In lieu of an abstract, here is a brief excerpt of the content:A Brief History of Medical Ethics Code in PolandJacek A. Piątkiewicz (bio)On March 15, 1934 a Parliamentary Act authorized the General Medical Chambers, a body incorporating all Polish physicians, to establish general rules of medical ethics. These rules governed medical conduct in Poland until 1950, when the Communist government dissolved the General Medical Chambers.From 1950 to 1989 the only medical organization in Poland tolerated by the Communist government was (...) the Polish Medical Association, which included about 30% of the country's physicians. In 1967 this group produced the "Collection of Ethico-deontological principles of the Polish Physician" which constituted a kind of code of medical ethics. This collection was a compromise between objective ethical principles and the demands of the Communist regime. For example, Principle 1 of the Collection stated that the physician "had to observe the ethico-deontological principles obligatory in socialist society."During round-table talks in early 1989 with representatives of the Communist government, the Solidarity movement argued for the revival of autonomous medical organizations like the Medical Chambers. On May 17, 1989 an Act of Parliament re-established the group. The Act (article 33, part 1) also stipulated that the National Congress of Physicians, the legislative body of Medical Chambers, establish rules of medical ethics. The Act (article 15, part 1) also states that all practicing Polish physicians are obliged to observe these rules.When the revived Chambers began its work in January 1990, its governing body—the General Medical Council—created a Commission to prepare a draft of a medical ethics code. After a year and a half of work, the Commission completed its draft, which received preliminary acceptance by the General Medical Council. [End Page 361]On December 13-14, 1991 the Extraordinary Second National Congress of Physicians was held in Bielsko-Biala (South Poland) and one of the main items on the agenda was the Code. Every article of the Code was discussed exhaustively throughout the second day of the meeting, and close to midnight the Code, including the Physician' Oath, was approved by an overwhelming majority (449 for, 75 against, 58 abstaining).Some of the liveliest discussion centered on Article 37, which relates to abortion. The delegates realized that the Code was inconsistent with a 1956 Act on abortion then under discussion in the Parliament which was not as restrictive as the Code. They decided to defer implementation of the Code for five months, until May 3, 1992. As described in the following text by Robert Baker, Article 37 has now been appealed and a decision resolving the discrepancy would have to come from Poland's Constitutional Tribunal or its Parliament. [End Page 362]Jacek A. Piątkiewicz Jacek A. Piątkiewicz, M.D., Ph.D., is Chairman of the Legislative Commission of the General Medical Council of Poland in Warsaw.Copyright © 1993 The Johns Hopkins University Press... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:LettersZbigniew Szawarski and Jacek A. PiatkiewiczPolish Code of Medical EthicsMadam:In the December 1992 issue of the Kennedy Institute of Ethics Journal you published the Polish Code of Medical Ethics with introductions by Jacek A. Piatkiewicz and Robert Baker. Jacek Piatkiewicz writes (p. 362), and Robert Baker follows him, that the new code "was approved by an overwhelming majority (449 for, 75 against, 58 abstaining)." I am afraid that these (...) figures are inconsistent with the data supplied by the Polish mass media. The leading Polish newspaper, Gazeta Wyborcza (16 December 1991), states that 354 delegates voted for the new code and 317 against it. The same figures are quoted by the most authoritative Polish political weekly, Polityka (4 January 1992).Mr. Piatkiewicz does not mention either that 40 delegates left the convention before the vote in protest over the undemocratic proceedings. If we add those 40 potentially negative votes to the 317 votes against, then the result is not at all "an overwhelming approval" for the new code.I am not a physician myself, and I was not present at the Second National Congress of Physicians in Bielsko-Biala, however, I find this discrepancy disturbing. Respect for facts seems to me equally imperative as respect for human life.Jacek A. Piatkiewicz Replies:In his letter Mr. Szawarski denies the data I presented on the vote approving the Polish Code of Medical Ethics. He has quoted the figures published by the Polish mass media as the true ones. Interestingly enough, he did not try to confirm them with the Polish General Medical Chamber, which has the original documents on the Extraordinary Second National Congress of Physicians. The figures I cited regarding the Code's approval are clearly stated on page 63 of the Congress proceedings.So where do the figures presented in Mr. Szawarski's letter come from? As Mr. Szawarski states, these figures have been published in some Polish newspapers, among them "the most authoritative Polish political weekly, Polityka" (a description that was especially accurate during the Communist period of Poland's history). The figures are simply untrue. The figures presented refer only to the result of the vote on article 37 of the Code, which concerns abortion. The very narrow margin (354 for, 317 against, 38 abstaining) decided the formulation of the exceptions to the abortion ban, which are "saving the mother's life and health" and "when pregnancy is the result of a criminal act." But what was the alternative considered in the vote? It was the single exception, "to save the mother's life," that was in the [End Page 355] original draft of the Code (page 44 of the Congress proceedings).Mr. Szawarski finds the discrepancy in the figures cited disturbing. I am disturbed too, but the cause of my concern is of a completely different nature. Why does Mr. Szawarski not try to reconcile "the discrepancy" by asking organizers of the Congress for an explanation?Zbigniew SzawarskiCentre for Philosophy and Health Care University of Swansea, WalesJacek A. PiatkiewiczGeneral Medical Council of PolandCopyright © 1993 The Johns Hopkins University Press... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:LettersZbigniew Szawarski and Jacek A. PiatkiewiczPolish Code of Medical EthicsMadam:In the December 1992 issue of the Kennedy Institute of Ethics Journal you published the Polish Code of Medical Ethics with introductions by Jacek A. Piatkiewicz and Robert Baker. Jacek Piatkiewicz writes (p. 362), and Robert Baker follows him, that the new code "was approved by an overwhelming majority (449 for, 75 against, 58 abstaining)." I am afraid that these (...) figures are inconsistent with the data supplied by the Polish mass media. The leading Polish newspaper, Gazeta Wyborcza (16 December 1991), states that 354 delegates voted for the new code and 317 against it. The same figures are quoted by the most authoritative Polish political weekly, Polityka (4 January 1992).Mr. Piatkiewicz does not mention either that 40 delegates left the convention before the vote in protest over the undemocratic proceedings. If we add those 40 potentially negative votes to the 317 votes against, then the result is not at all "an overwhelming approval" for the new code.I am not a physician myself, and I was not present at the Second National Congress of Physicians in Bielsko-Biala, however, I find this discrepancy disturbing. Respect for facts seems to me equally imperative as respect for human life.Jacek A. Piatkiewicz Replies:In his letter Mr. Szawarski denies the data I presented on the vote approving the Polish Code of Medical Ethics. He has quoted the figures published by the Polish mass media as the true ones. Interestingly enough, he did not try to confirm them with the Polish General Medical Chamber, which has the original documents on the Extraordinary Second National Congress of Physicians. The figures I cited regarding the Code's approval are clearly stated on page 63 of the Congress proceedings.So where do the figures presented in Mr. Szawarski's letter come from? As Mr. Szawarski states, these figures have been published in some Polish newspapers, among them "the most authoritative Polish political weekly, Polityka" (a description that was especially accurate during the Communist period of Poland's history). The figures are simply untrue. The figures presented refer only to the result of the vote on article 37 of the Code, which concerns abortion. The very narrow margin (354 for, 317 against, 38 abstaining) decided the formulation of the exceptions to the abortion ban, which are "saving the mother's life and health" and "when pregnancy is the result of a criminal act." But what was the alternative considered in the vote? It was the single exception, "to save the mother's life," that was in the [End Page 355] original draft of the Code (page 44 of the Congress proceedings).Mr. Szawarski finds the discrepancy in the figures cited disturbing. I am disturbed too, but the cause of my concern is of a completely different nature. Why does Mr. Szawarski not try to reconcile "the discrepancy" by asking organizers of the Congress for an explanation?Zbigniew SzawarskiCentre for Philosophy and Health Care University of Swansea, WalesJacek A. PiatkiewiczGeneral Medical Council of PolandCopyright © 1993 The Johns Hopkins University Press... (shrink)