The modern doctor needs to be cognizant of the needs and rights of the individual patient and, to a lesser extent, of the community generally. Doctors who possess good communication skills, respect their patients and have a broad knowledge of the law as it pertains to medical practice will be well equipped to resolve most of the ethical dilemmas which they will encounter in the practice of their profession.

The similarity of some of the key tenets of the Hippocratic Oath to modern codes of medical ethics has already been remarked upon. However, codes of ethics are not immutable and each ethical principle needs to be interpreted in the light of prevailing circumstances and should not be followed blindly, without thought about the real issues involved. In seeking differences between the Hippocratic Oath and modern ethical concepts two principles stand out; namely the modern emphasis on patient autonomy and the concept of distributive justice.

A simple example is the significantly altered attitude to advertising by doctors over the past two decades. Previously, ethical codes had strictly limited advertising by doctors on the basis that persons who were ill and seeking medical attention were vulnerable to misleading advertisements which promised more than medicine could offer. This limitation has gradually been replaced by the principle of a community's right to information. Of interest is that so far only a small minority of doctors have taken advantage of the relaxation of attitudes to advertising and it is still too early to determine whether the change has been to the benefit or detriment of the community.

Conflict between specific ethical principles, or conflict between the conscience of the individual doctor and a legal request for medical services which are morally unacceptable to that doctor, are dilemmas with which the medical profession is familiar. As society through its parliament and its courts increasingly wishes to use the law to regulate aspects of medical practice, situations will arise where the law appears to be in direct conflict with the generally agreed ethical code of the profession, as can be seen in the Rights of the Terminally Ill Act 1995 of the Northern Territory.

In other instances, the law intervenes, or parliament creates new law, when the medical profession or one or more of its members is out of step with community thinking, or where the community, via its parliament, perceives that patients could suffer harm should doctors not voluntarily recognize or accept the ethical obligations and the privileged position they occupy. Such laws generally set the outermost limits within which doctors must function in any given circumstance.

The complexity of modern medical interventions, the need to fully inform and involve patients in decision making, and the continuing community perception that the power balance in the doctor-patient relationship is inappropriately lopsided, combine to challenge the homogeneity of the ethical values held by doctors and may lead to more frequent legal intervention. There are those, however, who believe that adherence by doctors to agreed codes of conduct into which the community has had input would be a much more effective means of protecting the community than the legal system. For this to work, the medical profession needs to be increasingly more willing to participate in debating complex medical ethical issues with community representatives. . .