JenniferReiling, Editorial Assistant
Copyright 2000 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2000American Medical Association
It is thought by some persons that members of the medical profession become hardened to suffering and death by reason of their more or less constant association with both of these conditions; but investigation will disclose that there is no body of men more thoughtful and considerate for the comfort and welfare of those that come under their care. Occasionally in the pursuit of his duties, the medical man may be compelled to resort to measures that to the layman may seem unnecessarily harsh and severe. The cold bath, for instance, has been considered such a measure. Again, many patients do not consider milk a food, and complain bitterly of being starved if given no other nourishment. It is, therefore, incumbent on the physician to be especially careful in experimental observations, as well as guarded in his manner of description, in order that both his motives and his methods be not exposed to hostile and unjust criticism. Several years ago a great hue and cry was aroused because of the administration of thyroid extract to a number of cases of dementia in the course of a perfectly legitimate and well-intended therapeutic experiment. As a further illustration of the distorted and exaggerated interpretation that is every now and then placed on medical reports, an account of a recent experience is an interesting example. There was published in the Archiv für Klinische Medicin,2 by an assistant of the medical clinic at Jena, a description of the methods pursued in a case of diabetes insipidus, in which the amount of water permitted for drinking-purposes was greatly restricted, so that the patient, as a result, suffered greatly from thirst, and secretly obtained water and other fluids. The report goes on to say that he was accordingly locked in a room, and, to relieve his thirst, drank dirty water, as well as his own urine. With the appearance of untoward symptoms the treatment was discontinued. As might be expected, this report gave rise to considerable acrid criticism, not alone of this particular case, but of the medical profession generally. In defense of the course pursued, it is pointed out by the chief of the clinic where the observations were made that the treatment was instituted purely for curative purposes, that the patient had been informed of the inconveniences to which he might be subjected, that he nevertheless consented to be treated in this way, that he was at liberty to leave the hospital whenever he chose, but that he remained for two months and afterward returned of his own accord, and that, although the events described occurred three years previously, the patient had been up to the time of his death, two years later, always grateful to the physicians of the clinic for the consideration shown him.
THE QUESTION OF CRUELTY IN THERAPEUTIC OBSERVATIONS.. JAMA. 2000;284(10):1214. doi:10.1001/jama.284.10.1214-JJY00029-3-1