Essays in Medical Sociology, Volume 2 (of 2)

CHAPTER XII

RECAPITULATION OF PRINCIPLES 148

INTRODUCTION

A controversy is persistently carried on between an increasing body of the non-professional laity and an important section of the medical profession, in relation to the methods pursued in investigating biological phenomena.

The criticism of medical research by non-medical people is naturally resented by some who are engaged in experimentation, and it is stated seriously that non-scientific persons will impede progress if they interfere with or succeed in restricting the efforts of those who specially devote themselves to this branch of research.

This controversy is still going on in ever-widening circles, and it is bound to do so until the present confusion of thought which exists on this subject is removed, and the broad distinction between right and wrong experimentation is more fully acknowledged and more clearly defined. Our relation to the lower animals has never yet been brought fully into the clear light of reason and conscience. Yet in the order of Providential development it must so come forward.

As advancing humanity has gradually recognised natural rights as existing in the various races of mankind, and is carrying on a persistent warfare against human slavery, and slowly awakening to the moral crime of introducing disease and vice amongst native races, and the rights as well as duties of women and of children are being gradually recognised, so the time has come when the natural rights of inferior living creatures must be seriously studied.

This study has become obligatory, not only in regard to the welfare of the brute creation, but for the sake of our own human growth as rational and moral beings.

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The common-sense of mankind recognises our right to use the lower animals for human benefit, whilst our superior intelligence gives us the power to so use them. But ‘can’ and ‘ought’ are different aspects of our mental constitution, which require to be harmonized. What we can do is not the true measure of what we ought to do in any department of life.

We can starve a child or lash a horse to death, but we have no right to do so.

The laws of our human constitution compel us to recognise that intellect and conscience, although essential parts, are not identical parts of our nature. Long experience shows us that social progress can only become permanent when conscience guides intelligence.

How far the guidance of conscience can extend, with the practical results to medical research involved in the recognition of such guidance, forms the subject of present consideration.

CHAPTER I. _the Growth of Conscience_

The Growth of Conscience

It is through the gradual and harmonious development of intelligence with that element in our nature that we name conscience that the human race passes from lower to higher states of civilization. In pursuing our ideals, conscience is our instinctive monitor of right and wrong.

Our great naturalist, Darwin, laid down as a law of evolution that ‘the moral sense, or conscience, is by far the most important of the differences between man and the lower animals. Duty--“ought”--is the most noble of all the attributes of man.’

Victor Hugo, with the prophetic insight of genius, calls conscience ‘that modicum of innate science with which each one is born.’

The growth of human conscience in its perception of justice and in its sympathetic relation to creation is the surest measure of individual and national progress. Various intellectual theories may be formed as to the origin and growth of conscience. It may be held to be intuitive, springing up as inevitably as the instinctive feelings born with the natural relations of life; or it may be looked upon as gradually evolved, the ‘result of countless experiences of fear, love, utility, transmitted through generations.’

But however originating, conscience is a positive and potent fact. It is, indeed, the mightiest factor in social life. It is the great controller of selfhood. It enlarges human character and guides human conduct. The deepening of this principle through the growth of justice and sympathy marks an advancement in the type of humanity. Increasing respect for life is one of the clearest signs of growing conscience. Our reverence for the principle of life grows with our enlarging intellectual perception of its universality and its unlimited power of development.

As life is marked by activity, and cannot remain stationary, so conscience shares this law of life. It must inevitably advance or retrograde.

The degradation as well as the development of conscience may be seen amongst us in the midst of our present civilization. It is contrary to the most rudimentary element of conscience to feed upon one’s kind, and cannibal tribes who devour their captives represent the lowest type of humanity; even the dogs of the Arctic voyager will endure the slow agony of starvation for days before their human taskmasters can compel them to eat the flesh of their companions. The well-known naturalist, Mr. W. H. Hudson, states that wolves, when pressed with hunger, will sometimes devour a fellow-wolf; as a rule, however, rapacious animals will starve to death rather than prey upon one of their own kind.

Yet shipwrecked sailors, even of our own English race, have been known to drink the blood and eat the flesh of their own comrades when confronted by starvation.

We find that intelligence may exist without conscience, but the human type changes to a destructive force when this separation takes place. A lamentable example of the social danger created by the destruction or absence of rudimentary conscience amongst us is shown by the betrayal and murder of the little boy Eccles in Liverpool, for the sake of his clothes, by his two companions of eight and nine years old. There was the deliberate plot to entice him to a pond; the throwing him three times into the water as he scrambled out; the final holding him under water until all struggle had ceased. These facts make a striking, but not unique, object-lesson, showing how intelligence may exist without conscience amongst all our appliances of civilization, and the danger of such separation.

Examples of the social devastation produced by official corruption and business dishonesty are too numerous to be detailed; they are seen in what are called civilized countries--in London, Paris, Rome, and across the ocean. The lack of conscience in public and private transactions creates social misery proportioned to its extent.

Recognising, therefore, that this distinctive principle of conscience is a fact of gradual development, that it grows by the union of the moral with the intellectual elements in our nature, and that the far-reaching consequences for good or evil of vivid or dulled conscience in the individual and the nation are far beyond our power of foresight, a grave responsibility rests upon us in this matter. We are bound to realize that any custom, or method of education, or proposed course of action, that seems to violate the natural instincts of humanity, or is contrary to the present enlightened conscience of any section of our Anglo-American race, demands imperatively the most careful consideration on our part.

CHAPTER II. _conscience in Medicine_

Conscience in Medicine

Every intelligent member of the medical profession will certainly recognise the special value of human conscience in the profession.

The problems which are involved in the practice of the beneficent art, the absolute reliance which the anxious patient is compelled to place in his physician, the helplessness of the poor, who form so large a majority of those who need medical aid, and who are without the defences of wealth and station, show the need of keen moral sense, as well as intelligence, in those who practise the art of medicine.

The very discoveries of medical science enforce this necessity; for the possibility of abuse in the employment of such beneficent agents as anæsthetics and hypnotism, by incompetent or conscienceless operators, is a very serious fact.

This special responsibility of the medical profession to society is greatly increased by the fact that the training of a very large section of our intelligent youth during the important years of early manhood rests upon them. The moral as well as intellectual influence exerted by those who guide the college, the hospital, the dispensary, and post-graduate classes, will mould the future action of one of the most influential portions of the community--those, viz., on whom the health of the nation chiefly rests.

Now, whilst all recognise the need of the trained and skilful care of a nation’s health, and perceive also that rightly organized medical schools and hospitals are of great value in educating our health-guardians, how is it that a profound distrust of these institutions has grown up in our midst, that the support of hospitals becomes increasingly difficult, whilst at the same time the sentiment of benevolence and desire to help the poor is constantly extended?

How is it that the beneficent and necessary art of medicine no longer commands that respect and confidence which its essential character as part of our social institutions would seem to demand?

The answer to these serious questions involves both moral and intellectual considerations. These problems have arisen from failure to perceive that in education moral and intellectual activity cannot be advantageously divorced, or that one portion of our complex nature cannot be beneficially developed whilst other portions are entirely ignored or injured.

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