Chapter III: On The Offices Of Physicians And Pharmacists

2331. • A grave and delicate office lies upon PHYSICIANS, and, proportion being preserved, upon SURGEONS and PHARMACISTS, because the life of men, and the safety of their life, are entrusted to them.

Hence they ARE HELD, and indeed under grave obligation: 1. To know those things which pertain to the exercise of their office; - 2. to apply those cares which correspond to the gravity of the disease;

3. to preserve equity in exacting stipend. In these things, if by their own fault they fail, they are liable to reparation of the damage which has followed from this. But in particular:

I. PHYSICIANS (and Surgeons) sin gravely: 1. If without sufficient skill they undertake a grave disease or wound to be cured; or if, when a grave and unusual disease occurs, they do not devote effort to special study of the medication. - 2. If, once the danger of the sick person has been recognized, they are not present to him opportunely. - 3. If they neglect necessary treatment, or do not permit other suitable physicians, where it is fitting, to be called. - 4. If, the nature of the disease not having been well inspected, they rashly apply doubtful or dangerous remedies, especially with risk of life or grave lesion. (See n. 84, 2.) - 5. If easily, and without true necessity, they absolve from fasting, from abstinence from flesh, from hearing Mass. - 6. If they despise a poor sick person constituted in grave danger. - 7. If they exact too great a price; or compel to useless expenses, e.g. by prescribing superfluous medicines, multiplying visits, etc. - 8. If they advise abortion, onanism, or other illicit things. - 9. If they do not preserve the secrets committed to their trust, e.g. by divulging shameful diseases without just cause. - 10. If they do not opportunely warn of grave danger of sickness, that the Sacraments may be conferred. - 11. If in a case of necessity they neglect to baptize. - 12. If in time of plague they abandon the sick without help, for curing whom they have been constituted by the Community with stipend.¹

2332. • IT IS ASKED. Whether a physician is held TO WARN the sick concerning confession to be made?

Resp. 1. If there is question of a mortal disease, or one proximately dangerous, he is held by NATURAL LAW to warn the infirm person, by himself or through others; for each one ought, at least from charity, when he can without grave detriment to himself, to remove from his neighbor the danger of eternal damnation. "Oh how miserable it is," exclaims St. Alphonsus,² "to see so many sick persons (and especially those who are of distinguished dignity) reduced to the extremities of death, so that they may prepare the accounts of life soon to be rendered to God, at a time when they are almost lifeless, when they can scarcely then form words, scarcely hear others, scarcely conceive the state of their own conscience, and sorrow for their sins! And all this happens by the fault of those physicians, who, lest they displease the sick or their relatives, do not make them more certain concerning the danger; indeed they continue to flatter them, until they themselves are altogether despaired of concerning life."

2. If there is question at least of a grave disease, namely when it must be feared that it may become mortal, the physician ought by POSITIVE LAW, that is, from the decree of the Fourth Lateran Council, cap. 22, and from the Constitution Supra gregem of Pius V (where the law has been received and has not fallen into desuetude), he ought, I say, by himself or through another, to warn the infirm person concerning confession to be made within three days; these having elapsed, he is held to abandon the one not confessed.³ - The motive of this law is, lest the infirm, if they know that only the despaired-of are warned, be too much disturbed from such warning; by which it would happen that they would more difficultly take counsel for their own conscience, and easily be cast into a grave danger of life. - But Doctors note that the physician is not obligated to warning if he is morally certain that the infirm person is in a good state of conscience; nor is he held to abandon him if graver causes are present for not abandoning him, especially if no hope of helping the soul is present.⁴

2333. • II. A PHARMACIST sins: 1. If, rude and ignorant, he exercises the office. - 2. If without due diligence he prepares medicines. - 3. If he supplies one medicine for another (unless it were equally good, and of equal price), against the prescription of the physician, with danger of grave damage. - 4. If he sells useless medicines. - 5. If he furnishes medicines for inducing sterility, or for expelling the fetus (although such medicines were plainly ineffective): both because of the scandal which he furnishes to those requesting; and because the imagination of women, from which abortion is usually produced, is not a little stirred by this; and because he commits himself to the danger of undergoing the penalties which civil laws have established against prevarications of this kind.⁵