Limits...
Thinking otherwise: Royal Victoria Hospital, Wednesday 26th September 2012.

Bell PM - Ulster Med J (2013)

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Affiliation: Consultant Physician, Royal Victoria Hospital, and Honorary Professor of Medicine, Queen's University of Belfast, Grosvenor Road, Belfast BT12 6BA.

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I attended my first Annual Oration in the 1970s having been led there by Dr John S Logan... I won’t name the orator that year, but I do not recall finding it all that compelling... It appears he just went round Athens talking to people... It is strange how disturbing those in authority found logical argument... It is understandable for frustrated patients, with chronic or incurable illnesses, or with symptoms which doctors have failed to acknowledge or explain, to turn to alternative medicines and unorthodox practitioners... In 1946 twenty doctors and three administrators were charged with war crimes and crimes against humanity for their part in the human experimentation in the Nazi concentration camps... The defence argument was that they were engaged in necessary wartime research and that they were following the orders of their superiors... Steven Miles has told us that at prisons in Abu Ghraib, Iraq and Guantanimo Bay, Cuba “at an operational level, medical personal evaluated detainees for interrogation, and monitored coercive interrogation, allowed interrogators to use medical records to develop interrogation approaches, falsified medical records and death certificates and failed to provide basic medical care. ” The Red Cross accused physicians of flagrant abuses of medical ethics... I don’t equate the Nazi doctors with those in Iraq or Cuba in any scale of evil, but it is clear that the modern doctor must remain vigilant This applies in today’s NHS in the form of so-called “whistleblowing” with respect the practice of either an individual colleague or an organisation... In the aftermath of the Mid Staffordshire NHS Foundation Trust scandal, the House of Commons Medical Committee called on the General Medical Council to send out a clear signal to doctors that they are as much at risk of being investigated for failing to report concerns about a fellow doctor as they are from poor practice on their own part... In the introduction to his book “Tyranny of Health” he states “On a bitterly cold February day in the winter of 1987 I had to break into the house of an elderly couple who had succumbed to a combination of infection and hypothermia... While I waited for the ambulance I found unopened on the doormat, a copy of the government’s “Don’t die of ignorance” leaflet which has been distributed to twenty-three million households as part of the campaign to alert the nation to the danger of AIDS... The Appeal Court judges drew on the statement of Judge Easterbrook of the US Seventh Circuit Court of Appeals; “scientific controversies must be settled by methods of science rather than by the methods of litigation... More papers, more discussion, better data – not larger awards - mark the path towards superior understanding of the world around us. ” So, finally, how is the argumentative doctor to proceed? Perhaps most seriously Stockmann allows a degree of self interest to influence his actions which extend beyond the strictly medical.

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The Death of Socrates by Jacques-Louis David. With permission from the New York Metropolitan Museum of Art through the Images for Academic Publishing initiative.
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fig1: The Death of Socrates by Jacques-Louis David. With permission from the New York Metropolitan Museum of Art through the Images for Academic Publishing initiative.

Mentions: The Germans have a nice word “andersdenker”, one who thinks the other thought or thinks otherwise. In medicine, as in other walks of life, we should all be prepared to be, from time to time, andersdenker. History is littered with instances of great minds, and of course some not so great minds, who have run up against the prejudice of established opinion whether that opinion is held within cliques, oligarchies, majorities or even, sad to say, within democracies, for it was they, the democrats in Athens in the 5th century BC, who sentenced Socrates to death – as depicted by Jacques-Louis David in this picture now hanging in the Metropolitan Museum of Art in New York (figure 1).


Thinking otherwise: Royal Victoria Hospital, Wednesday 26th September 2012.

Bell PM - Ulster Med J (2013)

The Death of Socrates by Jacques-Louis David. With permission from the New York Metropolitan Museum of Art through the Images for Academic Publishing initiative.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3756869&req=5

fig1: The Death of Socrates by Jacques-Louis David. With permission from the New York Metropolitan Museum of Art through the Images for Academic Publishing initiative.
Mentions: The Germans have a nice word “andersdenker”, one who thinks the other thought or thinks otherwise. In medicine, as in other walks of life, we should all be prepared to be, from time to time, andersdenker. History is littered with instances of great minds, and of course some not so great minds, who have run up against the prejudice of established opinion whether that opinion is held within cliques, oligarchies, majorities or even, sad to say, within democracies, for it was they, the democrats in Athens in the 5th century BC, who sentenced Socrates to death – as depicted by Jacques-Louis David in this picture now hanging in the Metropolitan Museum of Art in New York (figure 1).

View Article: PubMed Central - PubMed

Affiliation: Consultant Physician, Royal Victoria Hospital, and Honorary Professor of Medicine, Queen's University of Belfast, Grosvenor Road, Belfast BT12 6BA.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

I attended my first Annual Oration in the 1970s having been led there by Dr John S Logan... I won’t name the orator that year, but I do not recall finding it all that compelling... It appears he just went round Athens talking to people... It is strange how disturbing those in authority found logical argument... It is understandable for frustrated patients, with chronic or incurable illnesses, or with symptoms which doctors have failed to acknowledge or explain, to turn to alternative medicines and unorthodox practitioners... In 1946 twenty doctors and three administrators were charged with war crimes and crimes against humanity for their part in the human experimentation in the Nazi concentration camps... The defence argument was that they were engaged in necessary wartime research and that they were following the orders of their superiors... Steven Miles has told us that at prisons in Abu Ghraib, Iraq and Guantanimo Bay, Cuba “at an operational level, medical personal evaluated detainees for interrogation, and monitored coercive interrogation, allowed interrogators to use medical records to develop interrogation approaches, falsified medical records and death certificates and failed to provide basic medical care. ” The Red Cross accused physicians of flagrant abuses of medical ethics... I don’t equate the Nazi doctors with those in Iraq or Cuba in any scale of evil, but it is clear that the modern doctor must remain vigilant This applies in today’s NHS in the form of so-called “whistleblowing” with respect the practice of either an individual colleague or an organisation... In the aftermath of the Mid Staffordshire NHS Foundation Trust scandal, the House of Commons Medical Committee called on the General Medical Council to send out a clear signal to doctors that they are as much at risk of being investigated for failing to report concerns about a fellow doctor as they are from poor practice on their own part... In the introduction to his book “Tyranny of Health” he states “On a bitterly cold February day in the winter of 1987 I had to break into the house of an elderly couple who had succumbed to a combination of infection and hypothermia... While I waited for the ambulance I found unopened on the doormat, a copy of the government’s “Don’t die of ignorance” leaflet which has been distributed to twenty-three million households as part of the campaign to alert the nation to the danger of AIDS... The Appeal Court judges drew on the statement of Judge Easterbrook of the US Seventh Circuit Court of Appeals; “scientific controversies must be settled by methods of science rather than by the methods of litigation... More papers, more discussion, better data – not larger awards - mark the path towards superior understanding of the world around us. ” So, finally, how is the argumentative doctor to proceed? Perhaps most seriously Stockmann allows a degree of self interest to influence his actions which extend beyond the strictly medical.

Show MeSH
Related in: MedlinePlus