The Story of Dr. William Beaumont: The Accidental Father of Gastroenterology (Braun, W., HuffPost)

In 1822, Alexis St. Martin, a 20 year-old fur trapper, was gathering with other fur trappers at a trading post on Mackinac Island, Michigan. Another fur trapper had been drinking quite a lot of alcohol and accidently fired a musket, shooting St. Martin at a very close distance. The musket ball entered the skin and ribs, just below St. Martin's left nipple, which caused the man to fall to the ground. Hygiene and medical knowledge was limited at that time, so the other trappers figured that St. Martin would die very soon of infection or blood loss. They carried the injured man to a nearby army post where a Dr. William Beaumont was stationed. The men asked Dr. Beaumont to keep St. Martin comfortable.

Dr. Beaumont cared for St. Martin and bled him with leeches and gave him an enema, which was standard practice in 1822. Interestingly enough, St. Martin did not die.

As Dr. Beaumont observed his patient, he noticed that everything the he fed him seemed to emerge from the hole that was below his nipple. After two and a half weeks, St. Martin started having regular bowel movements and normal eating habits. However, the hole in his ribs remained open and connected directly to his stomach. A gastric fistula had formed, and his digestive tract was now open to the outside of his body. Dr. Beaumont started to realize that he could study the mechanism of digestion in the human body by tying small bits of food to a string and dipping them into the hole in St. Martin's thorax.

How could the Dr. convince the patient that they should agree to be a guinea pig and allow food tied to twine to be lowered into a hole in their body? Dr. Beaumont asked St. Martin if he would like to stay on as his manservant and help with chores around the hospital. Perchance St. Martin would not have wanted to return to the wilderness with a hole in his thorax. It is possible that, according to historical accounts, Dr. Beaumont convinced the barely literate St. Martin to sign a contract to be his servant. St. Martin stayed with Dr. Beaumont and acted as an experimental test subject for an additional 11 years.

In 1833, Dr. Beaumont published the first great works on digestive physiology. The doctor moved to St. Louis, Missouri and St. Martin moved or maybe fled to Quebec, Canada. Until Dr. Beaumont died in 1853, he tried to get St. Martin to come back and continue the experiments, but St. Martin would not. When St. Martin died in 1880, his family allowed the body to decompose before they buried him, just to ensure that another "mad scientist" would not try to resurrect him to pursue further research.

Step One: Gather Relevant Information- EX: Injury, Dr. noticed digestion process

Can you come up with more bits of relevant information that point to an ethical problem?

Step Two: Identify the Type of Ethical Problem

Moral Distress (Is the Dr. being prevented from doing something that he morally feels is right?)

Ethical Dilemma (Are there two opposing courses of action that can be taken?)

Locus of Authority (Is there more than one person that could be making an ethical decision?)

Step Three: Use Ethics Theories or Approaches to Analyze the Problem - Which would apply to this case?

Deontology - Focuses on duty

Teleology - Focuses on consequences

Principles-Based - Autonomy, Beneficence, etc.

Any others?