Linker Beth
Program in the History of Medicine and Science, Yale University, Sterling Hall of Medicine, New Haven, CT 06520-8015, USA.
J Hist Med Allied Sci. 2005 Jul;60(3):320-54. doi: 10.1093/jhmas/jri043.
The history of codes of ethics in health care has almost exclusively been told as a story of how medical doctors developed their own professional principles of conduct. Yet telling the history of medical ethics solely from the physicians' perspective neglects not only the numerous allied health care workers who developed their own codes of ethics in tandem with the medical profession, but also the role that gender played in the writing of such professional creeds. By focusing on the predominantly female organization of the American Physiotherapy Association (APA) and its 1935 "Code of Ethics and Discipline," I demonstrate how these women used their creed to at once curry favor from and challenge the authority of the medical profession. Through their Code, APA therapists engaged in a dynamic dialogue with the male physicians of the American Medical Association (AMA) in the name of professional survival. I conclude that, contrary to historians and philosophers who contend that professional women have historically operated under a gender-specific ethic of care, the physiotherapists avoided rhetoric construed as feminine and instead created a "business-like" creed in which they spoke solely about their relationship with physicians and remained silent on the matter of patient care.
医疗保健领域道德准则的历史几乎完全被讲述成了医生如何制定自身职业行为准则的故事。然而,仅从医生的视角讲述医学伦理的历史,不仅忽视了众多与医学专业同步制定自身道德准则的医护工作者,也忽略了性别在这些专业信条撰写过程中所起的作用。通过聚焦于以女性为主的美国物理治疗协会(APA)及其1935年的《道德与纪律准则》,我展示了这些女性如何利用她们的信条既讨好又挑战医学专业的权威。通过她们的准则,美国物理治疗协会的治疗师们以职业生存之名,与美国医学协会(AMA)的男性医生展开了一场动态对话。我得出的结论是,与历史学家和哲学家们所主张的职业女性在历史上遵循特定性别的关怀伦理不同,物理治疗师们避免使用被视为女性化的言辞,而是创建了一种“商业式”的信条,在其中他们只谈论自己与医生的关系,而对患者护理问题保持沉默。