Medical misadventure in an age of professionalisation, 1780–1890 by Alannah Tomkins

Author:Alannah Tomkins [Tomkins, Alannah]
Language: eng
Format: epub
Tags: Medical, History, Modern, 19th Century, Social History, General
ISBN: 9781526116109
Google: XHG5DwAAQBAJ
Publisher: Manchester University Press
Published: 2017-07-21T22:16:45+00:00

Conclusion

In cases of neglect under the poor law, structural conditions ‘allowed the perception of responsibility towards the pauper to be passed about between officials like the proverbial hot brick’, but this was also permitted by emergent medical ethics that were driven by uncertainty and competition as much as disinterest.139 To some extent it was a weakness in the emergent professional persona that enabled aggression and finger-pointing on the part of the poor-law authorities. At the same time, the poor law offered practitioners the scope for charges of neglect against each other, which veiled self-interest in public spirit wherever treatment of a pauper, or a failure to serve the guardians adequately, could be cited. Misdemeanour under the poor law did not tend to offer the opportunity to levy manslaughter allegations, though, since these tended to cluster around deaths among obstetric patients and spanned a wider section of the social spectrum.

Neither charges of neglect nor manslaughter proved useful for schooling the incipient profession, whereas abortion charges were much more suitable for giving unequivocal signals to struggling doctors about the importance of professional (and by implication manly) probity. Nonetheless, the pressures of the medical market meant that these messages were not always heeded. A significant proportion of even the visible abortion trade was conducted by fully-qualified men, at least a proportion of whom were motivated by money. A desire to remain solvent won out against allegiance to professional strictures or sub-textual appeals to masculine disinterest.

Charges of neglect, manslaughter, and abortion collectively illustrate the risks and frustrations associated with rising expectations both inside and beyond the profession. These expectations are best detected in the frequency of quotes from practitioners driven to exasperation and then reported verbatim; the implication of such reporting practice is that readers were being invited to agree that all such expressions were inappropriate or reprehensible.

Even so, public reaction to practitioner prosecution ran the gamut from sentimental support for doctors to violent opposition. The reaction to Heap in Manchester is particularly telling, since it points to a deep disparity between patient and marketplace requirements, for reliable access to efficient abortion, and professional discourse, which severely deprecated the termination of pregnancy. It is perhaps ironic that this divergence seems less pronounced in the case of allegations of sexual assault and murder, covered in the next chapter. Professional and lay popular opinion seem to have been closer together, if not entirely coincident, in these latter types of felony.

Notes

 1  See also Chapters 4 and 6.

 2  I.A. Burney, Bodies of Evidence. Medicine and the Politics of the English Inquest 1830–1926 (Baltimore and London: Johns Hopkins University Press, 2000), pp. 4–6.

 3  Burney, Bodies of Evidence, p. 6.

 4  Burney, Bodies of Evidence, chapter 2; P. Fisher, ‘The Politics of Sudden Death: The Office and Role of the Coroner in England and Wales, 1726–1888’ unpublished PhD thesis (Leicester University, 2007), chapter 4. The Lancet's commitment to Wakley's campaign outlived him; Fisher, ‘Sudden Death’, p. 98.

 5  Burney, Bodies of Evidence, p. 149.

 6  They could, however, turn to the press. See,

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