9B: Medical Ethics
Lutheran approaches towards medical uncertainty in the early twentieth century
University of Eastern Finland, Finland
From the introduction of the research university at the end of the nineteenth century, the balance between ‘medicine as an art’ and ‘medicine as a science’ gradually passed over to a purely ‘objective’ approach of medicine as a natural science. However, even the continuously succeeding breakthroughs in medical science never could and will be able to take away uncertainty completely in clinical decision making and therapeutic treatments.
Certainly in comparison to, for instance, the Catholic Church, the long-term acceptance of so-called modern medicine happened much more smoothly within the Lutheran Church. However, this absolutely did not mean that for physicians raised and educated in a Lutheran environment, their religious background was irrelevant. Lutherans generally favour(ed) open communication between caregiver and patient. Assuming a position of equality, the relationship between patients and health care providers had to be a partnership of trust.
How, in such kind of doctor-patient relationships, questions of uncertainty have been dealt with? How (Lutheran) physicians were taught to confront their patients with the fact that diseases are seldom black and white, and why it was sometimes preferred to hide the medical truth, since after all finally “one’s fate was in the hands of God”? By studying a large variety of educational documents from professors and students at the University of Helsinki we will offer a view on the possible impact of the Lutheran religion and the physicians’ personal religious views when dealing with medical uncertainty in education (and in their practical work), during the early twentieth century.
Balancing Knowledge Reliability and Ethical Acceptability at the Moscow Institute for New Antibiotics, 1950s-1970s
1HSE University St. Petersburg, Russian Federation; 2Siberian State Medical University, Russian Federation
Between the 1950s and the 1970s, the Moscow Institute for New Antibiotics developed a number of innovative drugs that were supposed to treat a range of different conditions. These findings were not only confined within the scientific realm proper but were also reported in the Soviet popular press. This unexpectedly became a source of much controversy in 1958, when an illustrated journal Sovetskii Soiuz (available globally in over a dozen languages from Finnish to Urdu) published an article about the Institute’s work directed at the development of drugs against cancer.
Within a few months, the office of received dozens of letters from desperate and frustrated readers from all over the Soviet Union and even from abroad. These readers (or, in many cases, their relatives) were usually suffering from final-stage cancer and were desperate to get any medicine that could potentially improve their condition. They were explicitly challenging Soviet scientists to abandon the complicated bureaucratic procedure for drug testing and to send them their experimental drugs, since, in the words of one reader, ‘death is near anyway’ (vsë ravno skoro smert’).
The Institute’s leadership, therefore, was confronted with a difficult task of balancing scientific reliability and ethical acceptability in practice. In the paper, we draw on archival and oral history materials to narrate the untold story of the dilemma that the scientists faced within the context of medical research ethics, Soviet bureaucratic procedures and mid-20th century mediality and use this case to problematize and historically situate the notion of ‘patient-centered care’.
"Vera Fautrix Eugenicae": Medicine, Physicians, and the Catholic Way to Eugenics
Università del Piemonte Orientale, Italy
The paper explores approaches and attitudes of European Catholic physicians towards eugenics in early 20th century. The debate about eugenics involved not only medicine and biology, but also demography, politics, culture, society. The eugenics studies produced debates and resistances, especially within the Catholics. Their opposition were scientific, medical, political, and theological: they criticized the lack of scientific basis in some eugenic hypotheses and defended the human freedom from the interventions of the governments, to preserve the social, moral, and political influence of Catholicism. Catholics opposed mostly towards the Nordic current of eugenics, spread in the Anglo-Saxon, German world, characterized by the idea of the need of an artificial selection of the humankind through strong interventions (sterilization, abortion, birth-control). A Latin current of eugenics based mostly education, prevention and demographic increase, and spread in Catholic Europe and Latin America, obtained consideration in part of the catholic movement, for example the Franciscan physician Agostino Gemelli. Rejecting the negative eugenics policies, Gemelli and other Catholic physicians and scientists (Fallon, Muckermann, Viollet, etc.) approved and embraced the Latin eugenics, stating that the Christian morals represented the effective eugenic principle. A Catholic medicine and its medical and biological argumentations played a key role. Catholic physicians tried to build a Catholic way to eugenics, in accordance with the Faith, and gain a public recognized role in the eugenic debates. The paper examines the the contributions of Catholic physicians in building a scientific and medical opposition to the Nordic eugenics and in shaping a Catholic eugenic approach.