Catholic Physicians\u27 Guilds

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The Linacre QuarterlyVolume 22 | Number 1 Article 42-1-1955Medical Advisory Committee to Assist CatholicHospitals: A ReportCatholic Physicians' GuildsFollow this and additional works at: https://epublications.marquette.edu/lnqPart of the Ethics and Political Philosophy Commons, and the Medicine and Health SciencesCommonsRecommended CitationCatholic Physicians' Guilds (1955) "Medical Advisory Committee to Assist Catholic Hospitals: A Report," The Linacre Quarterly: Vol.22 : No. 1 , Article 4.Available at: https://epublications.marquette.edu/lnq/vol22/iss1/41/tedteat rid� � to;J/4.ua eat4t>tte �04pttati c, OME six months ago the execu-0 tive board o f  th e Catholic hospital Association authorized the president to appoint a m e dical  advisory committee. The purpose of the committee is to have a rep­resentative group of medical men who can presen t  to the officers, the executive board and the Cath­olic Hospital Association staff the point of view of medical men re­lating to adminis trat ion,  nurs­ing service, the medical care and other patient services in the hos­pital. A great deal of assistance is expected in solving medical staff problems, the accreditation of hos­pitals, and the educational policies to be effected. The first meeting of this com­mittee was held in October at the central office of the A ss oc iat ion  in St. Louis. The following who had been asked to serve as mem­bers were present: Edward H. Bowdern, M.D., St. Louis, Mis­souri; Joseph V. Finnegan, M.D., St. Louis, Missouri; Raymond J. Bozzo, M.D., Washington, Mis­souri; Frederick M. Gillick, M.D., dean, School of Medicine, Creigh­ton University, Omaha, Nebraska; Will iam J. Lah ey ,  M.D., d i r ., m edical educat ion,  St. Francis Hospital, Har tford ,  Connecticut; Louis S. Smith, M.D., pathologist, St. Paul's Hospital, Dallas, Texas; Sister Loretto Marie, R.S.M., ad­ministrator, Mercy Hospital, Chi­cago, Illinois; Rev. John J. Hu-22 mensky, diocesan director of hos pitals, Cleveland, Ohio, and Rober S. Myers, M.D., F.A.C.S., assist, ant director, American College otSurgeons, Chicago, Illinois. The agenda included many dif­ficult and very significant problem, for Catholic hospitals. More than passing interest should be evoke in reading the report which fol­lows. The issues discussed affect many of our LINACRE QUARTERLY readers in a professional capacity and they might well be encouraged to lend effort to help solve some of them in their spheres of duty. It is with this hope in mind that our editor, Father John J. Flanagan, S.J., exec u t i ve d i r ector  of the Catholic Hospital Association, ar­ranged to include the report in this issue of the journal. EDUCATIONAL PROGRAMS FOR INTERNS The first topic discussed was education for interns in Catholic hospitals. There was general agree­ment that hospitals could not solve the problem of inadequate supplyof interns but that Catholic hos­pitals could not expect to receive their share of interns unless the ed­ucational programs were strength­ened. It was p o i n t ed out that speakers and conferences do not make a good educational program.Bedside education under the guid­ance of staff men who are willing to instruct and supervise must be LINACRE QUARTERLY effectively organiz ed and  inte- 2.grated into the overall pr.ogram. The practice of using interns .towrite all the histories and to assis}all surgeons for th� . �urp�e t�e Th Catholic Hospital Asso-e hos ciation should encourage -· t ls to foster medical educa­pt a though it tion programs; eve� . -. . service was cntiozed y givmg ·tt mem-. . f the commi ee maJonty o d d 3 h ·t was recommen e . bers ; rat er, i . d nl to is an expense item, it will c�n 1tribute to improv ed medica practice. Th Catholic Hospital Asso­cia�on should set up co��erlences or workshops for me ica that interns be ass1gne o .Y. ho were capable and willing men wh d that they be responsi­to teac an b fble for only a limited num f e�l :atients so that they can_ . o o fp h h from the wntmg o them t roug the history to discharge. b of the Most of the mem ers . in ·ttee favored a rotating -commi · h. 'th a minimum assign-terns ip wi f 15. beds and a maximum ment o of 25. h It was also pointed out that t de kee ing of good medical recor s wa: most. important in an educa-. 1 ro ram and that young tiona P g ld b taught to Physicians shou e . 11 . d that are medica y write recor s 1 significant rather than mere � com­plete in a quantitative way. t.was I d that private patients a so agree d . Id and should be use m a cou . It was notedteaching program. h 1· t in Cat o lC that the autopsy ra e d b hospitals should be improve e-f the value of the autopsy cause o f · roved for education and or imp . The following three patient care. . f endations are deserving o recomm special mention; 1. Advise hospitals to hav� a _df­rector of medical educatio�, m 11 hospitals an educational sma · tte e would suffice. A comm1 . 1 qualified pathologist or radio o-ist might, when n ec e ss ary:, g as medical education di-serve rector.FEBRUARY, 1955 ff d maintain a consultant sta an service. RESEARCH Comment was made on the mea-amount of research being done �erCatholic hospitals and the small m b of Catholic doctors en-num er h ht a ed in research. It was t oug g g h ·tals are discouraged many ospi h 11 ·t ·s the opinion t at a because i 1 d research is expensive and deman 1 . g in time, space and personne . m h t there are It was pointed out t a . d two kinds of research, basic a� 1. . 1 The former does require c mica . f 11 t· e · l aborator i es , u - im extensive d d staff special equipment an a �-' f ds Clinical research is quate un . d be car-less pretenti�us an Ile t:s ital by ried on even m a sma .P . 1· t or general practl-any speoa is . l . The attitude of medica men tioner. . h t ·m-d administrators is t e mos I. ;:rtant factor. The de�re tot i:fuire and to learn on t e par q d d the willingness of the octor an to the administration to ei:dcoufra�l�t·. s t d to provi e aci I ie coopera e, an . 1 and environment are essentla . RECOMMENDATIONSTh Catholic Hospital Asso-1. e d ge re-ciation shoul encoura d . t · a g e n eralsearch, in ica mg attitude of approval and at-23 tendance at professional meet� ings. 2. Hospitals should be encour�aged to attempt only the typeof research adapted to eachi�stitution. Community hos­pitals should be cautious aboutengag in g  in expensive re­search projects.3. The Catholic Hospital Asso­ciation s h ould publish thesources of grants for research.4. Research must originate withdoctors, but administrat ionshould be alert to encourageand to cooperate with effortsof physicians by giving spaceand some secretarial assist­ance.5. Research for its own sake isdangerous.6. Promulgate the principle thatbetter patient care will resultfrom:a) A review of principlesb) A good educational p r o ­gram c) The research that will bethe concomitant result. 7· 1:'h� Catholic Hospital Asso­c1at1on should conduct surveys and collect papers delivered 9. Cert ain areas of researc  l could support the teaching c:the Church; e.g., in obstetric;we need research to disprov :the accusation that it is clan.gerous _for a mother to go toCatholic hospital  for a dlivery.IO. An_ advisory committee o: res1de�cies might be organize to designate subjects for re search. . l l. <;all attention to the packag library service of the Ameri can College of Surgeons. 12. Ge�r Hospital Progress morlto mterests of the ph · . h ys1c1ar w _  � thinks it solely an ad m1mstrative organ. 13. P_rove that the Catholic Hos­�1tal Association is interestec�n the doctor himself and clin­ical practice.14. Expla!n �he Catholic HospitalAssoc1at1on to physicians by abrochure for them.THE CATHOLIC HOSPITALAND MEDICAL STAFF ORGANIZATION The �dvisory committee felt that medical staff discipline should be left to the staff as much as by staff members of Catholic hospitals. 'bl W pos-si e. hen the staff fa ·1 t . . 1 s o exer� 8. In enc<?uraging research andeducation we are only pickingup the tradition characteristicof the Church in earlier timeswhen the better  med i calschool� in Europe were underCatholic auspices and whenthe greatest progress in schol­arship was made by Catholicscholars.24 c1se its responsibility in promoting good practice and when it fails tocorrect abuses, then administration has an obligation to act. . Medical men resent attempts to " 1· " h po ice th em, and religious and lay people s ould respect the profess i onal prerogatives and responsibilities of the doctors. T�e medical audit, it was pointed out, is becoming more widespread LINACRE QUARTERLY and more important. Good doctorswelcome it as a device for pro­moting better patient care. In dis­cussing the accreditation of hos­pitals. it was stated that smallhospitals can be approved if them edical staff and administ ra­tion make certain that the requiredfunctions are being carried out.Although the five following com­mittees are essential in a well or­ganized staff-executive, creden�tials, joint conference, tissue, andmedical records-a small hospitalstaff can satisfy requirements bydemonstrating that the functionsof these five committees are being·carried out by one committee or by the staff as a whole. In large hospitals it is very help­ful to rotate members of committeesas much as possible so that moremembers 0£ the staff may becomefamiliar with the functioning andthe importance of the committees.In some instances, administra�tion in Catholic hospitals movestoo rapidly and takes drastic actionwithout con sulting the medicalstaff. This statement led to thetopic which came up frequently inthe deliberations of the committee,the need for better liaison betweenthe medical staff and the governing· boards of Catholic hospitals. It was pointed out that the joint con�ference committee  is an excel­lent device to remedy this situation.It was suggested that the MotherGeneral or Mother Pr ovincialmight well be a member of thatcommittee or at least  attend ameeting of the committe when shevisits the hospital. There was a feeling that hospi�tal administrators should be carefulFEBRUARY, 1955 to seek advice from well qualifiedand p'rogressive members of thestaff rather than from one who ispleasing and popular and diplo�matic. ETHICAL STANDARDSA fear was expressed that someCatholic hospitals are concernedonly in preventing abortions andsterilizations and do not realizethe ethical and moral implicationsinvolved in ghost surgery and theunnecessary removal of organs. Itwas felt that hospitals should beadvised regarding the morality in�volved in ghost surgery, unneces­sary surgery and fee splitting. It was recommended that the individu al hospital require thatthose who participate in consulta­tion sign as consultant and thatwhen a surgeon performs an oper­ation on recommendation of theattending physician, the surgeonbe introduced to the pat'ient andhis function explained. It is alsorecom m e nded  that  the  latestamendment of  the A.M.A. codebe publicized among all hospitals.THE GENERA� PRACTITIONERDiscussion revealed that an in­creasing number of people preferthe services of the general practi�tioner. However, in some sectionsof the country the general practi�tioners have difficulty receivingappointments to the staff of hospi�tals. In large staffs, the generalpractitioner seems to be overlookedand gets least consideration. Representatives of the staff of the Catholic Hospital Associationinformed the committee that the· members of the Association were on record through a convention25 -. -resolution recommendin th (atholic hospitals make grov7s�o:�s�rff a genera] practice section in� o r ganiza ti o n. It waspointed out that the model b lalso sug t d b Y- aws is encouraged and the al l -i m p o r tan t family physician.recognized i 1 capacity of 1 ges e Y the Cath 1· H ftal Association indud; ip\ov�s?i­or a 1 1s1on genera practice section. th The committee recomme n dedNURSING th The_ committee recognized tha .ere is a sh o r  t a  g e of d N •gra uat .urses salaries have not kept ac.at_ an annual review be made ofme�1caJ staffs With a view to eJimi­nating those who d th J O not avail with other salaries Th Pb f h C · e mem ero t e ommittee felt that th are too many instances of inaJ:·quate cHare, of carelessness an,e;;se ves of privileges and thus ma e a place for those who errors ow . that . . ever, it was admitte, more wo th . ] are r y, Inc uding qualified the att��::i�t�f �hoef ��i:es pNalleI:·general practitioners. Most g 1 P r t · t · enera ac I i o ners realize th . do not write d or. urse, sh ld d at merit ou etermine a physic. • tus on a staff. ian s sta-The committee hoped that ple could be educated to pleo­fa ·1 h consu t a hmi Y P ysician who will r f t em to a . 1. e er A f specia ist if necessary �a� was expressed that som�spec1al1sts are attempt· as 1 mg to actth. genera practitioners and thatThis �ould be a medical hazard e mcreasing b f · ist . num er o special-. s is such that doctors do notwish. t� make house calls. and ifspecialist does niake a h a th f · ouse call � ee 1s usually $25.00.d· he . committee concluded thata�8JuJs1on by stating that hospitals octors have a resp 'b·J· th goo notes, becausee doct o r s are not f 'thf I . k · a1 U JI eepmg up charts and nurses be-come careless · because doctors d not take time to read t c . no es or k supervise and check on th work. e nurses SPIRIT OF CHARITYThe �embers of the committeewere as ed to comment h · · f h on t ('spmt o c arity in Cath 1· h tals Th o 1c osp1-that· the ey_ �txprfessed. a convictionspm o charity d vail, but that the pubJ1·c does pre­re J ·  · I oes not a ize it. t was pointed out thatno mathematical amount ca b for h · I n e set c . anty. n times of finan . ldepression, the need for charit;i� to see that th ons1 I ity e general practitioner greater and the need ·11JS f w1 varyrom community to . commumty.26 LINACRE QUARTERLYDysmenorrhea and Stilbestrol by JOHN J. LYNCH, S.J.A. MONG generally accepted pro­fi. cedures in the managementof primary dysmenorrhea, the ad­ministration of estrogen receivesrather frequent mention in medicalliterature.1 The calculated effect ofthis hormone, commonly prescribedin the form of diethylstilbestroltablets, is to achieve painless men­struation through temporary sus­pension of the ovarian function,since usually "primary dysmenor­rhea does not occur in the absenceof ovulation." 2 If it is true that oneeffect of the medication is to in­hibit ovulation, and that it is onlythrough th� attainment of this firstresult that painless flow is achieved.then immediately a question canarise regarding the lawfulness ofthe temporary sterility which nec­essarily occurs. It may in factappear at first sight that the useof stilbestrol would have to becondemned . for the very reasonswhich have been adduced againsthesperidin as an antifertility fac­tor.3There is, however, a distinct and important difference between fer­tility c o ntrol as previously dis­cussed and estrogen therapy in the 1 Greenhill, J. P., Year Book of Obstet-rics & Gyriecology, 1953-1954 Series, 512-515.2 [bid., 513 f. 3 Cf. Linacre Quarterly, Aug. 1953, 83-88, and Nov. 1953, 118-122. In these articles fertility control is shown to be morally objectionable on two counts: (a) as an unjustified mutilation of thehuman generative function, and ( b) asa species of contraception.FEBRUARY, 1955 present instance. First of all, it is clear that the natural function of the ovaries is at least two-fold, generative and endocrine. Hence whenever ovarian activity is sus­pended, two immediate results are necessarily produced: the subject is rendered sterile, temporarily at least; and the system is deprived of certain glandular secretions which are u su a l ly beneficial. but some­times harmful. to bodily health. Now it is entirely conceivable that either one of those results could be desired and intended without the other. One might, for example, intend sterility while disclaiming completely any deliberate intent to affect secondary sex characteristics. Or, by the same token, one might be intent on preventing metastasis of breast carcinoma and repudiate all direct intention to bring about sterility. Of those two examples involving the same morally indif­ferent act ( suspension of ovarian activity). we recognize the first as illicit and the second as potentially permissible, since in the one casethe direct intention is illicit, where­as in the other all direct intent is legitimate. And that is why we condemn fertility control as commonly un­derstood.. There the directly in­tended object of medication is ster­ility itself, and any other possible consequences are incidental by­products as far as subjective in­tention is concerned. Sin c e  the 27 

Medical Advisory Committee to Assist Catholic Hospitals: A Report

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Medical Advisory Committee to Assist Catholic Hospitals: A Report

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