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At what point in history were humans ever held back by a moral code especially when there's no punishment for breaking the code?Humans are controlled only by laws and punishments for breaking those laws. Without deterrents, humans can go to any lengths to bend ethics and even break any ethical code.One of the modern versions of the Hippocratic Oath:I swear to fulfill, to the best of my ability and judgment, this covenant:I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.I will apply, for the benefit of the sick, all measures which are required, avoiding those twin traps of overtreatment and therapeutic nihilism.I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug.I will not be ashamed to say "I know not," nor will I fail to call in my colleagues when the skills of another are needed for a patient's recovery.I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.I will prevent disease whenever I can, for prevention is preferable to cure.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.If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.Written in 1964 by Louis Lasagna, Academic Dean of the School of Medicine at Tufts University, and used in many medical schools today.[1][1][1][1]If you read it carefully, each part of the above oath is open to interpretation and it relies on the physician’s own personal boundaries of reason to define what is the most ethical or moral thing to do.Expecting doctors who belong to a corrupt society in general to somehow operate within a certain moral code is being naive. Humans are flawed organisms and just like any other organism, self interest trumps morality any day.The morality/ethicality of a typical doctor is close to any highly educated individual in the same community he/she lives in. So no physician really operates within this code. So a doctor in India is as ethical as an Indian bureaucrat (IPS/IAS/IFS). A doctor in US is as ethical as a financial analyst in US.However laws are a different cup of tea. When you break laws and you have a reasonable chance to get punished for violating it, people fall in line. If you do something morally heinous but profitable but you don’t get punished for it-either because it’s legal in that country or the judicial system is lax- the chances are that this morally heinous act will be repeated. This is why physicians in the developed world draw the hard line on ethics while in developing nations that line is loosely defined.There was one gentleman who recently took the following oath:"I do solemnly swear (or affirm) that I will faithfully execute the Office of President of the United States, and will to the best of my ability, preserve, protect and defend the Constitution of the United States."[2][2][2][2]Just a few days after saying those words, President Donald Trump signs an executive order banning people from 7 muslim majority countries from entering US: Trump's Muslim ban: 'It's shock and awe without bombs' .The American constitution was written by immigrants. A country composed of descendants of immigrants now is banning foreigners from entering their great country. So much for upholding the American constitution and it’s values! So there….Footnotes[1] Guides: Bioethics: Hippocratic Oath, Modern version[1] Guides: Bioethics: Hippocratic Oath, Modern version[1] Guides: Bioethics: Hippocratic Oath, Modern version[1] Guides: Bioethics: Hippocratic Oath, Modern version[2] Oath of office of the President of the United States - Wikipedia[2] Oath of office of the President of the United States - Wikipedia[2] Oath of office of the President of the United States - Wikipedia[2] Oath of office of the President of the United States - Wikipedia

Initially it would be impossible to tell whether the aliens had intelligence or not. Human judgment alone would lead our astronauts to discount that possibility. They would report back to NASA that the lifeforms appeared sedentary and plant-like, with minimal response to environmental changes, and no innate capacity for reason. Familiar markers of intelligence such as the existence of a brain, a verbal language, or visible manipulation of their environment would not be present at all.The primary purpose of all tests conducted on the planet surface would be to assess danger, and to clarify the possibility of transporting the creatures to earth. Among the initial experiments would be to identify the type and range of energies that would produce a reaction in the aliens. The first of these would involve simple touch. But like terrestrial plants, these creatures could be bent or be split apart, without displaying any new behavior or appearing to respond in any way.The astronauts would expose some samples of the lifeforms to the full range of electromagnetic radiation, first at weak levels, but then applying stronger doses until they could confirm a total lack of response to that form of energy. Even a powerful microwave burst would have no effect on them.Electrical energy, however, would produce a profound reaction. For this test, the astronauts would generate a plume of ionized gas and send it drifting across the rockface supporting the alien colony. As the gas reached the outer edge of the colony, the aliens, who normally took the form of rounded tufts of feathery interlocking waveforms, would transform dramatically. The waveforms would appear to untangle themselves into long threads that would float on the atmosphere, pulsating and gyrating gradually, extending a great distance from their footholds in the rock.As the ionization diminished, the threads would collapse back to their former shape and location.Over months, the astronauts would observe other occasions of similar transformation. They would conclude that the aliens' lengthy thread formation indicated an ingestion phase. During this time, they would absorb energy in the form of particulate matter and electrical energy from the atmosphere. Their return to the feathery waveform shape would indicate that the aliens had begun a reproductive cycle. This would culminate, several days later, in great plumes of spore-like or seed-like material shooting upwards in forceful bursts, catching the atmospheric currents and drifting gradually down again to land on a fresh outcropping of rock, where a new colony of the creatures would take root.The astronauts would report all of these findings back to NASA. Over nearly a full year, they would conclude that these creatures were of a very simple order, possessing neither emotion nor intention, existing merely to feed and reproduce.A portion of the studies would include gathering living samples for dissection. Every part of the creatures' biology would be isolated and examined under a variety of conditions. Organs would be identified, hypotheses put forward as to their nature and function, and tests would be devised to confirm or refute these hypotheses. Chemical compositions would be identified and quantified. Centrifuges would characterize the average chemical proportions of the creatures and of each organ and constituent part. Environmental chambers would be designed and built to house the creatures during a return voyage to Earth.Once there, Nasa scientists and representatives of other federal departments would conduct more detailed examination. The risk of terrestrial contamination would be deemed extremely low, as these creatures could not survive for even a moment outside of their protected environments. After several more months of study, the decision would be made to supply living alien environmental containers to various pharmaceutical corporations, energy corporations, universities, and a few private medical institutions.Soon there would be a great bloom of innovation, as these organizations began to unravel the secrets of the complex biological materials of the alien tissues. Whole industries would be spawned, as well as new medicines, fuels, batteries, new computing paradigms, construction materials, and so on.A certain segment of the population would protest, sometimes violently, against the importation of these creatures from their home world. Some would argue that we had not yet fully determined the extent of the aliens' intelligence, and therefore could conceivably be committing terrible crimes against them, crimes that they could consider to be acts of war.Others would argue that the alien biology could be proven ultimately to be incompatible with Earth's ecosystems; and that the mere fact that the aliens appeared to die on contact with our atmosphere was not sufficient reassurance against the possibility of catastrophic consequences for all of humanity.Other protestors would argue that the aliens had tricked us into bringing them here, and that now they were proceeding quietly to take over the world.But most people would accept the situation, especially as the new alien-based products began to hit the market. Soon, elements of alien biology would be found in the vast majority of consumer purchases. Like plastic, it would become ubiquitous, and would eventually be taken entirely for granted.The possibility of hybrid alien/terrestrial life would be an ongoing topic of debate. At first it would be considered a complete impossibility by laypeople and scientists alike. The aliens would have no DNA, so what could there possibly be to hybridize?And yet it would occur. The first of these would come about almost accidentally. Scientists working on product testing for one of the pharmaceutical corporations would introduce portions of living alien tissue into the bodies of still living rabbits and pigs. Experimenting with a variety of grafting techniques, the scientists would observe that under certain circumstances, the alien tissue would fuse more tightly with that of the animal, and the bonded portions would engage in a process of chemical exchange - of a completely new biological function.In those early tests, the animals would die almost immediately. The fusion of animal and alien tissue simply produced toxins that could not be absorbed by the animal. But having observed this partial functionality between tissue types, the corporation would begin an intensive study of the phenomenon, to identify under exactly what circumstances, and which portions of each terrestrial and alien creature, could be made to bind together in this way.Eventually it would be determined that the alien biology would fuse in the least dangerous ways to the glandular and neural regions of a host, altering the animal's behavior, intelligence, growth patterns, and reproductive habits; and also the composition of the blood and other secretions. Even egg and sperm would be affected. After reproduction occurred between samples, the scientists would find that the offspring contained the same instances of alien biology, fused to the newborn host's glandular and neural structures in the identical way as the parents.At first the prospect of entirely new household pets and livestock for edible consumption would seem promising. And some of the scientists would take their experiments home with them to test them out with their families. But as the company reported its findings to the patent office and various federal oversight departments, word of this development would begin to leak out to the general population, and a new wave of protests would erupt in every large city across America and Europe.These protests, led by scientists, would carry a more technical message than those that had come before. Because of the inheritability of these biological changes, if any of the altered animals escaped the lab and bred in the outside world, the extent to which those animals could affect the ecosystems they encountered could be very extreme. The entire planet could be at risk.But the question, however timely, would soon become moot. Doctors would begin to find nodules of alien biology embedded within the glandular systems and along the brain stems of their human patients. The first of these would appear to be isolated incidents. But as word spread, more and more people would request that they be tested for alien biology as well. And millions would be shown already to be infected.The origin of the infection would be traced to the families of the scientists experimenting with hybridization. Stock prices of those pharmaceutical companies would plummet. Products using alien biology would be pulled from the shelves by retail outlets across the world, vanishing by the millions almost overnight. But there would be no way to contain the further spread of the infection. Even identifying the means of transmission would take months and months, during which time hundreds of millions more would be infected. Impoverished nations in Africa would confirm that the alien biology had spread there as well, though an accurate count of the numbers of infected people would be impossible to tally, due to lack of infrastructure, medical personnel, and financial resources.The political world and the press would erupt in a slew of accusations against NASA and the current administration, as well as the most involved sectors of industry.A panicky population would begin to wear breathing masks to work, despite there being no evidence of airborne transmission.Gradually however, as no one seemed to become ill or report any problems associated with the infection, life would continue. The alien biology by now would have spread to all human, animal, and plant populations. But the need to get on with their lives would overwhelm the fear that most people felt, at being somehow occupied by the alien aspects of themselves. In time, schools and workplaces would return to normal activities.Research physicians would also begin to report certain benefits of the hybridization. Some formerly intractable human illnesses would be wiped out entirely; while certain glandular dysfunction associated with age would be improved. In this way, the motivation to find a 'cure' for the alien infection would diminish, some sectors of the scientific world arguing against it altogether. Funding for such research, initially very high, would drop off precipitously.Slowly, life would return to normal. People who previously had been in a nearly continuous state of panic, would cluster together once more against the sides of buildings, gradually working their fibrous feet into the concrete structures. Their feathery waveforms would begin to resemble the more natural appearance of the rounded tufts of the past. And as these changes took place, people would gradually feel reassured about the situation.Their eating habits would also gradually settle down, and people would once again start to send out their threads to gather up nutrients from the air. And finally, in a burst of human solidarity, plumes of joyful newborns would be seen drifting through the skies. All would be as it had been before, and everyone would wonder what the fuss had ever really been about.

There is a Nocebo Effect that has the same veracity toward the negative as the Placebo Effect has toward positive results.Nocebo Effecta detrimental effect on health produced by psychological or psychosomatic factors such as negative expectations of treatment or prognosis.Placebo EffectA beneficial effect, produced by a placebo drug or treatment, that cannot be attributed to the properties of the placebo itself, and must therefore be due to the patient's belief in that treatment.(definitions from Google’s dictionary)This is an excerpt of a paper I wrote on the subject of Nocebo Effect to a specific healthcare organization framed by the requirements of the Hippocratic Oath. I’ve modified it to eliminate references to the specific organization:The Nocebo EffectInformation physicians must understand and apply to fulfill their Hippocratic OathTo frame the conversation that follows, here is a modern version of the Hippocratic Oath:I swear to fulfill, to the best of my ability and judgment, this covenant:I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.I will apply, for the benefit of the sick, all measures which are required, avoiding those twin traps of over treatment and therapeutic nihilism.I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug.I will not be ashamed to say "I know not," nor will I fail to call in my colleagues when the skills of another are needed for a patient's recovery.I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.I will prevent disease whenever I can, for prevention is preferable to cure.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.If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.Written in 1964 by Louis Lasagna, Academic Dean of the School of Medicine at Tufts University, and used in many medical schools today.[i]Dr. Ted Kaptchuk, Professor of Medicine and Professor of Global Health and Social Medicine at Harvard Medical School and Dr. Rebecca Erwin Wells, M.D., http://M.P.H.at Wake Forest Baptist Health wrote:[ii]“Research demonstrates that detailed disclosures of possible adverse effects, compared to minimal descriptions, can lead to more adverse events through what is usually called the nocebo (negative placebo) response.”Every clinician should be informed about the Nocebo Effect.[iii] Lack of knowledge is no excuse, because even if it is new enough that the individual practitioner could be excused, it does not excuse Healthcare Systems that should be up to date on new research—especially since the research is not that new. Research demonstrates that Placebo and Nocebo Effects are real and have powerful influences on patient outcomes. It has been six years since Perspectives in Biological Medicine published an article on The Placebo Effect: illness and interpersonal healing authored by a team from the Department of Bioethics National Institutes of Health, the Department of Neuroscience University of Turin Medical School National Institute of Neuroscience and Osher Research Center Harvard Medical School, which stated, “The communicative interaction of practitioners with patients, both verbal and nonverbal, may produce placebo effects even without the use of discrete treatments.”[iv]“Words are the most powerful tool a doctor possesses, but words, like a two-edged sword, can maim as well as heal.” — Bernard Lown“By definition, a nocebo effect is the induction of a symptom perceived as negative by sham treatment and/or by the suggestion of negative expectations. A nocebo response is a negative symptom induced by the patient’s own negative expectations and/or by negative suggestions from clinical staff in the absence of any treatment. The underlying mechanisms include learning by Pavlovian conditioning and reaction to expectations induced by verbal information or suggestion. Nocebo responses may come about through unintentional negative suggestion on the part of physicians and nurses. Information about possible complications and negative expectations on the patient’s part increases the likelihood of adverse effects. Adverse events under treatment with medications sometimes come about by a nocebo effect.”[v] [Emphasis added]The review of studies stated, “Doctor–patient communication and the patient’s treatment expectations can have considerable consequences, both positive and negative, on the outcome of a course of medical therapy.” [vi] Anyone who is aware of the Nocebo Effect, and I submit that at this time in our history with over 151 articles published on the subject, that every physician has an ethical responsibility to be cognizant of the Nocebo Effect and to apply that knowledge in line with the responsibilities associated with the Hippocratic Oath, should act as if their words have power. If the sole practitioner might still be excused, a hospitalist or intensivist in a major healthcare system would not be excused by a well-informed jury.Consider further the finding that, “Patients are highly receptive to negative suggestion, particularly in situations perceived as existentially threatening, such as impending surgery, acute severe illness, or an accident. Persons in extreme situations are often in a natural trance state and thus highly suggestible.”[vii]“Expectation is a powerful thing,” says Robert DeLap, M.D., head of one of the Food and Drug Administration’s Offices of Drug Evaluation. “The more you believe you’re going to benefit from a treatment, the more likely it is that you will experience a benefit.”A 2012 article in the American Journal of Bioethics written by Rebecca Erwin Wells and Ted J. Kaptchuk, both of Beth Israel Deaconess Medical Center and Harvard Medical School stated, “Evidence suggests that the Nocebo Effect can significantly increase various nonspecific symptoms and complaints, resulting in psychological distress, significant excess costs because of increased medication non-adherence, extra treatment visits, and additional medicines prescribed to treat the Nocebo Effects.”[viii] Healthcare organizations should ensure that all clinicians in the organization receive appropriate ethics training to comply with best practice recommendations.Today, many physicians are not being trained to understand this potent violator of the Hippocratic Oath—The Nocebo Effect.[i] (Home | Johns Hopkins University)[ii] (Wells & Kaptchuk, 2012)[iii] (Benedetti, Pollo, Lopiano, Lanotte, Vighetti, & Rainero, 2003) (Häuser, Hansen, & Enck, 2012) (Miller, Colloca, & Kaptchuk, 2009) (Petersen, et al., 2014) (Stathis, Smpiliris, Konitsiotis, & itsikostas, 2013) (Wells & Kaptchuk, 2012)[iv] (Miller, Colloca, & Kaptchuk, 2009)[v] (Häuser, Hansen, & Enck, 2012)[vi] (Häuser, Hansen, & Enck, 2012)[vii] (Häuser, Hansen, & Enck, 2012)[viii] (Wells & Kaptchuk, 2012)I note that some of the other responses state something along the lines of:The Placebo Effect and the Nocebo Effect do nothing.This statement is wrong.Both the Placebo Effect and the Nocebo Effect influence the health of individual’s every day.The fact that science has not yet determined HOW the process works or what the MIND/BODY Connection that causes them to work operate does not equate to the processes doing nothing.In 1847, Ignaz Semmelweis was ridiculed by people who think in similar ways to those who claim the Nocebo and Placebo Effects do nothing.Why was Dr. Semmelweis ridiculed?Because he suggested that it would be beneficial for physicians to wash their hands between patients and between handling cadavers and patients. The ridicule of his work continued for 50 years until the microscope was invented and humans discovered bacteria and viruses. When I wrote my first book, I referred to this disbelief in something that we can prove exists but we don’t yet know how it works as The Galileo Effect.Dr. Semmelweis demonstrated that the rate of child bed fever for women dropped from 32% to 1% when physicians followed his hand washing advice.His advice was still ignored. How many children became orphans because his advice was ignored?How many health benefits continue to be forgone while we ignore the benefits of the Placebo Effect?How many detriments to individual health occur because we ignore the Nocebo Effect?Full Disclosure: I teach classes that educate clinicians on the Nocebo Effect.This answer by William La Chenal addresses Homeopathic medicine very well. Is the reverse true with the placebo effect? In other words, if someone believes homeopathic remedies will make them sicker, will their health suffer?However, even if homeopathic wasn’t valid, the Nocebo and Placebo Effects could be invoked via belief that it works.