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The license to slice, maim, violate.

The License to Slice, Maim and Violate

We are fortunate that so many medical doctors practice responsibly and within guidelines laid down by their local professional boards. It is also a matter of luck that few of them range beyond their capabilities because no constraints exist that keep a physician from performing surgery in which he is not qualified.

The license to practice medicine permits every doctor to use the knife. The most conscientious of practitioners prolong their studies so that they can qualify in the field of surgery. Such certification by medical boards provide some protection for patients. It would take a scalpel-happy maverick to violate all of a professional board's restraints. Yet, if he did, the probability of his being stopped is remote.

Consider the case of Dr. James C. Burt, a Dayton, Ohio, physician who has been accused of performing crude experiments on hundreds of women without their consent.

The Ohio State Medical Board recently formally charged Dr. Burt with "gross immorality" and "unprofessional conduct" in surgery performed to restructure his patients' genitals, procedures the board said often caused permanent physical damage.

The physician detailed some of his procedures in a book written in 1975. If the Ohio State Medical Board is now horrified by Burt's surgical techniques, the fault does not lie with lack of information. Many of his colleagues read the book and knew of his methods. Most observers say it is reasonable to assume that members of the board should have known. Why did it take a publicity explosion to push the medical community into action?

Several doctors in the Dayton medical community are under investigation for what they knew. Others say they repeatedly told board investigators about Dr. Burt's practices but charge that the board did not take action.

Dr. Burt has also been criticized by the American College of Obstetricians and Gynecologists, an organization that sets standards for gynecology practiced in American medical schools. He is not a certified member of the American Board of Obstetrics and Gynecology, officials of that organization say. Were Burt's methods not known to anyone in that august group?

Dr. Burt is accused of practicing extremely unorthodox surgery. His book, revealingly titled Surgery of Love, made no attempt to disguise the author's contempt for female genitalia: he considered them "inferior" and "structurally inadequate," according to that work.

If Dr. Burt is guilty of all the improper procedures of which he is accused, and if the newly awakened forces of leadership on medical boards around the country are now stirred into action, some awareness may come out of the tragedy. But more than passing mindfulness is needed. Who practices surgery -- and with what qualifications -- is a question that should concern both physicians and the public.
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Copyright 1989 Gale, Cengage Learning. All rights reserved.

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Title Annotation:physicians' responsibilities
Publication:Nutrition Health Review
Date:Jan 1, 1989
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