John Gregory and the invention of professional medical ethics and the profession of medicine

We do not expect sympathy from a good accountant, or a good lawyer. An unsympathetic accountant or lawyer can be good, we might even take the lack of sympathy to be a mark of professionalism; however, there is something profoundly wrong, even unprofessional, about unsympathetic physicians. Good doctors ought to have a caring heart. We inherit this expectation from the Scottish Enlightenment. Undoubtedly, the pre-eminent apostle of this ideal was the philosopher-physician, John Gregory of Edinburgh (1724-73). Yet, despite the global influence of Gregory's writings, they have been out of print for all but the last two years of the twentieth century. Thanks, however, to the initiative of Laurence McCullough, an American bioethicist who works at the Baylor College of Medicine in Houston, Texas, we now have a comprehensive scholarly edition of the two published versions of Gregory's lectures on medical ethics, as well as five previously unpublished manuscripts, including student transcripts of Gregory's lectures. McCullough has also written the first book-length intellectual biography of Gregory. This is a welcome addition to the literature on medicine during the Scottish Enlightenment, and to the history of eighteenth-century medical ethics. In John Gregory and the invention of professional medical ethics and the profession of medicine, McCullough offers a comprehensive critical account of the development of the Edinburgh physician's medical ethics and of his philosophy of medicine. The book divides into four chapters: an introduction; an intellectual history of Gregory, his life and times; a critical exposition of his lectures on medical ethics; and an assessment of his significance. McCullough uses his detailed knowledge of Gregory's life to analyse the man's ideas. Thus, he spotlights Gregory's relationship with Elizabeth Robinson Montague of the Bluestocking Circle (1725-1800) to lend support to his claim that Gregory deliberately set out to "feminize" the qualities of a good physician. paints Gregory as subscribing to a conception of the medical profession that was initially outlined by Francis Bacon (1561-1626) in his influential Latin-language essay, 'The advancement of learning' (1605). Haakonssen, however, reads Gregory as one of several variations on Baconian themes sounded by Protestant Dissenters, including Percival and Rush. McCullough's Gregory, in contrast, is more secular and much more innovative. Specifically, McCullough argues that: (1) Gregory invented English-language medical ethics by transforming an informal tradition of lecturing medical students on medical propriety into a formal tradition; (2) that Gregory invented secular medical ethics by providing a theoretical account …