Am.  Jour.  Pharm.  ) 
September,  1920.  ) 
The  Ethics  of  Prescribing. 
669 
expect  good  work  if  it  is  not  paid  for,  and  until  doctors  receive  some 
encouragement  from  the  powers  that  be  they  will  continue  to  give 
but  scant  heed  to  the  writing  of  their  health  insurance  prescriptions. 
A  slovenly  prescription  is  never  ethical.  It  cannot,  on  the  face  of 
it,  conform  to  the  fundamentals  of  a  good  prescription. 
To  be  strictly  ethical  a  prescription  should  fulfil  all  the  following 
essentials : 
(1)  It  should  be  carefully  written  on  a  sheet  of  notepaper,  not 
on  a  scrap  of  anything  that  comes  handy. 
(2)  It  should  preferably  be  written  in  ink. 
(3)  It  should  contain  the  name  (and  probably  also  the  address) 
of  the  patient  for  whom  it  is  intended,  and  should  always  be  dated. 
(4)  It  should  contain  carefully  worded  directions  for  its  use. 
(5)  It  should  be  initialed  (or  preferably  signed)  by  the  writer. 
(6)  When  it  contains  dangerous  ingredients  the  words  "not  to 
be  repeated"  ought  to  be  incorporated. 
(7)  It  should  contain  no  incompatibility  or  any  proprietary 
remedy  whose  action  is  unknown  to  the  prescriber. 
These  fundamentals  aim  high,  perhaps;  but  after  all  is  it  too 
much  to  ask  that  a  scientific  man  should  exercise  very  great  care  in 
giving  what  is,  perhaps,  to  the  patient  the  most  essential  part  of  his 
services?  The  patient  is  unusually  observant  in  such  matters,  and 
if  he  notices  any  carelessness  on  the  part  of  the  doctor  in  writing 
the  prescription  his  confidence  is  apt  to  be  somewhat  shaken. 
Students  too  often  qualify  without  having  had  their  attention 
drawn  to  these  matters.  The  modern  tendency  is  to  discount  pre- 
scription-writing altogether,  and  to  store  the  mind  with  pharmaco- 
logical actions,  most  of  which  have  not  been  put  to  any  real  clinical 
test,  and  consequently  are  of  comparatively  little  value  from  the 
point  of  view  of  the  actual  practice  of  medicine.  A  lecture  or  two 
on  the  ethics  of  prescribing  would  be  of  infinitely  more  practical 
value  than  numerous  exhortations  on  the  effects  of  digitalis  and  other 
drugs  on  the  frog !  We  have  not  to  deal  with  frogs  but  with  human 
beings,  and  pharmacology  becomes  valueless  to  the  student  unless 
it  is  taught  from  the  clinical  standpoint.  The  doctor  who  can 
write  a  good  ethical  prescription  is  a  safer  man  than  one  who  has 
merely  a  knowledge  of  drugs  as  they  have  been  used  in  the  research 
laboratory.  The  tendency  to-day  is  to  ignore  the  practical  side  in 
teaching,  and  this  is  specially  noticeable  in  our  universities.  The 
student  of  to-day  will  be  the  practicing  doctor  of  to-morrow,  but 
