Book contents
- Frontmatter
- Contents
- Acknowledgments
- Introduction
- Part I
- 1 Divided loyalties: harm to the profession vs. harm to the patient
- 2 Medical epistemology, medical authority and shifting interpretations of beneficence and nonmaleficence
- 3 Medical harms and patients' rights: the democratization of medical morality
- Part II
- Part III
- Appendix
- Bibliography
- Index
3 - Medical harms and patients' rights: the democratization of medical morality
Published online by Cambridge University Press: 22 September 2009
- Frontmatter
- Contents
- Acknowledgments
- Introduction
- Part I
- 1 Divided loyalties: harm to the profession vs. harm to the patient
- 2 Medical epistemology, medical authority and shifting interpretations of beneficence and nonmaleficence
- 3 Medical harms and patients' rights: the democratization of medical morality
- Part II
- Part III
- Appendix
- Bibliography
- Index
Summary
According to the Oxford English Dictionary, the term ‘iatrogenic’ was introduced in 1924 in Bleuler's Textbook of Psychiatry. An iatrogenic disease was one having a primarily psychological manifestation brought on by a physician's diagnosis. To be sure, the remarks of the physician were implicated in this definition, but the suggestibility of the patient was also regarded as a factor in the development of the illness. In his description of the natural history of a specifically iatrogenic neurosis, Bleuler explains that ‘the physician solemnly diagnoses “enlargement of the heart”, whereupon the patient is frightened and breaks down until the X-ray photograph resorted to by another physician relieves him of his nightmare’. Although it is not surprising to find psychiatric literature attributing a psychological etiology to ill health, the prevailing medical epistemology of the late nineteenth century also helps to explain this early conceptualization of iatrogenic illness. In the holistic interpretation of illness (and health) dominant throughout the nineteenth century and central to the early history of psychiatry, communication between doctor and patient was conceived as one among the many factors that could alter the patient's experience of well-being. Indeed, the AMA's (American Medical Association) 1847 Code highlights the potential risks of this verbal exchange in its observation that ‘the life of a sick person can be shortened not only by the acts, but also by the words or the manner of a physician.
- Type
- Chapter
- Information
- Medical HarmHistorical, Conceptual and Ethical Dimensions of Iatrogenic Illness, pp. 61 - 78Publisher: Cambridge University PressPrint publication year: 1998