Medical Etiquette.

New Zealand Tablet, Volume XXX, Issue 22, 29 May 1902, Page 2

Medical Etiquette.

During the past week what is known as the Dr. Davies case has been the all-absorbing topic of conversation in Dunedin, and as the Press Association has given the fullest publicity to the incident, the interest and feeling it has aroused locally have probably extended, though in a lesser degree, to the rest of the Colony. The matter has been so fully threshed out in the daily papers that it may seem superfluous to make any further reference to it, but as the main question involved is one of general interest, and as it is easier to look fairly and calmly at the matter now than it was in the heat of the popular outcry which was evoked on the first publication of the facts, it may be permitted us to say just a word or two. The facts of the case may be very briefly stated : Mr. G. M. Marshall, a well-known homeopathic chemist of Dunedin, had called in Dr. Stephenson, a legal I}' qualified doctor, who, however, practises as a homeopathist, to attend Mrs. Marshall in her confinement. About one o'clock in the morning Mrs. Marshall became very bad, and Dr. Stephenson advised that to save the mother's life the life of the child should be sacrificed, and in order that the necessary operation might be performed he urged Mr. Marshall to go at once for another doctor and to be sure and get one who was possessed of the necessary instrument. Mr. Marshall went to several places only to find that the doctors were out, but eventually called on Dr. Davies, who, however, in answer to his appeal for help, replied that ' Dr. Stephenson was a homeopathist, and therefore he (Dr. Davies) could not meet him in consultation.' Mr. Marshall pleaded that the case was a very serious one —a case, indeed, of life and death —but Dr. Davies replied that that was <-O much the more reason why he should not consult with Dr. Stephenson, and in any case he had not got the instrument required. I'ltimately, after meeting with a fuither refusal from another doctor, Mr. Marshall secured a doctor who had got the necessary instrument and was willing to use it, but before the operation could be attempted Mrs. Mar"hill succumbed.

Before publishing the facts of the case the representatives of the Press called on Dr. Davies for any explanation he had to offer and the doctor, who admits that he is not very ready at expressing himself when called on unexpectedly, made a statement ol his position which was so unfortunately and unguardedly worded as to put his attitude in the very worst possible light with the jiubl.c and which theie is now good reason to believe was very far short of doing him justice. After explaining that he knew there was no use in his going without the instrument and that he considered his refusal would in\e>lve no hardship to the patient seeing that, as lie suppose d, theie were plenty of other medical men willing and ready to act, he proceeded to add these unfortunate words : ' I consider that my skill is my own property, and that r should not be compelled to dispense with it. As a matter of fact 1 cannot be compelled to di-pen^-e with it. You may dra^ a horse to the water, but >ou cannot force him to drink If lam compelled to go to a case 1 cannot be compelled to use my skill upon it. Supposing 1 had gone under compulsion, does it necessarily follow that the patient would get the benefit of my skill ? If "i had gone under protest, as would have been the ease if I went at all, I should have felt very uncomfortable.' Taken in their strictest sense these woids describe an attitude which is altogether indefensible and which is opposed to the plainest dictates of humanity. One alter another of Dr. D v ies' patients, however, have come forward to testify that he is as a doctor the personification of <h idleness and kindness, so that it is practically certain that he was not, m the foregoing word';, describing hi-, o*vn person .1 attitude but was merely making a general statement to the (fleet that it a doctor weie compelkd against his will to attend in such a case II j t : 1 . - would be gamed seeing that, though \ou nn^hl, by some form of compulsion, force him to be piesent, vt v could never compel him to u-e to the full the special personal skill he might happen to |„>sst ss. Unfortunately the general public are not in the habit of stop. ping to diaw nice di^tn etions. In tins c i^t tl'cy took the woids in tlicir most obviou-. ;>nd nio^t ol>ii<ti >n ib!e sense and <i perfect storm oi n.diynati n vv.is a'ciM-o. lln pipus were full of letteis from mtligna t wwts .md homhed J u^b mds, several of the letteis be.ng o I- nsivcly peisuiial and moie ihnn one going the length ol u.;s_ctling per onal vio'enee to the

offender. Eventually Dr. Davies made a further explanation pointing out that the nature of the instrument asked for indicated that the case was not one of extreme urgency, and practically disavowing the interpretation which had been put upon his words, and the ebullition of popular feeling on the matter has now almost subsided.

There are two questions which naturally arise out of this incident, namely, what is the extent of.Dr. Davies' personal culpability in the matter looked at in the light of common sense and common humanity, and secondly, Is the attitude which was attributed to him permitted by the regulations of the Medical Association, and generally approved by the profession. As to the first, it is beyond question that Dr. Davies, first statement of his position, as quoted above, even looked at from the most charitable stand-point, was most unfortunate and ill-advised. Dr. Davies undoubtedly committed a grave blunder and he has suffered for it. It may be pointed out in mitigation of further punishment that amongst all who have had professional dealings with Dr. Davies he bears the reputation of being particularly gentle and humane so that his whole life gives the lie to the harsher interpretation of hiE words ; that he had consistently declined to consult with the homeopath doctor ever since the latter had come to Dunedin ; that he did not possess the instrument required and as he intimates that he has never used the instrument during the whole course of a very extensive practice it is not unreasonable to assume that he might have had some hesitation, if not actual scruples, about performing an operation which, as is shown in another column, is unequivocally condemned by the Catholic Church; and finally that he has expressly disclaimed the ugly construction which had been put upon his words and has practically apologised for ever having uttered them. The case has yet to go before the medical tribunal and under all the circumstances the public may now very safely leave it there. As to the position of the Medical Association in the matter and of the profession generally that has been satisfactorily vindicated by the publication, at the instance of the Association, of the rule governing the conduct of the profession with regard to homeopaths. It is contained in the Code of Medical Ethics (adopted by the New Zealand Medical Associatian) and is as follows :— 'There is no profession in the National Code of Ethics in anywise inconsistent with the broadest dictates of humanity, and that the article of the code which relates to the consultations cannot be correctly interpreted as interdicting, under any circumstances, the rendering of professional services whenever there is a pressing or immediate need for them. On the contrary, to meet the emergencies occasioned by disease or accident, and to give a helping hand to the distressed without unnecessary delay, is a duty fully enjoined on every member of the profession, both by the letter and by the spirit of the entire code.' That is all that could be desired, and if the profession act up to the spirit of that regulation there will be little ground for complaint. Moreover, the President of the Association has, in a very temperate letter, expressly repudiated the objectionable sentiments in Dr. Davies' statement, and has given a distinct assurance that the Association do not consider that, m the event of any person calling on a doctor at any hour, it is right that he should be sent lrom door to door until such assistance is obtained.

Disagreable as the outcry has been for the particular doctors concerned, there can be little doubt that the exhibition of public feeling in this matter will do a great deal of good. It may not, indeed, lead, as was at first anticipated, to legislation on the subject nor to the establishment of any Government institution for securing the supply of medical aid in extreme and urgent case-,. It will sccuie much the same result, however, by hardening up public feeling on the subject. It will show the medical profession that they are, after all, just as amenable to the pressure of public opinion as any other section of the community, and that it they disregard in any flagrant way the dictates of charity and humanity, they will very speedily be brought to book. In Dunedin, at least, the public may feel sure there will be no cases of discourtesy or incivility from the doctors for a considerable time to come.