Developments in the Role of Medicine in Relation to Reproduction

Abstract

In the history of medicine over the last century we have witnessed a proliferation of medical specialisms. Differentiation has occurred in response to many concurrent changes and particularly to advances in medical technology, to changes in the nature and distribution of health and disease, and to differing emphases placed upon specific qualities, behaviour and performance of individuals and populations or the relative importance of an age or sex-group. Advances in medical technology stemming from the health related physical sciences may produce ethical problems in treatment or necessitate organisational changes in the structure of the profession but their introduction can be relatively easily controlled because they are both initiated and mediated through the health professions or through related (and often medically dominated) professions. Changes stemming, however, from general social, economic and political changes in social structure pose questions of a different order, because they may appear to contravene or threaten to override the traditional medical ethics — the image which the profession holds of itself as concerned with the health of individuals, the doctor-patient relationship, and the autonomy of the profession. Clinging with extraordinary dexterity to the notion that medicine is value-free, that the doctor is concerned solely with ’health’ and is uninfluenced by social and political ideologies, societal needs can only be accomodated if a social, economic or political goal can be translated into concepts of health.

Direct reprint requests to: Raymond Illsley, M.R.C. Medical Sociology Unit, Institute of Medical Sociology, Aberdeen, Scotland.