{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T05:40:28Z","timestamp":1791265228277,"version":"4.1.0"},"reference-count":29,"publisher":"BMJ","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Med Ethics"],"published-print":{"date-parts":[[2006,6]]},"abstract":"<jats:p>Vesicovaginal fistula was a catastrophic complication of childbirth among 19th century American women. The first consistently successful operation for this condition was developed by Dr J Marion Sims, an Alabama surgeon who carried out a series of experimental operations on black slave women between 1845 and 1849. Numerous modern authors have attacked Sims\u2019s medical ethics, arguing that he manipulated the institution of slavery to perform ethically unacceptable human experiments on powerless, unconsenting women. This article reviews these allegations using primary historical source material and concludes that the charges that have been made against Sims are largely without merit. Sims\u2019s modern critics have discounted the enormous suffering experienced by fistula victims, have ignored the controversies that surrounded the introduction of anaesthesia into surgical practice in the middle of the 19th century, and have consistently misrepresented the historical record in their attacks on Sims. Although enslaved African American women certainly represented a \u201cvulnerable population\u201d in the 19th century American South, the evidence suggests that Sims\u2019s original patients were willing participants in his surgical attempts to cure their affliction\u2014a condition for which no other viable therapy existed at that time.<\/jats:p>","DOI":"10.1136\/jme.2005.012559","type":"journal-article","created":{"date-parts":[[2006,5,26]],"date-time":"2006-05-26T13:45:36Z","timestamp":1148651136000},"page":"346-350","source":"Crossref","is-referenced-by-count":109,"title":["The medical ethics of Dr J Marion Sims: a fresh look at the historical record"],"prefix":"10.1136","volume":"32","author":[{"given":"L L","family":"Wall","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2006,5,26]]},"reference":[{"key":"2025092413264459000_32.6.346.1","first-page":"59","volume":"23","year":"1852","journal-title":"Am Journal Med Sci"},{"key":"2025092413264459000_32.6.346.2","doi-asserted-by":"crossref","unstructured":"Harris S. Woman\u2019s surgeon: the life story of J Marion Sims. New York: Macmillan, 1950.","DOI":"10.1097\/00007611-195006000-00023"},{"key":"2025092413264459000_32.6.346.3","unstructured":"Barker-Benfield GJ. The horrors of the half-known life: male attitudes toward women and sexuality in nineteenth century America. New York: Harper and Row, 1976."},{"key":"2025092413264459000_32.6.346.4","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.87.11.1773"},{"key":"2025092413264459000_32.6.346.5","first-page":"10","volume":"22","year":"1985","journal-title":"Sage"},{"key":"2025092413264459000_32.6.346.6","unstructured":"McGgregor DK. From midwives to medicine: the birth of American gynecology. New Brunswick, NJ: Rutgers University Press, 1998."},{"key":"2025092413264459000_32.6.346.7","unstructured":"Byrd WM, Clayton LA. An American health dilemma: a medical history of African Americans and the problem of race, vol. 1: beginning to 1900. New York: Routledge, 2000."},{"key":"2025092413264459000_32.6.346.8","unstructured":"Kapsalis T. Public privates: performing gynecology from both ends of the speculum. Durham, NC: Duke University Press, 1997."},{"key":"2025092413264459000_32.6.346.9","doi-asserted-by":"publisher","DOI":"10.1136\/jme.19.1.28"},{"key":"2025092413264459000_32.6.346.10","unstructured":"Butterfield H. The whig interpretation of history. New York: WW Norton, 1965."},{"key":"2025092413264459000_32.6.346.11","first-page":"114","volume":"3","year":"1879","journal-title":"Trans Am Gynecol Soc"},{"key":"2025092413264459000_32.6.346.12","doi-asserted-by":"publisher","DOI":"10.1097\/01.ogx.0000148847.52752.62"},{"key":"2025092413264459000_32.6.346.13","doi-asserted-by":"publisher","DOI":"10.1016\/S0029-7844(02)02498-5"},{"key":"2025092413264459000_32.6.346.14","doi-asserted-by":"publisher","DOI":"10.1097\/00006254-199609000-00024"},{"key":"2025092413264459000_32.6.346.15","unstructured":"Velpeau A. New elements of operative surgery: in three volumes [trans Townsend PS]. New York: Samuel S Wood, 1847, volume III :858\u20139."},{"key":"2025092413264459000_32.6.346.16","unstructured":"Pancoast J. A treatise on operative surgery. Philadelphia: Carey and Hart, 1844."},{"key":"2025092413264459000_32.6.346.17","unstructured":"Schuppert M. A treatise on vesicovaginal fistula. New Orleans: Daily Commercial Bulletin Printers, 1866."},{"key":"2025092413264459000_32.6.346.18","doi-asserted-by":"crossref","unstructured":"King PA. Race, justice and research. In: Kahn JP, Mastroianni AC, Sugarman J, eds. Beyond consent: seeking justice in research. New York: Oxford University Press, 1998:88\u2013110.","DOI":"10.1093\/oso\/9780195113532.003.0006"},{"key":"2025092413264459000_32.6.346.19","unstructured":"Kollock PM. History and treatment of vesicovaginal fistula: a report read before the medical society of the state of Georgia, at their annual meeting at Augusta, April 8th, 1857. Augusta, GA: McCafferty\u2019s Office, J Morris, Printer, 1857."},{"key":"2025092413264459000_32.6.346.20","unstructured":"Hamlin C, Little J. The hospital by the river: a story of hope. Melbourne: Pan Macmillan Australia, 2003."},{"key":"2025092413264459000_32.6.346.21","first-page":"1","volume":"5","year":"1854","journal-title":"NY Med Gazette J Health"},{"key":"2025092413264459000_32.6.346.22","unstructured":"Sims JM. Silver sutures in surgery: the anniversary discourse before the New York Academy of Medicine, November 18, 1857. New York: William Wood, 1858."},{"key":"2025092413264459000_32.6.346.23","unstructured":"Sims JM. The story of my life. New York: D Appleton and Co, 1884."},{"key":"2025092413264459000_32.6.346.24","unstructured":"Fenster JM. Ether day: the strange tale of America\u2019s greatest medical discovery and the haunted men who made it. New York: HarperCollins, 2001."},{"key":"2025092413264459000_32.6.346.25","unstructured":"Pernick MS. A calculus of suffering: pain, professionalism and anaesthesia in nineteenth century America. New York: Columbia University Press, 1985."},{"key":"2025092413264459000_32.6.346.26","first-page":"25","volume":"39","year":"1859","journal-title":"Med Times Gazette"},{"key":"2025092413264459000_32.6.346.27","first-page":"109","volume":"1","year":"1854","journal-title":"Am Med Monthly"},{"key":"2025092413264459000_32.6.346.28","doi-asserted-by":"crossref","unstructured":"Schachner A. Ephraim McDowell, the \u201cfather of ovariotomy\u201d and founder of abdominal surgery. Philadelphia: JP Lippincott, 1921.","DOI":"10.1097\/00000441-192205000-00019"},{"key":"2025092413264459000_32.6.346.29","first-page":"705","volume":"5","year":"1849","journal-title":"South Med Surg J"}],"container-title":["Journal of Medical Ethics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jme.2005.012559","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T20:26:56Z","timestamp":1758745616000},"score":1,"resource":{"primary":{"URL":"https:\/\/jme.bmj.com\/lookup\/doi\/10.1136\/jme.2005.012559"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2006,5,26]]},"references-count":29,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2006,5,26]]},"published-print":{"date-parts":[[2006,6]]}},"alternative-id":["10.1136\/jme.2005.012559"],"URL":"https:\/\/doi.org\/10.1136\/jme.2005.012559","relation":{},"ISSN":["0306-6800","1473-4257"],"issn-type":[{"value":"0306-6800","type":"print"},{"value":"1473-4257","type":"electronic"}],"subject":[],"published":{"date-parts":[[2006,5,26]]}}}