The sun. [volume] (New York [N.Y.]) 1833-1916, 1896-11-29
RIGHTS OF THE SURGEON.
AN IMPORTANT MEDICAL QUESTION
IN A LONDON Ia AUIT
Cnn the Pntient Prescribe the Limits of
nn Operation Trad Telephone Service
The Motor Car Boon,-A Scotchmnn's

q point OF MS much public Importance as that at
issue In tho now famous Kitson-Playfair trial Of
last spring occupied the attic ution of q London
court for three days this week. A Judge and
Jury were asked to decide whether a surgeon is
Justified IN pursuing an operation beyond the
limits liked BY a patient, In other words, is 1t
a medical mans right or duty to override the
known wishes Of a patient, oven In the beet In
terests of tho health or life Of the sufTcrerf
The action was one brought by n hospital
nurse named Beatty against DIR. Charles ]. Gull
lingworth, an eminent London surgeon. The
defendant performed the operation OF double
ovariotomy upon Miss Bentty at st. Thomas's
Hospital two years ago. The plaintiffs case
was that she distinctly forbade the surgeon 70
go beyond the single operation. In consequence
OF his having exceeded his Instructions. abe had
been compelled by her conscientious scruples TO
break of her marriage engagement. Tho de-
fence was that sho had given at least tacit con-
sent to whatever operation might prove neces-
Snry. and that under the circumstance the
Doctors action was war; Rntablo aud Imperative.
The chief issue was unfortunately somewhat
obscured In tho course OF the trial. and the re-
cult WAS n practical vindication of the surgeon.
Public opinion. however, is by no means unani-
NOUS IN approving the verdict Some surpris-
Ing evidence was offered By several OF the most
prominent surgeons in England with regard to
the custom of tho medical profession. Not only
the defendant. hut such eminent surgeons as
Sir Thomas Spencer Wells. Lawson TAFT. and
other leaders of tho profession, affirmed that
they would refuse to perform any operation
under such n restriction as the plaintiff de-
c,nred she had imposed. The public will nat
urally regard this as a decidedly arbitrary posi-
tion for IL surgeon to assume. II such be tho
universal attitude of the profession, then every
rrnn who seeks the aid OF q surgeon must sub.
nit himself un:eservcdly to his knife or 20
without surgical assistance. In q case of hip
disease, for instance, the patient cannot have the
op;Ion TO forbid amputation II he submits to an
operation which Is expected to be merely for
the purpose OF examining the seat of the mis-
chief. The most simple operations may become
t's most serious upon the surgeons sole re-
si"nstpility, and the patient can make no COM
r!aiut, provided only that the operator has
acted according To his best judgment. Such Is
the nlitnite authority which the leaders OF
Inslish >urgcry demand before they will place
th":r skill ut the service of n patient. And IL
the 'rti''rrs, then Of course the most humble
n.stn er OF the profession as well, for 1t is ad-
n.i,tei that the rule must be universal.
In Miss Bestty's case II was admitted by DR..
tni'inrworth that on coming into the operating
room she forbade him to do more than the
single operation. He says that he replied that
SHE NUT leave that to his discretion. She do
lies that he made any such response. He argues
that she was not in n sufficiently calm frame of
mind to give any instructions at such n time,
and that taking her place upon the operating
taule was tacit consent TO his using his full dis
erection. He admits that when he found condi-
tions which. in his opinion, demanded the
double operation he hesitated and remarked to
his assis,auts:
Considering the patients wish. this case In
wolves serious complications. and l shall have
70 consider q bit" He decided on overriding
the patients wish In the interest of her health.
Sir Thomas Wells, perhaps the greatest ex-
pert in such cases. testified that. judging from
DIR. Cullingworth's notes of the case. he did not
think the double operation was necessary, but
lie had no doubt the doctor had acted con-
sc!eiciDusly. DR.. Cullingworth ana his as
tistant affirmed that the patients health and
life would both have boon irnperilled by failure
TO complete the operation. She might have lived
ten years, but the operation was absolutely
necessary for radical cure. Both Judge and
jury took DR.. Cullingworth's view of the case
and his duty with regard to it, and the verdict
was promptly in his favor.
But. as ! have said. there are two opinions
among the public in the matter. Tho editor of
the Duly Nctrs. for instance. remarks: After
all, the patients life is his own affair, and there
is no reason why he should be compelled by
doctors decree for the sake of life to lose what
makes life worth living" The point Is not
cirarly decided by the verdict In this case, hut
II Is likely t" be quoted in future as full author
ity for q surgeons ignoring at his pleasure any
instructions which q patient may undertake to
give him.
There are signs OF q coming telephone revolt
in Eng!and-not against the National Tele-
phOJe Company. which owns and operates tho
local exchanges in Great Britain and Ireland,
but against the Government management OF
~ trunk lines. The biggest Job in Parliament
during recent years was the passage OF the bill
for the purchase Of the telephone trunk lines
BY lii. Government. This branch of the tele-
phon. business proved utterly improbable to
the National Telephone Company. The corpor-
alton succeeded in unloading the service upon
the Gnvernmont at a scandBlously high price.
II WAS assumed. OF course, that II the Govern
m'ni could operate q Post ONCE and telegraph
sy.tem It would certainly be able TO manage q
telephone service efficiently. Experience thus
fr shows Just the contrary.
The nter-municipal service. when the lines
were under the control OF the National 1ele-
phone Company, was prompt and satisfactory.
Then the service between towns was compare
lively simple. Two subscribers in different
towns were put into communication directly
through their respective local exchanges. Now
81 n man in London wishes to speak with q man
IN Liverpool he calls up his own central oflce
and makes known his desire. The operator
t'crc Transmits the request tn the general Post
Office in London. That office. whom It gets
ready. communicates with the general Post Of
fics in Liverpool, and thence to the local tele-
pIone exchange In the latter city. and finally
the desired subscriber Is reached. Under the
old system such connections did not require
NOR" than two minutes. Tho Government
SEEM tn b: unable to accomplish II In less than
TWENTY-FIVE minutes. and often a much longer
time 10 occupied. 1t is even of recent record
that n call 70. a subscriber in another town,
given at 10 O'Clock in the mornlnR. was not put
through til 4:5o in the afternoon. No expla-
nation or excuse for this practical paralysis of
the telephone system under Government man
Rgement has been given.
The telephone has by no means become the
almost universal and popular institution In
England that 1t is In most countries. 1t Is not
possible In London, for instance. to call up your
butcher. grocer. doctor, or friend on the other