The business of ethics: gender, medicine, and the professional codification of the American Physiotherapy Association, 1918-1935

The history of codes of ethics in health care has almost exclusively been told as a story of how medical doctors developed their own professional principles of conduct. Yet telling the history of medical ethics solely from the physicians' perspective neglects not only the numerous allied health care workers who developed their own codes of ethics in tandem with the medical profession, but also the role that gender played in the writing of such professional creeds. By focusing on the predominantly female organization of the American Physiotherapy Association (APA) and its 1935 "Code of Ethics and Discipline," I demonstrate how these women used their creed to at once curry favor from and challenge the authority of the medical profession. Through their Code, APA therapists engaged in a dynamic dialogue with the male physicians of the American Medical Association (AMA) in the name of professional survival. I conclude that, contrary to historians and philosophers who contend that professional women have historically operated under a gender-specific ethic of care, the physiotherapists avoided rhetoric construed as feminine and instead created a "business-like" creed in which they spoke solely about their relationship with physicians and remained silent on the matter of patient care.     

Separate and unsanitary: African American women railroad car cleaners and the Women's Service Section, 1918-1920

The Women's Service Section (WSS) investigated federally controlled railroad stations and yards at the end of World War I. Few women worked in car cleaning before the war, and railroad management preferred to block women workers, especially African Americans, from gaining any kind of foothold in railroad work. African American women were the single largest group of railroad car cleaners during this period but they were routinely denied adequate facilities, including toilets, locker rooms, and dining facilities throughout the railroad system. By raising the issues of facilities, workers' rights, and public health, these women shaped federal policy and widened the agenda of the WSS to include a direct attack on segregated workplaces. This article argues that African American women car cleaners launched an industrial campaign that wove together concerns about racism, sexism, and health issues, and successfully removed barriers to women working in a predominately male industry.     

Policing the social boundaries of the American Medical Association, 1847-70

In May 1870 the American Medical Association (AMA) voted to deny the admission of black delegates and their white colleagues to the national meeting in Washington, D.C. Historians of race and medicine have customarily viewed this decision as marking a crucial milestone in the formation of the nexus between racism and the development of the American medical profession in the era after the Civil War (1861-64). This study recasts this narrative by locating the 1870 decision in relation to the antebellum practices of the association and their social consequences for American medicine. It argues that the viability of the AMA as the national voice of the profession was critically dependent on rejecting racial equality. Indeed, at a moment when the question of the abolition of slavery polarized the nation, the AMA was founded in 1847 to create a voluntary professional organization, national in scope, dedicated to raising the standards of medical training and practice. To this end, the AMA elected presidents and selected host cities for annual meetings in the North, South, and West. Seven out of the fourteen meetings and six out of fourteen presidents were from slave and/or border states. These institutional practices together with the representation of blacks as different and enjoying an appropriate status as slaves grounded the national identity of the profession in black subordination. Similarly, the gendered discourses about healing and practices of female exclusion privileged medical authority as male by drawing on and reinforcing patriarchy. In the wake of the war, leaders hoped to restore the national character of the organization by resuming antebellum practices. In response to the new possibilities for blacks in medicine--as represented by the biracial National Medical Society--the AMA took steps to vigorously police the racial boundaries of the national profession. As this study will show, the 1870 decision reflected the logic of the racial politics at the heart of the association's antebellum past and would loom large in its future.     

Beyond the metaphor of the pendulum: electroconvulsive therapy, psychoanalysis, and the styles of American psychiatry

It is common to represent the history of American psychiatry by comparing it to a pendulum. In this metaphorical rendering, psychiatry has swung back and forth between extremes of emphasis on psyche (life events and inner conflict ruling etiological thinking, talk therapy dominating treatment) and soma (biochemical sources dominating etiological thinking, somatic treatments dominating treatment). This article argues that, while this metaphor is suited to capturing certain aspects of American psychiatric history, it distorts others by, for example, exaggerating the extent of dogmatism on either side and obscuring continuities in psychiatry's history. The article looks specifically at the reception by psychoanalysts to the introduction of electroconvulsive therapy. It shows that psychoanalytic views of ECT were diverse and more receptive to ECT than the pendulum metaphor might lead us to believe.     

James Naughtie,The Accidental American: Tony Blair and the Presidency

Abstract

The terms "justice" and "necessity" are often employed in discussions of war. The just war tradition seeks to delineate when wars are and are not just; other theologians who do not find this approach helpful may nevertheless resort to the logic of necessity. Although unjust, some wars may still be deemed necessary. Barth employs both the language and logic of justice and necessity in his approach to war. The purpose of this paper is to address Barth's exposition of war in relation to his approach to divine justice and the necessity of Christian affliction. It does not attempt to make any large claims about the just war tradition or other approaches to war. Rather, it is intended to be an immanent critique of Barth from Barth's own theology, showing that, although consistent with his view of church and state, Barth's theology of war is inconsistent with his view of both God's character as just and the external necessity of affliction to Christian witness.     

The Forging of the Polish Army, 1918-1919

ABSTRACT

With the regaining of independence by Poland in November 1918 it was essential to create a unified homogenous army, the more so that Poland was faced by conflict from its neighbours at a time when the borders of Poland were by no means formed let alone finalised. There were at least four seperate Polish armies and a plethora of local formations springing up all over the country. From these four formations: the Polish Military Organisation, the Polnische Wermacht, the Greater Poland Army and the Polish “Blue” Army in France. Moreover, the officer and NCO corps came from four distinct traditions. Those of the wartime Legions (Polish tradition) and of the three partitioning powers. All had different military traditions and training. An important factor was also that many of the them had only a rudimentary knowledge of the Polish language having served in garrisons far from the Polish lands. Faced with wars with the Ukrainians for Lwów and the south eastern lands, with the Germans over the Province of Greater Poland, Pomerania and Silesia, with the Czechs over Teschen and above all with Bolshevik russia in the east it was essential that the Polish Army unified as quickly as possible. That this was done within the year and eventually resulted in Poland winning the Polish-Bolshevik War of 1919-1920 and securing its borders and independence was in no small measure a result of the rapid unification and creation of an homogenous Polish Army with a single command structure and organisation. The binding glue was the deep rooted sense of national pride and desire to live and work in a free Poland.     

The Reichswehr, the Republic and the Primacy of Foreign Policy, 1918-1923

This article contends that the relationship between the Reichswehrand the Republic was shaped by the primacy of foreign policybetween 1918 and 1923. In this period the major concern of theofficers was the stabilization of the German Reich, which wouldpreserve Germany as a Machtfaktor in Europe and serve as thebasis for a revisionist and militarized foreign policy. Foreignpolicy matters and aims shaped their attitude to domestic politics.Cooperation with the Republic enabled the officers to achievethe stabilization of the Reich by 1923. They were also ableto introduce important reforms in the military structure ofthe Reich, which showed that cooperation with the Republic couldpay dividends. In terms of the substance of foreign policy theReichswehr followed a pragmatic, unideological approach by developinglinks with the Red Army. By examining the relationship betweenthe Reichswehr and the Republic from the perspective of theprimacy of foreign policy, it is possible to come to a fullerunderstanding of the shifting nature of civil-military affairsin the Weimar Republic.