Doctor's Dilemma Research Articles

The doctors' dilemma.

IN the preface to the Doctor's Dilemma, George Bernard Shaw says: Make up your mind how many doctors the community needs to keep it well. Do not register more or less than this number; and let registration constitute the doctor a civil servant with a dignified living wage paid out of public funds. Although this statement was made in 1911, it has a remarkably contemporary ring and could as easily be made in 1978 by a consumer advocate or by a government official. It also constitutes the major dilemma of American medicine today — that is, how to deploy the . . .

The Marriage of Contraries: Bernard Shaw’s Middle Plays by J.L. Wisenthal

127 J.L. Wisenthal, The Marriage of Contraries: Bernard Shaw's Middle Plays (Cambridge, Mass.: Harvard University Press 1974). 259. $10.00 Emperor or Galilean, empire of the flesh or of the spirit, stupidity or imagina­ tion, power material or power spiritual - many of the chords resounding throughout Shaw's works and life are struck in this tightly argued, solidly based discussion of some of the major plays. Shaw has always invited contraries of opinion and action, choosing to emphasize the dialectics of debate in his lifelong attempt to persuade the reader to contemplate the range of choices before him, forcing him to select and therefore to think. Wit, rhetoric, sentiment, and impudence are drawn into the barrage of truths and counter-truths which make up Shaw's style; like Wilde, he might easily have pronounced: "Give a man a mask and he will tell you the truth." For Shaw's masks were many, and he never rested from his self-appointed role of Happy Hypocrite. The Marriage of Contraries concentrates on nine plays written between 1903 and 1923: Man and Superman, Major Barbara, John Bull's Other Island, The Doctor's Dilemma, Pygmalion, Misalliance, Heartbreak House, Back to Methuselah, and Saint Joan. However, Professor Wisenthal marshals an im­ pressive force of examples from a much wider range of novels, essays, letters, reviews, unpublished manuscripts, secondary sources, and many of the other plays. Despite the complexities of his subject, the argument is simple: Shaw, concerned primarily with the division between the empire of the flesh and the empire of the spirit, strives to illustrate through his writings the evolutionary path by which a comprehensive synthesis of opposites may eventually be achieved. Professor Wisenthal sees this pattern explicit in characterization, especially in reversals of the audience's expectations of character, and implicit in form. Not surprisingly, this approach is most effective for such avowed problem plays as Man and Superman, Major Barbara, The Doctor's Dilemma and - to a lesser extent - Misalliance. The tripartite analysis of Man and Superman as book, comedy, and handbook brilliantly provides rich insight into Shaw's economic philosophy and turns up rewarding parallels with other plays, au­ thors, and nationalities (Shaw once reminded William Archer of "m y extraor­ dinarily happy command of classes & grades of civilization"). Professor Wisenthal 's reading is particularly effective when he draws parallels between characters; indeed he might have extended this further, for example, by de­ veloping the link between Captain Shotover's powerful warning of the drunken captain and Larry Doyle's impassioned denunciation of the dreaming Irishman. Similarly, his comments on the influence of Swift, Blake, Carlyle, Ibsen, and Nietzsche are illuminating; but what of those acknowledged models, Bunyan and Dickens? So too, although several comparisons are drawn between Shaw and Yeats, he overlooks Yeats's own frequent paraphrasing of Blake's "Without contraries there is no progression." 128 Inevitably such an attempt to map Shaw clearly and consistently - to assume that clarity of thought represents simplicity of theory and presentation founders , because subject and manner are so fascinatingly complex. The danger is evident even in Professor Wisenthal's discussion of Man and Superman, when he attributes the force of the Devil's cynicism to pessimism in Shaw himself, and when the too simple equation of Doha Ana with Philistinism not only deflates the resounding ending to the Hell Scene but subtly aligns the power of the Life Force with the wrong camp. Greater hazards, and deeper currents, threaten when hidden motives (which run counter to Shaw's character presentation) are attributed to Undershaft so that the reading of Major Barbara may come out as charted; nor can Saint Joan's great speeches be simply dismissed as “ embarrassingly rhetorical." We must, as Shaw instructed Ellen Terry, learn to read on the lines, rather than between the lines; we must learn to trust the author. Otherwise it is too easy to provide, for example, a simple reading of pessimism for both Joan and Captain Shotover (and thence for Shaw) and choose to ignore the melodramatic, sensational, and comic complexities of Shaw's dramatic form. Wisely, Professor Wisenthal does not examine those plays which do not cleanly follow the dialectical pattern...

"The Surgeon's Dilemma"—Continued

In the November 1975 issue of theArchives, Dr Richard Warren published a penetrating analysis of my Harper's article, The Surgeon's Dilemma. Dr Warren refers to it, erroneously, as The Doctor's Dilemma, but this is the only inaccuracy in his article. Dr Warren's criticisms are four: He [Crile] has not come to grips with the question of why a surgical fee is larger for a 'bigger' operation. Answer: I have never understood or attempted to explain why a operation should command a bigger fee. I have always believed that the surgeon should be paid for the treatment of the disease rather than for the extent of mutilation that he inflicts. Only in this way can the surgeon's selection of treatment be free of conflict of interest. Dr Warren implies that Crile advocate a leveling of salaries between specialists. Answer: I have never thought or written any such

"The doctor's dilemma".

In the May 1975 edition of Harper's Magazine , Dr George Crile, Jr, has published an article, Doctor's Dilemma. In it he describes the problems that confront the surgeon when he is asked, or asks himself, to choose a simple operation over a more complicated one. The author contends that, even though the simpler procedure has been shown to be as effective, the greater surgical fee generated by the larger operation often influences the choice. There is thus a conflict of interest. He further states that even if this stimulus did not exist, the surgeon is prone to choose the complicated operation for another reason, Funktionlust , defined by Konrad Lorenz as the innate hunger of any professional to use to the utmost his or her highly developed skill. Such are the discoveries that Dr Crile has chosen to release in the lay press. I found his statement of the problem,

The donor doctor's dilemma: observations on the recognition and management of brain death.

Professor Jennett first defines the term `brain death' and the problems arising from a diagnosis of death, some the result of recent technological advances. The diagnosis is not necessarily connected with donor transplants, although in the popular mind this is still so. The criteria for establishing brain death and the sources of potential error in this diagnosis are outlined. The diagnosis of brain death can be made confidently, as is already common practice, and this should become standard good medical practice.

Arbuthnot Lane and "The Doctor's Dilemma"

Arbuthnot Lane and "The Doctor's Dilemma"

Arbuthnot Lane and "The Doctor's Dilemma"

Arbuthnot Lane and "The Doctor's Dilemma"

Informed consent—a doctor's dilemma

AORN JournalVolume 18, Issue 4 p. 810-811 The Experts Research Q & A Informed consent—a doctor's dilemma John A Mitchell JD, John A Mitchell JDSearch for more papers by this authorCharles L Cragin III JD, Charles L Cragin III JDSearch for more papers by this author John A Mitchell JD, John A Mitchell JDSearch for more papers by this authorCharles L Cragin III JD, Charles L Cragin III JDSearch for more papers by this author First published: October 1973 https://doi.org/10.1016/S0001-2092(07)60836-9AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Volume18, Issue4October 1973Pages 810-811 RelatedInformation

Male thoughts of the female doctor's dilemma.

Male thoughts of the female doctor's dilemma.

The doctor's dilemma: Whether or not torecommend continuous renal dialysis or renal homotransplantation for the child with end-stage renal disease

The doctor's dilemma: Whether or not torecommend continuous renal dialysis or renal homotransplantation for the child with end-stage renal disease

Euthanasia: A physician's view

Euthanasia is a doctor's dilemma. It is against the law knowingly to shorten a human life for medical reasons. Furthermore, a physician is expected to prolong life. It is also the duty of the physician to relieve suffering. And yet the very act of relieving suffering may shorten a patient's life. Euthanasia is commonly thought of as "mercy killing." Actually the term is derived from the Greek and more accurately means "well death." "Active" euthanasia involves the administration of a drug or other modality to induce death. "Passive" euthanasia refers to the withholding of a treatment that would otherwise prolong life (or shorten death, as the case may be).

Physicians Gather in Atlantic City

Physicians Gather in Atlantic City

Therapeutic vs Prophylactic Castration

During the past 75 years the rival merits of prophylactic vs therapeutic castration have been vigorously championed more or less empirically by many clinicians concerned with the total treatment of breast cancer. In premenopausal patients with operable breast cancer, is it wiser to perform prophylactic castration as an adjunct to mastectomy or is it wiser to reserve this procedure for the palliative treatment of recurrent or metastatic disease? This is, indeed, the doctor's dilemma! As long as the practice of medicine continues to be a "science of uncertainty and an art of probability" then the patient's "destiny trembles in the balance, and the preponderance of either scale is by our own choice." <h3>Therapeutic Castration.—</h3> It is quite obvious that ovarian hormones have a profound effect on hormonesensitive cancers of the breast. The remarkable clinical response of some tumors of the breast to therapeutic castration certainly confirms this concept. This beneficial

The doctor's dilemma

The doctor's dilemma

A doctor's dilemma

A doctor's dilemma

SHAW AMONG THE DOCTORS.

I fancy that most of our readers will have seen or read George Bernard Shaw's famous play, The Doctor's Dilemma . It is a hilarious satire of medical pomposity and pretensions, and a merciless exposure of so-called society medicine. Shaw thoroughly enjoys playing the mighty Achilles among the bumbling medical Trojans. For his wit and superb swordmanship we can forgive him the blind spot which he always exhibited when it came to matters of medical science. Few people realize, however, how the irrepressible Irishman obtained what might be called the medical atmosphere and his knowledge of the shortcomings of medical practice. This matter was dealt with delightfully by Mr. Hesketh Pearson, the London journalist and biographer, about twenty years ago in a number of John O'London's Weekly , that periodical which, under the editorship of Wilfred Whitten, delighted such a large constituency for several decades. The central idea of the play was

The Doctor's Dilemma—Drug Therapy and the Facts of Life

Probably in no country in the world does the potency and purity of drugs correspond as strictly with the claims of the manufacturers as in the United States. Multiple safeguards are set up for the protection of the public. After the research departments of the various drug and biological houses have produced what they consider a useful and safe drug, it is submitted to the Food and Drug Administration where the protocols supporting the claims are examined. In the cases of antibacterial drugs the manufacturers usually carry on what clinical trials their access to patients will permit and at the same time send out many batches of the new drug to clinical investigators throughout the country. Usually the results of the pharmacological studies and the clinical trials by physicians form the basis for the final decision regarding permission to market the new product. If in vitro bacterial sensitivity tests indicate

The endotoxins of gram-negative bacteria and host resistance.

There is only one genuinely scientific treatment for all diseases, and that is to stimulate the phagocytes. Stimulate the phagocytes. Drugs are a delusion. — George Bernard Shaw, The Doctor's Dilemma (Act 1), 1906.TN 1893 Pfeiffer observed that the intraperitoneal injection of the cholera vibrio into mice resulted in the lysis of the injected bacteria by the host defense mechanisms. After this lysis the mice sickened and died. Pfeiffer conceived of a toxin that was released by the lysis from within the bacteria and thus devised the term endotoxin. It was subsequently shown that Pfeiffer was in error, that . . .

“The doctor's dilemma”

“The doctor's dilemma”

Review: The Devil's Disciple; The Doctor's Dilemma

Review: The Devil's Disciple; The Doctor's Dilemma