0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
JAMA 100 Years Ago |

THE QUESTION OF CRUELTY IN THERAPEUTIC OBSERVATIONS.

JAMA. 2000;284(10):1214. doi:10.1001/jama.284.10.1214-JJY00029-3-1.
Text Size: A A A
Published online

Extract

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.

Topics

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal

First Page Preview

View Large
First page PDF preview

Figures

Tables

References

CME
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

Jobs
brightcove.createExperiences();