One of the oldest independent works of medical ethics begins not with an illness but with a trust. It is called Akhlāq aṭ-Ṭabīb, “The Ethics of the Physician”, an epistle from the great ar-Rāzī to his students. Its first sentence reads:
“Whoever comes to you has expected the best of you, and whoever has chosen you has made you the trustee of his soul.”
ar-Rāzī, Akhlāq aṭ-Ṭabīb
It does not explain how to cure an illness. It explains how to become a physician.
Abū Bakr ar-Rāzī, who died around 925, headed the Bīmāristāns of Rayy and Baghdad. So he did not write these rules at a desk, but out of daily service at the bedside. And the hospital from which he wrote was an Islamic institution. Treatment free of charge, for the poor man as for the prince, carried by the Waqf, and at the same time a school. The principles of the work bear exactly this spirit.
What does ar-Rāzī require of the Ṭabīb? First, learning that never ends. The first thing you owe yourself, he writes, is to keep away from distraction and pleasure and to read unceasingly in the books. Then gentleness and discretion. The physician should be rafīq, gentle with people, should protect their modesty and keep their secrets. Third, humility. ar-Rāzī warns against the practitioner whom pride seizes the moment a patient recovers under his hands, as though he himself and not Allah were the Healer. Fourth, justice. The physician should treat the poor as he treats the rich. And finally, care before action. No treatment without thorough examination, no bloodletting without checking the patient’s history, pulse, and urine, and always the milder remedy first. Against the charlatans who treat without knowledge and without conscience, he warns explicitly.
One has to be clear about what this is. A code of honor for the healing professions, a thousand years before the modern professional codes. Not decided by a committee, but written by a master to his students, grown out of the Islamic hospital.
The patient is an Amāna
The heart of it is that first sentence. The patient makes you amīn rūḥihi, the trustee of his soul. This is exactly what we at HAKIM mean when we say the patient is an Amāna. A person places himself in your hand, vulnerable and in trust, and what is entrusted belongs in the end to Allah.
For whoever has grasped this, the rest follows of its own accord: the learning, the gentleness, the humility, the justice. Akhlāq aṭ-Ṭabīb is therefore not a piece of medical history to marvel at. It is an examination of conscience that is as fresh for us today as it was eleven centuries ago.