INTRODUCTION

Despite apparent similarities with modern medical ethics, the relationship between medicine and ethics was very different from that found in Western countries in the twenty-first century. A major factor was that no one group of practitioners achieved a monopoly or near monopoly on legitimacy. Ethics, therefore, served, among other purposes, as a weapon in the war of words between rivals in the medical marketplace. Traditional medical ethics were much in evidence especially in the writings of physicians who modeled themselves on classical authors, but, significantly, there also came into play more general ethical considerations drawn from Christianity, which had wide social currency and appeal.

The contexts within which medicine and ethics operated helped to shape the early modern relationship between medicine and ethics. Today, the role of the state is crucial. It supervises the practice of medicine directly and/or indirectly by giving to a particular group of practitioners the right to act as a profession and to police the actions of its members. State control of medicine usually involves a strong ethical component, for instance, concerning the actions of individual doctors and the use of new techniques and medicines. In early modern Europe, state control over medicine was weak, although not completely absent. The tribunals of the protomedicato in Spain, parts of Italy and in Spanish America, as well as the city colleges of physicians and guilds of surgeons and apothecaries throughout Europe, were given by the state the right to license practitioners and to supervise medical practice.