The Doctors Dilemma: Preface | Page 2

cruelties in the pursuit of knowledge,
and justifies them on grounds which would equally justify practising
the same cruelties on yourself or your children, or burning down
London to test a patent fire extinguisher, but, when it has shocked the
public, tries to reassure it with lies of breath- bereaving brazenness.
That is the character the medical profession has got just now. It may be
deserved or it may not: there it is at all events, and the doctors who
have not realized this are living in a fool's paradise. As to the humor

and conscience of doctors, they have as much as any other class of men,
no more and no less. And what other men dare pretend to be impartial
where they have a strong pecuniary interest on one side? Nobody
supposes that doctors are less virtuous than judges; but a judge whose
salary and reputation depended on whether the verdict was for plaintiff
or defendant, prosecutor or prisoner, would be as little trusted as a
general in the pay of the enemy. To offer me a doctor as my judge, and
then weight his decision with a bribe of a large sum of money and a
virtual guarantee that if he makes a mistake it can never be proved
against him, is to go wildly beyond the ascertained strain which human
nature will bear. It is simply unscientific to allege or believe that
doctors do not under existing circumstances perform unnecessary
operations and manufacture and prolong lucrative illnesses. The only
ones who can claim to be above suspicion are those who are so much
sought after that their cured patients are immediately replaced by fresh
ones. And there is this curious psychological fact to be remembered: a
serious illness or a death advertizes the doctor exactly as a hanging
advertizes the barrister who defended the person hanged. Suppose, for
example, a royal personage gets something wrong with his throat, or
has a pain in his inside. If a doctor effects some trumpery cure with a
wet compress or a peppermint lozenge nobody takes the least notice of
him. But if he operates on the throat and kills the patient, or extirpates
an internal organ and keeps the whole nation palpitating for days whilst
the patient hovers in pain and fever between life and death, his fortune
is made: every rich man who omits to call him in when the same
symptoms appear in his household is held not to have done his utmost
duty to the patient. The wonder is that there is a king or queen left alive
in Europe.
DOCTOR'S CONSCIENCES
There is another difficulty in trusting to the honor and conscience of a
doctor. Doctors are just like other Englishmen: most of them have no
honor and no conscience: what they commonly mistake for these is
sentimentality and an intense dread of doing anything that everybody
else does not do, or omitting to do anything that everybody else does.
This of course does amount to a sort of working or rule-of-thumb
conscience; but it means that you will do anything, good or bad,
provided you get enough people to keep you in countenance by doing it

also. It is the sort of conscience that makes it possible to keep order on
a pirate ship, or in a troop of brigands. It may be said that in the last
analysis there is no other sort of honor or conscience in existence--that
the assent of the majority is the only sanction known to ethics. No
doubt this holds good in political practice. If mankind knew the facts,
and agreed with the doctors, then the doctors would be in the right; and
any person who thought otherwise would be a lunatic. But mankind
does not agree, and does not know the facts. All that can be said for
medical popularity is that until there is a practicable alternative to blind
trust in the doctor, the truth about the doctor is so terrible that we dare
not face it. Moliere saw through the doctors; but he had to call them in
just the same. Napoleon had no illusions about them; but he had to die
under their treatment just as much as the most credulous ignoramus that
ever paid sixpence for a bottle of strong medicine. In this predicament
most people, to save themselves from unbearable mistrust and misery,
or from being driven by their conscience into actual conflict with the
law, fall back on the old rule that if you cannot have what you believe
in you must believe in what you have. When your child is ill or your
wife dying, and you happen to be very fond of them, or even when, if
you are not fond of them, you are human enough to forget every
personal