The Codification of Medical Morality: Historical and Philosophical Studies of the Formalization of Western Medical Morality in the Eighteenth and Nineteenth Centuries Volume Two: Anglo-American Medical Ethics and Medical Jurisprudence in the Nineteenth Ce

242 Pages·1995·2.88 MB·English

by  Robert Baker (auth.)

THE CODIFICATION OF MEDICAL MORALITY
Philosophy dna Medicine
VOLUME 49
Editors
H. Tristram Engelhardt, Jr., Center for Ethics, Medicine, and Public Issues, Baylor
College of Medicine, Houston, Texas and Philosophy Department, Rice
University, Houston, Texas
Stuart F. Spicker, Center for Ethics, Medicine, and Public Issues, Baylor College of
Medicine, Houston, Texas
Associate Editor
Kevin W. Wildes, S.J., Department of Philosophy, Georgetown University,
Washington, D.C.
Editorial Board
George J. Agich, School of Medicine, Southern Illinois University, Springfield, Illinois
Edmund Erde, University of Medicine and Dentistry of New Jersey, Camden, New
Jersey
Patricia A. King, J.D., Georgetown University Law Center, Washington, D.C.
E. Haavi Morreim, Department of Human Values and Ethics, College of Medicine,
University of Tennessee, Memphis, Tennessee
The titles published in this series are listed at the end of this volume.
THE CODIFICATION OF
MEDICAL MORALITY
Historical and Philosophical Studies of
the Formalization of Western Medical Morality
in the Eighteenth and Nineteenth Centuries
Volume Two: Anglo-American Medical Ethics and Medical
Jurisprudence in the Nineteenth Century
detidE yb
ROBERT BAKER
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KLUWER ACADEMIC PUBLISHERS
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Library of Congress Cataloging-in-Publication Data
A C.I.P. Catalogue record for this book is available from the Library of Congress.
ISBN 0-7923-3528-7
Published by Kluwer Academic Publishers,
P.O. Box 17, 3300 AA Dordrecht, The Netherlands.
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© 1995 Kluwer Academic Publishers
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Printed in the Netherlands
|n Memory of
Freda Baker
TABLE OF CONTENTS
PREFACE ix
Robert Baker / Introduction 1
PART ONE / THE NINETEENTH-CENTURY AMERICAN
CODIFICATION OF MEDICAL ETHICS
RETPAHC ENO Robert Baker / An Introduction to the Boston
--
Medical Police of 1808 25
- John Warren, Lemuel Hayward, John Fleet / Boston Medical
Police 41
RETPAHC OWT Robert Baker / The Historical Context of the
--
American Medical Association's 1847 Code of Ethics 47
-John Bell/Introduction to the Code of Medical Ethics 65
-John Bell, Isaac Hays et al. / Note to Convention 73
- Isaac Hays~Code of Ethics 75
RETPAHC EERHT Stanley Joel Reiser / Creating a Medical
--
Profession in the United States: The First Code of Ethics of the
American Medical Association 89
RETPAHC RUOF Tom L. Beauchamp / Worthington Hooker
--
on Ethics in Clinical Medicine 105
viii TABLE OF CONTENTS
RETPAHC EVIF Robert M. Veatch / Diverging Traditions:
--
Professional and Religious Medical Ethics of the Nineteenth
Century 121
PART TWO / MEDICAL ETHICS AND MEDICAL
JURISPRUDENCE IN NINETEENTH-CENTURY BRITAIN
RETPAHC XIS Chester Burns / Reciprocity in the Development
--
of Anglo-American Medical Ethics, 1765-1865 531
RETPAHC NEVES Peter Bartrip / An Introduction to Jukes
--
Styrap's A Code of Medical Ethics (1878) 145
-Jukes Styrap/A Code of Medical Ethics 149
RETPAHC THGIE M. Anne Crowther / Forensic Medicine
--
and Medical Ethics in Nineteenth-Century Britain 173
RETPAHC ENIN Peter Bartrip / Secret Remedies, Medical
--
Ethics, and the Finances of the British Medical Journal 191
RETPAHC NET Russell G. Smith / Legal Precedent and Medical
--
Ethics: Some Problems Encountered by the General Medical
Council in Relying upon Precedent when Declaring Acceptable
Standards of Professional Conduct 205
219
NOTES ON CONTRIBUTORS
221
INDEX
PREFACE
Like many novel ideas, the idea for this volume and its predecessor arose over
lunch in the cafeteria of the old Wellcome Institute. On an atternoon in Septem-
ber 1988, Dorothy and Roy Porter, and I, sketched out a plan for a set of confer-
ences in which scholars from a variety of disciplines would explore the emergence
of modern medical ethics in the English-speaking world: from its pre-history in
the quarrels that arose as gentlemanly codes of etiquette and honor broke down
under the pressure of the eighteenth-century "sick trade," to the Enlightenment
ethics of John Gregory and Thomas Percival, to the American appropriation
process that culminated in the American Medical Association's 1847 Code of
Ethics, and to the British turn to medical jurisprudence in the 1858 Medical Act.
Roy Porter formally presented our idea as a plan for two back-to-back con-
ferences to the Wellcome Trust, and I presented it to the editors of the PHI-
LOSOPHY AND MEDICINE series, H. Tristram Engeihardt, Jr. and Stuart .F
Spicker. The reception from both parties was enthusiastic and so, with the
financial backing of the former and a commitment to publication from the
latter, Roy Porter, ably assisted by Frieda Hauser and Steven Emberton, or-
ganized two conferences. The first was held at the Wellcome Institute in De-
cember 1989; the second was sponsored by the Wellcome, but was actually
held in the National Hospital, in December 1990.
Our plan was to publish the conferences as a two-volume set, in which each
volume would explore a different century but would nonetheless be united to its
companion by a single comprehensive conception reflected in the common title,
"The Codification of Medical Morality: Historical and Philosophical Studies of
the Formalization of Western Medical Morality in the Eighteenth and Nineteenth
Centuries." We jointly edited volume one, Medical Ethics and Etiquette ni the
Eighteenth Century, which was published in 1993. By the time we turned our
ix
x ECAFERP
attention to the second volume, Anglo-American Medical Ethics and Juris-
prudence in the Nineteenth Century, however, we found that the factors that
had originally linked us - a common tie to the Wellcome Institute, the conven-
ience of living in London, a common conception of our purpose-had dissolved.
We were working at great distances from each other and were plagued moreover
by delays. Graciously allowing the slowest to set the pace, Dorothy and Roy
Porter turned over the task of completing the editing to me- although the over-
all conception of this volume was jointly theirs; they supplied most of the con-
tributors with editorial comments, and, as noted earlier, Roy Porter was the actual
organizer of the 1990 Wellcome conference. Perhaps the one point on which the
present volume directly differs from the one we originally conceived is that it
includes, as the original did not, three nineteenth-century codes of medical eth-
ics (the Boston Medical Police, the unabridged 1847 AMA Code of Ethics, and
Jukes Styrap's Code of Medical Ethics) and accompanying introductions.
In editing this volume 1 incurred many debts, particularly to the contribu-
tors for their willingness to revise the papers they presented at the conference
but most especially for their patience. I owe a special debt to two contributors
-
in particular: Chester Burns, who although unable to attend the Wellcome Con-
ference, nonetheless willingly provided a text of the 1808 Boston Medical Po-
lice and permitted us to reproduce his essay, "Reciprocity in the Development of
Anglo-American Medical Ethics" (which is reprinted with the permission of
Science History Publications); and Peter Bartrip, who supplied me with a copy
of Jukes Styrup's code and who wrote a brief foreword.
Four great libraries provided the primary sources referred to throughout
this volume: theAmerican and Harry Ransom collections of the University of
Texas at Austin; the Blocker History of Medicine Collection at the University
of Texas Medical Branch at Galveston; the library of the New York Academy
of Medicine; and, of course, the library at the Wellcome Institute of the His-
tory of Medicine, London. All the librarians were kind - although often be-
mused by the prospect of a philosopher searching for truth in archival sources
the most generous with her time, however, was undoubtedly lnci Bowman
-
of the Blocker collection. Travel to these collections was funded by the Hu-
manities Faculty Development Fund of Union College.
In closing, I should like to acknowledge two special debts: one to my friend
and editor, Stuart Spicker, whose keen eye and incisive understanding brings
out the best that a book has to offer; the other to my secretary, Marianne
Snowden, without whose diligence, commitment and energy this book would
not have come to fruition.
ROBERT BAKER
ROBERT BAKER
~TRODUCTION
In 1789, at the very birth of the United States, one of its founding fathers,
Professor Benjamin Rush, signer of the Declaration of Independence and a
founder of the medical college of the University of Pennsylvania, concluded
his annual course with a lecture on the type of physician the new nation needed.
He urged his students to be financially independent farmers who dealt hon-
estly with their patients.
There is more than one way of playing the quack. It is not necessary, for this purpose, that a
man should advertise his skill, or his cures, or that he should mount a phaeton t and display his
dexterity in operating to an ignorant and gaping multitude. A physician acts the same part, in a
different way, who assumes the character of a madman or a brute in his manners, or who conceals
his fallibility by an affected gravity and taciturnity in his intercourse with his patients. Both
characters, like the quack, impose on the public (36, p. 255).
Rush then urged his students to cultivate, in a new "American" way, the very
virtues that had been inculcated in him by his teacher, John Gregory, of Edin-
burgh - piety, attention, humanity, and beneficence. He concluded with a stir-
ring appeal.
Human misery of every kind is evidently on decline. Happiness, like truth, is a unit. While the
world, from the progress of intellectual, moral, and political truth, is becoming a more safe and
agreeable place for man, the votaries of medicine should not be idle. All the doors of the temple
of nature have been thrown open, by the convulsions of the late American Revolution. This is
the time, therefore, to press upon her alters. eW have already drawn from them discoveries in
morals, philosophy, and government; all of which have human happiness for their object. Let
us preserve truth and happiness, by drawing from the same source, in the present critical moment,
a knowledge of antidotes to those diseases which are supposed to be incurable (36, pp. 263-264).
I
R. Baker (ed.), The Codification of Medical Morality, 1-22.
© 1995 Kluwer Academic Publishers. Printed in the Netherlandi'.