JAHR ~ Vol. 2 ~ No.

4 ~ 2011

UDK 17:01:19
Conference paper

Eleni M. Kalokairinou*

Tracing the roots of European bioethics

back to the Ancient Greek philosophersphysicians
ABSTRACT
Contrary to the usual claim that Bioethics is a contemporary discipline, I argue that its origins can be traced back to the Ancient Greek philosophers-healers. In classical antiquity
philosophy was almost inseparable from medicine not only in the sense that philosophers
like Empedocles, Plato and Aristotle contributed to its development, but also in that later
philosophers conceived of moral principles and rules in order to prevent the physicians malpractice and the patients harassment. From this point of view, the philosophers-physicians
Hippocrates, Galen and Celsus have laid the foundations of the science known under the
name of "Bioethics".
Keywords: bioethics, ancient Greek medicine, philosophers-physicians, Hippocrates

If we look at the contemporary literature of medical ethics, we get the impression

that Bioethics, an interdisciplinary science of about 35-40 years, has its origins in
the United States. Gilbert Hottois, for instance, in his book, Qu est-ce que la Biothique? argues that it was the American oncologist Van Rensselaer Potter who first
used the term "Bioethics" in his article, "Bioethics, the science of survival", which
was then included in his book, Bioethics: Bridge to the Future in 1971.1 A number
of publications following Potters introduction of the term further support the idea
that it was the American scientists and philosophers concern about the ethical dilemmas, raised by the development of medical sciences and technologies, which
1 Gilbert Hottois, Quest-ce que la Biothique?, J. Vrin, Paris 2004, p. 10. See, also, Van Rensselaer Potter, Bioethics:
Bridge to the Future, Prentice-Hall, 1971.

* Correspondence address: Eleni Kalokairinou, Assistant Professor, (Elected Associate Professor of the Aristotle
University of Thessaloniki), Department of Classics and Philosophy, University of Cyprus, P.O. Box 20537, 1678
Nicosia, Cyprus. e-mail: [email protected], [email protected]

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gives rise to this new interdisciplinary science called Bioethics.2 But if we leave the
term aside and, instead, concentrate on the kind of ethical problems which the development of the contemporary biomedical sciences raise, we will realize that, long
before Potter, philosophers physicians like Hippocrates, Galen and Celsus, philosophers like Plato, Aristotle, Immanuel Kant, Friedrich Schleiermacher, Hans Jonas,
Albert Schweitzer and, of course, the German theologian and philosopher Fritz Jahr
(1895-1953) investigated and attempted to answer the same questions which contemporary American bioethicists contend to have dealt with first. Our contention
therefore is that Bioethics is a European discipline and that we must trace it to its
roots if we wish to verify this fact.
In studying the origins of the European Bioethics it would be a serious omission if
we did not turn to people like Hippocrates, Galen and the Roman Celsus who admittedly laid the foundations of the modern discipline known under the name of
Bioethics. For, apart from their strict medical treatises, Hippocrates, Galen and their
contemporary physicians composed certain deontological treatises to which almost
all the principles of contemporary Bioethics can be traced. However, before one examines the content of the Ancient Greek deontology and the way in which it has
influenced contemporary Bioethics, one has to consider the medical art or "science"
as it was conceived and practiced in antiquity.
Medicine, connected as it is to man and human nature, appears in a fairly advanced
stage of human civilization.3 In antiquity, when we talk about medicine we do not
refer so much to a body of theoretical knowledge, as we do today, but, instead, to
certain therapeutic practices. Similarly, the physician is not a scientist who possesses
a fair amount of theoretical knowledge which he applies in life, but he is the practical healer who applies certain accepted practices for the healing of a disease or the
cure of a wound. To be more precise, we should mention that these medical practices had a divine character. Before we say anything about the practical healers, we
should be reminded that it was the soothsayers and augurs who, from the signs of
the weather or the intestines of sacrificial animals, could conclude which practice
in the wide sense - could be followed for the cure of the disease or the expiation of
the plague which had befallen a community or a royal House. Consequently, it was
more the soothsayers and the augurs job than that of the practical healers to find
ways to purify the profane action and to expiate the plague. However, the idea of
2

See, for instance, T. Beauchamp, "Ethical Theory and Bioethics" in T. Beauchamp and L. Walters (eds.),
Contemporary Issues in Bioethics, Wadsworth, Belmont 1999.
In this paragraph I draw pretty closely to what I am saying in, Eleni Kalokairinou, " .
 
        " in Mark G. Kuczewski and Ronald Polansky (.),
:
    
 
, . .  , .   
  , Travlos, Athens 2007, p. 528-529.

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Eleni M. Kalokairinou: Tracing the roots of European Bioethics back to the...

the divine origin of diseases began to give way. The Ancient Greeks soon realized
that they were caught into an undesirable dualism and that they could not accept
that all "normal phenomena were natural and all abnormal phenomena were
divine".4 They gradually reached the conclusion that all phenomena are natural and
divine and that there are always certain elements of a phenomenon which cannot be
explained. In this way, philosophy in the end replaces religion, as it tries to provide
explanations for diseases which religion itself could not account for.
The kind of relation which exists between ancient medicine and philosophy is one
of the most important problems that has engaged and still engages classicists and
philosophers. Even though they all admit that ancient medicine and philosophy are
related in a rather complicated manner, a number of classicists argue that it was ancient medicine that influenced ancient Greek philosophical thought. However, the
dominant view nowadays is that it was the ancient Greek philosophers who laid the
foundations of ancient medicine.5 This view is mainly corroborated by the ancient
Greek sources. Thus Aristotle writes in his treatise On Sense and Sensible Objects:
It is further the duty of the natural philosopher to study the first principles of
disease and health; for neither health nor disease can be properties of things
deprived of life. Hence one may say that most natural philosophers, and those
physicians who take a scientific interest in their art, have this in common: the
former end in studying medicine, and the latter base their medical theories on
the principles of natural science.6
Similarly, in the 1st century A.D., the Roman philosopher-physician Celsus in the
prooemium of his work, De Medicina says:
At first the science of healing was held to be part of philosophy, so that
treatment of disease and contemplation of the nature of things began through
the same authorities; clearly because healing was needed especially by those
whose bodily strength had been weakened by restless thinking and nightwatching. Hence we find that many who professed philosophy became expert

Hippocrates, transl. W. H. S. Jones, The Loeb Classical Library, Harvard University Press and William
Heinemann, Cambridge Massachusetts, London 1984, vol. I, General Introduction, p. x-xi.

5
On this claim see, Michael Frede, "Philosophy and Medicine in Antiquity" in Essays in Ancient Philosophy,
Clarendon Press, Oxford 1987, pp. 225-242.
6 Aristotle, On sense and sensible objects 436a19-b1 in On the Soul, Parva Naturalia, On Breath, transl. W. S. Hett,
The Loeb Classical Library, Harvard University Press and William Heinemann Ltd, Cambridge Massachusetts,
London 1986.

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in medicine, the most celebrated being Pythagoras, Empedocles and

Democritus.7
The Milesian philosophers Thales, Anaximander and Anaximenes were mostly concerned with physics and astronomy and not so much with anthropology and medicine. However, things change as soon as the Pythagoreans were established in Croton of Italy, where there was a medical tradition. Alcmaeon of Croton is a
Pythagorean or, at least, belonged to the Pythagorean circle and was the first philosopher who attempted to lay the theoretical principles of medicine and, then, to
adapt them to experience. He breaks away from the prevailing view of his time according to which disease was conceived in ontological terms and, instead, he considers it as part of nature. In the extant fragment of his work, 
  (On
Nature), he argues that the body consists of a number of opposite elements or forces, i.e. cold-hot, moist-dry, sweet-bitter etc.8 The harmonious mixing ( ) and
the balance (!  ") between these opposite forces of the body constitutes health,
whereas the supremacy ( ") of any of these over the others causes disease.
The theory of the opposite constituents which Alcmaeon of Croton introduces was
prevailing throughout ancient medicine. But, as Cornford points out, the various
medical schools differed on what each took these ultimate constituents to be.9 Alcmaeon, as we have seen, considered these elements to be opposite powers. But when
his theory is accordingly adopted by the medical school of Cos, the powers are replaced by the "fluid substances, the humours".10 This development took place gradually and we can trace it if we study carefully Hippocrates treatise On Ancient Medicine a treatise in which, as we shall see, the writer complains intensely for the
intrusion of philosophy into medicine.11 He maintains that these opposites are not
substances but powers of secondary importance. He further argues that the body is
composed of certain opposite humours which have properties or powers that influence health more than temperature does. Thus, in the Hippocratic school health is
the harmonious blending of these humours ( ), whereas the dominance of the
one over the others ( ") is the sign of disease. In the treatise Nature of Man

7 Aulus Cornelius Celsus, De Medicina, Prooemium 6-7, transl. W. G. Spencer, The Loeb Classical Library,
William Heinemann Ltd and Harvard University Press, Cambridge Massachusetts, London 1971.
8

Diels, H. and W. Kranz, Die Fragmente der Vorsokratiker, Weidmann 1989, vol. I, 24, B4, [22].

Cornford, F.M., Platos Cosmology, The Timaeus of Plato translated with a running commentary, Routledge,
London (1937) 2000, p. 332.

10

Cornford, p. 333. See, also, Hippocrates, vol. I, General Introduction, p.xlvi-xlviii.

11

See, below, notes 27 and 28.

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which Aristotle attributes to Polybus, it is maintained that the humours are four:
phlegm, blood, yellow bile and black bile.12
On the other hand, thinkers like Empedocles of Croton, who belonged to the Italian and the Sicilian school, followed a different line of thought. Empedocles, for instance, materialized these four ultimate constituents of the body, i.e. fire, air, water
and earth, the #$%, as he called them. These elements were taken to be the
components of the body and of everything else. The analogies with which these different elements are mixed determine not only the different kinds of beings but also
the different individual human natures.13 Given these four components, Philistion of
Locri developed a theory of health and disease. Put briefly, there are as follows:
Philistion holds that we consist of four forms (!&), that is elements:
fire, air, water, earth. Each of these has its own power: fire the hot, air the
cold, water the moist, earth the dry. Diseases arise in various ways, which
fall roughly under three heads. (1) Some are due to the elements, when the
hot or the cold comes to be in excess, or the hot becomes too weak and
feeble. (2) Some are due to external causes of three kinds: (a) wounds; (b)
excess of heat, cold, etc.; (c) change of hot to cold or cold to hot, or of
nourishment to something inappropriate and corrupt. (3) Others are due to
the condition of the body: thus, he says, when the whole body is breathing
well and the breath is passing through without hindrance, there is health;
for respiration takes place not only through mouth and nostrils, but all over
the body14
Historians inform us that Philistion was practicing at Syracuse and it is almost certain that he influenced Diocles of Carystos in Euboea, who was later regarded as "a
second Hippocrates". Diocles practised in Athens and wrote medical treatises on almost every topic between 400-350 B.C.15 Cornford observes that there is a lot of
agreement on many issues between Diocles and Plato, something which leads us to
conclude: (a) that they knew of each others work, and (b) that they both had been
influenced by Philistions teaching.16 Cornford invokes Platos Second Letter which,

12

Hippocrates, vol. I, General Introduction, p. xlviii-xlix. See, also, Cornford, p. 333.

13

Diels, H. and W. Kranz, Die Fragmente der Vorsokratiker, vol. I, 31, B 110.

14

Cornford, p. 333.

15

Cornford, p. 334.

16

Cornford, p. 334.

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in his opinion, suggests that Philistion attended Dionysius II and Plato must have
met him there during his trip to Italy.17
Plato is obviously influenced by Empedocles. In Timaeus he describes how the
world was created, discusses the creation of man, presents the functions of the human body and the soul and, in the final part, offers an account of diseases. Following roughly Philistions classification of diseases, he distinguishes three kinds of diseases. There are, first of all, the diseases that are due to the prevalence or the
deficiency or even the misplacement of the ultimate constituents.18 As Plato puts it:
The origin of disease is plain, of course, to everybody. For seeing that there are
four elements of which the body is compacted, earth, fire, water and airwhen, contrary to nature, there occurs either an excess or a deficiency of these
elements, or a transference thereof from their native region to an alien region;
or again, seeing that fire and the rest have each more than one variety, every
time that the body admits an inappropriate variety, then these and all similar
occurrences bring about internal disorders and disease.19
There are, secondly, "diseases of the secondary tissues", as Cornford calls them.20
Plato has in mind here the tissues which are composed of some or of all the ultimate
constituents. Such tissues are marrow, bone, sinew and flesh. This second type of
disease appears when the normal process of nourishment is reversed. In this case,
instead of building up in the tissues the appropriate substances which are in the
blood in order to repair the waste and to fight corruption, the flesh breaks down
and discharges the substances back into the blood. Poisonous kinds of humours
may be secreted and the damage may further affect the bones and the marrow.21
Plato describes the second type of diseases as follows.
Again in the structures which are naturally secondary in order of construction,
there is a second class of diseases to be notedNow when each of these
substances is produced in this order, health as a rule results; but if in the
reverse order, disease. For whenever the flesh is decomposed and sends its
decomposed matter back again into the veins, then, uniting with the air, the
blood in the veins, which is large in volume and of every variety, is diversified
17

Cornford, p. 334, note 1.

18

Cornford, p. 334.

19

Plato, Timaeus 82 A in Timaeus, Critias, Cleitophon, Menexenus, Epistles transl. by R.G. Bury, The Loeb
Classical Library, William Heinemann and Harvard University Press, London, Cambridge Massachusetts 1981.
20

Cornford, p. 335.

21

Cornford, p. 335-6.

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by colours and bitter flavours, as well as by sharp and saline properties, and
contains bile and serum and phlegm of every sort. For when all the substances
become reversed and corrupted, they begin by destroying the blood itself, and
then they themselves cease to supply any nourishment to the body.22
Thirdly, there are the diseases which are related to: (a) breath, (b) phlegm and (c)
bile.23 These are diseases which are mainly due to respiration problems, to the blockage of air inside the body. They are further due to the formation of noxious humours, such as phlegm and bile.
As may well be expected, Plato concludes his treatment of diseases in the Timaeus
by discussing a further category, that of the diseases of the soul. These may be due
either to the bad condition of the body or to the asymmetry which could exist between the soul and the body.24 It is beyond our present purposes to examine the way
Plato conceived of these diseases. However, it remains noteworthy that so long ago
Plato was well aware of what we today would call mental illness.
Platos pupil, Aristotle, though he did not follow his fathers profession, esteemed medicine highly. Medicine is quite often employed by him as a model paradigm for developing his ethical and political ideas. The reader of the Nicomachean Ethics will soon realize
the wide use of medical examples Aristotle makes in his discussion of ethical issues.
Among his writings are included treatises which show his genuine interest in issues concerning mans physiology and pathology. Treatises like, On the Soul, On Sense and Sensible Objects, On Memory and Recollection, On Sleep and Waking, On Dreams, On Prophecy in Sleep, On Length and Shortness of Life, On Youth and Old Age, On Life and Death,
On Respiration and others express his concern for medical and anthropological matters
which he, as a philosopher, was in much more competent position to discuss than a
mere physician. Aristotles contribution to medicine has convinced almost everyone
that philosophy and medicine were two inextricably related disciplines since neither
philosophers can avoid studying medicine nor can physicians get their reasoning started unless they invoke the first principles of natural philosophy.25 As he writes:
As for health and disease it is the business not only of the physician but also
of the natural philosopher to discuss their causes up to a point. But the way in
which these two classes of inquirers differ and consider different problems
22

Plato, Timaeus, 82 C - 83 A.

23

Plato, Timaeus, 84 D; Cornford, p. 340.

24

Plato, Timaeus, 86 B 87 B and 87 B 89 D; Cornford, p. 343-352.

25

On the relations between ancient medicine and philosophy see my article, "Ancient Medicine and Philosophy:
A philosophers perspective" forthcoming in the proceedings of the conference, Medicine in the Ancient
Mediterranean world, Nicosia 27-29 September 2008, ed. D. Michaelides, Oxbow Books, Oxford.

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must not escape us, since the facts prove that up to a point their activities
have the same scope; for those physicians who have subtle and inquiring
minds have something to say about natural science, and claim to derive their
principles therefrom, and the most accomplished of those who deal with
natural science tend to conclude with medical principles.26
Physicians and philosophers were very much convinced in the 4th century B.C. of
the close relationship between philosophy and medicine. This relationship becomes
even more obvious in the treatise attributed to Hippocrates. Hippocrates of Cos is a
major physician of the 5th century B.C. to whom more than sixty extant medical
treatises are attributed. Classicists disagree as to whether or not all these treatises
have been written by the same person; instead they prefer to talk of the treatises of
the Corpus Hippocraticum. Leaving aside the issue of authorship, what is interesting
is that while in certain treatises Hippocrates explains certain medical phenomena by
arguing from given hypotheses or axioms to conclusions, as philosophers do, in certain other treatises this method is criticized. Thus, in the treatise On Ancient Medicine Hippocrates first criticizes those who deduce medical conclusions from first
principles and then he puts forward his own view. He writes:
All who, on attempting to speak or to write on medicine, have assumed for
themselves a postulate as a basis for their discussion heat, cold, moisture,
dryness, or anything else that they may fancy - who narrow down the causal
principle of diseases and of death among men, and make it the same in all
cases postulating one thing or two, all these obviously blunder in many points
even to their statements, but they are most open to censure because they
blunder in what is an art, and one which all men use on the most important
occasions, and give the greatest honours to the good craftsmen and
practitioners in it.27
And he adds:
But my view is, first, that all that philosophers or physicians have said or
written on natural science no more pertains to medicine than to painting.28
The first impression one gets from the above quotation is that in the treatise On Ancient Medicine Hippocrates attacks philosophy. This is how it was interpreted in antiq26 Aristotle, On Respiration, 480 b 22-31 in On the Soul, Parva Naturalia, On Breath, transl. W. S. Hett, The Loeb
Classical Library, Harvard University Press and William Heinemann Ltd, Cambridge Massachusetts, London
1986.
27

Hippocrates, vol. I, On Ancient Medicine, I, 1-11.

28

Hippocrates, vol. I, On Ancient Medicine, XX, 9-10.

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Eleni M. Kalokairinou: Tracing the roots of European Bioethics back to the...

uity. This interpretation was being held until recently. Celsus, for instance, in the
prooemium of his work De Medicina writes that it was Hippocrates, a man of philosophical skill and medical talent, "who separated this branch of learning from the
study of philosophy".29 In light of further research, however, classicists, philosophers
and physicians have come to conclude that this is not necessarily what Hippocrates
has been doing. G. E. R. Lloyd in his article "Who is attacked in On Ancient Medicine?" is raising the question, whether the author of the treatise is attacking all the
thinkers who reduced medical questions to philosophical questions of first principles,
whether he is attacking the whole medical school, or just a particular individual.30 The
conclusion which contemporary scholars and classicists tend to reach is that Hippocrates in the particular treatise is attacking a certain medical school, namely the
Dogmatists, who behind the manifest symptoms of a disease, assumed the existence of
the hidden causes of it, which to a great extent determined the kind of treatment to be
applied to the particular patient. This does not mean that Hippocrates is combating
philosophy as such, since the other medical schools of his days were also influenced by
other philosophical schools. Thus the Empiricists, for instance, were influenced by the
skeptic school, the Methodists were influenced by the atomic philosophers, whereas
the fourth major school, the Pneumatists, were mainly eclectic and were equally influenced by the Stoic school and the theory of the four humours.31
It is no doubt that ancient Greek physicians turned to philosophy in order to ask its
support in the theory of knowledge, logic and natural philosophy. However, in the
5th century B.C. the character of philosophy changes. From cosmos - and natureorientated, which was so far, philosophy becomes man-orientated, it is focused on
the study of man, it becomes primarily "anthropological". This is why in the 5th and
4th centuries B.C. philosophys main object of research is man, and the branches of
philosophy which mainly flourish then are moral and political philosophy. Philosophy influences medicine again but this time in a different manner.
We can find examples of the way philosophy influences medicine during this period
in Hippocrates deontological treatises, The Oath (!
), The Physician (

"
#), Law ($%), Decorum (
 &), Precepts (
') and
On Ancient Medicine (
 (
' "
)), in Galens brief treatise, That the excellent physician is a philosopher (! * +
 "
-  %) and in the
Roman Celsus treatises and in Sextus Empiricus work.

29

Celsus, De Medicina, Prooemium, 7-8.

30

G.E. R. Lloyd, "Who is attacked in On Ancient Medicine?", Phronesis 8 (1963), p. 108-126.

31

Paul Carrick, Medical Ethics in the Ancient World, Georgetown University Press, Washington 2001, p. 41.

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If we study these treatises carefully, we will see that their author is not concerned so
much with putting forward a theory of health and disease or a physiological theory of
the functions of the human body. Instead, what interests him is to bring out the importance the physicians character has for the diagnosis and the cure of the disease. Put
differently, the authors of these treatises do not see the physician merely as a mere
"engineer", i.e. as a technocrat who knows how to apply specialized knowledge and
practices in order to cure the disease. Instead, they see him as the good, wise man who
cares for and respects the patient as a human being. It is worth recalling what Hippocrates says on this matter in the most ancient text of medical deontology, the Oath:
I will use treatment to help the sick according to my ability and judgment,
but never with a view to injury and wrong-doing.32
And a few lines afterwards he adds:
Into whatsoever houses I enter, I will enter to help the sick, and I will abstain
from all intentional wrong-doing and harm, especially from abusing the
bodies of man or woman, bond or free.33
The apprentice physician should not only be taught the medical art but he should
also exercise his character so as to be well-disposed towards the patient. So, as the
author of the Oath declares, the young physician swears to leave every injustice and
harm aside (the contemporary principle of non-maleficence) and to enter the house
of the patient with the aim to help the sick (the contemporary principle of
beneficence).34 And not only this. The young physician also swears to be trustworthy and never reveal what he sees or hears while practising his art, proving in this
way to be the earliest initiator of what in contemporary medical deontology and bioethics we call the principle of confidentiality. Hippocrates writes in this respect:
And whatsoever I shall see or hear in the course of my profession, as well as
outside my profession in the intercourse with men, if it be what should not be
published abroad, I will never divulge, holding such things to be holy secrets.35
32

Hippocrates, vol. I, The Oath, 16-18.

33

Hippocrates, vol. I, The Oath, 24-28.

34

Hippocrates, vol. I, The Oath, 24-28. It is interesting to point out that the contemporary bioethicists who
support the four-principles approach to Bioethics, otherwise known as principalism, among their basic principles
include the two bioethical principles stated above by Hippoctates. Thus, the American T.L. Beauchamp and J.
F. Childress in their book, Principles of Biomedical Ethics put forward the principle of respect for autonomy, the
principle of beneficence, the principle of non-maleficence and the principle of justice. Whereas the British Raanan
Gillon in his own work entitled, Philosophical Medical Ethics, also includes these two Hippocratic principles among
the other bioethical principles he propounds.
35

Hippocrates, vol. I, The Oath, 29-32.

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The physician will approach his patient with the required respect, he will consider
his case carefully and he will appreciate the difficult circumstances he and his family
are in, showing in this way that he deserves his patients trust who puts into his
hands the most sacred thing he has, his life. As Hippocrates writes in another, equally famous, deontological treatise, The Physician:
The intimacy also between physician and patient is close. Patients in fact put
themselves into the hands of their physician, and at every moment he meets
women, maidens and possessions very precious indeed. So towards all these
self-control must be used.36
In all these encounters with his patients and their families the physician should behave with continence and self-control. As Hippocrates puts it:
Such then should the physician be, both in body and in soul.37
If what is of greatest importance is the patients well being, then the physician
should not try to exact his payment right from the start. Such a thing may lead the
patient to believe that if the right agreement does not take place between the two,
the physician will go away. On the contrary, the physician must be compassionate
and must take into account the patients financial situation. And if need be to offer
his services for free, he should not hesitate to do it, bringing to mind the benefits he
has already received, and his good name. He should not hesitate to offer his help to
a stranger or to a needy. As he writes:
For where there is love of man, there is also love of the art.38
Consequently, medical knowledge and skillfulness on their own do not contribute to the
patients cure, if the physician is not a good and charitable character. It is a happy coincidence if the physician is both good at his art as well as a good character. But where such
a thing is not possible, then it is better if he is a good man and not particularly a good
physician than the other way around. For, whereas the good character compensates for
the deficient art, the bad character corrupts and damages the most perfect art.
It is becoming obvious now why, according to Galen, the man who was preparing to
become a physician had to receive not only medical teaching and training, but he had
also to study the liberal arts or what we would call today the humanities.39 According to
36

Hippocrates, vol. II, The Physician, 24-28.

37

Hippocrates, vol. II, The physician, 28-29.

38

Hippocrates, vol. I, Precepts, VI, 6-7: "' ( * +", -  /  "".

39

Galen, On The therapeutic Method, Books I and II, transl., introd. and comment. R. J. Hankinson, Clarendon
Press, Oxford 1991, Book I, 1.4-5, 3.15, 4.1-3, Book II, 6.14.

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the Ancient Greeks, the medical teaching and training provided the students with the
necessary knowledge and experience for treating the disease, in the same way as the
teaching of an art, i.e. shipbuilding or the art of war, equipped the young with the necessary knowledge for building ships or winning a war. The liberal arts or the humanities, on the other hand, did not teach him a particular art. On the contrary, they addressed the students character and contributed to the cultivation of his feelings and the
development of his abilities and his virtues. By arousing his self-consciousness and his
good will, the liberal arts urged him to perform prudent, just and brave acts and, in this
way, to become himself prudent, just and brave, in a word wise. But, as he became wise,
he at the same time became a better physician. It is in this sense that Hippocrates argues that the physician who is a philosopher amounts to being a god. As he puts it:
For a physician who is a lover of wisdom is the equal of a god. Between
wisdom and medicine there is no gulf fixed; in fact medicine possesses all the
qualities that make for wisdom. It has disinterestedness, shamefastness,
modesty, reserve, sound opinion, judgment, quiet, pugnacity, purity,
sententious speech, knowledge of the things good and necessary for life,
selling of that which cleanses, freedom from superstition, pre-excellence
divine. What they have, they have in opposition to intemperance, vulgarity,
greed, concupiscence, robbery, shamelessness.40
Today things, to be sure, are much more complicated. The bioethical principles
which the classical deontologists propounded had to be further supplemented with
more elaborate principles and rules so as to handle efficiently the complex problems
which contemporary medical science and technology creates. Furthermore, our
crowded contemporary societies could not just rely upon the physicians good character, as was the case in antiquity. They had to establish all the right social structures
and mechanisms for protecting the patients and their families. Be that as it may, the
truth remains that the basic principles and rules which are often invoked in serious
discussions of bioethical issues are not modern and recent as one may at first think.
Even though the term "Bioethics" was introduced in the 20th century, nevertheless
the actual discipline of Bioethics, under any name whatever, was first conceived and
widely practised some twenty-five centuries ago.

Hippocrates, vol. II, Decorum, V, 1-13: "!1 ( 2   ! 2 3 4  5 (  5 6/ ( 73
/ ( 8 ( 1 " 6 !* -, 9:", 6 ;, 6:" ,   , 2<, " ,
= :", 9- , 2, +  ", >  & 1 ?"   & / 9+, -  
92 , 9  ", @ 5 ". 8 :  ( A 8 :  1 9  ", 1 ?: ", 1
9 ", 1 6:", 1 9" , 1 9"".

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