Doctor-Patient Relationship

Today, a patient can discuss his medical condition, prognosis and available treatment options with his physician. In fact, he can actively participate in his medical care. Compare this with the doctor-patient relationship at the beginning of the 20th century. In this relationship, the doctor was revered for his knowledge and the patient was simply expected to follow the doctor’s advice without question. This was the setting in which human experimentation first took place. In her book Subjected to Science, Susan Lederer describes the many abuses that occurred in human experimentation at the turn of the last century. An unequal doctor-patient relationship greatly contributed to the abuses in early human experimentation.

With the advent of human experimentation, physicians began to see their patients as objects of experimentation. Human experimentation, encouraged by the great advances in medicine in the late 19th century, inspired many physicians to become medical scientists. Several journals dedicated exclusively to the publication of original medical research arose at this time, requiring physicians to be empirical like true scientists rather than clinicians. Substantial human experimentation was inspired by the discovery of the germ theory of disease and by the development of new technologies like x-rays, and the stomach tube. For example, Henry Heiman, a New York pediatrician, describes in 1895 the successful inoculation of gonorrhea in several patients, making them the ultimate culture medium. X-rays were used to study the developing fetus as well the sequential growth of bones in infants and children without regard to long-term effects. Also, in 1921, physicians deliberately induced scurvy in otherwise healthy infants simply to study the progression of disease. These insensitive actions stemmed from a warped doctor-patient relationship, one in which the physicians abandoned their patients’ trust and treated them as objects of science rather than...