Austin O'malley

Essays in Pastoral Medicine Austin O'malley

T HE term Pastoral Medicine is somewhat difficult to define because it comprises unrelated material ranging from disinfection to foeticide. It presents that part of medicine which is of import to a pastor in his cure, and those divisions of ethics and moral theology which concern a physician in his practice. It sets forth facts and principles whereby the physician himself or his pastor may direct the operator's conscience whenever medicine takes on a moral quality, and it also explains to the pastor, who must often minister to a mind diseased, certain medical truths which will soften harsh judgments, and other facts, which may be indifferent morally but which assist him in the proper conduct of his work, especially as an educator. Pastoral medicine is not to be confused with the code of rules commonly called medical ethics. The material of pastoral medicine requires constantly renewed discussion, because medicine in general is progressive enough frequently to devise better methods of diagnosis and treatment, and thus the postulates of the moral questions involved are changed. This discussion, however, is not easily made. The facts upon which the ethical part of pastoral medicine rests are furnished by the physician for the consideration and judgment of the moralist ? the physician educated after modern methods knows little or nothing of ethics and can not himself make accurate moral decisions. The moralist, on the other hand, is commonly a poor counsellor to the physician, because long training in medicine is needed before the physical data of the moral decisions is comprehended. The physician, therefore, is at a loss to determine what he mayor may not do in cases that involve the greatest moral responsibility, and the priest is a hesitating guide because the moral theologies do not convincingly present the doctrine in these cases. Now and then such subjects have been proposed for discussion to a group of physicians and moralists, but usually no practical conclusion has been reached because one side did not understand the other. In 1898 there was a series of articles on ectopic gestation in the American Ecclesiastical Review, in which moralists like Lehmkuhl, Sabetti, Aertnys, and Holaind, and some of the leading gynaecologists of America considered the questions but arrived at no decision. The physicians did not understand certain questions, other questions were on obsolete medical practice, essential questions were omitted, and from the data the moralists came to opposed conclusions. We find also in moral theologies deductions drawn from false medical sources. Reasons are given, for example, to justify the use of a large quantity of alcoholic liquor at a dose in cases of great pain, typhoid fever. snake-poisoning, and other diseases, in the supposition that such doses will benefit or cure the patient, whereas the physician that would follow that treatment would be guilty of malpractice. There was recently in America a discussion on the relation of oophorectomy to the impedimentum impotentiae. One side held that a lack of ovaries con5titutes impotence; the other side, that it does not. The discussion was useful because it incidentally gathered the full doctrine of the moralists on this subject, but from the medical point of view there is no connection whatever between these conditions. Some may think that the authors are inclined toward an exaggerated charity in suggesting the measure of responsibility for many human actions, but the physician that is brought much in contact with those suffering from mental defects of various kinds soon learns how easily complete responsibility becomes marred.