Service, not Servitude
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. . .That syphilis will convert a Caucasian child into a Mongoloid, however, is a statement ethnologists will hardly accept without further proof. The comparison, indeed, is entirely superficial and misleading . . .
Palmer JF. (Correspondence) A Question of Conscience. Br Med J. 1895;2(1814):870.
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We have received so many letters on this subject, containing, often, repetitions of arguments already used by other correspondents, that we find it impossible to publish all. We print below abstracts of some of the communications.
The Author of Mona Maclean thinks that not many practitioners of her sex will agree with Miss Kenealy’s views. . . .
Surgeon-Captain O’Callaghan, A.M.S., congratulates Miss Kenealy -on her courage in formulating in written words one of the many questions of conscience that have perplexed many minds. . .
Mr. Lawson Tait (Birmingham), while thinking Miss Kenealy quite wrong in her line of action, finds ” T. C. A.’s” letter inconclusive and not philosophic. . .
E. E. W., writing as a woman, dependent on the honest and straightforward dealing of medical men, asks whether, in the case instanced by Miss Kenealy, it was not wrong to withhold treatment from the mother. . .
Mr. A. G. S. Mahomed (Bournemouth) considers that in the case instanced by her, Miss Kenealy failed in her duty, since, though she thought mercurials would improve the mother’s condition, she failed to prescribe them. . .
Mr. T. E. Constant (Scarborough), writing as one who is not a medical practitioner, is stirred by a perusal of Miss Kenealy’s letter to inquire whether ladies are fit for a profession so severely practical as that of medicine. . .
BMJ. (Editorial) A Question of Conscience: BMJ comment. Br Med J. 1895;2(1814):870-871.
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Miss Kenealy is a lady who possesses the courage of her convictions, for few of her brother practitioners will regard her action as anything but morally indefensible. To purposely refrain from interfering to prevent abortion does not differ in principle from actively bringing it about, and the question she has raised resolves itself into whether it is justifiable in the interest of the child to procure abortion when the parents are syphilitic. If we admit the justifiability of abortion in these cases, we must also admit that it is justifiable . . . whenever there is a chance that the child will inherit any tendency to disease-a radical method of eliminating unhealthy strains in the race. As doctors we must regard life as sacred, and it is our plain duty to strive to save or prolong life as long as we can . . . and only when another life is threatened are we justified in contemplating any measure which will destroy life. Whether the life we are striving to save is or is not of value has nothing to do with us.
Welsford AG. (Correspondence) A Question of Conscience. Br Med J. 1895;2(1813):807.
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” A Question of Conscience ” opens up the very important question as to how far any individual has the right to make himself the judge of whether or not another human being is fit to live, and to withhold from him his chance of living. To do so is to accept a responsibility which to my mind is far beyond that which any man or woman individually should assume. . . The mother of the foetus in question trusts to the honour of her medical attendant to give both her and her child the best chances of life and health available; and whatever may be the opinion of Miss Kenealy of the exact degree of value of mercury as a ” cure ” for the disease, being convinced, as she seems to be, that it is the one drug offering any chance of improvement, however little, she will in my opinion be neglecting an obvious duty both to her patient and to society if she fails to make use of it.
RE. (Correspondence) A Question of Conscience. Br Med J. 1895;2(1813):807-808.
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I explained to her the cause and said ” You will have another dead child, then I shall treat you and you shall have a living one.” Now comes the question of conscience. ” Why not now ?” she asked. ” Because it is not expedient that the child at present in your womb should live.” I considered that no treatment could make such a change in it as to make life anything but a curse. Between seven and eight months she was again delivered of a dead child. I then put her under mercurial treatment. In twelve months she had a perfectly healthy son. I put this son under mercury for twelve months, keeping up the mother’s treatment uninterruptedly for three years. She had three more perfectly healthy children in rapid succession, which were not treated separately. Two years ago I visited the town and found them out and four better grown, better looking (they had all their mother’s beauty) or more intelligent young men and women you could not find in their station in life, two were married and had healthy children. . . Miss Kenealy’s conscience and mine, I think, are at one on the question.
Ormsby J. (Correspondence) A Question of Conscience. Br Med J. 1895;2(1813):806.
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The doctrine that we may determine who are fit to live and who are not-for this is what her practice really comes to has for some time past been abandoned by civilised nations, and although the race would doubtless be improved if the doctrine could be successfully applied, it is, apart from other considerations, too dangerous a one, for man and woman too is prone to err.
JNC. (Correspondence) A Question of Conscience. Br Med J. 1895;2(1813):807.
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In view, therefore, of our uncertainties and of our defective insight as to the present and of our absolute blindness as to the future I would say, that if we have the power of checking these abortions, it will be wise, and therefore right to exercise that power. And that we do possess by various means such a power, I have no doubt in a considerable number of cases. . . But the principle underlying our rule of action here discussed is of far wider application than to the case of abortions, for, if it be right to suspend treatment in what we guess to be Nature’s wisdom, so we should, in the event of Nature’s apparent failure, be wise in interfering in the opposite direction, and to this end adopt measures to cause and assist Nature to expel its contents, which we guess to be in a damaged condition; but this, my experience has shown, would in the long run be destructive of a considerable number of foetuses that might, for ought we know, have become ornaments and useful members of society. And so, how can we logically limit this principle to the treatment of abortions alone? Why not apply it to the newborn infant which to us seems to be ineligible to live, and in the poor morsel of being, described only too truly, why not refuse it succour; and why not assist it out of its troubles in a dream of euthanasia? and the limit cannot rest here; we must apply the principle through all medicine and surgery; and not least in mental diseases. Where can we stop?
Hicks JB. (Correspondence) A Question of Conscience. Br Med J. 1895;2(1813):805-808.
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The sight of such an unfortunate child could not fail to produce the deepest compassion, and even indignation, when one records the fact that syphilis is a preventable disease, but when this induces Dr. Kenealy to tear up her prescription surely it is mere continentalism, and also a running away from the bounden duty of relieving the unhappy mother and yet unborn child, to save whom she was called in.
Biggs M. (Correspondence) A Question of Conscience. Br Med J. 1895;2(1813):806-807.
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A physician is called in to a pregnant woman in whom abortion threatens. The disturbance is found to be due to syphilis. The physician retires to another room . . .to write a prescription. There she sees a child of the same woman which she finds to be diseased. . . . the physician, finding the child an uncomfortable object, deprives the mother of the antidote prepared for her in order that the foetus in utero may abort. . . Miss Kenealy will no doubt admit that it is constructively the same thing as to procure abortion. . .I think Miss Kenealy’s attitude is defective.
TCA. (Correspondence) A Question of Conscience. Br Med J. 1895;2(1812):746-747.
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(Letter explains why she declined to treat a pregnant woman for syphilis, prevent spontaneous abortion). Nor can mercury by any possibility so affect the evolutionary impulse of an embryo as to carry it beyond the type Mongolian. For it would seem that the effect of syphilis is to retard evolution in such wise that from Caucasian parents an offspring characteristically Mongolian results-and that not a healthy but a maimed Mongolian. . . I could not persuade myself that the prevention of abortion by mercury argues that mercury is capable of bringing an embryonic child up to the desired human standard. I could not hope that its administration would do more than so enfeeble the mother’s physical conscience, and render it so insensate that it would fail to repudiate that which it was the bounden duty of its evolutionary instinct to repudiate.
Kenealy A. (Correspondence) A Question of Conscience. Br Med J. 1895;2(1811):682.