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INTRODUCTION
1. The
"First International Congress on the Histopathology of the Nervous
System" has succeeded in covering a truly vast amount of material. Through
detailed explanation and demonstration it had to put into exact perspective the
causes and first beginnings of the diseases of the nervous system properly so
called and of the diseases we call psychic. A report was read and an exchange
of views held on recent ideas and discoveries concerning lesions of the brain
and other organs, which are the origin and cause of nervous diseases as well as
of psychopathic illness. These discoveries have been made, partly, through
entirely new means and methods. The number and nationality of the participants
in the Congress, and especially of the speakers, show that specialists of the
most diverse countries and nationalities have exchanged experiences for their
own mutual benefit and to promote the interests of science, the interests of
the individual patient and the interests of the community.
2. You do
not expect Us to discuss the medical questions which concern you. Those are
your domain. During the past few days you have taken a general view of the vast
field of research and work which is yours. Now, in answer to the wish you
yourselves have expressed, We want to draw your attention to the limits of this
field-not the limits of medical possibilities, of theoretical and practical
medical knowledge, but the limits of moral rights and duties. We wish to make
Ourself the interpreter of the moral conscience of the research worker, the
specialist and the practioner and of the man and Christian who follows the same
path.
3. In
your reports and discussions you have caught sight of many new roads, but there
remain a number of questions still unsolved. The bold spirit of research
incites one to follow newly discovered roads, to extend them, to create new
ones and to renew methods. A serious, competent doctor will often see with a
sort of spontaneous intuition the moral legality of what he proposes to do and
will act according to his conscience. But there are other instances where he
does not have this security, where he may see or think he sees the contrary
with certainty or where he doubts and wavers between Yes and No. In the most
serious and profound matters, the man in the physician is not content with
examining from a medical point of view what he can attempt and succeed in. He
also wants to see his way clearly in regard to moral possibilities and
obligations.
4. We
would like to set forth briefly the essential principles which permit an
answer to be given to this question. The application to specific cases you will
make yourselves in your role of doctor, because only the doctor understands the
medical evidence thoroughly both in itself and in its effects and because
without exact knowledge of the medical facts it is impossible to determine what
moral principle applies to the treatment under discussion. The doctor,
therefore, looks at the medical aspect of the case, the moralist, the laws of
morality. Ordinarily, when explained and completed mutually, the medical and
moral evidence will make possible a reliable decision as to the moral legality
of the case in all its concrete aspects.
5. In
order to justify the morality of new procedures, new attempts and methods of
research and medical treatment, three main principles must be kept in mind:
1) The interests of medical
science.
2) The interests of the
individual patient to be treated.
3) The interests of the
community, the "bonum commune."
6. We ask
whether these three interests, taken singly or even together, have absolute
value in motivating and justifying medical treatment or whether they are valid
merely within certain determined limits? In the latter case, what are these
limits? To this We shall try to give a brief answer.
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