INTRODUCTION

This chapter provides a critical discussion and historical contextualization of German medical ethics texts and discourses between 1800 and World War Ⅱ. It considers four main areas: medical deontology as expressed in doctors’ writings and codes of conduct; professional discipline through medical tribunals; the impact of modern science on medical ethics; and the development of public debates on ethical issues such as euthanasia, abortion, and human experimentation.

MEDICAL DEONTOLOGY: FROM SAVOIR FAIRE TO PROFESSIONAL ETHICS

In the eighteenth century, university-trained German physicians were largely dependent for their income on a small, wealthy, and urban clientele (Lachmund and Stollberg 1995). The social status of these patients was often higher than that of the doctor. This “patronage relationship,” the absence of professional organization, and competition from nonacademic healers, produced the so-called savoir faire (i.e., know-how) literature. Its central objectives were to provide young doctors with techniques of conduct that would enhance their reputation and help to disguise their insecurities in medical treatment, of which they became increasingly aware. To cultivate their image, practitioners had to demonstrate their moral standing, namely, that they were ready to sacrifice their own comfort and pleasure, even their health and life. Such moral elevation aimed at distancing doctors from the mercenary behavior of quacks (Ritzmann 1999; see Chapter 28).

This kind of publication continued well into the nineteenth century, typically dealing with the triple relation of the doctor to patients, to colleagues, and to society at large.