The Moral Code of Physicians

| by Dr Ray Greek
article imagearticle image

Physicians attempt to abide by the Hippocratic oath, which has existed in various forms since ancient times. The modern version states, in part: “I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.” (Emphasis added.) The classical version states: “Whatever houses I may visit, I will come for the benefit of the sick, remaining free of all intentional injustice, of all mischief.”

Discrimination has always been frowned upon in medicine despite some practitioners denying care to various populations based on religious or political preference, or other trait or philosophy. Cases of discrimination are infamous, such as denial of care based on skin color, infectious disease status or sexual preference.

The UN’s Universal Declaration of Human Rights states: “Everyone has the right to freedom of opinion and expression; this right includes freedom to hold opinions without interference and to seek, receive and impart information and ideas through any media and regardless of frontiers.” And: “Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.” Notice that there is no link between one’s opinions and philosophy and the right to medical care.

There are many instances of physicians offering care and treatments despite the philosophy of the patient or the patient’s family. For example, physicians have gone to court in an attempt to provide blood transfusions for a critically ill child whose parents were Jehovah’s Witnesses. I have never heard of a physician counseling against a child or adult receiving a needed blood transfusion because the patient or family was a Jehovah’s Witness. I never heard of anything in current times that even remotely resembles such nonsense.

Until recently.

Apparently vivisection activists have been suggesting that animal activists be encouraged to avoid medication and treatments that might conflict with their philosophical belief.

Phillip Broadwith reports: “A new bill being introduced in the UK House of Lords proposes to make it mandatory for medicine labels to declare when animal research has been used in their development. The bill aims to emphasise that animal research is an essential part of producing safe and effective medicines, says its sponsor, Robert Winston.” (Emphasis added.)

Lord Winston is a popular British physician, media figure, and vivisector.

Gareth Macdonald wrote: “The idea - according to Lord Winston - is to ‘show the hypocrisy of those who try to pretend to unknowing members of the public that animal research can be abandoned’ by emphasising the role research involving animals plays is drug development.”

Macdonald quotes Anthony Baxter, CEO of Cyprotex as stating: “I can see the point of Lord Winston’s bill from the establishment in that it does expose the ‘hypocrisy’ of those people who do not acknowledge the valuable part played by in vivo [animal] studies in getting established medicines to market effectively and, with several notable exceptions, safely.”

There are numerous problems with this notion but I will confine myself to addressing five.

1. Labelling medications with the claim that animal-based research was responsible for the medication has no meaning. Read the labels on almost any complimentary and alternative medicine product and you will find claims that the product cures everything, was developed in ancient times, has no side effects, was proven effective in clinical trials, and so forth. Putting a label on something does not mean the contents of the label are true. The same applies to common household products.

2. Claims do not equal proof. With or without a label, claims of the necessity of animal-based research, when scrutinized, have not been supported by facts and the claimants have steadfastly refused to debate the subject against me either in the scientific literature or in a public venue.

3. There is a slippery slope here. I normally don’t worry about most slippery slope arguments as most simply don’t have a chance of materializing. But if today we label, will we tomorrow refuse to provide medications and treatments to people with certain philosophies or opinions? It has happened before and history has a tendency to repeat itself. Recently a woman died in Ireland because the government would not allow her to have an abortion. Savita Halappanavar presented to University Hospital Galway in Ireland in October 2012 because she was experiencing a miscarriage at 17 weeks of pregnancy. This happens at times and, while unfortunate, is not life-threatening provided an abortion is promptly performed. Even though there was no chance that the fetus would survive regardless of whether an abortion was performed, the hospital refused medical care — in this case, an abortion — on religious grounds. Halappanavar became septic and died. She would not have died had an abortion been performed. This situation is not unique and has direct parallels to labeling medications and the slippery slope.

4. The only hypocrisy I see here is that of vivisection activists like Winston who want to force their agenda on others despite the profound weakness of their claims, in addition to the hypocrisy of a physician coming dangerously close to denying medical care or counseling that patients should choose to deny themselves of medical care based on what are demonstrably false claims.

5. But lets assume the claims are true. Let’s assume that a medication receiving such a label was developed based on animal models and solely on animal models. Society currently takes advantage of medical knowledge obtained under very unethical circumstances. The benefits of lowering body temperature date back to human experiments performed by Nazis. These experiments, as well as others that proved beneficial for the rest of humanity, were addressed in the Nuremburg Doctors Trial. Other advances came from studying slaves, studying those with intellectual and developmental disabilities, as well as others who simply could not defend themselves. Yet, society today uses such knowledge on a daily basis. If Winston wants to be consistent (I assure you he does not) his proposal should include labelling treatments and practices that came from these unethical situations. By the same logic he uses to defend his proposal, people should know the origins of their medical care before taking advantage of it.

Ironically, Baxter, the CEO of Cyprotex, goes on to acknowledge that, “safety and toxicological potential in humans is potentially deeply flawed.” “Notable exceptions,” as Baxter stated previously, does not equal “deeply flawed.” One or the other but not both. In reality, animal-based testing is deeply flawed according to Pharma.

When a drug enters clinical trials, the company has very little idea if it will damage humans. Because ADMET studies in animals are so unreliable, Tom Patterson, chief scientific officer at Entelos, liked the current practice of drug testing in humans during clinical trials to making airplanes, trying to fly them, and marketing the one that does not crash. [1]

Many clinical trials are now conducted in India, where, according to India's Tribune newspaper, at least 1725 people died in drug trials between 2007 and 2011, even though these medications had been tested on animals.

Van Meer et al state:

The value of animal studies to assess drug safety is unclear because many such studies are biased and have methodological shortcomings. We studied whether post-marketing serious adverse reactions to small molecule drugs could have been detected on the basis of animal study data included in drug registration files. Of 93 serious adverse reactions related to 43 small molecule drugs, only 19 percent were identified in animal studies as a true positive outcome, which suggests that data from animal studies are of limited value to pharmacovigilance activities. [2]

A Reuters article on MSNBC quotes Francis Collins, the director of the National Institues of Health:

If things are going to fail, you want them to fail early. Now [with a new computer chip] you'll be able to find out much quicker if something isn't going to work." Collins said a drug's toxicity is one of the most common reasons why promising compounds fail. But animal tests -- the usual method of checking a drug before trying it on humans -- can be misleading. He said about half of drugs that work in animals may turn out to be toxic for people. And some drugs may in fact work in people even if they fail in animals, meaning potentially important medicines could be rejected. [3]


Only a vested interest group could simultaneously claim that their product, in this case animal-based research, was “essential” and that it was “deeply flawed.” Spin like this is straight out of Orwell’s "1984." I have written extensively regarding the fact that safety and efficacy in humans cannot be predicted from animal models and, as this blog concerns physicians who advocate for discrimination based on philosophy, I will not go into more detail on safety and efficacy.

The historical cases of medical discrimination were marked by outrage from the contemporaries of the abuser as well as physicians later in time. I have not found any of Lord Winston’s contemporaries questioning his ethics. Allow me to be the first: Lord Winston should permanently be denied a license to practice medicine. Physicians from Hippocrates to Albert Schweitzer would be horrified at his proposal.

A perusal of the interwebs reveals that Lord Winston enjoys debates. I wonder if he would agree to a debate a fellow physician on the following. Resolved: Animal models are not predictive for humans for response to drugs and disease. Probably not, as history has taught us that most of the thugs who practiced or sought to practice discrimination, exploit or manipulate others, deny justice in general, or who plotted to commit or eventually committed other atrocities, were also cowards.


1.         Hodgson, J., ADMET--turning chemicals into drugs. Nat Biotechnol, 2001. 19(8): p. 722-6.

2.         van Meer, P.J.K., et al., The ability of animal studies to detect serious post marketing adverse events is limited. Regulatory Toxicology and Pharmacology, 2012. 64(3): p. 345-349.

3.         Reuters. U.S. to develop chip that tests if a drug is toxic. 2011 September 16 [cited 2011 October 6]; Available from: - .To5AMnPaixF.