The Criminal Negligence of Physicians
This unreliability may be set down to the account of the medical profession. Realizing though they do the danger of concealment from the proper authorities, and in the face of the law which, as it gives them special privileges, requires of them a certain return, a considerable percentage of physicians falsify the returns to protect the sensibilities of their patrons. That they owe protection rather to the lives of the public, they never stop to think. Tuberculosis is the disease most misreported. In many communities it is regarded as a disgrace to die of consumption. So it is. But the stigma rests upon the community which permits the ravage of this preventable disease; not upon the victims of it, except as they contribute to the general lethargy. In order to save the feelings of the family, a death from consumption is reported as bronchitis or pneumonia. The man is buried quietly. The premises are not disinfected, as they should be, and perhaps some unknowing victim moves into that germ-reeking atmosphere, as into a pitfall. Let me give an instance. A clergyman in a New York city told me of a death from consumption in his parish. The family had moved away, and the following week a young married couple with a six-months-old baby moved in.
DR. J. MERCIER GREEN
HEALTH OFFICER OF CHARLESTON, SOUTH CAROLINA, WHO STAMPED OUT A SMALLPOX EPIDEMIC AND REFORMED THE CITY'S WATER SUPPLY
"What can I do about it?" asked the clergyman. "Mr. Blank's death was said to be from pneumonia; but that was only the final cause. He had been consumptive for a year."
"Warn the new tenants," I suggested, "and have them ask the Health Board to disinfect."
More than a year later I met the clergyman on a train and recalled the case to him. "Yes," he said, "those people thought it was too much trouble to disinfect, particularly since the reports did not give tuberculosis as the cause of death. Now their child is dying of tuberculosis of the intestines."
In this case, had the death been properly reported by the dead man's physician, as the law required, the City Board would have compelled disinfection of the house before the new tenants were allowed to move in. The physician who obligingly falsified that report is morally guilty of homicide through criminal negligence.
In Salt Lake City, in 1907, 43 deaths were ascribed to tuberculosis—undoubtedly a broad understatement. And in the face of the ordinance requiring registration of all cases of consumption, only five persons were reported as ill of the disease. By all the recognized rules of proportion, 43 deaths in a year meant at least 500 cases, which, unreported, and hence in many instances unattended by any measures for prevention of the spread of infection, constituted so many separate radiating centers of peril to the whole community.
Why is such negligence on the part of physicians not punished? Because health officials dread to offend the medical profession. In this respect, however, a vast improvement is coming about. Pennsylvania, Maryland, Indiana, Massachusetts, Minnesota, Wisconsin, and other States are not afraid to prosecute and fine delinquents; nor are a growing number of cities, among them Boston, New York, Rochester, Providence, and New Orleans. The great majority of such prosecutions, however, are for failure to notify the authorities of actively contagious diseases, such as scarlet fever, diphtheria, and smallpox.