The interpretation of traditional Chinese medical professionalism Zhang Daqing

1 、 Medical beneficence: the sources of traditional Chinese medical ideas

《 Ling Qu · Shizhuan 》 : 掌握医术，即可 “ 上以治民，下以治身，使百姓无病，上下 和亲，德泽下流 …… Zhang Zhongjing: 上以疗君亲之疾，下 以救贫贱之厄，中以保身长全，以养其生。 (1)Medicine as Humanity Art ： the basis of Confucian tradition of medicine

The Confucian principle of “love others” expresses the idea of respecting human lives. 《黄帝内经》：天覆地载，万物备悉，莫贵于人。 孙思邈： “ 人命至重，有贵千金。 ” 儒家认为仁爱是医生美德的体现。 范晔赞扬东汉医生郭玉 “ 仁爱不矜，虽贫贱厮养， 必尽其心力 ……” 由于医患之间事实上的不平等地位，儒家十分强 调医生的 “ 慎独 ” 和 “ 推己及人 ” 。 杨泉：夫医者，非仁爱之士，不可托也，非聪明 理达，不可任也，非廉洁淳良，不可信也。是 以古之用医，必选名姓之后，其德能仁恕博爱。

葛洪： “ 欲求仙者，要当以忠孝和顺 仁信为本，若德行不修，而但务方 术，皆不得长生也。 ”“ 欲求长生者， 必欲积善立功 ” 天道循环，善恶承负是道教重视行 善积德的伦理基础。 道教除相信天道承负外，还相信现 实的因果报应，即吉凶祸福乃是个 人行为善恶的必然报应。 (2) 、 the benevolence in Taoism

 Under the influence of the Buddhist ideas of "cause and effect" and "donation causing happiness", many Buddhists take the practice of medicine as a way to do good. The idea of rebirth and retribution of good and evil is an important part of Buddhist ethics. Buddhist takes Great Compassion as the first principle, "bemoaning the state of the universe and pitying the fate of humankind" as the starting point of morality and "not doing any evil and offering up all good conduct" as personal behavior rules. (3) the influence of Buddhist ethics to medical ethics

There are three moral perspectives in the ancient Chinese medical ethics: Confucianism, Daoism and Buddhism. So many moral theory coexist in Chinese medical ethics: deontology, value theory, virtue ethics, consequentialism,etc.. Although there are differences and interpretations to medical benevolence among these moral theory, the good in the value of medical care is shared unanimously by all 。

2 、 Medical beneficence ： the moral value of medical technology

The traditional Chinese doctors think much of the moral implications of medical technology. They deem the practice of medicine and saving lives as a benevolent morality intrinsically. The traditional Chinese medicine emphasize the integrity of technology and virtue of doctors. The excellent skills and good professionalism indicate the good virtue of doctors. (1) 、 Clinical therapy: the moral implications of medical technology

Medical good expresses the moral value of medical care, while this good can not be identified with that of medical professionals. The medial good and the professional good can be unified. But there are conflicts if we can not take their relationship rightly. So the traditional Chinese medicine emphasized this harmonious relation. (2) 、 Medical good & doctors’ good: conflicts and harmony

Medical good & doctors’ good: conflicts and harmony Their relationship includes: （ 1 ） harmonious relation （ 2 ） the gap of the two goods （ 3 ） the conflicts

 The conflicts between morality and benefits Confucianism holds that the morality takes precedence over benefits. This moral value is the central focus of ideal moral person, which has great influence on medicine. Physicians born in this atmosphere will take medicine as a means to construct the world and take the morality as practice of ideal person. Many Confucian doctors deem the practice of medicine as a benevolent cause to do good.

 The patient-doctor relationship (PDR) The traditional Chinese medicine considers the equal and close cooperation as the basis of medical trust of PDR. 对待病人要 “ 举乃 和柔，无自妄尊 ” ，并认为： “ 凡病家延医， 乃寄之以生死，理当敬重，慎勿轻藐，贫 富不在论财，自尽其诚，稍亵之则非重命 耳。 ”

3 、 From individual to society: medical benevolence in the context of Confucian culture

(1)Medical benevolence: an approach to realize self-value 范仲淹认为： “ 大丈夫之于学也，固欲 遇神圣之君得行其道， …… 能及大小生 民者，固惟相为然。既不可得矣，夫能 行救人利物之心者，莫如良医。果能为 良医也，上以疗君亲之疾，下以救贫民 之厄，中以保身长全。在下能及大小生 民者，舍夫良医，则未有之也。 ”

( 2) 、 benevolence and filial pity: from individual to family The Chinese culture emphasizes the family harmony and development. The Confucian idea of “humanity and love” indicates this characteristics of Chinese culture which is attached to family blood. The meaning of humanity is based on this father-son love in the patriarchal clan system.

(3) 、 Medical benevolence: from religious philanthropy organization to civil health protection organization  The Taoism and Buddhism deem medical care as a benevolent activity. This leads to the wide spread of using medicine as a means by missionary. Relieving pain and suffer is a way to believe the God.  The benevolence of medicine and Confucian morality meet the moral standards of feudalism ethics. So many Confucians choose the practice as their life goals.

(4) 、 The strategy of benevolence: the prescription for government to do good Health care is good to heal the wounded and rescue the dying, which involves the interests of the vast people. So the rulers of Chinese government in the history took the practice of medicine as an important strategy to practice humanity in politics.

4 、 medical benevolence: the differences between Chinese and the west

 The traditional Chinese medical ethics emphasizes the duty to “heal the wooded and rescue the dying”, and takes the human life as the first good.  The traditional Chinese medical ethics pay great attention to the opinion family members on the basis of that of individual patient.  The traditional Chinese medical ethics takes the patients’ interests as the first principle. It is justifiable that the doctor does not inform the patient personally if that information is adverse to treatment and cure.

In the context of Chinese culture, medical benevolence is a core part of medical practice for doctors, an important approach for doctors to realize their personal ideal and social value and a good description of “doctors and Confucians choosing the same way of life”. In the history of medical development, the idea of medical benevolence correspond with medical model in moral value. This is different from the west idea that morality separates with the medical technology.