Abstract
The link between science, medicine and public trust has been much discussed. Surgery shared in the public confidence in the efficacy of scientific medicine and the good intentions of its practitioners. This does not seem to have been directly linked to evidence of either. Harry Marks has argued that drug manufacturers were not included in the trust accorded to medical practitioners. Regulations and restrictions on the introduction of new drugs in America from the late 1930s were linked to widespread suspicion of commercial motives. The motives of surgeons were not suspected in the same way, and surgery in the 1930s was not subjected to the same tests of safety (or efficacy) that were beginning to be applied to drugs. Surgeons were free to adopt, adapt, or invent any surgical procedure as they saw fit. Was their surgery based on what Marks has called “the vagaries of clinical opinion”, and Christopher Lawrence the “incommunicable knowledge” behind clinical judgment? Or were surgeon citizens of “the republic of science”, basing their practice on what was considered at the time to be acceptable evidence?
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