The
The Workers' Newspaper of Administrative Medicine and Institutional
Life, Administration. National Insurance and Health.
^o. 1493, Vol. LYII. SATURDAY, JANUARY 30, 1915. PRICE ONE PENNY.
CIVIL HOSPITALS AND MILITARY OFFICIALS.
painful and unhappy incident is reported from
l^e Longford County Infirmary. It appears that
?n December 13 last Sir Thomas Myles, who has
eeii appointed Surgeon to the Forces in Ireland,
^ e*it to the infirmary in order to perform an opera-
tion for appendicitis on a soldier, and that Dr.
Uayne, who is in charge of the infirmary, refused
k? grant the use of the operating theatre unless
e himself performed the operation. Thereupon the
Patient was taken by motor-car to Dublin, where
e Was operated on at the Richmond Hospital.
uk>sequently the event came before the infirmary
^mittee in the shape of a complaint from the
^arl 0f Granard, K.P., colonel in command of a
?*ttalion of the Royal Irish Regiment stationed at
. ?ngford, and presumably, therefore, responsible,
a military sense, for the soldier whose appen-
Cltis led to the above unfortunate dispute. After
^bate, the infirmary committee decided that Dr.
dyne's action was indefensible, and, by a
^ Jority, a resolution was carried dismissing him
0lfi the control and charge of the hospital. Ob-
. Usly the incident has public as well as profes-
nsl aspects. The issue is not so simple as many
thay be likely to consider it, and a careful study of
e facts is necessary if an impartial judgment is
^ be secured. Here we make no pretence to
^ y knowledge of the occurrence other than can
e Earned from the public prints, and it is to
**ons of principle alone that we propose to
ress ourselves.
c vhen two medical practitioners fall into open
jud r?Versy on some point of procedure, the general
,0 S^ent is that the quarrel in essence is a dispute
in^erPretation of some authoritative and
eti *^e^nec^ code of rules known as professional
This will no doubt be the public impres-
^ ln the present case. As a matter of fact,
are no formal laws governing professional
tiec^l0llS' on^ certain principles which it is
0 ,e8sary to recognise in the interests not of doctors
U ;but also of patients. Now the first of these
is that the welfare of the sick man is
die * consideration. In the instance here under
u98ion it is certain that this principle was neg-
lected, for an unnecessary journey in a motor-car
is not a proceeding likely to promote the welfare of
a patient suffering from appendicitis. Eather, there-
fore, than subject the soldier to such a risk,
either Sir Thomas Myles or Dr. Mayne should
have yielded in the dispute. In our opinion,
the stronger claim in this direction fell upon
Dr. Mayne, and we think that, in refusing the use
of the hospital theatre, he made an error of judg-
ment. Even though, according to a somewhat
sarcastic legal maxim, we run a risk by so doing,'
we will give our reasons for this conclusion. In
the first place, the patient was a soldier, and Sir
Thomas Myles, in view of the appointment he holds,
could not divest himself of some measure of official
responsibility for the adequate performance of the
proposed operation. It is, of course, beyond ques-
tion that he himself was abundantly competent to
undertake the case, and his standing and repute
as a hospital surgeon of experience and skill must
have been perfectly well known to Dr. Mayne. For
anything we know to the contrary Dr. Mayne also
may have considerable surgical experience and skill,
but it by no means follows that certainty on this
point was possessed by Sir Thomas Myles, with
whom, as we have already said, official responsi-
bility for the proper care of the sick soldier in a
greater or less degree undoubtedly rested. In the
second place, we think Dr. Mayne might prudently
have recognised that existing circumstances make
the public judgment particularly sensitive in rela-
tion to any action which may appear harsh and un-
sympathetic towards a member of the Army on
whose valour our dearest interests depend; and he
might have felt sure that public opinion would be
alienated by any action in which the interests of a
suffering soldier were sacrificed for a scruple of
professional dignity. It was open to him to have
registered his protest at the time, and later to have
raised the whole question for public and professional
discussion. 'Had he taken such a course, we believe
he would have commanded a considerable body of
support. The decision of the committee, dismissing
Dr. Mayne from his hospital position, we regard as
wholly in excess of the necessities of the position,
and we hope that the Local Government Board will
390 THE HOSPITAL
not confirm it. Sucli a penalty is not the appro-
priate discipline for what was at most an error of
judgment.
A large question raised by the dispute involves
the relation between the civil hospitals and the mili-
tary authorities. These hospitals have their duly
appointed staffs, who are responsible for the proper
treatment of the patients placed under their care,
in the present juncture, some of these patients are
sick and wounded soldiers. Is the authority of the
ordinary staff to be superseded whenever there may
arrive on the scene a gentleman boasting a military
commission? If such is the official doctrine, it is
time it were most strenuously challenged. Our
civil, hospitals are most freely at the disposal of the
War Office in so far as they are needed, but if the)'
are to be utilised in this fashion their domestic
and internal management must be free from inter*
ference. The "War Office can, of course, comma11'
deer the hospitals, and thus can become fully re'
sponsible for their control. But it cannot lea?e
the hospital committees and staffs to bear responsi-
bility, and then, in occasional instances, supersede
their authority by the invasion of a military official-
The Longford incident illustrates the impossibility
of such a position, and so far as Dr. Mayne's actio11
is a protest against it we sympathise with hin1'
though, for reasons already given, we think he was
led into error in dealing with the circumstances ol
the individual case.


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