Dr James Marion Sims – kontrowersyjny „ojciec ginekologii”

Abstract

Vesico-vaginal fistula (VVF) was a a catastrophic and common complication of childbirth among American women. In the mid 1800s Dr. J. Marion Sims reported the successful repair of vesicovaginal fistulas with a technique he developed by performing multiple operations on on a group of young, enslaved, African American women who had this condition between 1846 and 1849. Numerous modern authors have attacked Sims’s medical ethics, arguing that he manipulated the institution of slavery to perform ethically unacceptable human experiments on powerless, unconsenting women. It is impossible to understand Sims’s operations within the clinical context of the 1840s. To avoid the problems of “presentism”, in which beliefs, attitudes, and practices of the 21st century are anachronistically projected backward into the early 19th century we have to judge Sims within the context of his time. This is the only way to understand that Sims’ first fistula operations were legal, that they were carried out with express therapeutic intent for the purpose of repairing these women’s injuries, that they conformed to the ethical requirements of his time, and that they were performed with the patients’ knowledge, cooperation, assent, and assistance. Though the legacy of Dr. Sims is for some authors controversial he still seems to be considered as “the father of gyncology” who developed the first consistently successful surgical technique for the vesico-vaginal fistula.