/a> and beyond.\u00a0 It is based, they might say, on the profound trust held by patients and society that doctors be not only competent but of good character.\u00a0 Without such trust, how can patients be satisfied that doctors will not take advantage of their vulnerability and the inequality of power.\u00a0 The erosion of this image of the trustworthy and morally upstanding doctor, so long in the making, may damage the relationship between doctor and patient and between doctor and society.<\/p>\n

Whatever the plausibility of these arguments and, in my opinion, the extreme harshness of Dr Arora\u2019s sanction (which is under appeal at the time of writing), the medical profession must consider with care the consequential effects, good and bad, of any proposal to alter expected standards of conduct on both the profession itself and on the health of the public.<\/p>\n

 <\/p>\n

Author<\/strong>: Daniel Sokol<\/p>\n

Affiliation<\/strong>: Barrister and Medical Ethicist, 12 King\u2019s Bench Walk<\/p>\n

Competing interests: <\/strong>None declared<\/p>\n

Social media accounts: <\/strong><\/p>\n

Twitter – @DanielSokol9<\/a><\/p>\n

Webpage \u2013 www.medicalethicist.net<\/a><\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

By Daniel Sokol In a highly publicised case, Dr Arora\u00a0 – a general practitioner – was suspended for a month after the Medical Practitioners Tribunal deemed her dishonest for telling a medical colleague that she had been promised a laptop when no such promise had been made.\u00a0 The Tribunal noted that Dr Arora\u2019s exaggeration brought […]<\/p>\n

Read More…<\/a><\/p>\n","protected":false},"author":353,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2146,8057],"tags":[],"class_list":["post-4294","post","type-post","status-publish","format-standard","hentry","category-in-the-courts","category-medical-ethics"],"yoast_head":"\nShould doctors be held to higher moral standards than others? - Journal of Medical Ethics blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/medical-ethics\/2022\/06\/09\/should-doctors-be-held-to-higher-moral-standards-than-others\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Should doctors be held to higher moral standards than others? - Journal of Medical Ethics blog\" \/>\n<meta property=\"og:description\" content=\"By Daniel Sokol In a highly publicised case, Dr Arora\u00a0 – a general practitioner – was suspended for a month after the Medical Practitioners Tribunal deemed her dishonest for telling a medical colleague that she had been promised a laptop when no such promise had been made.\u00a0 The Tribunal noted that Dr Arora\u2019s exaggeration brought [...]Read More...\" \/>\n<meta property=\"og:url\" content=\"https:\/\/blogs.bmj.com\/medical-ethics\/2022\/06\/09\/should-doctors-be-held-to-higher-moral-standards-than-others\/\" \/>\n<meta property=\"og:site_name\" content=\"Journal of Medical Ethics blog\" \/>\n<meta property=\"article:published_time\" content=\"2022-06-08T23:24:43+00:00\" \/>\n<meta name=\"author\" content=\"Mike King\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Mike King\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"5 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2022\\\/06\\\/09\\\/should-doctors-be-held-to-higher-moral-standards-than-others\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2022\\\/06\\\/09\\\/should-doctors-be-held-to-higher-moral-standards-than-others\\\/\"},\"author\":{\"name\":\"Mike King\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/#\\\/schema\\\/person\\\/b107957622bc42b2097d15e5e02a112c\"},\"headline\":\"Should doctors be held to higher moral standards than others?\",\"datePublished\":\"2022-06-08T23:24:43+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2022\\\/06\\\/09\\\/should-doctors-be-held-to-higher-moral-standards-than-others\\\/\"},\"wordCount\":944,\"commentCount\":0,\"publisher\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/#organization\"},\"articleSection\":[\"In the Courts\",\"Medical ethics\"],\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2022\\\/06\\\/09\\\/should-doctors-be-held-to-higher-moral-standards-than-others\\\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2022\\\/06\\\/09\\\/should-doctors-be-held-to-higher-moral-standards-than-others\\\/\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2022\\\/06\\\/09\\\/should-doctors-be-held-to-higher-moral-standards-than-others\\\/\",\"name\":\"Should doctors be held to higher moral standards than others? - Journal of Medical Ethics blog\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/#website\"},\"datePublished\":\"2022-06-08T23:24:43+00:00\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2022\\\/06\\\/09\\\/should-doctors-be-held-to-higher-moral-standards-than-others\\\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2022\\\/06\\\/09\\\/should-doctors-be-held-to-higher-moral-standards-than-others\\\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2022\\\/06\\\/09\\\/should-doctors-be-held-to-higher-moral-standards-than-others\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Should doctors be held to higher moral standards than others?\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/#website\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/\",\"name\":\"Journal of Medical Ethics blog\",\"description\":\"A blog to discuss the ethics of medicine in its many guises and formats.\",\"publisher\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/#organization\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"},{\"@type\":\"Organization\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/#organization\",\"name\":\"Journal of Medical Ethics blog\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/#\\\/schema\\\/logo\\\/image\\\/\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/files\\\/2026\\\/04\\\/jme-logo.png\",\"contentUrl\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/files\\\/2026\\\/04\\\/jme-logo.png\",\"width\":200,\"height\":50,\"caption\":\"Journal of Medical Ethics blog\"},\"image\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/#\\\/schema\\\/logo\\\/image\\\/\"}},{\"@type\":\"Person\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/#\\\/schema\\\/person\\\/b107957622bc42b2097d15e5e02a112c\",\"name\":\"Mike King\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/8caa7ddd85361ccfd46160d9dd41e9ff9aadde6fd8379b80c066d095d69f9f7b?s=96&d=mm&r=g\",\"url\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/8caa7ddd85361ccfd46160d9dd41e9ff9aadde6fd8379b80c066d095d69f9f7b?s=96&d=mm&r=g\",\"contentUrl\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/8caa7ddd85361ccfd46160d9dd41e9ff9aadde6fd8379b80c066d095d69f9f7b?s=96&d=mm&r=g\",\"caption\":\"Mike King\"},\"sameAs\":[\"https:\\\/\\\/www.otago.ac.nz\\\/bioethics\\\/people\\\/academic\\\/profile\\\/index.html?id=774\"],\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/author\\\/mking\\\/\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Should doctors be held to higher moral standards than others? - Journal of Medical Ethics blog","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/blogs.bmj.com\/medical-ethics\/2022\/06\/09\/should-doctors-be-held-to-higher-moral-standards-than-others\/","og_locale":"en_US","og_type":"article","og_title":"Should doctors be held to higher moral standards than others? - Journal of Medical Ethics blog","og_description":"By Daniel Sokol In a highly publicised case, Dr Arora\u00a0 – a general practitioner – was suspended for a month after the Medical Practitioners Tribunal deemed her dishonest for telling a medical colleague that she had been promised a laptop when no such promise had been made.\u00a0 The Tribunal noted that Dr Arora\u2019s exaggeration brought [...]Read More...","og_url":"https:\/\/blogs.bmj.com\/medical-ethics\/2022\/06\/09\/should-doctors-be-held-to-higher-moral-standards-than-others\/","og_site_name":"Journal of Medical Ethics blog","article_published_time":"2022-06-08T23:24:43+00:00","author":"Mike King","twitter_card":"summary_large_image","twitter_misc":{"Written by":"Mike King","Est. reading time":"5 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/blogs.bmj.com\/medical-ethics\/2022\/06\/09\/should-doctors-be-held-to-higher-moral-standards-than-others\/#article","isPartOf":{"@id":"https:\/\/blogs.bmj.com\/medical-ethics\/2022\/06\/09\/should-doctors-be-held-to-higher-moral-standards-than-others\/"},"author":{"name":"Mike King","@id":"https:\/\/blogs.bmj.com\/medical-ethics\/#\/schema\/person\/b107957622bc42b2097d15e5e02a112c"},"headline":"Should doctors be held to higher moral standards than others?","datePublished":"2022-06-08T23:24:43+00:00","mainEntityOfPage":{"@id":"https:\/\/blogs.bmj.com\/medical-ethics\/2022\/06\/09\/should-doctors-be-held-to-higher-moral-standards-than-others\/"},"wordCount":944,"commentCount":0,"publisher":{"@id":"https:\/\/blogs.bmj.com\/medical-ethics\/#organization"},"articleSection":["In the Courts","Medical ethics"],"inLanguage":"en-US","potentialAction":[{"@type":"CommentAction","name":"Comment","target":["https:\/\/blogs.bmj.com\/medical-ethics\/2022\/06\/09\/should-doctors-be-held-to-higher-moral-standards-than-others\/#respond"]}]},{"@type":"WebPage","@id":"https:\/\/blogs.bmj.com\/medical-ethics\/2022\/06\/09\/should-doctors-be-held-to-higher-moral-standards-than-others\/","url":"https:\/\/blogs.bmj.com\/medical-ethics\/2022\/06\/09\/should-doctors-be-held-to-higher-moral-standards-than-others\/","name":"Should doctors be held to higher moral standards than others? - Journal of Medical Ethics blog","isPartOf":{"@id":"https:\/\/blogs.bmj.com\/medical-ethics\/#website"},"datePublished":"2022-06-08T23:24:43+00:00","breadcrumb":{"@id":"https:\/\/blogs.bmj.com\/medical-ethics\/2022\/06\/09\/should-doctors-be-held-to-higher-moral-standards-than-others\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/blogs.bmj.com\/medical-ethics\/2022\/06\/09\/should-doctors-be-held-to-higher-moral-standards-than-others\/"]}]},{"@type":"BreadcrumbList","@id":"https:\/\/blogs.bmj.com\/medical-ethics\/2022\/06\/09\/should-doctors-be-held-to-higher-moral-standards-than-others\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/blogs.bmj.com\/medical-ethics\/"},{"@type":"ListItem","position":2,"name":"Should doctors be held to higher moral standards than others?"}]},{"@type":"WebSite","@id":"https:\/\/blogs.bmj.com\/medical-ethics\/#website","url":"https:\/\/blogs.bmj.com\/medical-ethics\/","name":"Journal of Medical Ethics blog","description":"A blog to discuss the ethics of medicine in its many guises and formats.","publisher":{"@id":"https:\/\/blogs.bmj.com\/medical-ethics\/#organization"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/blogs.bmj.com\/medical-ethics\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-US"},{"@type":"Organization","@id":"https:\/\/blogs.bmj.com\/medical-ethics\/#organization","name":"Journal of Medical Ethics blog","url":"https:\/\/blogs.bmj.com\/medical-ethics\/","logo":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/blogs.bmj.com\/medical-ethics\/#\/schema\/logo\/image\/","url":"https:\/\/blogs.bmj.com\/medical-ethics\/files\/2026\/04\/jme-logo.png","contentUrl":"https:\/\/blogs.bmj.com\/medical-ethics\/files\/2026\/04\/jme-logo.png","width":200,"height":50,"caption":"Journal of Medical Ethics blog"},"image":{"@id":"https:\/\/blogs.bmj.com\/medical-ethics\/#\/schema\/logo\/image\/"}},{"@type":"Person","@id":"https:\/\/blogs.bmj.com\/medical-ethics\/#\/schema\/person\/b107957622bc42b2097d15e5e02a112c","name":"Mike King","image":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/secure.gravatar.com\/avatar\/8caa7ddd85361ccfd46160d9dd41e9ff9aadde6fd8379b80c066d095d69f9f7b?s=96&d=mm&r=g","url":"https:\/\/secure.gravatar.com\/avatar\/8caa7ddd85361ccfd46160d9dd41e9ff9aadde6fd8379b80c066d095d69f9f7b?s=96&d=mm&r=g","contentUrl":"https:\/\/secure.gravatar.com\/avatar\/8caa7ddd85361ccfd46160d9dd41e9ff9aadde6fd8379b80c066d095d69f9f7b?s=96&d=mm&r=g","caption":"Mike King"},"sameAs":["https:\/\/www.otago.ac.nz\/bioethics\/people\/academic\/profile\/index.html?id=774"],"url":"https:\/\/blogs.bmj.com\/medical-ethics\/author\/mking\/"}]}},"_links":{"self":[{"href":"https:\/\/blogs.bmj.com\/medical-ethics\/wp-json\/wp\/v2\/posts\/4294","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.bmj.com\/medical-ethics\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.bmj.com\/medical-ethics\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.bmj.com\/medical-ethics\/wp-json\/wp\/v2\/users\/353"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.bmj.com\/medical-ethics\/wp-json\/wp\/v2\/comments?post=4294"}],"version-history":[{"count":0,"href":"https:\/\/blogs.bmj.com\/medical-ethics\/wp-json\/wp\/v2\/posts\/4294\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.bmj.com\/medical-ethics\/wp-json\/wp\/v2\/media?parent=4294"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.bmj.com\/medical-ethics\/wp-json\/wp\/v2\/categories?post=4294"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.bmj.com\/medical-ethics\/wp-json\/wp\/v2\/tags?post=4294"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}