The empathic practitioner: empathy, gender, and medicine

presumed to hold. Historians can work only with the published Minutes, and other official documents. The GMC and its members have published a number of accounts of the Council's work and history during this century, but a definitive history of the Council and its relationship to the wider history of medicine remains to be written. Russell Smith's book is, however, a large step in this direction, providing a thorough appraisal of the Council's function as a judicial body. The author's aim is to ascertain "whether or not the [GMC's] jurisdiction has complied with certain aspects of substantive and procedural justice". As part of this critique of the Council's disciplinary function, he examines historical examples of criticism of its disciplinary decisions and the procedures used to arrive at them. Changes in procedure and reasons for them are laid out with legal precision. Smith reminds us that the jurisdictive function of the Council arose out of "a half dozen inconspicuous lines" in the 1858 Medical Act which were scarcely debated in Parliament. However, in its first year it began erasing names from the register. The first practitioner to be struck off appealed to the High Court for restoration, complaining that his case had been heard in his absence. Over the intervening 136 years over a hundred cases have been brought against the GMC, demonstrating that the Council went on rather as it had begun. Smith's analysis of the Council's judgements focuses on the questions of legality, fairness, accountability, impartiality, effectiveness, efficiency and openness. The book is organized around the structure of disciplinary hearings themselves; examining the development of the jurisdiction and of proceedings, cases heard, sanctions and restorations to the Register, rather than chronologically. Perhaps his most striking conclusion is that the "judicial, quasi-criminal, adversarial procedures" of the Council are not the most effective way of setting and maintaining standards of professional conduct, their putative purpose. This begs the historical question as to why the Council not only chose, but then stuck to, a method of modulating medical behaviour that attracted criticism from the outset and is still found wanting in important ways. This and other such questions, such as who, in prosopographical terms, made up the Council, which could be explored with the sources available, are not addressed. Medical discipline uses the Council's history in appraising its validity and success as a judicial body, with the emphasis firmly on the present, …