A Practioner’s ‘true dignity’: patient-doctor relationship in England (1770-1849)

Effective doctor-patient communication has a central clinical function: building a therapeutic doctor patient relationship, which is the heart and art of medicine. Although the patient is becoming more and more expert in any health issue, both at scientific and at legal levels, he/she is still looking for shared perceptions and feelings regarding the nature of the health problem, the supposed goals of treatment, and psychosocial support. This implies a revision of the traditional ways of approaching the patient-doctor relationship: what the patient is looking for is no longer a qualified ‘technician’ but a passionate ‘supporter’. As the history of medicine demonstrates, the doctor must have an in-depth knowledge of the main communicative and relational mechanisms (both verbal and non-verbal, cognitive and emotional), a holistic vision of illness, and a deep understanding of the varied signs and expressions of human discomfort (Cesa-Bianchi 1998, 2002, 2010; Cristini, Cipolli, Porro & Cesa-Bianchi 2012; Cristini, Porro & Spano 2012; Porro 2012; Porro & Cristini 2012). Our study here is aimed at revising the role of the third millennium practitioner through some milestones of medical ethics, published in England between the end of the XVIII and the beginning of the XIX century: from Gregory (1770) to Percival (1803; 1849) literature on the topic shows that the doctor, far from being a mere informant and a scientist, must be a good communicator and a ‘caretaker’.