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The Doctor's Dilemma: Preface on Doctors
The Doctor's Dilemma: Preface on Doctors

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The Doctor's Dilemma: Preface on Doctors

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Titel: The Doctor's Dilemma: Preface on Doctors

von Oliver Goldsmith, Samuel Pepys, William Dean Howells, John Burroughs, William Harmon Norton, L. Mühlbach, Franklin Knight Lane, Walter Pater, Jonathan Swift, Augusta J. Evans, Trumbull White, Kathleen Thompson Norris, Matthew Arnold, Charles W. Colby, Shakespeare, James Fenimore Cooper, D. H. Lawrence, James Joyce, Ada Cambridge, Philip E. Muskett, Catherine Helen Spence, Rolf Boldrewood, Ernest Scott, Fergus Hume, H. G. Wells, Victor [pseud.] Appleton, Roald Amundsen, Max Simon Nordau, Henry David Thoreau, E. Phillips Oppenheim, Richard Wagner, Franz Liszt, Charlotte Mary Yonge, Charles Henry Eden, Charles Babbage, T. R. Malthus, Unknown, Joseph Ernest Morris, Robert Southey, Isabella L. Bird, Charles James Fox, Thomas Hariot, Cyrus Thomas, Bart Haley, Christopher Morley, Edgar Saltus, Marie Corelli, Edmund Lester Pearson, Robert Browning, John Aubrey, Benjamin Nathaniel Bogue, John McElroy, John Galsworthy, Henry James, Hamilton Wright Mabie, Mina Benson Hubbard, Elizabeth Cleghorn Gaskell, John Keble, Henry Lindlahr, Richard Henry Dana, Annie Wood Besant, Immanuel Kant, John Habberton, Baron Edward John Moreton Drax Plunkett Dunsany, T. B. Ray, Isabel Ecclestone Mackay, Frank C. Haddock, William John Locke, baron Arthur Léon Imbert de Saint-Amand, Ralph Centennius, United States, Library of Congress. Copyright Office, James Otis, George Hartmann, Sir Arthur Conan Doyle, George Gissing, John Henry Tilden, Thomas Wright, Frederick Samuel Dellenbaugh, Anonymous, J. Clontz, David Hume, Margot Asquith, Elmer Ulysses Hoenshel, Byron J. Rees, Lida B. McMurry, Georges Duhamel, Ramsay Muir, Edith Wharton, Charles Sturt, Lola Ridge, J. M. Stone, Annie Payson Call, Grant Allen, kniaz Petr Alekseevich Kropotkin, Steve Solomon, Isabel Moser, Aleksandr Sergeevich Pushkin, Horace W. C. Newte, Charles Darwin, Maurice Maeterlinck, Walter Bagehot, Henri Bergson, George Randolph Chester, John S. C. Abbott, L. Frank Baum, William T. Sherman, Philip Henry Sheridan, Friedrich Wilhelm Nietzsche, Ambrose Bierce, Ulysses S. Grant, F. Scott Fitzgerald, Alfred Lichtenstein, Abbot of Nogent-sous-Coucy Guibert, Nellie L. McClung, Alice Caldwell Hegan Rice, E. Nesbit, Henri Barbusse, J. M. Synge, Frank Norris, Louis Hémon, Henry Van Dyke, Thomas Guthrie Marquis, Susanna Moodie, Frank Bigelow Tarbell, René Descartes, Kirk Munroe, Francis Hopkinson Smith, Edna St. Vincent Millay, Talbot Mundy, George Meredith, Clemens Brentano, James De Mille, James Allen, Norman Douglas, Bolton Hall, Arthur Christopher Benson, James Oliver Curwood, Frank Jardine, Bertram Lenox Simpson, Freiherr von Justus Liebig, Cyril G. Hopkins, Mary Eleanor Wilkins Freeman, Evelyn Scott, Charles Monroe Sheldon, George Berkeley, Steven Sills, Sara Jeannette Duncan, Jules Verne, Irvin S. Cobb, Zane Grey, August von Kotzebue, John Addington Symonds, Marjorie Allen Seiffert, J. B. Bury, William Makepeace Thackeray, Jules Renard, Susan Coolidge, Huguette Bertrand, Mrs. C. F. Fraser, Ottilie A. Liljencrantz, William Morton Payne, Henry Adams, T. S. Arthur, Orison Swett Marden, T. S. Ackland, Anthony Trollope, graf Leo Tolstoy, Robert Smythe Hichens, Émile Gaboriau, Wilkie Collins, Charles Reade, Horace Walpole, Jennette Lee, Thomas Dykes Beasley, Inez Haynes Gillmore, L. H. Woolley, John Francis Davis, James B. Stetson, William Day Simonds, James O'Meara, Almira Bailey, Cuthbert Bede, Voltaire, Percy Bysshe Shelley, William Bennett Munro, Sir Richard Francis Burton, Horatio Alger, Paul Verlaine, Samuel Vaknin, William Ralph Inge, Madame de Staël, J. Hector St. John de Crèvecoeur, L. A. Abbott, F. Colburn Adams, John S. Adams, Thornton W. Burgess, Glenn D. Bradley, Eugen Neuhaus, Arthur E. Knights, Bret Harte, Maturin Murray Ballou, Jane G. Austin, Samuel Johnson, Frederick Niecks, Stephen Leacock, Suelette Dreyfus, Stéphane Mallarmé, Lyndon Orr, William Le Queux, Mary Wollstonecraft Shelley, Jeannie Gunn, Jean François Regnard, John Ruskin, A. I. Kuprin, Pierre Louÿs, George Barr McCutcheon, John Munro, Holman Day, William Stearns Davis, John Richardson, Mary Jane Holmes, Oliver Wendell Holmes, Finley Peter Dunne, C. J. Dennis, Ethel Sybil Turner, Julius Wellhausen, Arnold Bennett, Harold Bell Wright, Guðmundur Kamban, Charles Stuart Calverley, A. E. W. Mason, Charles Rivière Dufresny, David Starr Jordan, Wallace Irwin, J. W. Wright, Thomas Hardy, United States Rubber Company, Helen Reimensnyder Martin, William Fayette Fox, Lewis Carroll, Anna Katharine Green, Shell Union Oil Corporation, Louisa May Alcott, Theocritus, of Phlossa near Smyrna Bion, Moschus, Bertrand Russell, Guy de Maupassant, Henrik Ibsen, James Whitcomb Riley, Josephine Lawrence, Pierre Loti, Harry Alverson Franck, Albert Payson Terhune, Harold MacGrath, G. A. Henty, Harriet A. Adams, John Lothrop Motley, H. E. Bird, Joseph Crosby Lincoln, Michel Baron, Gene Stratton-Porter, James Clerk Maxwell, Norman Lindsay, Edward Lasker, Margaret Penrose, S. R. Crockett, Austin Hall, Homer Eon Flint, Various, Clarence Edward Mulford, Upton Sinclair, John Andreas Widtsoe, Thomas Bulfinch, David Graham Phillips, John Kendrick Bangs, Edmond Jaloux, Emile Littré, 13th cent. de Boron Robert, Samuel Butler, James Huneker, Jessie Graham [pseud.] Flower, St. George Rathborne, Charles Wesley Emerson, Winston Churchill, Edith Bancroft, Lloyd Osbourne, Jack London, Lyman Abbott, Belle K. Abbott, Sinclair Lewis, H. W. Conn, Ludwig Thoma, Sir Walter Scott, August Strindberg, Thomas Chapais, Ernest Giles, David Wynford Carnegie, Zoeth Skinner Eldredge, Eusebius Joseph Molera, C. C. Andrews, Robert Barr, John Hendricks Bechtel, Robert W. Chambers, Alice B. Emerson, Anna M. Galbraith, Laura Lee Hope, L. T. Meade, Harry Steele Morrison, Frank Gee Patchin, Louise Clarke Pyrnelle, William MacLeod Raine, Roy Rockwood, Edward Stratemeyer, Louis Tracy, Matthew White, Leonardo da Vinci, Albert Einstein, Clarence Young, Ludwig Leichhardt, Arthur B. Reeve, Mrs. Georgie Sheldon, Samuel Hopkins Adams, George Washington, John Adams, Thomas Jefferson, James Madison, James Monroe, John Quincy Adams, Andrew Jackson, Martin Van Buren, John Tyler, James K. Polk, Zachary Taylor, Millard Fillmore, Franklin Pierce, James Buchanan, Abraham Lincoln, Andrew Johnson, Rutherford Birchard Hayes, Chester Alan Arthur, Grover Cleveland, Benjamin Harrison, William McKinley, Theodore Roosevelt, William H. Taft, Woodrow Wilson, Warren G. Harding, Calvin Coolidge, Herbert Hoover, Franklin Delano Roosevelt, Harry S. Truman, Dwight D. Eisenhower, John F. Kennedy, Lyndon B. Johnson, Richard M. Nixon, Gerald R. Ford, Jimmy Carter, Ronald Reagan, George Bush, William Jefferson Clinton, George W. Bush, United States. Presidents., Bjørnstjerne Bjørnson, Rex Ellingwood Beach, Euripides, Henry C. Northam, Mary Raymond Shipman Andrews, Alice Brown, Mary Stewart Doubleday Cutting, Elizabeth Garver Jordan, Elizabeth Stuart Phelps, Mary Heaton Vorse, Edith Wyatt, Bernard Shaw

ISBN 978-3-7429-4916-5

Alle Rechte vorbehalten.

Es ist ohne vorherige schriftliche Erlaubnis nicht gestattet, dieses Werk im Ganzen oder in Teilen zu vervielfältigen oder zu veröffentlichen.


THE DOCTOR'S DILEMMA:


PREFACE ON DOCTORS


By Bernard Shaw


1909



Contents

DOUBTFUL CHARACTER BORNE BY THE MEDICAL PROFESSION DOCTOR'S CONSCIENCES THE PECULIAR PEOPLE RECOIL OF THE DOGMA OF MEDICAL INFALLIBILITY ON THE DOCTOR WHY DOCTORS DO NOT DIFFER THE CRAZE FOR OPERATIONS CREDULITY AND CHLOROFORM MEDICAL POVERTY THE SUCCESSFUL DOCTOR THE PSYCHOLOGY OF SELF-RESPECT IN SURGEONS ARE DOCTORS MEN OF SCIENCE? BACTERIOLOGY AS A SUPERSTITION ECONOMIC DIFFICULTIES OF IMMUNIZATION THE PERILS OF INOCULATION DOCTORS AND VIVISECTION THE PRIMITIVE SAVAGE MOTIVE THE HIGHER MOTIVE. THE TREE OF KNOWLEDGE. THE FLAW IN THE ARGUMENT LIMITATIONS OF THE RIGHT TO KNOWLEDGE A FALSE ALTERNATIVE OUR OWN CRUELTIES THE SCIENTIFIC INVESTIGATION OF CRUELTY ROUTINE THE OLD LINE BETWEEN MAN AND BEAST VIVISECTING THE HUMAN SUBJECT "THE LIE IS A EUROPEAN POWER" AN ARGUMENT WHICH WOULD DEFEND ANY CRIME THOU ART THE MAN WHAT THE PUBLIC WANTS AND WILL NOT GET THE VACCINATION CRAZE STATISTICAL ILLUSIONS THE SURPRISES OF ATTENTION AND NEGLECT STEALING CREDIT FROM CIVILIZATION BIOMETRIKA PATIENT-MADE THERAPEUTICS THE REFORMS ALSO COME FROM THE LAITY FASHIONS AND EPIDEMICS THE DOCTOR'S VIRTUES THE DOCTOR'S HARDSHIPS THE PUBLIC DOCTOR MEDICAL ORGANIZATION THE SOCIAL SOLUTION OF THE MEDICAL PROBLEM THE FUTURE OF PRIVATE PRACTICE THE TECHNICAL PROBLEM THE LATEST THEORIES

It is not the fault of our doctors that the medical service of the community, as at present provided for, is a murderous absurdity. That any sane nation, having observed that you could provide for the supply of bread by giving bakers a pecuniary interest in baking for you, should go on to give a surgeon a pecuniary interest in cutting off your leg, is enough to make one despair of political humanity. But that is precisely what we have done. And the more appalling the mutilation, the more the mutilator is paid. He who corrects the ingrowing toe-nail receives a few shillings: he who cuts your inside out receives hundreds of guineas, except when he does it to a poor person for practice.

Scandalized voices murmur that these operations are unnecessary. They may be. It may also be necessary to hang a man or pull down a house. But we take good care not to make the hangman and the housebreaker the judges of that. If we did, no man's neck would be safe and no man's house stable. But we do make the doctor the judge, and fine him anything from sixpence to several hundred guineas if he decides in our favor. I cannot knock my shins severely without forcing on some surgeon the difficult question, "Could I not make a better use of a pocketful of guineas than this man is making of his leg? Could he not write as well—or even better—on one leg than on two? And the guineas would make all the difference in the world to me just now. My wife—my pretty ones—the leg may mortify—it is always safer to operate—he will be well in a fortnight—artificial legs are now so well made that they are really better than natural ones—evolution is towards motors and leglessness, etc., etc., etc."

Now there is no calculation that an engineer can make as to the behavior of a girder under a strain, or an astronomer as to the recurrence of a comet, more certain than the calculation that under such circumstances we shall be dismembered unnecessarily in all directions by surgeons who believe the operations to be necessary solely because they want to perform them. The process metaphorically called bleeding the rich man is performed not only metaphorically but literally every day by surgeons who are quite as honest as most of us. After all, what harm is there in it? The surgeon need not take off the rich man's (or woman's) leg or arm: he can remove the appendix or the uvula, and leave the patient none the worse after a fortnight or so in bed, whilst the nurse, the general practitioner, the apothecary, and the surgeon will be the better.



DOUBTFUL CHARACTER BORNE BY THE MEDICAL PROFESSION

Again I hear the voices indignantly muttering old phrases about the high character of a noble profession and the honor and conscience of its members. I must reply that the medical profession has not a high character: it has an infamous character. I do not know a single thoughtful and well-informed person who does not feel that the tragedy of illness at present is that it delivers you helplessly into the hands of a profession which you deeply mistrust, because it not only advocates and practises the most revolting cruelties in the pursuit of knowledge, and justifies them on grounds which would equally justify practising the same cruelties on yourself or your children, or burning down London to test a patent fire extinguisher, but, when it has shocked the public, tries to reassure it with lies of breath-bereaving brazenness. That is the character the medical profession has got just now. It may be deserved or it may not: there it is at all events, and the doctors who have not realized this are living in a fool's paradise. As to the humor and conscience of doctors, they have as much as any other class of men, no more and no less. And what other men dare pretend to be impartial where they have a strong pecuniary interest on one side? Nobody supposes that doctors are less virtuous than judges; but a judge whose salary and reputation depended on whether the verdict was for plaintiff or defendant, prosecutor or prisoner, would be as little trusted as a general in the pay of the enemy. To offer me a doctor as my judge, and then weight his decision with a bribe of a large sum of money and a virtual guarantee that if he makes a mistake it can never be proved against him, is to go wildly beyond the ascertained strain which human nature will bear. It is simply unscientific to allege or believe that doctors do not under existing circumstances perform unnecessary operations and manufacture and prolong lucrative illnesses. The only ones who can claim to be above suspicion are those who are so much sought after that their cured patients are immediately replaced by fresh ones. And there is this curious psychological fact to be remembered: a serious illness or a death advertizes the doctor exactly as a hanging advertizes the barrister who defended the person hanged. Suppose, for example, a royal personage gets something wrong with his throat, or has a pain in his inside. If a doctor effects some trumpery cure with a wet compress or a peppermint lozenge nobody takes the least notice of him. But if he operates on the throat and kills the patient, or extirpates an internal organ and keeps the whole nation palpitating for days whilst the patient hovers in pain and fever between life and death, his fortune is made: every rich man who omits to call him in when the same symptoms appear in his household is held not to have done his utmost duty to the patient. The wonder is that there is a king or queen left alive in Europe.




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