Journal - International Society for the History of Islamic Medicine

MEDICAL ETHICS IN MEDÝEVAL ISLAM
opposite applies to him who breaks it (Nomos is “the
rule to follow,” “the law,” “the guiding norm.” In this
case, the rules mentioned in the Oath).
The reference to Aesculapius, at first surprising,
must be understood in the light of the fact that in the
Islamic world Aesculapius was not a god, as he was
among the Greeks, but simply the legendary originator
and discoverer of medicine (4). It is to be underlined
that Usaybia, like al-Ruhawi, interprets the prohibition
to perform surgery as limited to the cutting for the
stone and not to surgery in general (see below).
The oldest known surviving work in Arabic on
medical ethics is al-Ruhawi’s Adab al-tabib,
(“Practical Ethics of the Physician” or “Practical
Medical Deontology”), (5) which is based to a great
extent on Hippocrates and Galen.
Al-Ruhawi’s place of origin was most likely Ruha
(al-Ruhawi means “the one from Ruha”), which was
the old Edessa and is today Urfa (Turkey). A physician,
he was a converted Christian, (6) who practiced
in several cities of the Islamic world including
Baghdad. He wrote several works of which only the
Adab al-tabib survives.
In it, he underlines the qualities that the physician
is expected to have and the vices and evils that he
should avoid. The work also deals with every aspect
of the physician-patient relationship, e.g., respect and
confidentiality and developing mutual trust. Its content
is summarized by Hamarneh:
1. The physician ought to be always “hasib”, that
is honest, generous, noble of character, and
righteous who seeks God’s favor and mercy.
2. He should be “alim,” that is proficient, learned,
savant, capable and skillful.
3. He ought to be “wari,” a pious and God-fearing
devotee or a deeply religious person.
4. To be “ghayr ajul,” that is to take his time and
not to be in a rush but rather be congenial. The
physician further must possess three traits:
A. “‘Aql,” to have a sane mind, reason, common
sense and intelligence;
B. “Razanah,” that is having self-control, sober,
calm and composed, sedate and serious; and
finally,
JISHIM 2004, 3
Plinio PRIORESCHI
C. “Iffah,” to possess abstinence, chastity with
purity and decency with integrity and modesty.
He should protect himself against the following
vices, evils, malpractice and wickedness:
1. “Al-fujur,” meaning debauchery, licentiousness
or fornication.
2. “Al-khubth,” which means in Arabic malevolence
and malice.
3. “Al-danaah or al-danawah,” meaning lowliness,
vileness and meanness or dishonest.
4. “Al-ghadab,” wrath, anger or indignation.
5. “Al-jaza,” anxiety, anguish and apprehension
or uneasiness.
6. “Al-Shahwah,” craving, greed, carnal appetite
and lust or sexuality.
In addition, the author listed the six following virtuous
traits that the physician should possess:
1. The physician ought to be “miqdam,” that is to
be bold, daring, fearless and audacious.
2. He must be “shuja,” courageous, brave and
valiant as a hero.
3. Be “afif,” chaste, decent, modest and pure in
heart.
4. Be “sabur,” patient or long-suffering, forbearing
and forgiving, steadfast, tolerant and persevering.
5. “Mutamassik bil-haqq,” to be always just and
fair, unprejudiced, equitable, straightforward
and candid.
6. Finally to be “waqur,” dignified and stately,
venerable and reputable (6).
The following is a quote about inducing abortion:
… you must not mind the impatience of a woman
whom you see distressed and afflicted due to her gestation,
and not pity her or give her a remedy to make
her fetus fall. Whoever does so has no fear of God…
As to a bad mother, do not show any compassion
for her so that her shame will cause the improvement
of many other women. Beware of giving things [i.e.
abortifacients] like these; they are prescribed only if
you fear the death of the pregnant woman or the
fetus. There is no difference whether you administer
the drug or you buy it. Before deciding on the drug
treatment, it is essential that you read the book of
45