Doctors . . . are applied scientists.
Lewis Thomas 1
Americans share an ideology of the social function of medicine: a belief about the necessity of linking the practice of medicine to modern science, with all the social benefits and risks inherent in this institutional alliance. This powerful union makes innovation—the constant search for more effective treatments—the hallmark or “icon” of modern medicine. Several examples come to mind. The Tuskegee Study of Untreated Syphilis in the Negro Male—a dark chapter in our medical and public health history—has enduring significance for public policy debates. Our government’s sponsorship of the Human Genome Project—a massive scientific and technological effort to discover the individual structures of the thousands of genes in the human species—demonstrates how the social role of science in the service of medicine has been institutionalized. Finally, the recent revelations in a government-appointed advisory group’s report that perhaps thousands of individuals unknowingly took part in human radiation experiments after World War II dictate a reexamination of the actual meaning of supposed requirements of “informed consent” ethics and practices of American physicians and scientists.