{"id":46348,"date":"2019-12-31T11:04:03","date_gmt":"2019-12-31T10:04:03","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=46348"},"modified":"2020-01-08T12:23:08","modified_gmt":"2020-01-08T11:23:08","slug":"daniel-sokol-william-oslers-lasting-influence-on-medical-ethics","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2019\/12\/31\/daniel-sokol-william-oslers-lasting-influence-on-medical-ethics\/","title":{"rendered":"Daniel Sokol: William Osler\u2019s lasting influence on medical ethics"},"content":{"rendered":"<p><span style=\"font-weight: 400\">One hundred years ago, on 29<\/span><span style=\"font-weight: 400\">\u00a0December 1919, Sir William Osler died in Oxford from a haemorrhage following an operation to treat his empyema. He was 70. In his obituary of Osler in the <em>New York Evening Post<\/em> two days later, the celebrated haematologist Richard Cabot wrote: \u201c<\/span><i><span style=\"font-weight: 400\">I doubt if any single man has ever so deeply influenced any other profession.<\/span><\/i><span style=\"font-weight: 400\">\u201d The Royal Society of Medicine is currently putting on an exhibition in memory of Osler, described in the programme as the &#8220;father of modern medicine.&#8221;\u00a0\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">Since his death, dozens of books and thousands of articles have been written on Osler and his impact on many facets of medicine, from pathology to infectious diseases. This widespread influence is not surprising; Osler was one of the last &#8220;super generalist&#8221; doctors, having single handedly written the leading medical textbook <\/span><i>The Principles and Practice of Medicine<\/i><span style=\"font-weight: 400\"> in 1892.\u00a0\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">He certainly was no medical ethicist in the modern sense and once observed that he was \u201c<\/span><i><span style=\"font-weight: 400\">neither a philosopher nor the son of a philosopher.<\/span><\/i><span style=\"font-weight: 400\">\u201d Yet, his influence on the ethical standards of frontline doctors is likely to have been profound. You will still find doctors who will tell you how Osler\u2019s writings played a role in their professional development.\u00a0\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">However, based on my experience of teaching medical students and doctors, the ripples of his influence are fading. Mention Osler to a young medical audience today and you are likely to hear about Osler\u2019s nodes, those lesions that suggest a bacterial infection of the heart. The average age of members of the Osler Clubs and Societies of the world probably exceeds 60.<\/span><\/p>\n<p><span style=\"font-weight: 400\">In 2007, <a href=\"https:\/\/www.bmj.com\/content\/335\/7628\/1049.2.short\">I wrote provocatively in The <\/a><\/span><i><span style=\"font-weight: 400\">BMJ<\/span><\/i><span style=\"font-weight: 400\">:<\/span><\/p>\n<p><span style=\"font-weight: 400\">\u201c<\/span><i><span style=\"font-weight: 400\">I have long held the dangerous belief that William Osler\u2019s essays, judiciously used, could render teachers of medical ethics redundant.\u00a0 Virtually all the medical student needs for ethical behaviour is contained within them<\/span><\/i><span style=\"font-weight: 400\">.\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400\">Osler has had a lasting impact on my development as a medical ethicist and, later, as a lawyer. His encouragement to treat patients with infinite patience and without judgement, to stand up for principle and justice, to apply the Golden Rule of Humanity (\u201c<\/span><i><span style=\"font-weight: 400\">what you do not like when done to yourself, do not do to others<\/span><\/i><span style=\"font-weight: 400\">\u201d) and not to let \u201c<\/span><i><span style=\"font-weight: 400\">the ceaseless panorama of suffering dull that fine edge of sympathy with which we started<\/span><\/i><span style=\"font-weight: 400\">\u201d still rings true to modern ears. So too his emphasis on hard work, heeding the lessons of experience, and cultivating the heart just as much as the head. I try to apply those lessons\u2014with variable success\u2014in my own practice.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">Only last month, when representing a doctor who had acted benevolently towards a patient but in breach of guidelines, a line from Osler came to mind: \u201c<\/span><i><span style=\"font-weight: 400\">I have made mistakes, but they have been mistakes of the head not of the heart<\/span><\/i><span style=\"font-weight: 400\">.\u201d\u00a0\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">My client erred but it was a mistake of the head. Those are generally more amenable to correction than mistakes of the heart.<\/span><\/p>\n<p><span style=\"font-weight: 400\">Osler\u2019s influence on medical ethics, from 1919 to 2019, is unclear. To my knowledge, no book has been published on the subject. While medicine has changed enormously in the last century, and so too the context in which it is practised, I am convinced that much of Osler\u2019s writing, life, and work remains of value to the ethical and humane practice of medicine today.\u00a0\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">If unfamiliar with Osler, do consider a visit to the RSM\u2019s exhibition in London<\/span><span style=\"font-weight: 400\"> (open until 1<\/span><span style=\"font-weight: 400\">st<\/span><span style=\"font-weight: 400\"> February 2020) or Osler\u2019s former home at 13 Norham Gardens in Oxford<\/span><span style=\"font-weight: 400\">, read the excellent biography by Michael Bliss (\u201cWilliam Osler: A Life in Medicine\u201d)<\/span><span style=\"font-weight: 400\"> and start with Osler\u2019s essays with annotations by the Japanese Oslerians Dr Hinoara and Professor Niki<\/span><span style=\"font-weight: 400\">.<\/span><\/p>\n<p><i><span style=\"font-weight: 400\"><strong>Daniel Sokol<\/strong> is a medical ethicist and barrister at 12 King\u2019s Bench Walk.\u00a0 He is a former Council Member of the Osler Club of London and the author of \u2018Tough Choices: Stories from the Front Line of Medical Ethics\u2019.<\/span><\/i><\/p>\n<p><em><strong>Competing interests<\/strong>: None declared.<\/em><\/p>\n<p><span style=\"font-weight: 400\">\u00a0\u00a0<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>One hundred years ago, on 29\u00a0December 1919, Sir William Osler died in Oxford from a haemorrhage following an operation to treat his empyema. He was 70. In his obituary of [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2019\/12\/31\/daniel-sokol-william-oslers-lasting-influence-on-medical-ethics\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":46350,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[18886],"tags":[],"class_list":["post-46348","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-daniel-sokol"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Daniel Sokol: William Osler\u2019s lasting influence on medical ethics - The BMJ<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/bmj\/2019\/12\/31\/daniel-sokol-william-oslers-lasting-influence-on-medical-ethics\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Daniel Sokol: William Osler\u2019s lasting influence on medical ethics - The BMJ\" \/>\n<meta property=\"og:description\" content=\"One hundred years ago, on 29\u00a0December 1919, Sir William Osler died in Oxford from a haemorrhage following an operation to treat his empyema. 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