In 1847 the AMA published its first "code of medical ethics" which covered many subjects and, though short, is dense and diatribe-like. It seemed to me, when I read through it, that it was mainly concerned with discouraging various forms of quackery, which was rampant in the relatively unregulated environment of the early 19th century in the United States. We physicians were enjoined to "unite tenderness with firmness and condescension with authority" and our patients were reminded that they needed to do what we told them and not fuss and argue with us. Physicians were required to be always available to sick patients, to get consultation when necessary, to treat those who could not afford to pay. In turn, patients were told to avoid seeing more than one doctor because we might disagree and then there would be dissension within the profession. Physicians were to be of superior moral character, not advertise, not have patents on surgical instruments, be cheerful and treat each other and each others' family members for free. It was noted that if we were to treat our own family members, we would be apt to be timid and irresolute.
The American College of Physicians published its 6th ethics manual last year and said this about treating family and friends:
Physicians should usually not enter into the dual relationship of physician–family member or physician-friend for a variety of reasons. The patient may be at risk of receiving inferior care from the physician. Problems may include effects on clinical objectivity, inadequate history-taking or physical examination, overtesting, inappropriate prescribing, incomplete counseling on sensitive issues, or failure to keep appropriate medical records. The needs of the patient may not fall within the physician's area of expertise . The physician's emotional proximity may result in difficulties for the patient and/or the physician. On the other hand, the patient may experience substantial benefit from having a physician-friend or physician–family member provide medical care, as may the physician. Access to the physician, the physician's attention to detail, and physician diligence to excellence in care might be superior."