My brother and I are C-section babies. A Cesarean section is defined as a surgical procedure during which an incision of the mother’s abdomen is made to deliver the baby. Translation - we were essentially carved out from our mom’s stomach! Studying the etymology of this procedure’s name induces an exploration into the scientific history of gynecological medicine. Stories and myths point to the Cesarean section as being the type of delivery associated with how Julius Caesar, once dictator of the Roman empire, was birthed. Upon digging deeper, historical anecdotes about his romantic partner, Cleopatra, queen of the Ptolemaic kingdom prove to be of further relevance. Depictions of Queen Cleopatra as a royal seductress or even as a skilled leader pale in contrast to the dark deeds during her reign of ancient Egypt. As ruler, she supposedly used female servants, who had been condemned to death, as the source of her experiments, to quench her curiosity. Cleopatra would order for them to be forcibly impregnated, and later, would quite literally slice into their wombs before the pregnancy term came to an end, in order to see if she could accurately determine the sex of the child. 

 

     This anecdote, however accurate it may be, is how Sam Keane, the author of The Icepick Surgeon, introduces readers to a plethora of history’s bone-chilling atrocities committed in the name of science and medicine, constantly trampling ethical boundaries. Medical ethics can be defined as the applied branch of ethics that plays a role in the analysis of clinical medicine and corresponding scientific research. A code of ethics for physicians to follow was only finalized in 1847, drawing from English author and physician Thomas Percival’s propositions. Today, we categorize the branch of ethics into four distinct pillars: beneficence, non-maleficence, autonomy, and justice. This book depicts examples that defy the majority, if not all, of these pillars - grave robbers, the infamous Tuskegee syphilis study, medically inhumane Nazi experiments, and neurosurgeons’ use of an “icepick” to reach the frontal lobes of a patient through their eye sockets. Adverse effects of these experiments have transcended generations and reflect in some patients’ mistrust and hesitancy to this day.

 

     An echoing theme throughout the presentation of these various stories is that the moral disposition of a doctor or scientist is what truly matters. Intelligence should not be the singular entity that determines reputation and quality of care because when intellect is paired with unethical decision-making, the effects are not just harmful, but potentially deadly. 

 

     To move forward, we must observe these patterns of the past and not only learn from and avoid these mistakes, but also to ensure that future generations of professionals in healthcare provide the most ethical care, drawing from the four pillars of medical ethics and the expectations of an evolving healthcare landscape.