Where Confucianism Meets Chinese Medical Ethics2016-03-02 09:41:35Share:
To Chinese minds, medical practice puts Confucian philosophies into practice. However, medical practitioners in ancient China didn’t enjoy the same level of social and economic status as today’s physicians do, certainly nowhere close to the Confucian scholars of the age. Confucianism often only celebrated literary figures. Medical practitioners, with their work considered a type of ji (technique) or shu (art) of craftsmanship, stood on the lower social category of artisan.
In a society that valued men who spent time studying and competing in the annual imperial examinations to get a spot in civil service, medical practitioners didn’t quite meet expectations. They wandered around searching for herbs, doing experiments, and treating people with illnesses. The great Li Shizhen—the father of TCM—had in early life been considered unsuccessful. Before committing to medicine, he attempted to become a civil official, but he gave up after failing the examination three times.
Even court physicians didn’t enjoy many benefits and also faced the pressure of losing their life due to imperial malpractice. It was common for court physicians to be persecuted for failing to cure the illnesses of royal family members.
However, Sun Sumiao, a physician and alchemist during the Tang dynasty, opposed to these rankings. He said that the status of medical practitioners depended on their practices:
“If medical practice is based on deception, it is to be considered low. If medicine is practiced on the principle of veracity (cheng), it is not to be considered low. If a person’s knowledge of medicine is applied only to his own body, this is petty (xiao). If the application [of a person’s medical knowledge] is extended over all mankind, then that is not petty.”
Sun’s idea finds reconciliation with Confucian idea of “ren”, known in English as benevolence. This concept of human relationships is commonly known through the famous saying, “Do not do to others what you do not want them to do to you.” In China, re-emphasizes one’s familialdevotion and loyalty.
Huangfu Mi—author of the famous text Zhenjiu Jiayi Jing (Systematic Classic of Acupuncture and Moxibustion), wrote, “If a person is not good at medicine, he cannot help his emperor and parents when they are suffering from disease even though this person has a heart of loyal and filial piety (zhongxiao) and a nature of humanness and compassion (renci)”.
In Chinese traditional medicine, the concept of “ren” was often represented by the story of the legendary Emperor Shennong of the Han Dynasty risking his life tasting 100 kinds of plants to determine their medical quality. The story suggests that medicine is crafted by sage, therefore it is noble profession, and should be practiced with moral character.
The reconciliation of medical practices and Confucian ideas requires physicians—during medical training and practices—to master Confucius’ principles and strictly follow his morals. Li Yan, a physician during the Ming Dynasty, wrote that Confucianism is the root of medicine and suggested a practice of getting up early every morning to study one or two Confucian books as a way to purify the thoughts. At the core of “ren” lies the appreciation of human life. Sun emphasized this key idea by saying that medicine must come from the heart.
“When a doctor attends to his patient, he should compose himself, banish all his desires, and approach the case dedicated to the relief of the suffering with a compassionate heart,” he said.
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