Document mBooZ3OB583KXpZ9vVrx3Z7BQ

November l6, 1957 Dr,, William F. Ashe Chairman Department of Preventive Medicine The Ohio State University Columbus 10 Dear Dill: I don't want to argue with you, and least of all do I wish to quibble about medical ethics, I agree, in principle with * your position, and 1 also believe that industry displays its wisdom, and adaptability in practical as well as social terms when it recognises and accepts the ethic3 of its physicians and its own social responsibilities. This, I believe you will recognize, has been the practice where I can exercise ad ministrative control to the appropriate extent. However, we are not talking about the private and personal practice of medicine or the free personal and professional position of such a practitioner. We-are dealing With a now professional relation ship in a new and different society, and we have to be willing to work at our position and our rights in our new relationship, in which we are the members (by agreement or by contract) of an organization in whose councils we share but whose decisions we accept once they have been made, unless we are prepared to quit. Even then we are not free of responsibility for the privacy of judgments arrived at previously. Any other arrangement in our present society would lead to chaos and anarchy. p ^t " c^o I agree that new knowledge, especially when people are 5n jeopardy, coses a problem, to be fudged carefully, objectively and with moral v^sensitivltyi However^/which may seem to be an inescapable duty to one's colleagues and the expression of a right which cannot, in propriety, be taken away, is an entirely different matter, which involves legal considerations as well as personal, and questions of professional prestige which at times are opposed to the good of the community. As it happens, the publication of most articles, without identification of patients or their sources, is quite satisfactory for purposes of information and professional communi cation. This is done regularly. On the other hand, certain types of publications and certain types of data constitute a complete identification of their source, and this can be done only when the legal and professional relationships are clear. The fact is that there is no simple and firm rule' for professional conduct in a number of these situations, and one has to examine his motives and his conscience, and then as objectively as possible, with due re gard to the role of the physician (in one's own view) in human ?i Q Dr. V.'illlata P. Ashe- - (-2>* - November l6, 1957 \ \ society, take a course with full acceptance of its consequences. If we- are to exercise a beneficent influence on the industrial society of our time, we must take our place within industry and earn a position of confidence and leadership. This will not be done by cleverness or oandering, but by facing issues, explain ing our views, and persuading cur associates. Neither will it be done by assigning a posture of virtue or self assurance, but rather by displaying a spirit of inquire a willingness to ex amine the facts behind th issue, and an acceptance of the rules of open discussion and civilized behavior among ones peers * I think there is little doubt that we in medicine are achieving cur ends in the profeSsienalization of industrial medicine and in rostering the position which the industrial physician lost through his own irresponsibility, preoccupation and incompetence. We need not have a chip on our shoulder, or guilt on our conscience, therefore. In'comparing cur situation or our ethics with those Of the traditional practitioner of medicine. While we work through the situation created by our sins of omission and ignorance, we shall often be at a disadvantage, but we ard reaching a position of trust and respect among the socially minded industrial managers of our time. This position can be consolidated, and as the present confusion, based on the man:/ 'unsolved problems of Industrial hygiene, is dissipated, the problems of the type that gavp rise to this dis cussion will disappearin large part. The vulnerability of the aluminum industry, just as an example of the situation, to claims for damage { and punitive damage) is so great at present, that their attorneys have ever/ reason to be concerned lest they make a misstep. The decision arrived at in the Court of Appeals in the Martin case is one of the most glaring obstacle^ to medical and hygienic research and to the appropriate assumption by our industry of the responsi bility for its cun acts that I have ever encountered. This was utterly unpredictable, and was born cf a superb ignorance and irresponsibility oh the part cf the court. I hope and believe it will be reversed, for if it establishes a precedent, attention to, and investigation of, a potential hazard constitutes prima facie evidence of the existence of a source of injury. Under these con ditions, an investigation such as we conducted at m neara, serves to convict the plaintiff. This was exactly what AlCOA" chief counsel had in mind in discussing this report-;with us, in suggest ing certain alterations in verbiage,, and finally In holding up its publication (which in terns of our mutual)understanding, as the basis for our being engaged to do the work, he had the right to do). If this decision is. reversed, we shall'be able soon, I bel.ioV9, to publish this report in appropriate form, .but I think you. wili see why I am not prepared to push this Issue at. this particular tine. KE 0019745 yr. William F. Ashe -(2) November 16, 195? You will recognize, of course, that I have extended myself, somewhat, in my further discussion of this sub iect,, I do thi3 because I an not willing to have you believe that I am somewhat less than properly sensitive to ethical principles, or that I am ignorant of the ways of the world, I do not set myself up as being above reproach in either ethics or wisdom. I feel .sure, however, that we must cultivate both wisdom and virtue in. a soirit of humility, recognizing that neither of those qualities of mind and personality can be described in absolute terras , but must always be related to the times, the circumstances,and the human relationships concerned. This sounds Hire opportunism, but if so, it is the opportunism of the long range goal and not that of the present advantage. Sincerely yours. PA7 3S Robert A. Xehpe* K D. KE 0018746