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John Gregory and the Invention of Professional Medical Ethics and the Profession of Medicine, and: John Gregory's Writings on Medical Ethics and Philosophy of Medicine, and: Medicine and Morals in the Enlightenment: John Gregory, Thomas Percival and Benjamin Rush (review)

From: Journal of the History of Philosophy
Volume 37, Number 3, July 1999
pp. 535-538 | 10.1353/hph.2008.0890

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BOOK REVIEWS 535 splash) sort, with a suitable mix of historical detail, one could hardly do better than this book. If one is after progress down at the deep end, Vailati's book serves to show just how promising Leibniz and Clarke will be outside of the Correspondence. JAN A. COVER Purdue Unzversity Laurence B. McCullough.John Gregory and the Inventzon of Professional Medzcal Ethics and the Profession of Medicine. Dordrecht, Boston, London: Kluwer Academic Publishers, 1998. Pp. xv + 347- Cloth, $14o.oo. Laurence B. McCullough, editor.John Gregory's Writings on Medzcal Eth,cs and Philosophy of Medicine. Dordrecht, Boston, London: Kluwer Academic Publishers, 1998. Pp. xi + 254. Cloth, $1o5.oo. Lisbeth Haakonssen. Medicine and Morals in theEnlightenment:John Gregory, Thomas Percival and Benjamin Rush. Amsterdam, Atlanta: Rodopi, 1997- PP- x + 247. Paper, $ 2o.5o. The Scottish Enlightenment is widely appreciated for its contributions to philosophy, economics, sociology, law, chemistry, and medicine. The ideas and theories advanced by Hume, Smith, Millar, and Ferguson are still widely debated. John Gregory (17~ 4- 1773), important in his own time, is not as well known as some of his friends and colleagues. He was professor of medicine at the University of Edinburgh from 1766 to 1773, where he taught introductory lectures on the theory and practice of medicine. A set of extensive student notes from these lectures, entitled Observations on theDuties and Offices of a Physician, appeared anonymously in 177o. Two years later, Gregory himself published a revised version of his lectures under the title Lectures on the Duties and Qualifications of a Physician. These two books are said to mark the beginnings of profes- sional medical ethics in the English-speaking world. They are also sometimes character- ized as having anticipated bioethics. McCullough's comprehensive John Gregory and the Invention of Professional Medical Ethics and the Profession of Medicine is the first modern intellectual biography of Gregory. Based on extensive research into eighteenth-century institutional context and the study of hitherto unknown manuscripts, he gives a full account of Gregory's education at Edinburgh and Leiden, and his practice and teaching of medicine at Aberdeen, Lon- don, and Edinburgh. He stresses the importance of Gregory's membership in the Aberdeen Philosophical Society and his close contact with Mrs. Montagu and her Circle for the understanding of his medical ethics. McCullough also shows that Bacon's experi- mental method had a decisive influence on Gregory. Gregory took over Bacon's three offices or ends of medicine: preservation of health, prolonging of life, and curing of diseases. In 1772, perhaps anticipating his premature death from hereditary gout, he added a fourth office, namely easing the pain of dying. Gregory referred mainly to Bacon (and Reid) in his Lectures to make clear how we can enlarge our medical knowl- edge by the method of experience and observation, pointing out that the progress of medicine had been seriously retarded by the way in which it was taught since Hippocrates. He also thought it was handicapped by the view that only professionals 536 JOURNAL OF THE HISTORY OF PHILOSOPHY 37:3 JULY a999 should practice it, and claimed that even quacks have their advantages because their interest and reputation seldom suffer from the failure of the experiments necessary for the improvement of the medical profession. Gregory also argued that we should regard medicine not as a trade but as an art. In this context the principle of sympathy (or humanity) became important for him. Sympa- thy was the basis of the central duties in his Lectures. In a time of extreme instability of manners, when medicine was regarded more as a trade than an art, there was no physician-patient relationship based on the epistemological and moral authority of the physician. According to McCuUough, it was Gregory who created "the physician-patient relationship as fiduciary. The virtues of the physician as fiduciary -- openness to convic- tion, tenderness, and steadiness -- provided for him the moral causes that would gather physicians together into a group worthy of the name, 'profession,' in its intellectual and moral senses" (265). The physician should no longer view his patients as moral strangers. McCullough claims that Gregory's medical ethics is not just...



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