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It is hard to capture in words, rules whose origin must be in the heart, and whose application must be governed by the conscience. Samuel Johnson declared it to be one of the maxims of civil law that definitions are hazardous,1and the statement applies equally to moral codes, where the intent of the law is so clearly more important than the letter of the law. Although medicine is much older than Christianity, and ethical principles for medical practice were conceived about 2500 BC by the Babylonians, there is still no immutable system of rules of ethics comparable to those of mathematics or the natural sciences. Fundamental principles regarding moral conduct have not changed, but it is necessary periodically to review and adjust the code to meet changing concepts and new situations without lowering the basic standards of integrity, the hallmark of an honorable profession. Fee splitting is condemned
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John H. Budd (1966) studied this question.
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