American journal of diseases of children (1960)
-
Historical Article
Reared in adversity: institutional care of children in the 18th century.
The earliest public pediatric care of the 18th century in this country took the form of "outdoor relief." Institutional care followed, first almshouses were built; then orphanages, hospitals, and dispensaries. Almshouses not only included workhouses but provided comprehensive medical services. Throughout the 18th century, people often referred to the almshouses as hospitals. ⋯ By the middle of this 20th century, practically all of them had been absorbed by hospitals. In these institutions, pediatric knowledge advanced and medical manpower developed even during the 18th century. By the end of that century, social movements began from which evolved the 19th-century concern for the welfare of children.
-
Medical ethics has increased in importance in medical education and practice as a consequence of advances in definitive treatment of patients. Most problems in ethics related to medicine have certain common denominators. ⋯ Failure to differentiate moral from nonmoral decisions as well as differences in level of moral reasoning also account for substantial differences in analyzing a given clinical problem. Finally, individual moral policy may be rendered ineffective because of institutional policies that result from purely pragmatic considerations.
-
Pediatric ambulatory fellowships are post-residency training program designed to prepare pediatricians to deliver, organize, and evaluate primary pediatric care. A survey of the members of the ambulatory Pediatric Association details the funding, structure, content, and outcome of these training programs. The Ambulatory Pediatric Association has recently approved guidelines for the standards and content of these fellowship programs.