The Ethics of Medical Homicide and MutilationO'Malley, Austin
Religion
The Ethics of Medical Homicide and Mutilation
O'Malley, Austin
Medical ethics
Cold and hot baths, Turkish and Russian baths, hot sitz-baths and
ocean bathing are not permissible during gestation. Tepid baths and
spongings are to be substituted. Near term the bath-tub is not safe
because of danger of uterine infection from unclean water. Then
shower-baths are better, but these are dangerous if the woman must
step over an enameled bath-tub side to take them, because she may
slip and fall. Vaginal douches are not to be used in pregnancy except
in certain diseased conditions, under the direction of a competent
physician.
Therapeutic abortion and therapeutic induction of premature labor are
employed in five chief groups of conditions: (1) contracted pelvis;
(2) diseases caused by pregnancy; (3) diseases coincident with
pregnancy; (4) habitual death of the child after viability but before
term; (5) prolonged pregnancy. There is no such act as therapeutic
abortion of an inviable child; all abortions of inviable children,
when direct, are criminal, and nothing criminal is therapeutic. The
consideration of narrow pelvis, and the diseases caused by pregnancy
and coincident therewith, will be treated in detail.
When the child dies after viability but before term the cause is
most commonly syphilis. In such cases a Wassermann reaction should
be made from both parents; and even if it is negative, and no other
definite cause for the fetal death can be found, syphilitic treatment
should be tried on the father and mother. Bright's disease, even when
scarcely diagnosable, anemia, diabetes, adiposity, and hypothyroidism
are other lethal causes of habitually still-born infants. Not seldom
the cause is in the husband. If he is an alcoholic (and two or
three drinks of whiskey a day make any man an alcoholic), if he is
especially susceptible to the toxin of tobacco (and tobacco alone may
render some men not only sterile but impotent), if he is a worker in
poisonous metals, an X-ray operator, a user of narcotics, exhausted
with overwork and worry, affected with weakening systemic disease,
his germ-cells are unfit for their function. Such men are not
technically sterile, but they are practically sterile.
Some women carry the child beyond term, with the effect that the baby
is overgrown for normal delivery. The head is harder and more angular
than it should be, the long bones stiffer and less pliable, the
muscles tenser. All these changes make the delivery so difficult that
the overgrown child may be fatally injured at birth. Physicians must
be cautious in believing histories of enormous children at previous
births at which they were not present. Mothers and nurses are likely
to exaggerate the size of infants.
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