John Gregory's Writings on Medical Ethics and Philosophy of Medicine (review)

Most academic students of the history and philosophy of medicine know that Dr. John Gregory (1724–73) practiced what we would call “academic medicine” in Enlightenment Scotland (Aberdeen and Edinburgh), expounded on the physician’s duty to himself and his patients, and has been called the father of medical ethics. For a long time Gregory lingered in the annals of obscurity: merely another Enlightenment doctor with a philosophical profile. However, his stock rose in the 1970s when the interface of philosophy and medicine was enhanced by the rapid rise of medical ethics as a subject of the highest importance. More recently, he has been elevated to a father figure for medical ethicists in search of their patron saint Columba. The problem is that few students have ever read anything Gregory wrote with a critical eye, and still fewer can tell you precisely what aspect of his career renders him so deserving. If challenged they could not tell you why, for example, Gregory advocated Latin so ardently, or why the medical ethics of the German pioneer philosopher-doctor Friedrich Hoffmann (1660–1742) should be considered of less importance.

Given this state of affairs more than two hundred years after Gregory’s death, it is evident that what is most needed is a study addressed to the contemporary literate reader that draws out the significant strains while presenting its results in an engaging and entertaining manner. The subject matter—medical ethics—requires it, being inherently didactic and pragmatic rather than inherently entertaining or innately pleasurable. Perhaps a readable biography of the man himself, providing a dramatic and vivid sense of the epoch; or a study of its medical arrangements so far as the doctor-patient relation is concerned, with Gregory as protagonist; or an equally readable, if nonetheless authoritative, interpretative study of Gregory’s mindset that places him in a broad Enlightenment context that is not so specialized as to frighten away the uninitiated. A small paperback anthology of Gregory’s main works, especially the pronouncements on which his reputation rests, prefaced by a readable introduction, would go a long way to place him in the niche he probably deserves. But it would have to be packaged in just the right way.

None of these books currently exists. If they were to be published, no one would be better equipped to write them than Dr. Laurence McCullough, who has steeped himself in Gregory for more than two decades. Here he produces a very different kind of edition of Gregory’s two published works—the Observations on the Duties and Office of a Physician (1770) and Lectures on the Duties and Qualifications of a Physician (1772)—and reproduces Gregory’s manuscript lecture notes. The latter are useful and appear for the first time, accompanied by a most informative introduction and a catalog of the whereabouts of Gregory’s manuscripts. This edition follows quickly on the heels of McCullough’s interpretative study of Gregory’s medical ethics, the previous volume (no. 56) in this series, entitled John Gregory and the Invention of Professional Medical Ethics and the Profession of Medicine (1998), the only comprehensive study of Gregory’s ethics.

The present anthology draws on its predecessor for its materials, extracting the same topics found there to constitute the context for Gregory’s medical ethics: specifically, Gregory’s relation to the world of eighteenth-century medicine, his experimental Baconian method, his feminine ethics (feminine because he wrote it as his Father’s Legacy to His Daughters [1786]), and his all-important attitude to David Hume’s principle of sympathy. Each topic is well delineated. The discussion of Hume, however, is more problematic than acknowledged here, and may not satisfy Humeans who have a different sense than Dr. McCullough of Gregory’s relation to the eighteenth century’s greatest skeptic. It is hardly surprising that Gregory...