THE TRAVAILS AND TRIUMPHS OF PUBLISHING THE FIRST GLOBAL HISTORY OF MEDICAL ETHICS The Cambridge World History of Medical Ethics Examines the Evolution of Medical Ethics from the 12th Century to Today I t's a large authoritative-looking green book with gold lettering on the cover and spine, about the size of standard piece of stationary but as thick as phone book. Weighing in at around 4 pounds, it took a team of two editors working with 56 authors from 20 countries dur- ing the course of 12 years to write the 63 chapters that fill the 876 dual-column encyclopedia-like pages that make up The Cambridge World History of Medical Ethics. One of the first things readers will find in the book is a 77-page "Chronology of Medical Ethics." As historians, we sought to offer clini- cians, bioethicists — everyone, in fact — a sense of historical context in which events occurred, texts were written and policies implemented. The Chronology, with its multi-column representation of events, people, texts and policies graphically presents this context, showing as well as telling what happened when. We started the Chronology in 4,000 BCE, the date of the first known cities which, if you take the notion of "civilization" as the culture of cities liter- ally, is the birth of civilization. The first three peo- ple cited in the Chronology are religious figures: Moses (circa 1,200 BCE), Kong Qiu or Confucius (551-479 BCE) and Buddha (563-482 BCE). Jesus doesn't enter the pages of history until half a millennium later. The first texts cited are those of the Hippocratic Corpus, including the oath (around 400 BCE), followed by St. Augustine's De Civitate Dei (City of God) in 413 CE, cited for its discus- sion of suicide. These are followed, in turn, by two pivotal Islamic texts, Hunain Ibn Ishaq's, More Questions and Answers and al-Ruhawi's The Ethos of the Doctor, both written between 850 and 899 CE. The first Asian work listed is Ishimpo, com- piled in 10th century Japan by Yasuyori Tanba. Anyone whose curiosity was piqued about Jewish, Confucian, Buddhist, Christian or Islamic medical ethics can, of course, find detailed infor- mation in various chapters of the book. DOCUMENTING LANDMARKS As the Chronology makes graphically clear, Christian medical ethics emerge in the 12th cen- tury with the development of the decretum and Ad Aures, the latter dealing with issues of doc- tors' guilt in cases involving medical errors. By the 14th century, physicians such as Henry of Mondeville began speaking on medical ethics and, anticipating a debate that would echo down the centuries to contemporary bioethics, human- ists took pen in hand to criticize physicians and medical practices. Among these proto-bioethi- cists was Petrarch, who famously quipped that "physicians are the only occupational group that can kill people and go unpunished." By the 16th century, Europeans had rediscov- ered Hippocratic medicine, and in 1525, the known Hippocratic texts were translated into Latin, the universal language of European medicine and science. In the same century some medical schools reintroduced the tradition of swearing the Hippocratic Oath on graduation (Heidelberg, 1558). We constructed the Chronology so that it would offer easily accessible reference points for current events, like the upcoming worldwide cel- ebration of the 450th anniversary of Galileo's birth in 2014. Anyone seeking to put this world- Dr. Baker, left, is director of the bioethics program at Union Graduate College-Mount Sinai School of Medicine and the William D. Williams Professor of Philosophy at Union College, Schenectady, N.T., and Dr. McCullough is chairman, Medical Ethics and Health Policy at the Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston. BY ROBERT B. BAKER, Ph.D., & LAURENCE B. McCULLOUGH, Ph.D. HEALTH PROGRESS MARCH - APRIL 2009 • 65