Adab al-Tabib
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''Adab al-Tabib'' ( ar, أدب الطبيب ''Adab aț-Ṭabīb'', ''
Morals Morality () is the differentiation of intentions, decisions and actions between those that are distinguished as proper (right) and those that are improper (wrong). Morality can be a body of standards or principles derived from a code of cond ...
of the Physician'' or ''Conduct of a Physician'') is the common title of a historical Arabic book on
medical ethics Medical ethics is an applied branch of ethics which analyzes the practice of clinical medicine and related scientific research. Medical ethics is based on a set of values that professionals can refer to in the case of any confusion or conflict. T ...
, written by
Al-Ruhawi Ishāq bin Ali al-Rohawi ( ar, إسحاق بن علي الرهاوي) was a 9th-century author of the first medical ethics book in Arabic medicine. His ''Ethics of the Physician'' contains the first documented description for peer review processes ...
, a 9th-century physician. The title can be roughly translated "Practical Ethics of the Physician". As the name suggests, it focuses on adab, the Islamic concept of etiquette and personal ethics, as it is defined in a medical context. One of the earliest texts on Islamic medical ethics, it has been called the "crowning achievement" of early works concerning ''adab'' in medicine.


Influences

Al-Ruhawi was born a Christian, probably of the Nestorian sect that had split from mainstream Christianity in 530. Although it is not entirely clear, he was most likely still a Christian when he wrote ''Adab al-Tabib''. Despite his beliefs, ''Adab al-Tabib'' is primarily an Islamic text, built upon Islamic beliefs and practices. Due to this strong Islamic influence, a modern scholar has disputed this interpretation, claiming that only a full Muslim could have produced such a text. ''Adab al-Tabib'' builds on the works of several earlier Muslim and middle-eastern Christian philosophers and medical authorities, like
Al-Kindi Abū Yūsuf Yaʻqūb ibn ʼIsḥāq aṣ-Ṣabbāḥ al-Kindī (; ar, أبو يوسف يعقوب بن إسحاق الصبّاح الكندي; la, Alkindus; c. 801–873 AD) was an Arab Muslim philosopher, polymath, mathematician, physician ...
and
Hunayn ibn Ishaq Hunayn ibn Ishaq al-Ibadi (also Hunain or Hunein) ( ar, أبو زيد حنين بن إسحاق العبادي; (809–873) was an influential Nestorian Christian translator, scholar, physician, and scientist. During the apex of the Islamic ...
. However, it draws from many other historical traditions as well, especially those of ancient Greece. The book incorporates themes and direct quotes from Greek philosophers such as
Aristotle Aristotle (; grc-gre, Ἀριστοτέλης ''Aristotélēs'', ; 384–322 BC) was a Greek philosopher and polymath during the Classical period in Ancient Greece. Taught by Plato, he was the founder of the Peripatetic school of ...
,
Plato Plato ( ; grc-gre, Πλάτων ; 428/427 or 424/423 – 348/347 BC) was a Greek philosopher born in Athens during the Classical period in Ancient Greece. He founded the Platonist school of thought and the Academy, the first institution ...
, and
Hippocrates Hippocrates of Kos (; grc-gre, Ἱπποκράτης ὁ Κῷος, Hippokrátēs ho Kôios; ), also known as Hippocrates II, was a Greek physician of the classical period who is considered one of the most outstanding figures in the history o ...
, among others. It also borrows particularly heavily from the writings of the prominent Roman physician
Galen Aelius Galenus or Claudius Galenus ( el, Κλαύδιος Γαληνός; September 129 – c. AD 216), often Anglicized as Galen () or Galen of Pergamon, was a Greek physician, surgeon and philosopher in the Roman Empire. Considered to be o ...
. Despite his thoroughness in citing his influences, Al-Ruhawi notably makes no mention or acknowledgement to any earlier texts that specifically deal with Islamic medical ethics, suggesting that this book may have been the earliest work on the subject. Because contemporary and later Islamic works have been relatively neglected in analysis, it is difficult to ascertain Al-Ruhawi's impact on later thinkers in the field. Given Al-Ruhawi's extensive research and reliance on older traditions, and the degree to which Islamic medical ethics followed his ideas, it is likely that Al-Ruhawi's book was generally well-received and accepted.


Content

''Adab al-Tabib'' is divided into twenty chapters, each dealing with a specific topic of medical ethics. They fall into three general categories: the conduct of the physician, the conduct of the patient, and the conduct of the public at large towards the medical profession and their patients. The text covers a physician's personal beliefs and practices, placing great importance on his faith in God and personal health and hygiene, as well as his manner with his colleagues, nurses, and patients. Al-Ruhawi emphasizes respect for the physician in patients and visitors, even allowing for a doctor to overrule a patient's wishes when it is necessary for their health to do so. He says that doctors should be placed high in the social hierarchy, with enough pay that they aren't forced into other work, although he also instructs doctors not to flaunt their wealth. Al-Ruhawi says that the fees charged for rich patients should be enough to cover the expenses of poor patients who cannot pay for themselves, as otherwise medical care for both the rich and the poor suffer. In ''Adab al-Tabib'', Al-Ruhawi also discusses legislative practices and penalties for false and incompetent doctors. To weed out quacks, he advocates medical exams and licenses, the contents of which would be heavily based on the works of Galen. He encourages doctors to keep records of the patient's symptoms, treatments, and progress, so that it may be reviewed by peers should the patient die under his care. For this reason, ''Adab al-Tabib'' records one of the first known descriptions of what we today call
scholarly peer review Scholarly peer review or academic peer review (also known as refereeing) is the process of having a draft version of a researcher's methods and findings reviewed (usually anonymously) by experts (or "peers") in the same field. Peer review is ...
. Although he admits that patient survival is not always possible and is ultimately up to God, Al-Ruhawi recommends severe penalties for doctors who allow patients to die through negligence, even up to execution.


References

{{Islamic medicine Ethics books Medical works of the medieval Islamic world Medical ethics