Evening Post. FRIDAY, APRIL 20, 1891. MEDICAL ETIQUETTE AND MAORI PATIENTS.

Evening Post, Volume XLVII, Issue 93, 20 April 1894, Page 2

Evening Post. FRIDAY, APRIL 20, 189 1.

MEDICAL ETIQUETTE AND MAORI PATIENTS.

4 The Wellington Branoh of the New Zealand Medical Association has, we are glad to find, responded promptly to our suggestion that it should consider and express an opinion upon the questions arising ont of the evidenco (riven at the late inquest at Petone— so far as they relate to matters of professional etiquette and the duties of medical practitioners in suoh cases. The members of the Association gavo long and attentive consideration to tho matter, and the resolutions at which they arrived wore published in our columns last night. We do not think the first resolution is very happily worded. It wonld hayo been better had the Association confined itself to the assertion oS» a general principle. The wording of the resolution suggests the idea that Dr. Lamb had been put upon his trial, and that the jury of his follows acquitted him. It is to be regretted that the personal aspect of the matter was intruded. Had tho Association simply laid down the principles whioh the profession as a whole recognises as its guide under certain circumstances, the larger jury of publio opinion might have been trusted to apply them to the partioular case. The Association has formulated a prinoiple which we believe to be in strict accordance with the traditions and ethics of the profession, and it is a very satisfactory one. It is that in coses of life and death no medical man is justified in withholding his assistance from a fellowpractitioner on any srround of etiquette. This is satisfactory so far as it goes. But the Medical Association recognises by its resolution that a medical man is justified in passing a " bad mark " on as a pationt to a fellow practitioner, if there be one in tho neighbourhood. It is silent on the point of whether a medical men is justified in refusing to attend a case without a guarantee of payment where there is not another practitioner available. Would the second praotitioner in such a case as contemplated in the resolution be justified, equally with the first practitioner, in declining to attend if not paid P If not, why should tho first praotitioner enjoy an immunity from unprofitable work whioh wonld be denied to Praotitioner No. 2 ? Let us here say of the medical profession generally that perhaps no class of men do more good work for suffering humanity without hope of fee or reward than doctors do. Wo have known them night after night depriving themselves of muoh-needed natural rest to attend difticult and unpleasant cases in which there was not a shadow of a chance of a fee. There is no more oharitable or humane olass of men in the world than the medical profession, and the patience and endurance of its mombers are often sorely tried. We cannot wonder if they sometimes turn a little rusty at what they deem unnecessary demands upon their charity and skill. The members of tho profession at the Hutt have for years given much gratuitous aid to native patients, and, as many of the natives there are quite able to pay for the medical attendance they require, we are not surprised that tho doctors have got tired of working for nothing. The prinoiple that they should be paid by native pationts who aro able to_ pay is a sound and propor one, but discrimination is sometimes necessary in asserting even a wholesome principle, which through habit may have beeu allowed to fall into disuse. We oannot help thinking that it was an error of judgment on Dr. Lamb's part to assert the principle of pre. payment by native patients so deoidedly in a case euoh as that of Wikitobia RktistiNA. It is evident also from the evidence at the inquest that Dr. Lamb did what the Association says should not be done. Although informed that the case was one of life or death, he refused to assist Dr. ScanLAN in it. That ho immediately afterwards did all that humanity required by going to attend tho case himself, and attending it skilfully until, through no fault of his, death occurred, we entirely agree with the Medical

Association. In this caße Dr. Lamb did not requiro assistance, but it wonld appear that had_ the cass beeu one requiring tho services of two medical men, he would still have refused on some point of etiquette to meet Dr. Scanlav, and accept a_ joint responsibility. The Medical Asscoiation very properly lays down the general rule that ono doctor should not refuse, on any grounds of etiquette, to assist another in cases of life and death. Even if the Medical Association had not enunciated snch a sensible and proDer rule, we think Dr. Lamb has put himself out of court as to any plea of etiqnette preventing him from meeting Dr. Scanlan, by his, in tho firat instance, advising the Maori who came for him to go for Dr. Scanlan and get that praotitioner to attend tho case A more cultivated intelligence than a Maori's may well fail to understand or appreciate tho refinement of etiquette which would justify a medical man in refusing to meet in consultation, when the case became serions. the fellowpractitioner whom he had in tho first instance advised or recommended or suggested Bbould bo called into attend the patient. We do not think that Dr. Lamb can fairly be held responsible for anything more serions than error of judgment as to the right or best course to take under certain no doubt perplexing circumstances, and any error of this kind which ho may have committed he fully atoned for by his subsequent services to the patient. He has certainly nothing to reproach himself with as to the consequences of hia refusal to assist Dr. Scanlan, for the patient was not in tbe slightest degree prejudiced by that refusal. Dr. Lamb was at her bedside almost as soon as he conld have been hod he gone with Dr. Scanlan, and alone he did all that medical skill could do to save the woman's life. The assistance of a second practitioner was not needed, Dr. Lamb having the instruments which Dr. Scanlan was unfortunately not provided with. There is another point dealt with in the Medical Association's resolutions to wh'ch we must refer. It is the Civil List grant for medioal advice for Maoris. The Petone natives, we know, agree with the Medical Association on this point. We cannot do so. At ono time a medioal man at the Hutt used to receive .£IOO a year to attend to the natives there. Gradually this sum was reduced, and ultimately the salary was, we think very properly, abolished altogether. The Civil List grant was never intended for the assistance of a few well-to-do natives living amidst a settled European population. It was intended to provide medicine and such 'advice as might be possible for natives living in remoto districts, far from European centres, and presumably according to native custom. Natives so situated could not bo expected to pay for medical aid, and the Imperial Government properly stipulated that to a certain extent it should be provided for them by the colony. A considorablo sum is still annually expended "in accordance with this intention. Most of the natives at tho Hutt, however, are quite as well able to pay for a doctor's services when needed as aro the majority of their European neighbours, nnd we see no reason why the State should pay for them. If there are any cases of destitute natives there who need medical assistance, we have no doubt that a proper representation of the facts to the Government would lead to its being supplied, but, except in cases of real poverty, we think it wonld be a misapplica ion of the publio funds to expend any portion of the Civil List native grant in paying for medical attendance on Petone Maoris, who are generally quite able to pay their own doctors' bills.