• H. August van Alphen
Conference paper
Part of the Acta Neurochirurgica Supplements book series (NEUROCHIRURGICA, volume 74)


In his graduation address to the medical students of Jefferson Medical College, Philadelphia in 1926 — an address which he entitled “Consecratio Medici” — Harvey Cushing delineated the ethical standard in medicine in his time; he called this “common devotion”. He defined common devotion in the following way: “Devotion is an attribute one cannot estimate and record by ordinary standards. How much the practising doctor cares about his patients as individuals apart from their being the source of his livelihood; how much the medical scientist may be interested in promoting science rather than in securing his own promotion; how much the teacher influences his pupils to their best efforts, unmindful of what the curriculum briefly requires of him; how much the student engages in his work for the work’s sake, regardless of his marks and rating — all these things depend on a devotion which places spiritual above material rewards” [1]. With this statement, Cushing criticized the debasement of clinical practice, the overemphasis on research and the search for personal gain amongst his colleagues. He considered these to be the most important moral hazards in medicine at that time. This moral standard, defined by Cushing some 70 years ago, sounds very modern, even today, and by and large, is still valid. Numerous new developments in the last decades have, however, made medical practice far more complex than it was in Cushing’s time, and have added many ethical problems and hazards to those mentioned above.


Medical Ethic Ethical Standard Moral Standard Personal Gain Material Reward 
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    Bucy PC (1978) Queen of surgical arts. Editorial. Surg Neurol 10: 317Google Scholar

Copyright information

© Springer-Verlag Wien 1999

Authors and Affiliations

  • H. August van Alphen
    • 1
  1. 1.Department of NeurosurgeryAcademisch Ziekenhuis Vrije UniversiteitAmsterdamThe Netherlands

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