Internal and external morality of medicine: lessons from New Zealand

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Abstract
Henk ten Have has described internal morality as those values, norms, and rules that are intrinsic to the practice of medicine.3 Internal morality arises from within a community of practitioners—doctors, nurses, teachers—and it is based on how one should behave in one's daily work. These are shared values that are learnt from one another and may or may not be written down. External morality is the view from outside, reflecting the ethos of the wider society. The recent discipline of bioethics has grown up largely outside medicine and has developed principles of its own. Rules drawn from principles in bioethics and from other ethical doctrines in society are often codified into laws.