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From the foreword and the preface to the end of chapter 44 this is a fascinating and thought provoking (if very
occasionally to this particular reviewer just provoking!) collection of articles. Although the book is about pri-
mary care ethics anyone interested in health care ethics-including those who work in hospitals- will find in it
interesting and intellectually nourishing material. Whether you dip or devour, you won’t regret.
Raanan Gillon
Faculty of Medicine, School of Public Health
Emeritus Professor of Medical Ethics

This book is an excellent mix of ethical theories and exposition combined with practical examples. Written by
many of the thought leaders of the collective primary care conscience the chapters cover the reality of the breadth
of modern general practice. It is a valuable and accessible resource for everyday GP ethical dilemmas, for educa-
tors and for those developing policy.
Simon Gregory
Chair of RCGP Committee on Medical Ethics
Director and Dean of Education and Quality, Midlands and East
Health Education England

This enterprising collection spans the breadth of primary care in multiple ways. Contributions from general
practitioners, philosophers, nurses, physiotherapists, dentists, health economists, educationalists, patients and
others reflect the rich variety that makes up primary care. Authors do not shy away from the messy complex-
ity of primary care. Instead, they embrace the uncertainty inherent in the day-to-day reality of primary care.
Numerous stakeholder perspectives are used to identify and analyse ethical issues, using a diversity of frame-
works and models. The theoretical perspectives represented in the book (ranging from Hippocrates to postmod-
ernism) mirror the eclecticism of primary care itself. Practical advice sits alongside heartfelt accounts of issues
that challenge practitioners. The book is helpfully organised into four sections, on the primary care interaction,
vulnerable patients, teaching and learning, and justice and resources. The section on teaching and learning
is particularly valuable, with its strong focus on reflective practice and the practical challenges of combining
service delivery with educational goals. The section on the primary care encounter is wide-ranging, including
discursive explorations of important concepts as well as discussion of the specific features of primary care that
warrant its own ethical analysis. Case studies provide tantalising glimpses into the consultation, thereby show-
casing the richness of the primary care environment. Chapters in the section on justice and resources do not shy
away from political topics such as funding models and workforce issues.
The Handbook focuses on general practice as delivered within the National Health Service, which may limit
its appeal to other members of the primary care team. However, there is something here for everyone, whether
the reader is looking for guidance on duties in primary care, a framework for analysing a difficult consultation,
insights into the voice of the patient, or an understanding of the economics of primary care. Throughout there is
a welcome focus on ‘ethics of the ordinary’ or ‘everyday ethics’, reflecting the ethical nuances of the millions of
interactions that occur each day in primary care.
Wendy Rogers
Professor of Clinical Ethics
Macquarie University
 Handbook of
Primary Care Ethics

Edited by
Andrew Papanikitas
John Spicer
CRC Press
Taylor & Francis Group
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Library of Congress Cataloging‑in‑Publication Data

Names: Papanikitas, Andrew, editor. | Spicer, John, 1954- editor.

Title: Handbook of primary care ethics / [edited by] Andrew Papanikitas, John Spicer.
Description: Boca Raton, FL : CRC Press/Taylor & Francis Group, [2018] |
Includes bibliographical references and index.
Identifiers: LCCN 2017033137 (print) | LCCN 2017033901 (ebook) | ISBN
9781315155487 | ISBN 9781785230905 (pbk. : alk. paper) | ISBN
9781498769679 (hardback : alk. paper)
Subjects: | MESH: Primary Health Care--ethics | Family Practice--ethics |
General Practice--ethics
Classification: LCC R724 (ebook) | LCC R724 (print) | NLM W 84.61 | DDC
174.2--dc23
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 Contents

Foreword ix
Preface xi
Acknowledgements xv
Editors xvii
Contributors xix
How to use this book xxix

PART 1 THE PRIMARY CARE INTERACTION 1

1 Autonomy and consent in family medicine 3
Iona Heath and Jay Bowden
2 Benefits, harms and evidence – Reflections from UK primary healthcare 11
Margaret McCartney
3 Why it can be ethical to use placebos in clinical practice 17
Jeremy Howick
4 Compassion in primary and community healthcare 25
Joshua Hordern
5 The ethics of the family in primary care 35
Michael Weingarten
6 Culture and ethics in healthcare 45
David Misselbrook
7 The ethics of complementary and alternative medicine (CAM) 53
Nevin Mehmet and Christine Stacey
8 The oughts of omnipractice 61
John Spicer
9 Micro-ethics of the general practice consultation 71
Roger Neighbour
10 Analysing an ordinary consultation 81
Rafik Taijbee
11 The voice of the patient 91
Rosamund Snow

PART 2 ON VULNERABLE PATIENTS 95

12 Children and the ethics of primary care 97
Pekka Louhiala
13 On frailty and ethics: Negotiating narratives 105
Deborah Bowman
14 Achieving a good death in primary care: Ethical challenges at the end of life 113
Benedict Hayhoe

v
 Contents

15 The ethics and challenges in caring for vulnerable migrants in primary care 123
Paquita de Zulueta
16 Proximity, power and perspicacity: Ethical issues in primary care research 137
Jonathan Ives
17 Integrating ethical theory with musculoskeletal primary care practice 145
Clare Delany
18 Power, prejudice and professionalism: Fat politics and medical education 159
Jonathon Tomlinson
19 Genethics and genomics in the community 169
Imran Rafi and John Spicer
20 Confidentiality and forensic disclosure in the primary healthcare setting 179
Helen Salisbury, Sharon Dixon, and Selena Knight
21 Mental health and ethics in primary care 187
Selena Knight, Andrew Papanikitas, and John Spicer
22 Veterans and the ethics of reciprocity in UK primary healthcare 197
Hilary Engward
23 On residential care ethics 203
Michael Dunn

PART 3 TEACHING AND LEARNING 211

24 Ethics and the professional identity of a general practitioner in twenty-first century Britain 213
John Gillies
25 Teaching and learning ethics in primary healthcare 225
Andrew Papanikitas and John Spicer
26 Interprofessional ethics in the primary care setting 233
Hilary Engward
27 The ethics of teaching and learning in primary care 241
John Spicer and Andrew Papanikitas
28 Evidence-based primary care ethics 251
Roger Newham and Andrew Papanikitas
29 Narrative ethics and primary care 259
John Launer
30 Learning from the assessment of ethics in UK general practice 267
David Molyneux
31 Try this at home: Values-based practice and clinical care 279
Bill (KWM) Fulford and Ed Peile
32 Adopting an alternative worldview: Perspectives from postmodernism 287
Chris Caldwell and Sanjiv Ahluwalia

PART 4 ON JUSTICE AND RESOURCES 295

33 Beyond rationing: The ethics of commissioning in and by primary healthcare 297
Dennis Cox and Andrew Papanikitas
34 The moral atom: Mapping out the relational world of healthcare professionals 307
Ioanna Psalti
35 Moral ecosystems: Exploring the business dimension in healthcare reforms 315
Ioanna Psalti and Michael Paschke

vi
 Contents

36 The duty of candour in primary care 327

Suzanne Shale
37 The inescapability of conscience in primary healthcare 341
Andrew Papanikitas
38 Professional self-care in primary care practice – An ethical puzzle 353
Emma McKenzie-Edwards
39 Global primary care ethics 361
Bridget Kiely and Carwyn Rhys Hooper
40 Primary care, the basic necessity: Part I: Explorations in economics 369
Malcolm Torry
41 Primary care, the basic necessity: Part II: Explorations in ethics 377
Malcolm Torry
42 The special ethics of dentistry 385
David Obree and Andrew Trathen
43 The ethics of administration 393
Peter Toon
44 From professionalism to regulation and back again 401
Surendra Deo

Index 411

vii
 Foreword

From a traditional clinical point of view, community or general practice may not seem to be
easy. Where tasks are defined, and challenges have known causes, researched treatments and
objective outcomes, it might be said that everyone knows where they are, and problems are
largely professional ones. In community practice, however, very few of these descriptions apply.
Here, a patient’s complaints may be poorly defined and hard to grasp, or multiple, disparate and
overwhelming. Whether speaking to a nurse, a physiotherapist, a public health practitioner or
any other specialist, the way in which a patient or his/her relative explains the condition may be
unfamiliar to the professional, and the key issue may be tangential, unexpressed or even delib-
erately hidden. Patient’s lifestyle or culture may be very different from that of clinician’s life-
style and has different preoccupations or aims from those with which she is familiar. Arriving
from the security of hospital practice, the newcomer may feel deprived of skills, in a fog, as if
she had suddenly been dropped into a boundary zone, the badlands, where every move seems
to provoke more problems. Leaning on such insecure foundations, community public health
can seem to share some of these structural faults. As to generalising in terms of planning or
politics, well, some might say, best not to try.
In such a situation, many would feel that they have enough to cope with without the addi-
tional stress of asking a moral question, such as what is best, what might be better and what is
right and wrong? But, the very reverse is the case. Without those questions, confusion is further
confounded. Once they begin to be asked, the fog begins at last to clear. Medical ethics started
as a discipline over half a century ago when specialist treatments like transplants and dialysis
were new, but this book turns the searchlight towards the place where moral issues actually
arise. It brings its focus sharply onto what should be done there in the making of ordinary
everyday decisions.
Yet here again, if we are not careful, a similar difficulty as we started with above can arise.
Ethical issues have come to be described and categorised under clear phrases or labels that are
linked to an ill-considered action or (conversely) to an ideal aim. Many of these derive from
the struggles in a hospital or teaching context to cope with the bizarre or the impossibly chal-
lenging. But, in the press of professional life in primary care, the issues are different; and many
decisions simply do not come with familiar headings or indeed with moral headings at all. For
instance, where medical practice meets people’s ordinary lives, the question in mind may often
be less what to do about ‘this illness’ than whether there is an ‘illness’ here to be attended to at
all. Where health as a concept has various interpretations, the good outcomes desired may not
even be expressed in terms of improved health.
Thus, the issues that a person could discuss or encounter with a primary care clinician are
both hard to predict and at the same time theoretically almost limitless. A professional in com-
munity practice, therefore, should think clearly, discuss with all involved and make good deci-
sions about topics that may be surprising and may well not have any easy labels. And his or her
authority will largely reside in being able not just to reach a decision but also explain and justify
in terms that satisfy the patient as to why she has reached the conclusions that she has. Both

ix
 Foreword

the boundaries and the conclusions will have to be clear, even in a fuzzy field – if only for the
sake of the rest of the work that day!
How should we learn to do this? Paul Freeling, an early pioneer in academic practice, was
fond of asking ‘Give me a case and I’ll give you a research project’. The same could very pro-
ductively be said for thinking in ethics. I would maintain that almost every encounter between
individuals or groups in primary care would productively raise a small handful of issues whose
discussion would improve that care. But in this rich profusion, where should one start? There
are many possibilities, not the least of which is simply realising when on reflection what you
are doing or being asked to do is simply wrong, or could have been done a lot better. Also, one
of my own surprises as a (relatively!) calm individual was, having often been anxious but never
angered as a hospital doctor, how frequently in general practice I had to control my temper. So it
has come to be my view that passion of any sort – anger, say, or extreme enthusiasm, disdain or
disgust – indicates something that needs urgent ethical examination (as well as management).
Therefore, we might also say ‘give me a strong emotion (expressed or repressed) in a medical
encounter and I’ll give you an ethical issue’. Whether we are working as an individual or in
a team, in treatment or prevention, in research, teaching, management, advocacy or politics,
the resulting analysis should always be cool and clear, but should never deny its origin in a
‘hot’ topic. Moral medical practice is made for man, not, as sometimes seems to be the attitude
within professions, the other way round.
We shall all need the insights of a wide range of disciplines to help us, both in the formula-
tion and in the processing of such work, even though this field of applied ethics may need to
start and finish at different points from those disciplines. The challenges are many: somehow
we have to bring clear thinking to bear on a charged debate, to make the discussion, whether
with others or in our own heads, wider by consciously addressing the arguments against our
own cherished opinions as well as for them, and, where medical ethics often parts company
with its philosophical advisers, reaching a conclusion which could actually and immediately be
put into practice. We shall need to keep a close eye on what we are there to do, and how best to
work with others: as one might put it, a good sense of ‘self’, of ‘other’ and of ‘together’.
At this point, it should be clear how important this book is, perhaps even raising the ques-
tion about how we have managed without it before. You will find it does not flinch from explor-
ing possible issues, and more. It covers the meeting between patients and their advisers in
community care from the beginning of the encounter to the end. It examines the way in which
problems come to community practice as well as the minutiae of the doctor’s response: and
goes out from clinical behaviour to wider issues in public health and community politics. It
not only asks what is right but also how to find what is better in the midst of so much demand
on the resources of time and energy. Nobody wants the dogmatic or moralistic, and what will
always be important in every area will be to lay out clearly the thinking and reasoning that will
help us to reach conclusions, the ‘why’ as well as the ‘what’.
Read it carefully but critically: your day may be a bit longer, but I can assure you your nights
will be very much more peaceful.

Roger Higgs
Institute of Medical Ethics
St Helens, England

x
 Preface

Handbooks tend to be light on grand concepts. I’ll put forth only one.
‘The danger of isolation, and the healing power of good connection’.
What I will describe here I would call ‘A relational ethics’.

Since 1978, when my first novel, The House of God, appeared1, I have been asked to speak all
over the world, and from the start, in a less refined way, this concept has always been what
I say, putting it in terms of ‘Staying Human in Medicine’. I’m delighted to use it here, in this
remarkable scholarly and pragmatic volume put together by my dear and remarkable friends
Andrew and John.2 Note that this guiding phrase is central not just to medicine but also to our
lives. My attempt to write about American primary care is a novel, The Spirit of the Place, about
a doctor going back to his home town to join the old doc who steered him into medicine when
he was a lost teenager.3
Hints of this concept were present in The House, in rudimentary form. Over and over, there
is the phrase, ‘Being with (x)’ – sometime ‘x’ is the patient, or a family member, or a colleague,
or, even oneself. As The Fat Man, the hero of the novel who deftly conceals his deep care for
patients, docs, and life itself: ‘I make them feel that they’re still part of life, part of some grand
nutty scheme instead of alone with their diseases. With me, they still feel part of the human
race’. And at the end of the novel, the African-American intern chuck sums up the main reason
that the year in The House has been horrific: ‘How can we care for patients, if nobody cares
for us?’.4 The tone of any institution comes from the top; the top of the House was unwise and
abusive in the way that almost all big power-over systems are such. In my new institution-
alisation, New York University Medical School, run by three of my generation who trained at
‘The House of God’ hospital, there is an aura of ‘We were treated badly, and now that we are
in a position of power, we will not treat the ‘lower-downs’ badly’. The institution reflects this
kindness from the top, all the way through.
What is a good connection? (See We have to talk: Healing Dialogues between Women and Men,
the novel Mount Misery and the play Bill W. and Dr. Bob).5,6,7
Think of going to lunch with a friend. If the lunch goes well, by the end each of you feels an
increase of ‘five good things’: more energy or zest, more sense of self-worth and worth of the
other, more self-knowledge and knowledge of the other, more empowered to take action, and,
last, a desire for more connection – ‘Hey let’s do this again soon!’ Note, especially the issue of
‘power’. This is not the traditional model of the dominant culture, where ‘power’ resides in a
person. Rather, the power here arises in connecting. You may have felt burnt out, unable to act,
disempowered, when you went to lunch, but in the mutual connecting there is an arising of
power in both of you. (The gerund is as close as our language gets to describing this.) This is
especially helpful for doctors: it means that good connection helps you to take action in your job
and your life! It helps you to be a better clinician and person. Note that in this ‘relational model’,
the measure of a person’s psychological health and growth does not reside in the ‘self’. Rather
it resides in the quality of that person’s relationships.

xi
 Preface

THREE NEW LAWS OF MEDICINE*

A good connection is a mutual connection; a good relationship is a mutual relationship. If it
ain’t mutual, it ain’t good; if it is, it is. A mutual connection is when each person sees the other
clearly, and each person senses the other ‘feeling seen’. There’s a ‘click’ – like, well, what we call
love. We know it when know it.
This leads to three new Laws of Medicine, crucial to primary care – and – do see this – to our
lives:

1. The Shift to the ‘We’, ‘The Connection’, ‘The Relationship’: We live in an ‘I’/’You’ world,
which implies adversarial relationships, the kind that makes lawyers rich. It is quite easy
to introduce the word ‘We’ into conversations with patients and others in your life. Way
back when I was a psychiatrist, I found that if I said to a patient, ‘Tell me about your
mother’, I would hear about the mother, usually in narrowly ‘self’ terms; if I asked ‘tell me
about the relationship with your mother’, all of a sudden the aperture opened up, and the
patient would say, ‘Well, in the relationship with my mother, there’s x, y, z’ – which were
in fact, the ‘qualities of the relationship with the mother’, which opened things up for our
understanding, and, frankly, healing. Here’s the key: if you as a doctor (and person) use
the word ‘We’, the patient will answer using the word ‘We’ – and the word concretises the
fact that there is a relationship here! Old time patriarchal surgeons used to say, ‘I did
the tests, and I’m going to operate on you’. Now surgeons might say, ‘I did the tests, and
I suggest operating, but you can get a second opinion’. Both statements are ‘I’/‘You’. But
if the surgeon says, ‘I did the tests. Let’s talk about what we can do’. The patient will say,
‘Well I think we can…’ Try it. Oh, and the main reason surgeons get sued is if the patient
doesn’t feel there is a good relationship there.
2. Connection Comes First: With a patient (or, e.g., a spouse or friend), if you are in good
connection, you can talk about anything; if you’re not in good connection, you can’t talk
about anything. Connection comes first. And connection with a patient is not really a
matter of the time it takes: the good docs can do it quickly, with a look, a hand in a hand
or on a shoulder, an attentive listening (most doctors interrupt within 17 seconds and talk
80% of the time thereafter).
3. It’s Not Just What We Do, It’s What We Do Next: In relationships – again, with patients and
others – nobody gets it right all the time – it’s what you do after you get it wrong that
matters. The challenge is, when you are in a disconnect, if you can ‘hold the idea that
there is a relationship here, with a past and present, you can walk the other through it to
a better connection’. In fact, just to say, at that crucial fractious angry or sullen moment:
‘We’re in a disconnect’ – is a connecting statement. Differences can be used in dialogue
to turn disconnections into better connections. We describe this work of moving from
disconnects to connection in terms of gender difference in We Have to Talk: Haling
Dialogues between Women and Men.5

* In 1978, Samuel Shem’s novel The House of God offered a set of rules of thumb (the ‘Laws’) that were essen-
tial to newly qualified doctors’ survival. The ‘Laws’ of The House of God, as espoused by the all-knowing
fictional resident The Fat Man, were the key to survival for both interns and patients. The novel was recently
named on Publishers Weekly as the second in the Ten Best Satires of all Time, after Don Quixote.

xii
 Preface

WHAT’S ALL THIS GOT TO DO WITH PRIMARY CARE?

Well, since this admirable specialty is the closest to living your job, in community, all this is
central to every aspect: from individual patients to when you turn out the light and go home and
in your centrality in your community, your country – hey, your world. And boy does the world
need us to know how to connect, and create community and live with others, now. Clinicians
are in a great position, through the job we have taken on – not for money or fame or any other
of the ‘craving’ jobs where the process and the product is the same – making money – but for
providing care for those who suffer: to be with others at the crucial moments of their lives, the
three Buddhist ‘heavenly messengers’ of ‘illness, old age and death’, and helping to walk them
through. It’s a great job – despite the epidemic of all the admin-shit by the financiers.
In my novel The Spirit of the Place, about primary care in a small town, at one point the young
doctor has to make a decision. He is surprised to hear the words, ‘Don’t spread more suffering
around. Whatever you do, don’t spread more suffering around’. And he makes his decision. We
clinicians, especially in your specialty, are lucky: we are present at the most crucial moments of
our patient’s lives – and their families’ lives. As we all know, everyone suffers – big suffering,
little suffering, it’s not optional. If any of us, clinicians or patients, try to walk through it alone,
tough it out – we will suffer more and spread more suffering around. But if we walk through the
crucible of suffering with others – and that’s where we clinicians come in, that’s our job, that’s
why we went into this specialty, not or the big bucks or the fame – if we walk with them through
their suffering, we and they will not suffer as much, and will not spread more suffering around,
and we will come through it with awareness, and even joy.8

Samuel Shem
NYU Langone Medical Center, NY

REFERENCES
1. Shem S. The house of god. New York: Richard Marek Publishers Inc.; 1978.
2. Papanikitas A, Spicer J, eds. Handbook of primary care ethics. London: CRC Press; 2016.
3. Shem S. The spirit of the place. New York: Berkley Publishing Group; 2008.
4. Shem S. The house of god. London: Black Swan Edition; 1985: 372.
5. Shem S, Surrey J. We have to talk: Healing dialogues between women and men. New York:
Basic Books; 1998.
6. Shem S. Mount misery. New York: Random House; 1997.
7. Shem S, Surrey J. Bill W. and Dr. Bob. New York: Samuel French; 1987.
8. Shem S, Surrey J. The Buddha’s wife: The path of awakening together. New York: Atria
Books; 2015.

xiii
 Acknowledgements

The editors would like to thank all of our contributors and reviewers, as well as the publishing
team at Taylor and Francis.
We feel fortunate indeed that Elsbeth Manders agreed to grace our cover with her artwork.
We would also like to acknowledge the institutional support that has made this volume
possible. The Royal Society of Medicine Open Section and General Practice and Primary
Healthcare Section have run an annual Primary Care Ethics conference since 2011 with inputs
from a group of clinicians and academics who have from time to time been called The Ethics of
The Ordinary group or the Primary Care Ethics Group.
The Nuffield Department of Primary Care Health Sciences, Harris Manchester College, The
Collaborating Centre for Values-Based Practice, The Oxford Healthcare Values Partnership and
The Oxford Research Centre for the Humanities have all provided support and creative space
as we and our contributors developed this project. We would similarly like to acknowledge the
Royal College of General Practitioners’ committee on medical ethics, and successive RCGP
conference organising committees who have provided a much needed forum for the discussion
of ethical issues. Much research took place at the British Medical Association library and we
thank the staff for their assistance.
Our work with many groups of learners, particularly those centred in primary care, over
the years has helped stimulate and evolve our interest in conceiving and developing this book.
We finally thank our colleagues, our patients and our families, for keeping us grounded in
the real world and (in the case of the latter) occasional tea and proofreading.

xv
 Editors

Andrew Papanikitas is an academic general practitioner currently in an academic clinical

lectureship in the Nuffield Department of Primary Care Health Sciences at the University of
Oxford. He holds degrees in medicine, the history of medicine, and medical law and ethics, as
well as postgraduate diplomas in history, philosophy, child health and higher education teach-
ing. He has taught medical ethics and law at King’s College London (KCL) and St George’s
medical schools. From 2010 to 2017, he has co-led a module on ethics law and professionalism
for the KCL Department of Primary Healthcare. He currently co-leads an online MSc module
in ‘Ethics for the biosciences’ at the University of Oxford. He is on the council of the Royal
Society of Medicine GP and Primary Healthcare Section and was president of the RSM Open
Section from 2012 to 2015. He currently serves as a co-opted observer on the Royal College
of General Practitioners’ ethics committee. He has been ethics and philosophy editor for the
London Journal of Primary Care and peer reviews for several journals. He has written several
books and chapters themes relating to both clinical examinations and medical ethics, including
the ‘Crash course in medical ethics and sociology’. In January 2014, he was appointed direc-
tor for the Society of Apothecaries’ Diploma Course in philosophy and ethics of health care.
Dr Papanikitas’ PhD thesis, ‘From the classroom to the clinic: ethics education and general
practice’, explores ethics education in UK general practice.

John Spicer is a general practitioner in London, and Head of Primary Care Education and
Development for Health Education England – South London. He has taught and written on
clinical ethics for many years, having previously been a senior lecturer in law and ethics at
St George’s University of London. He is a member of the UK Clinical Ethics Network board,
and a London Arts and Health Forum trustee.

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 Contributors

Sanjiv Ahluwalia is postgraduate dean at Health Education England – North Central and East
London. He was previously Head of Primary Care Education and Development. He led on the
development and provision of primary care education and development, including GP training.
He is also a practising GP in a deprived community in North London. He has been involved
in postgraduate education since 2002, as a GP trainer, programme director, associate director
and Head of School for GP Training across London. Sanjiv’s interests include the effects of
postgraduate GP training on patient outcomes, medical professionalism and complexity theory
in healthcare and education.

Stephen Bergman, professor of medical humanities at New York University, writes under the
name Samuel Shem. Alongside a career in psychiatry, he is an acclaimed author of several
novels, plays and textbooks, and his work has been translated into several languages. The House
of God, his first novel, has sold over 3 million copies. His work exposes the potential moral chal-
lenges of the medical workplace and the connection between values, good relationships and
healing. Other novels include Mount Misery (a darkly comic tale about psychiatric training) and
the Spirit of the Place, set in the context of American small-town family practice. His most recent
play is Bill W and Dr Bob, written with partner Janet Surrey about the foundation of Alcoholics
Anonymous.

Jay Bowden is a general practitioner in South London with a diverse portfolio including medi-
cal education, integrated adolescent health, NHS and private general practice. He has worked
with a variety of different patient demographics, ranging from deprived inner city areas to
affluent leafy London suburbs and even spent some time at a medium security prison, though
not at Her Majesty’s pleasure! This diverse experience has enabled him to reflect on some of
the enablers and barriers to patient autonomy. He is a strong believer in innovation in health-
care, particularly where this involves integration of services and empowerment of patients to
improve outcomes. He has taught medical ethics at undergraduate level and retains a strong
interest in this field.

Deborah Bowman is professor of bioethics, clinical ethics and medical law and deputy ­principal
(Institutional Affairs) at St. George’s, University of London. She is also the Editor-in-chief of
the BMJ journal Medical Humanities. She is particularly interested in therapeutic relationships,
narrative ethics, mental health, public engagement and the ways in which moral questions can
be explored via the arts, particularly theatre and literature. She is a regular broadcaster and has
contributed to, and presented, a wide range of programmes, particularly for radio, including
Inside the Ethics Committee, Test Case, Inside Health, Night Waves and Start the Week.

Chris Caldwell is executive director of Nursing at Tavistock & Portman NHS Foundation
Trust in London and programme director for the CapitalNurse Programme, working with
Health Education England (HEE), NHS England and NHS Improvement. Chris was previously

xix
 Contributors

dean for Healthcare Professions at HEE working across North Central East London. Other
past roles include Assistant Director of Nursing, Education and Organisational Development at
Great Ormond Street Hospital for Children in London as well as a range of roles in education,
clinical practice and policy at local and national level. She is an honorary visiting professor at
City, University of London, vice chair of the London Perinatal Mental Health Network and a
member of the London Mental Health Programme’s Clinical Leadership Group. Chris is a reg-
istered nurse in adult and children’s nursing and a nurse teacher. She has a Masters in Health
Psychology and gained her Doctorate from Ashridge Business School focusing on transforma-
tional organisational change.

Dennis Cox is a GP based in Cambridge with 35 years of clinical experience. He has an MA

in medical law and ethics and has taught at the medical school in Cambridge. He is an experi-
enced expert witness for the courts and was a member of the Liverpool Care Pathway Review
Panel for the Department of Health. He is a current member of the RCGP ethics committee.

Clare Delany is an associate professor in medical education at Melbourne Medical School, The
University of Melbourne. Clare also works as a clinical ethicist at the Royal Children’s Hospital
Children’s Bioethics Centre in Melbourne conducting clinical ethics consultations, education
and research in paediatric bioethics. Clare’s research and publications have mostly centred on
physiotherapy; however, she reaches beyond the profession to teach and research in clinical
ethics, health professional education and higher education more broadly. Clare has served as
vice president of the Physiotherapists’ Registration Board in Victoria and chair of the Australian
Physiotherapy National Professional Standards Panel and is current chair of the Humanities
and Applied Sciences Human Research Ethics Committee at the University of Melbourne. Her
most recent book as co-editor is titled: When Doctors and Parents Disagree: Ethics, Paediatrics and
the Zone of Parental Discretion.

Surendra Deo has a background in general medical practice, forensic medicine, and profes-
sional regulation. He is a case examiner and employer liaison advisor with the General Medical
Council in the UK, and an associate director for the Health Education England in North
London. In the past, he was an adjudicator for the Solicitors Regulation Authority in the UK.
The chapter was prepared in a personal capacity. The opinions expressed in this book are the
author’s own and do not reflect the views of the GMC or Health Education England.

Sharon Dixon is a general practitioner in Oxford, UK. She is a medical adviser with the Health
Experiences Research Group within the primary care department at the University of Oxford.
She is a tutor on the clinical communication skills course in the Oxford University Clinical
School. Sharon is the Oxfordshire primary care lead for Female Genital Mutilation and is a
member of the Oxfordshire FGM multi-agency operations group.

Michael Dunn is a lecturer in health and social care ethics at the Ethox Centre, University
of Oxford. He is also the director of Undergraduate Medical Ethics and Law Education, and
the director of the Ethox Centre’s Graduate Research Training Programme. Michael’s aca-
demic research interests span a range of issues in healthcare ethics and bioethics, and he
is the author of over 50 peer reviewed journal articles and book chapters. The predominant
focus of his current work seeks to address ethical questions presented by the development and
expansion of community-based and long-term care practice, law and policy – both in the UK
and internationally. Michael is a senior fellow of the Higher Education Academy (SFHEA), an
xx
 Contributors

associate editor of the Journal of Medical Ethics, a member of the editorial board of Ethics and
Social Welfare, and a member of both clinical and research ethics committees.

Hilary Engward is a senior research fellow in the Veterans and Families Institute at Anglia
Ruskin University, where she leads on research into veterans and families living with limb loss.
Hilary is a senior lecturer on PhD/EdD courses, with a specific interest in interprofessional
learning and working across the medical and health professions. She also leads on research
exploring organisational understandings of incident and serious incident reporting in NHS
organisations and teaches health care ethics across medical and nursing undergraduate and
postgraduate courses at various organisations.

Bill (KWM) Fulford is a fellow of St Catherine’s College and member of the Philosophy Faculty,
University of Oxford; emeritus professor of philosophy and mental health, University of Warwick
Medical School; and director of the Collaborating Centre for Values-based Practice, St Catherine’s
College, Oxford (valuesbasedpractice.org). His previous posts include honorary consultant psy-
chiatrist, University of Oxford, and special adviser for Values-based Practice in the Department
of Health. His publications include Moral Theory and Medical Practice, The Oxford Textbook of
Philosophy and Psychiatry and The Oxford Handbook of Philosophy and Psychiatry. He is lead editor
for the Oxford book series International Perspectives in Philosophy and Psychiatry and founder
editor and chair of the Advisory Board of the international journal Philosophy, Psychiatry, &
Psychology (PPP). His Essential Values-based Practice (2012), co-authored with Ed Peile, is the launch
volume for a new series from Cambridge University Press on values-based medicine.

John Gillies was a rural general practitioner in Scotland for 28 years after working in Africa. He
is interested in ethics and philosophy of medicine. He is now an honorary professor of general
practice at the University of Edinburgh, deputy director of the Scottish School of Primary Care
and co-director of the Global Compassion Initiative of the University Global Health Academy.

Benedict Hayhoe is a general practitioner in central London, and NIHR clinical lecturer in
primary care at Imperial College London. He qualified from University College London in 2005
and was awarded an LLM in Legal Aspects of Medical Practice from Cardiff University in 2009.
Having completed his MD on the subject of advance care planning in primary care in 2014, he
remains interested in the interaction of law and ethics with medical practice and in dementia,
elderly and end-of-life care.

Iona Heath worked as an inner city general practitioner in Kentish Town in London from
1975 until 2010. She is a past president of the UK Royal College of General Practitioners. She
has written regularly for the British Medical Journal and has contributed essays to many other
medical journals across the world. She has been particularly interested to explore the nature of
general practice, the importance of medical generalism, issues of justice and liberty in relation
to healthcare, the corrosive influence of the medical industrial complex and the commercialisa-
tion of medicine, and the challenges posed by disease-mongering, the care of the dying and
violence within families.

Roger Higgs worked for over 30 years in south London as general practitioner and academic.
He founded a single-handed practice that went on to be a major multidisciplinary group
and started the Department of General Practice and Primary Care at King’s College School
of Medicine (now King’s College). Awarded MBE as service developer and educator, he has
xxi
 Contributors

published in these areas as well as medicine and bioethics. His particular interests in the latter
are case analysis, truth telling and narrative approaches, and books include In That Case with
Alastair Campbell and The New Dictionary of Medical Ethics with Kenneth Boyd and Anthony
Pinching. He teaches on the Society of Apothecaries’ Diploma Course in philosophy and ethics
of healthcare.

Joshua Hordern is associate professor of Christian ethics in the Faculty of Theology and
Religion at the University of Oxford and a fellow of Harris Manchester College. He leads the
multi-disciplinary Oxford Healthcare Values Partnership (www.healthcarevalues.ox.ac.uk) and
serves on the Royal College of Physicians Committee for Ethical Issues in Medicine. Before
taking up his post in Oxford, he was a research fellow at Wolfson College in the University
of Cambridge, associate director of the Kirby Laing Institute for Christian Ethics and a local
authority councillor with St Edmundsbury Borough Council. His publications include Political
Affections: Civic Participation and Moral Theology (Oxford University Press, 2013). He is married
to Claire, a doctor.

Jeremy Howick received his PhD from the London School of Economics in 2008. He was a
lecturer at University College London, and he is currently a senior researcher at the University
of Oxford, where he does both philosophical and epidemiological research on placebos and the
value of empathy. He has published widely on evidence based medicine and the placebo effect.
Dr. Howick is also the founding director of the Oxford Empathy Programme

Carwyn Rhys Hooper was born in Wales and currently lives in London. He is a senior lecturer
in medical ethics and law at St George’s, University of London. He is also the course director for
a number of different global health degrees at the same institution. After completing a medical
degree he studied philosophy. He then completed a PhD in law. Carwyn has a particular inter-
est in global health ethics and public health ethics. He is also very interest in public engagement
and he regularly discusses ethico-legal issues on television and radio. He is the general and
company secretary of the Institute of Medical Ethics and he has served as an ex officio member
of the clinical ethics committee at St George’s University Hospitals NHS Foundation Trust for
seven years.

Jonathan Ives is a senior lecturer in biomedical ethics and law in the University of Bristol’s
Centre for Ethics in Medicine, having previously worked at the University of Birmingham.
His primary research interests are the Ethics and Sociology of fatherhood and families, and
­methodology in Bioethics, but he has published on a variety of topics including research e­ thics,
end of life ethics, and ethics and medical education. He is editor of the book Empirical Bioethics:
Theoretical and Practical Perspectives, published by Cambridge University Press, and is a co-opted
member of the Royal College of General Practitioners Medical Ethics Committee.

Bridget Kiely is a general practitioner, with a background in Public Health and Tropical
Medicine. Working with King’s Sierra Leone Partnership at Connaught Hospital in Freetown,
Sierra Leone, she witnessed the consequences of poor access to quality primary care on a daily
basis, from unnecessary deaths due to vaccine preventable illnesses such as tetanus to renal
failure from untreated hypertension. She worked with the Ministry of Health and Sanitation
in Sierra Leone on their post Ebola recovery plan that aimed to significantly increase access
to basic essential services. Currently she works with SafetyNet Primary care, a charity
dedicated to bringing primary care to marginalised and vulnerable populations in Ireland.
xxii
 Contributors

She is passionate about the importance of primary care at a global level and universal access
to health care and takes every opportunity to advance these causes.

Selena Knight is a GP Registrar at Chelsea and Westminster Hospital and an academic clini-
cal fellow in the Department of Primary Care and Public Health at King’s College London. She
has BSc in Medical Ethics and Law from King’s College London. She has continued her interest
in ethics through establishing an ethics teaching programme for medical students at Imperial
College London, being a member of the Imperial College Clinical Ethics Committee, and work-
ing as an intern at the World Health Organisation’s Global Health Ethics Unit. Her main areas
of interest are ethics education, clinical ethics and public health ethics.

John Launer is a doctor, family therapist, educator and writer. He was a general practitioner
in Edmonton, north London, for over 20 years, and is an honorary consultant at the Tavistock
and Portman NHS Trust. He is currently lead programme director for educational innovation
at Health Education England. He has written extensively on narrative medicine and its applica-
tions in primary and secondary care.

Pekka Louhiala is a lecturer in medical ethics at the University of Helsinki. He has degrees
in both medicine and philosophy, and he also works as a part-time paediatrician in private
practice. He has published on various topics in medical ethics, philosophy of medicine and
epidemiology. His current academic interests include conceptual and philosophical issues in
medicine, such as evidence-based medicine and placebo effects.

Margaret McCartney is a general practitioner in Glasgow who writes about evidence-based

medicine. She is the author of The Patient Paradox: Why Sexed Up Medicine is Bad for Your Health
and Living with Dying: Finding Care and Compassion at the End of Life.

Emma McKenzie-Edwards is a general practitioner and medical educator in Oxford. She

teaches undergraduates at Oxford University and runs a course at Magdalen College School
in Oxford for sixth formers considering studying medicine. Emma has previously taught at the
Peninsula College of Medicine and Dentistry in Exeter and the Australian National University
in Canberra.

Nevin Mehmet is the senior lecturer in healthcare ethics at the University of Greenwich.
She runs the undergraduate and postgraduate ethics teaching for the Paramedic Science
and Applied Health Science programmes. Following her BSc in Complementary Therapies,
she pioneered integrated healthcare by instigating an aromatherapy clinic within a GP
surgery in North London while also co-ordinating a Complementary Therapy Clinic in a
large south London family practice that was also the training centre for Aromatherapy and
Complementary Therapy students. She also participated in preparation for the voluntary reg-
ulation of Aromatherapists for the CNHC. While participating in the development of Health
and Well-being programmes at the university, she completed her MA in healthcare ethics and
law at Keele University and is currently researching ethics education for paramedic practice
for her doctoral studies.

David Misselbrook was a South London GP for 30 years. He was involved with GP training,
CPD development and medical ethics. He is dean emeritus of the Royal Society of Medicine, past
course director of the Society of Apothecaries diploma course in philosophy applied to medicine
xxiii
 Contributors

and is senior ethics advisor to the British Journal of General Practice. He now teaches family medi-
cine and ethics for RCSI Bahrain, where he is associate professor of family medicine.

David Molyneux is a general practitioner and GP educator who works in East Lancashire. He
is involved in GP education throughout the north of England and runs medical ethics courses
for GPs and GP registrars. He has been a clinical skills (CSA) examiner for the Royal College of
General Practitioners since the examination began. He also works at the University of Leeds as
a medical ethics tutor and a personal tutor. His research interests concern the nature of auton-
omy and the relationship between autonomy and welfare. He has been awarded a doctorate in
professional medical ethics at Keele University and is currently completing a BA in philosophy
at London University.

Roger Neighbour is a past president of the Royal College of General Practitioners. He is the author
of The Inner Consultation, The Inner Apprentice and The Inner Physician. Now retired from clinical
practice, he teaches and lectures in the UK and worldwide on the general practice consultation.

Roger Newham is a senior lecturer at Buckinghamshire New University teaching research

methods and professional ethics. He is a registered nurse (California and UK), where he worked
primarily in HIV and AIDS care from 1989 to 1995. He has an MA Philosophy from Birkbeck
College (University of London) and a doctorate in Bioethics (University of Keele).

David Obree is a practising dentist and medical ethics teacher. He is a fellow in medical ethics
and medical education at the University of Edinburgh and honorary lecturer in social and com-
munity medicine at the University of Bristol.

Michael Paschke is a medical device patent analyst with Landon IP and the United States
Patent and Trademark Office as well as regulatory and ethics board member at the University
of Michigan Medical School. He has an educational background in biomedical engineer-
ing and kinesiology from the University of Michigan and is presently a Master’s student at
Oxford University. Michael has years of experience serving on the boards for the University of
Michigan and Yale University Medical School Institutional Review Regulatory Boards, NuPath
Community Credit Union and Downtown Windsor Business Accelerator. Concurrent with his
work in healthcare regulations and healthcare ethics, he is the City Planning Commissioner for
the city of Riverview, Michigan, where he is heavily engaged with local business entrepreneurs
and executives.

Ed Peile is professor emeritus in medical education, University of Warwick, a fellow of

three Royal Medical Colleges in the UK, and was awarded the 2009 President’s Medal of the
Academy of Medical Educators for his lifetime achievement in medical education. He has now
retired from clinical practice but remains active in academic life, researching and ­publishing
on ­values-based practice. He was recently appointed chair of the Education, Training and
Standards Committee of the Academy of Healthcare Sciences.

Ioanna Psalti is a strategy advisor with long-term interests on the dynamics between micro-
level processes and macro-level events. She is extensively involved in the review and develop-
ment of EU policies for health, research and security and a regular contributor to the events
organised by the Oxford Healthcare Values Partnership, a network of academics, educators and
clinicians with an interest in policies for primary healthcare. She is currently working on the
xxiv
 Contributors

methodology of national healthcare reforms including a framework for exploring associated

ethical issues. Ioanna completed her DPhil studies in inorganic chemistry as the holder of the
EPA Florey Studentship at Queen’s College, Oxford, under Professor Allen Hill, the 2010 recipi-
ent of the Queen’s Medal for his protein electrochemistry work which revolutionised glucose
monitoring. Ioanna is also trained in creative action methods and sociodrama and has addi-
tional research interests in organisational change, identity, diversity and trust surfacing in fam-
ily business and multinational organisations. Ioanna has written extensively from language
books to scientific research and history of policies, and she is the author of Across the Bridge, a
chronicle of the impact of policies on the development of ocean sciences in North Wales. She is
co-editor of the British Journal of Psychodrama and Sociodrama and a regular workshop leader in
the Baltic Moreno Days, the international practical psychodrama conference. Since 2007, she is
the director of Dime Limited, a UK-based communications company.

Imran Rafi is a general practitioner principal and senior lecturer in primary care education at St
George’s, University of London. He is chair of the Royal College of General Practitioners (RCGP)
Clinical Innovation and Research Centre (CIRC), providing leadership to oversee the clinical
priority programme, contributing to programmes that support research and promote quality
improvements in general practice. He has an interest in genetics for at least 10 years and has been
a member of the Health Education England Genome Advisory Board and the Human Genome
Strategy Group Service working group. He was a founder member of the Primary Care Genetics
Society and the World Organisation of Family Doctors specialist interest group in primary care
genetics, as well as the Society for Academic Primary Care specialist group on primary care genet-
ics. He is currently funded by the HEE on the Masters Medical Genomics course at the University
of Cambridge. He is a member of the RCGP and fellow of the Royal College of Physicians.

Helen Salisbury did a degree in philosophy and psychology before training in medicine. She
is a GP in Oxford and runs the communication course for medical students there. Helen is
also medical director of the Health Experiences Research Group at the Nuffield Department of
Primary Care Health Sciences.

Suzanne Shale works as an independent consultant in the fields of healthcare ethics, patient
safety and healthcare leadership. She is Ethics Advisor to the NHS England Patient Safety
Steering Group and a member of the DH Independent Reconfiguration Panel. During 2013, she
chaired the ‘Surgical Never Events Task Force’ on behalf of NHS England and is now a member
of the group implementing its major recommendations. She is a former Oxford University legal
scholar with training in counselling, group facilitation and conflict resolution. Her consultancy
has a strong focus on restoring trust and improving support for patients and professionals
following harm in care settings. She presents lectures and masterclasses on trust, disclosure,
human factors and patient safety throughout the UK, Australia, Europe and Japan. Suzanne is
the chair of Action Against Medical Accidents (AvMA). AvMA is the leading organisation for
justice and patient safety, and campaigned for many years for a legal duty of candour. She was
previously vice chair of Compassion in Dying, and chair of the mental health service provider
Umbrella. Suzanne is the sole author of Moral Leadership in Medicine: Building Ethical Healthcare
Organizations (Cambridge University Press 2012).

Rosamund Snow (1971–2017) lived with chronic disease since she was a teenager. Described
by colleagues as ‘A true ethnographer’, her PhD thesis was entitled, ‘The role of patient exper-
tise inside and outside the health system: patient education in diabetes’. As The British Medical
xxv
 Contributors

Journal’s patient editor, she worked with patient authors from all backgrounds on the journal’s
educational series ‘What Your Patient Is Thinking’. She also worked at the University of Oxford
medical school, developing and researching patient involvement in medical education. She died
on 2 February 2017.

Christine Stacey was a senior lecturer in nursing and stress management at the University
of Greenwich following 18 years of working on all five continents and in 17 developing world
countries. During her overseas career, she was involved in a range of health-related projects
and interventions including the health and well-being of volunteers working for the United
States Peace Corps. Returning to the UK in 1999, she decided to further her knowledge of
other health systems undertaking a degree in Complementary Medicine, followed by a Masters
in Education. Her research interest was in psychoneuroimmunology, particularly the role of
Complementary Medicine for Health and Well-being. She is currently happily retired and
studying genomic medicine as a hobby.

Rafik Taibjee trained as a general practitioner in Birmingham and the Black Country before
becoming a GP principal in Merton. He is the chairman of Merton Health Federation and of
Health Education England [South London]. He is a GP trainer and a GP training programme
director at King’s GP Scheme, London. He has an interest in Equality and Diversity, and Gay
and Trans Healthcare. His ethical interest was developed through studying for a Master’s in
Public Health, at King’s College, London.

Jonathon Tomlinson is general practitioner, trainer and undergraduate tutor at The Lawson
Practice, London, UK. He writes a blog about the relationships between doctors and patients at
https://abetternhs.wordpress.com/ and is on twitter https://twitter.com/mellojonny.

Peter Toon practised as a general practitioner for 30 years. He also held academic posts at
University College London, Queen Mary University of London and the GP Deanery, where
he worked mainly on postgraduate and continuing education. He has written many academic
papers, particularly on the ethics of medical reports, preventive healthcare and virtue ethics in
medical practice, as well as his three major works, What Is Good General Practice?, A Flourishing
Practice, and Towards a Philosophy of General Practice.

Malcolm Torry is a visiting senior fellow in the Social Policy Department at the London School
of Economics. His research interests include the reform of the UK’s benefits system, and the
characteristics and management of religious and faith-based organisations. He is married to a
South London GP.

Andrew Trathen currently practises as a public health specialty registrar in London. His previ-
ous roles have been as a primary care dentist, and a Wellcome Trust clinical research fellow in
the medical humanities. He teaches ethics to undergraduate and newly qualified dentists, and
he is interested in professionalism and developing ethics curricula.

Michael Weingarten was born in England and educated at Oxford University. He was a
GP in a Yemenite immigrant town in Israel for 35 years, and author of Changing Health and
Changing Culture – The Yemenite Jews in Israel. As professor of medicine at Tel‐Aviv University,
he chaired the Departments of Family Medicine and Behavioural Sciences. In 2011, he moved
to the Galilee as founding Dean of Education at the Faculty of Medicine in Galilee, of Bar Ilan
xxvi
 Contributors

University. He was 2015–2016 visiting scholar at the Centre for Ethics in Healthcare (ETHOX)
and Green Templeton College, Oxford University.

Paquita de Zulueta is a sessional London general practitioner (GP) with a special interest in
clinical ethics, mental health, migrant health and professional well-being and development.
She is honorary senior clinical lecturer at Imperial College and a cognitive behavioural therapist
(CBT) in private practice, as well as coach and mentor for clinicians. She has been involved in
GP education for many years as programme director and educational supervisor. She is a mem-
ber of the Nuffield Council on Bioethics, the executive committee of the Worshipful Society of
Apothecaries of London as well as the Imperial College Healthcare NHS Trust clinical ethics
committee. She was the programme director for the applied clinical ethics course (ACE) at
Imperial College for several years and runs seminars on ethics and law for medical students,
postgraduates and established practitioners. She has written articles and book chapters on a
broad variety of topics in clinical ethics, and her current area of research is compassion in
healthcare and compassionate resilience. She is president-elect of the Royal Society of Medicine
Open Section, the section concerned with the interface between healthcare and society.

xxvii
Another random document with
no related content on Scribd:
honor. The offence which provoked this assault is not even hinted at,
though it may have arisen from the troubled state of public affairs.
Captain Praa was a man of influence and dignity in the community,
an exiled Huguenot, of remarkable skill in horsemanship and arms.
In spite of all this, it appears probable that the sentiment of the
community was in sympathy with the two turbulent assaulters and
batterers, for they were fined only six shillings and three pounds
respectively. They threw themselves on the mercy of the Court, and
certainly were treated with mercy.
There are, however, few women-criminals named in the old Dutch
and early English records, and these few were not prosecuted for
any very great crimes or viciousness; the chief number were brought
up for defamation of character and slander, though men-slanderers
were more plentiful than women. The close intimacy, the ideal
neighborliness of the Dutch communities of New York made the
settlers deeply abhor all violations of the law of social kindness. To
preserve this state of amity, they believed with Chaucer “the first
vertue is to restraine and kepen wel thine tonge.”
The magistrates knew how vast a flame might be kindled by a
petty spark; and therefore promptly quenched the odious slander in
its beginning; petty quarrels were adjusted by arbitration ere they
grew to great breaches. As sung the chorus of Batavian women in
Van der Vondel’s great poem:—

“If e’er dispute or discord dared intrude,

’Twas soon by wisdom’s voice subdued.”

In spite, however, of all wariness and watchfulness and patience,

the inevitable fretfulness engendered in petty natures by a narrow
and confined life showed in neighborhood disputes and suits for
defamation of character, few of them of great seriousness and most
of them easily adjusted by the phlegmatic and somewhat dictatorial
Dutch magistrates. In a community so given to nicknaming it seems
strange to find such extreme touchiness about being called names.
Suits for defamation were frequent, through opprobrious name-
calling, and on very slight though irritating grounds. It would certainly
seem a rather disproportionate amount of trouble to bring a lawsuit
simply because you were called a “black pudding,” or a verklickker,
or tale-bearer, or even a “Turk;” though, of course, no one would
stand being called a “horned beast” or a “hay thief.” Nor was “Thou
swine” an offensive term too petty to be passed over in silence. The
terrible epithets, spitter-baard and “Dutch dough-face,” seem to
make a climax of opprobriousness; but the word moff was worse, for
it was the despised term applied in Holland to the Germans, and it
led to a quarrel with knives.
I wish to note in passing that though the Dutch called each other
these disagreeable and even degrading names, they did not swear
at each other. Profanity was seldom punished in New Amsterdam,
for practically it did not exist, as was remarked by travellers.
Chaplain Wolley told of “the usual oath” of one Dutch colonist,—the
word “sacrament.”
The colonists were impatient of insulting actions as well as words.
Sampson said in “Romeo and Juliet,” “I will bite my thumb at them,
which is a disgrace to them if they bear it;” so “finger-sticking” was a
disgrace in colonial times if unresented, and it was actionable in the
courts. The man or woman who pointed the finger of scorn at a
neighbor was pretty sure to have the finger of the law pointed at him.
The curious practice of the Dutch settlers alluded to—the giving of
nicknames—may be partly explained by the fact that in some cases
the persons named had no surname, and the nickname was really a
distinguishing name. These nicknames appear not only in the
records of criminal cases, but in official documents such as the
patents for towns, transfers of estates, civil contracts, etc. In Albany,
in 1655 and 1657, we find Jan the Jester, Huybert the Rogue,
Jacobus or Cobus the Looper, squint-eyed Harmen, the wicked
Domine. On Long Island were John the Swede, Hans the Boor,
Tunis the Fisher. In Harlem was Jan Archer the Koop-all (or buy-all).
In New York, in English days, in 1691, we find Long Mary, Old Bush,
Top-knot Betty, Scarebouch. These names conveyed no offence,
and seem to have been universally adopted and responded to.
 It would appear to a casual observer glancing over the court-
records of those early years of New York life under Dutch
supremacy, that the greater number of the cases brought before the
magistrates were these slander and libel cases. We could believe
that no other court-room ever rang with such petty personal suits; to
use Tennyson’s words, “it bubbled o’er with gossip and scandal and
spite.” But in truth slander was severely punished in all the colonies,
in New England, Virginia, Pennsylvania; and it is not to the detriment
of the citizens of New Netherland that they were more sharp in the
punishment of such offences, for it is well known, as Swift says, that
the worthiest people are those most injured by slander.
The slander cases of colonial times seem most trivial and even
absurd when seen through the mist of years. They could scarce
reach the dignity of Piers Plowman’s definition of slanders:—

“To bakbyten, and to bosten, and to bere fals witnesse

To scornie and to scolde, sclaundres to make.”

To show their character, let me give those recorded in which

Thomas Applegate of Gravesend, Long Island, took an accused part.
In 1650, he was brought up before the Gravesend court for saying of
a fellow-towns-man that “he thought if his debts were paid he would
have little left.” For this incautious but not very heinous speech he
paid a fine of forty guilders. The next year we find him prosecuted for
saying of a neighbor that “he had not half a wife.” Though he at first
denied this speech, he was ordered “to make publick
acknowledgement of error; to stand at the publick post with a paper
on his breast mentioning the reason, that he is a notorious,
scandalous person.” This brought him to his senses, and he
confessed his guilt, desired the slandered “half a wife” to “pass it by
and remit it, which she freely did and he gave her thanks.” Next
Mistress Applegate was brought up for saying that a neighbor’s wife
milked the Applegate cows. She escaped punishment by proving
that Penelope Prince told her so. As a climax, Thomas Applegate
said to a friend that he believed that the Governor took bribes. The
schout in his decision on this grave offence said Applegate “did
deserve to have his tongue bored through with a hot iron;” but this
fierce punishment was not awarded him, nor was he banished.
When the tailor of New Amsterdam said disrespectful words of the
Governor, his sentence was that he “stand before the Governor’s
door with uncovered head, after the ringing of the bell, and to declare
that he falsely and scandalously issued such words and then to ask
God’s pardon.”
The magistrates were very touchy of their dignity. Poor Widow
Piertje Jans had her house sold on an execution; and, exasperated
by the proceeding, and apparently also at the price obtained, she
said bitterly to the officers, “Ye despoilers, ye bloodsuckers, ye have
not sold but given away my house.” Instead of treating these as the
heated words of a disappointed and unhappy woman, the officers
promptly ran tattling to the Stadt Huys and whiningly complained to
the Court that her words were “a sting which could not be endured.”
Piertje was in turn called shameful; her words were termed “foul,
villanous, injurious, nay, infamous words,” and also called a
blasphemy, insult, affront, and reproach. She was accused of
insulting, defaming, affronting, and reproaching the Court, and that
she was in the highest degree reprimanded, particularly corrected,
and severely punished; and after being forbidden to indulge in any
more such blasphemies, she was released,—“bethumped with
words,” as Shakespeare said,—doubtless well scared at the
enormity of her offence, as well as at the enormity of the magistrate’s
phraseology.
The notary Walewyn van der Veen was frequently in trouble,
usually for contempt of court. And I doubt not “the little bench of
justices” was sometimes rather trying in its ways to a notary who
knew anything about law. On one occasion, when a case relating to
a bill of exchange had been decided against him, Van der Veen
spoke of their High Mightinesses the magistrates as “simpletons and
blockheads.” This was the scathing sentence of his punishment:—
“That Walewyn Van der Veen, for his committed insult, shall
here beg forgiveness, with uncovered head, of God, Justice,
 and the Worshipful Court, and moreover pay as a fine 190
guilders.”
This fine must have consumed all his fees for many a weary
month thereafter, if we can judge by the meagre lawyers’ bills which
have come down to us.
Another time the contumacious Van der Veen called the Secretary
a rascal. Thereat, the latter, much aggrieved, demanded “honorable
and profitable reparation” for the insult. The schout judged this
epithet to be a slander and an affront to the Secretary, which
“affected his honor, being tender,” and the honor of the Court as well,
since it was to a member of the Court, and he demanded that the
notary should pay a fine of fifty guilders as an example to other
slanderers, “who for trifles have constantly in their mouths curses
and abuses of other honorable people.”
Another well-known notary and practitioner and pleader in the
busy little Court held in the Stadt Huys was Solomon La Chair. His
manuscript volume of nearly three hundred pages, containing
detailed accounts of all the business he transacted in Manhattan, is
now in the County Clerk’s Office in New York, and proves valuable
material for the historiographer. He had much business, for he could
speak and write both English and Dutch; and he was a faithful,
painstaking, intelligent worker. He not only conducted lawsuits for
others, but he seems to have been in constant legal hot water
himself on his own account. He was sued for drinking and not paying
for a can of sugared wine; and also for a half-aam of costly French
wine; and he was sued for the balance of payment for a house he
had purchased; he pleaded for more time, and with the ingenuous
guilelessness peculiar to the law said in explanation that he had had
the money gathered at one time for payment, but it had somehow
dropped through his fingers. “The Court condemned to pay at
once,”—not being taken in by any such simplicity as that. He had to
pay a fine of twelve guilders for affronting both fire inspector and
court messenger. He first insulted the brandt-meester who came to
inspect his chimney, and was fined, then he called the bode who
came to collect the fine “a little cock booted and spurred.” The Court
in sentence said with dignity, “It is not meet that men should mock
and scoff at persons appointed to any office, yea a necessary office.”
He won one important suit for the town of Gravesend, by which the
right of that town to the entire region of Coney Island was
established; and he received in payment for his legal services
therein, the munificent sum of twenty-four florins (ten dollars) paid in
gray pease. He kept a tavern and was complained of for tapping
after nine o’clock; and he was sued by his landlord for rent; and he
had a yacht, “The Pear Tree,” which ran on trading trips to Albany,
and there were two or three lawsuits in regard to that. He was also a
farmer of the excise on slaughtered cattle; but, in spite of all his
energy and variety of employment, he died insolvent in 1664. The
last lawsuit in which Lawyer Solomon had any share was through a
posthumous connection,—the burgher who furnished an anker of
French wine for the notary’s funeral claimed a position as preferred
creditor to the estate.
A very aggravated case of scorn and resistance of authority was
that of Abel Hardenbrock against the schout de Mill. And this case
shows equally the popular horror of violations of the law and the
confiding trust of the justices that the word of the law was enough
without any visible restraining force. Hardenbrock, who was a
troublesome fellow, had behaved most vilely, shoving the schout on
the breast, and wickedly “wishing the devil might break his neck,”
simply because the schout went to Hardenbrock’s house to warn his
wife not to annoy further Burgomaster De Peyster by unwelcome
visits. Hardenbrock was accordingly seized and made a prisoner at
the Stadt Huys “in the chamber of Pieter Schaefbanck, where he
carried on and made a racket like one possessed and mad,
notwithstanding the efforts of Heer Burgomaster Van Brught, running
up to the Court room and going away next morning as if he had not
been imprisoned.” It was said with amusing simplicity that this cool
walking out of prison was “contrary to the customs of the law,” and a
fine of twenty-five florins was imposed.
For serious words against the government, which could be
regarded as treasonable, the decreed punishment was death. One
Claerbout van ter Goes used such words (unfortunately they are not
given in the indictment), and a judgment was recorded from each
burgomaster and schepen as to what punishment would be proper.
He was branded, whipped on a half-gallows, and banished, and
escaped hanging only by one vote.
All classes in the community were parties in these petty slander
suits; schoolmasters and parsons appear to have been specially
active. Domine Bogardus and Domine Schaets had many a slander
suit. The most famous and amusing of all these clerical suits is the
one brought by Domine Bogardus and his wife, the posthumously
famous Anneke Jans, against Grietje von Salee, a woman of very
dingy reputation, who told in New Amsterdam that the domine’s wife,
Mistress Anneke, had lifted her petticoats in unseemly and extreme
fashion when crossing a muddy street. This was proved to be false,
and the evidence adduced was so destructive of Grietje’s character
that she stands disgraced forever in history as the worst woman in
New Netherland.
Not only were slanderers punished, but they were disgraced with
terrible names. William Bakker was called “a blasphemer, a street
schold, a murderer as far as his intentions are concerned, a defamer,
a disturber of public peace,”—the concentration of which must have
made William Bakker hang his head in the place of his banishment.
They were also rebuked from the pulpit, and admonished in private.
Perhaps the best rebuke given, as well as a unique one, was the
one adopted by Domine Frelinghuysen, who had suffered somewhat
from slander himself. He had this rhyme painted in large letters on
the back of his sleigh, that he who followed might read:—

“Niemands tong; nog neimands pen,

Maakt my anders dan ik ben.
Spreek quaad-spreekers: spreek vonder end,
Niemand en word van u geschend.”

Which, translated into English, reads:—

 “No one’s tongue, and no one’s pen
Makes me other than I am.
Speak, evil-speakers, speak without end,
No one heeds a word you say.”

The original Court of the colony was composed of a Director and

his Council. In 1656, in answer to complaints from the colonists, the
States-General ordered the election of a board of magistrates, in
name and function like those of the Fatherland; namely, a schout,
two burgomasters, and five schepens. The duties of the
burgomasters and schepens were twofold: they regulated municipal
affairs like a board of aldermen, and they sat as a court of justice
both in civil and criminal cases. The annual salary of a burgomaster
was fixed at one hundred and forty dollars, and of a schepen at one
hundred dollars; but as these salaries were to come out of the
municipal chest, which was chronically empty, they never were paid.
When funds did come in from the excise on taverns, on slaughtered
cattle, the tax on land, the fees on transfers, etc., it always had to be
paid out in other ways,—for repairs for the school-room, the Graft,
the watch-room, the Stadt Huys. It never entered the minds of those
guileless civic rulers, two centuries ago, to pay themselves and let
the other creditors go without. The early city schout was also schout-
fiskaal till 1660; but the proper duties of this functionary were really a
combination of those pertaining now to the mayor, sheriff, and
district-attorney. In the little town one man could readily perform all
these duties. He also presided in Court. An offender could thus be
arrested, prosecuted, and judged, by one and the same person,
which seems to us scarcely judicious; but the bench of magistrates
had one useful power, that of mitigating and altering the sentence
demanded by the schout. Often a fine of one hundred guilders would
be reduced to twenty-five; often the order for whipping would be set
aside, and the command of branding as well.
Sometimes justice in New York was tempered with mercy, and
sorely it needed it when fierce English rule and law came in force.
Felons were few, but these few were severely punished. A record of
a trial in 1676 reveals a curious scene in Court, as well as an
astonishing celerity in the execution of the law under English rule
and in the English army. Three soldiers stole a couple of iron pots,
two hoes, a pair of shears, and half a firkin of soap. They were tried
in the morning, confessed, cast into “the Hole” in the afternoon, and
in the evening “the Governor ordered some persons to go to the
prisoners and advise them to prepare for another world, for that one
of them should dye the next day.” On the gloomy morrow, on
Saturday, the three terror-stricken souls drew lots, and the fatal lot
fell to one Thomas Weale. The court of aldermen interceded for him
and finally secured his reprieve till Monday. The peaceful Dutch
Sunday, darkened and shocked by this impending death, saw a
strange and touching sight.
“In the evening a company of the chiefe women of the City,
both English and Dutch, made earnest suite to the Governor
for the Condemned man’s life. Monday in the morning the
same women who came the last night with many others of the
better sort, and a greater number of the ordinary Dutch
women, did again very much importune the Governor to spare
him.”
These tender-hearted colonists were indorsed and supplemented
by the petition of Weale’s fellow-soldiers in the garrison, who
pleaded the prisoner’s youth and his past usefulness, and who
promised if he were pardoned never to steal nor to conceal theft. As
a result of all this intercession, the Governor “graciously” granted
pardon.
This promise and pardon seem to have accomplished much in
army discipline, for thereafter arrests for crime among the soldiery
were rare. Five years later a soldier was accused of pilfering.
“The Court Marshall doth adjudge that the said Melchoir
Classen shall run the Gantlope once, the length of the fort:
where according to the custome of that punishment, the
souldiers shall have switches delivered to them, with which
they shall strike him as he passes between them stript to the
waist, and at the Fort-gate the Marshall is to receive him, and
there to kick him out of the Garrison as a cashiered person,
 when he is no more to returne, and if any pay is due him it is
to be forfeited.”
And that was the end of Melchoir Classen.
Gantlope was the earlier and more correct form of the word now
commonly called gantlet. Running the gantlope was a military
punishment in universal use.
Another common punishment for soldiers (usually for rioting or
drinking) was riding the wooden horse. In New Amsterdam the
wooden horse stood between Paerel Street and the Fort, and was
twelve feet high. Garret Segersen, for stealing chickens, rode the
wooden horse for three days from two o’clock to close of parade with
a fifty-pound weight tied to each foot. At other times a musket was
tied to each foot of the disgraced man. One culprit rode with an
empty scabbard in one hand and a pitcher in the other to show his
inordinate love for John Barleycorn. Jan Alleman, a Dutch officer,
challenged Jan de Fries, who was bedridden; for this cruel and
meaningless insult he too rode the wooden horse. In Revolutionary
days we still find the soldiers of the Continental Army punished by
riding the wooden horse, or, as it was sometimes called, “the timber
mare;” but it was probably a modification of the cruel punishment of
the seventeenth century.
A sailor, for drawing a knife on a companion, was dropped three
times from the yard-arm and received a kick from every sailor on the
ship,—a form of running the gantlope. And we read of a woman who
enlisted as a seaman, and whose sex was detected, being dropped
three times from the yard-arm and tarred and feathered.
These women petitioners for Soldier Weale of whom I have told,
were not the only tender-hearted New Yorkers to petition for “mercy,
that herb of grace, to flower.” During Stuyvesant’s rule his sister,
Madam Bayard, successfully interceded for the release, and thereby
saved the life, of an imprisoned Quaker; and in September, 1713,
two counterfeiters were saved from the death penalty by the
intervention of New York dames. We read, “Most of the gentlewomen
of the city waited on the Governor, and addressed him earnestly with
prayers and tears for the lives of the culprits, who were accordingly
pardoned.” When two sailors rioted through the town demanding
food and drink, and used Carel Van Brugh so roughly that his face
was cut, they were sentenced to be fastened to the whipping-post,
and scourged, and have gashes cut in their faces; the wife of Van
Brugh and her friends petitioned that the sentence should not be
carried out, or at any rate executed within a room. Doubtless other
examples could be found.
The laws of New Netherland were naturally based upon the laws
and customs of the Fatherland, which in turn were formed by the
rules of the College of XIX. from the Imperial Statutes of Charles V.
and the Roman civil law.
The punishments were the ordinary ones of the times, neither
more nor less severe than those of the Fatherland or the other
colonies. In 1691 it was ordered that a ducking-stool be erected in
New York on the wharf in front of the City Hall. The following year an
order was passed that a pillory, cage, and ducking-stool be built.
Though scolds were punished, I have never seen any sentence to
show that this ducking-stool was ever built, or that one was ever
used in New York; while instances of the use of a ducking-stool are
comparatively plentiful in the Southern colonies. The ducking-stool
was an English “engine” of punishment, not a Dutch.
The colonists were astonishingly honest. Thieves were surprisingly
few; they were punished under Dutch rule by scourging with rods,
and usually by banishment,—a very convenient way of shifting
responsibility. Assaults were punished by imprisonment and
subjection to prison fare, consisting only of bread and water or small
beer; and sometimes temporary banishment. There was at first no
prison, so men were often imprisoned in their own houses, which
does not seem very disgraceful. In the case of François de Bruyn,
tried for insulting and striking the court messenger, he was fined two
hundred guilders, and answered that he would rot in prison before he
would pay. He was then ordered to be imprisoned in a respectable
tavern, which sentence seems to have some possibility of mitigating
accompaniments.
 In 1692 it was ordered in Kings County that a good pair of stocks
and a pound be made in every bound within Kings County, and kept
in sufficient repair. In repair and in use were they kept till this century.
Pillories too were employed in punishment till within the memory of
persons now living. The whipping-post was really a public blessing,
—in constant use, and apparently of constant benefit, though the
publicity of its employment seems shocking to us to-day. The public
whipper received a large salary. In 1751, we learn from an
advertisement, it was twenty pounds annually.
Some of the punishments were really almost picturesque in their
ingenious inventions of mortification and degradation. Truly it was a
striking sight when “Jan of Leyden”—a foul-mouthed rogue, a true
blather-schuyten—was fastened to a stake in front of the townhouse,
with a bridle in his mouth and a bundle of rods tied under each arm,
and a placard on his breast bearing the inscription, “Lampoon-riter,
false accuser, defamer of magistrates.” Though he was banished, I
am sure he never was forgotten by the children who saw him
standing thus garnished and branded on that spring day in 1664. In
the same place a thief was punished by being forced to stand all day
under a gallows, a gallows-rope around his neck and empty sword-
scabbard in his hand, a memorable figure.
And could any who saw it ever forget the punishment of Mesaack
Martens, who stole six cabbages from his neighbor, and confessed
and stood for days in the pillory with cabbages on his head, that “the
punishment might fit the crime;” to us also memorable because the
prisoner was bootlessly examined by torture to force confession of
stealing fowls, butter, turkeys, etc.
He was not the only poor creature who suffered torture in New
Amsterdam. It was frequently threatened and several times
executed. The mate of a ship was accused of assaulting a sheriff’s
officer, who could not identify positively his assailant. The poor mate
was put to torture, and he was innocent of the offence. The assailant
was proved to be another man from whom the officer had seized a
keg of brandy. Still none in New Amsterdam were tortured or pressed
to death. The blood of no Giles Corey stains the honor of New
Netherland.
 Sometimes the execution of justice seemed to “set a thief to catch
a thief.” A letter written by an English officer from Fort James on
Manhattan Island to Captain Silvester Salisbury in Fort Albany in
1672 contains this sentence:—
“We had like to have lost our Hang-man Ben Johnson, for
he being taken in Divers Thefts and Robbings convicted and
found guilty, escaped his neck through want of another
Hangman to truss him up, soe that all the punishment that he
received for his Three Years’ Roguery in thieving and stealing
(which was never found out till now) was only 39 stripes at the
Whipping Post, loss of an Ear and Banishment.”
We have the records of an attempt at capital punishment in 1641;
and Mr. Gerard’s account of it in his paper “The Old Stadt-Huys” is
so graphic, I wish to give it in full:—
“The court proceedings before the Council, urged by the
Fiscal, were against Jan of Fort Orange, Manuel Gerrit the
Giant, Anthony Portugese, Simon Congo, and five others, all
negroes belonging to the Company, for killing Jan Premero,
another negro. The prisoners having pleaded guilty, and it
being rather a costly operation to hang nine able-bodied
negroes belonging to the Company, the sentence was that
they were to draw lots to determine ‘who should be punished
with the cord until death, praying the Almighty God, the
Creator of Heaven and Earth, to direct that the lot may fall on
the guiltiest, whereupon’ the record reads, ‘the lot fell by
God’s Providence on Manuel Gerrit, the Giant, who was
accordingly sentenced to be hanged by the neck until dead as
an example to all such malefactors.’ Four days after the trial,
and on the day of the sentence, all Nieuw Amsterdam left its
accustomed work to gaze on the unwonted spectacle. Various
Indians also gathered, wondering, to the scene. The giant
negro is brought out by the black hangman, and placed on the
ladder against the fort with two strong halters around his
neck. After an exhortation from Domine Bogardus during
which the negro chaunts barbaric invocations to his favorite
Fetich, he is duly turned off the ladder into the air. Under the
 violent struggles and weight of the giant, however, both
halters break. He falls to the ground. He utters piteous cries.
Now on his knees, now twisting and groveling on the earth.
The women shriek. The men join in his prayers for mercy to
the stern Director. He is no trifler and the law must have its
course. The hangman prepares a stronger rope. Finally the
cry for mercy is so general that the Director relents, and the
fortunate giant is led off the ground by his swarthy friends,
somewhat disturbed in his intellect by his near view of the
grim King of Terrors.”
Up to February 21, 1788, benefit of clergy existed; that is, the plea
in capital felonies of being able to read. This was a monkish privilege
first extended only to priestly persons. In England it was not
abolished till 1827. The minutes of the Court of General Quarter
Sessions in New York bear records of criminals who pleaded “the
benefit” and were branded on the brawn of the left thumb with “T” in
open court and then discharged.
As the punishments accorded for crimes were not severe for the
notions of the times, it is almost amusing to read some fierce
ordinances,—though there is no record of any executions in
accordance with them. For instance, in January, 1659, by the
Director-General and Council with the advice of the burgomasters
and schepens it was enacted that “No person shall strip the fences
of posts or rails under penalty for the first offence of being whipped
and branded, and for the second, of punishment with the cord until
death ensues.” It is really astonishing to think of these kindly Dutch
gentlemen calmly ordering hanging for stealing fence-rails, though of
course the matter reached further than at first appeared: there was
danger of a scarcity of grain; and if the fences were stolen, the cattle
would trample down and destroy the grain. Later orders as to fences
were given which appear eminently calculated to be mischief-
making. “Persons thinking their neighbors’ fences not good, first to
request them to repair; failing which to report to the overseers.” In
1674 all persons were forbidden to leave the city except by city-gate,
under penalty of death; this was of course when war threatened.
 The crime of suicide was not without punishment. Suicides were
denied ordinary burial rites. In Dutch days when one Smitt of New
York committed suicide, the schout asked that his body be drawn on
a hurdle and buried with a stake in his heart. This order was not
executed; he was buried at night and his estates confiscated. When
Sir Danvers Osborne—the Governor for a day—was found dead by
his own act, he was “decently interred in Trinity churchyard.”
Women in New York sometimes made their appearance in New
York courts, as in those of other colonies, in another rôle than that of
witness or criminal; they sometimes sat on juries. In the year 1701,
six good Albany wives served on a jury: Tryntje Roseboom, Catheren
Gysbertse, Angeneutt Jacobse, Marritje Dirkse, Elsje Lansing, and
Susanna Bratt. They were, of course, empanelled for a special duty,
not to serve on the entire evidence of the case for which they were
engaged.
Many old records are found which employ quaint metaphors or
legal expressions; I give one which refers to a custom which seems
at one time to have been literally performed. It occurs in a
commission granted to the trustees of an estate of which the debts
exceeded the assets. Any widow in Holland or New Netherland could
be relieved of all demands or claims of her husband’s creditors by
relinquishing all right of inheritance. This widow took this privilege; it
is recorded thus:—
“Whereas, Harman Jacobsen Bamboes has been lately
shot dead, murdered by the Indians, and whereas the estate
left by him has been kicked away with the foot by his wife who
has laid the key on the coffin, it is therefore necessary to
authorize and qualify some persons to regulate the same.”
There was a well-known Dutch saying which referred to this
privilege, Den Sleutel op het graf leggen, and simply meant not to
pay the debts of the deceased.
This legal term and custom is of ancient origin. In Davies’ “History
of Holland” we read of a similar form being gone through with in
Holland in 1404, according to the law of Rhynland. The widow of a
great nobleman immediately after his death desired to renounce all
claim on his estate and responsibility for his debts. She chose a
guardian, and, advancing with him to the door of the Court (where
the body of the dead Count had been placed on a bier), announced
that she was dressed wholly in borrowed clothing; she then formally
gave a straw to her guardian, who threw it on the dead body, saying
he renounced for her all right of dower, and abjured all debts. This
was derived from a still more ancient custom of the Franks, who
renounced all alliances by the symbolic breaking and throwing away
a straw.
In other states of the Netherlands the widow gave up dower and
debts by laying a key and purse on the coffin. This immunity was
claimed by persons in high rank, one being the widow of the Count
of Flanders.
In New England (as I have told at length in my book, “Customs
and Fashions in Old New England,”) the widow who wished to
renounce her husband’s debts was married in her shift, often at the
cross-roads, at midnight. These shift-marriages took place in
Massachusetts as late as 1836; I have a copy of a court record of
that date.
I know of but one instance of the odious and degrading English
custom of wife-trading taking place in New York. Laurens Duyts, an
agent for Anneke Jans in some of her business transactions, was in
the year 1663 sentenced to be flogged and have his right ear cut off
for selling his wife, Mistress Duyts, to one Jansen. Possibly the
severity of the punishment may have prevented the recurrence of the
crime.
After a somewhat extended study and comparison of the early
court and church records of New England with those of New York, I
cannot fail to draw the conclusion—if it is just to judge from such
comparisons—that the state of social morals was higher in the Dutch
colonies than in the English. Perhaps the settlers of Boston and
Plymouth were more severe towards suspicion of immorality, as they
were infinitely more severe towards suspicion of irreligion, than were
their Dutch neighbors. And they may have given more publicity and
punishment to deviations from the path of rectitude and uprightness;
but certainly from their own records no fair-minded person can fail to
deem them more frail, more erring, more wicked, than the Dutch.
The circumstances of immigration and the tendencies of
temperament were diverse, and perhaps it was natural that a
reaction tending to sin and vice should come to the intense and
overwrought religionist rather than to the phlegmatic and prosperous
trader. In Virginia and Maryland the presence of many convict-
emigrants would form a reasonable basis for the existence of the
crime and law-breaking which certainly was in those colonies far in
excess of the crime in New Netherland and New York.
I know that Rev. Mr. Miller, the English clergyman, did not give the
settlement a very good name at the last of the seventeenth century;
but even his strictures cannot force me to believe the colonists so
unbearably wicked.
It should also be emphasized that New Netherland was far more
tolerant, more generous than New England to all of differing religious
faiths. Under Stuyvesant, however, Quakers were interdicted from
preaching, were banished, and one Friend was treated with great
cruelty. The Dutch clergymen opposed the establishment of a
Lutheran church, and were rebuked by the Directors in Holland, who
said that in the future they would send out clergymen “not tainted
with any needless preciseness;” and Stuyvesant was also rebuked
for issuing an ordinance imposing a penalty for holding conventicles
not in accordance with the Synod of Dort. Many Christians not in
accordance in belief with that synod settled in New Netherland.
Quakers, Lutherans, Church of England folk, Anabaptists,
Huguenots, Waldenses, Walloons. The Jews were protected and
admitted to the rights of citizenship. Director Kieft, with heavy
ransoms, rescued the captive Jesuits, Father Jogues and Father
Bressani, from the Indians and tenderly cared for them. No witches
suffered death in New York, and no statute law existed against
witchcraft. There is record of but one witchcraft trial under the
English governor, Nicholls, who speedily joined with the Dutch in
setting aside all that nonsense.
 CHAPTER XIII
CHURCH AND SUNDAY IN OLD NEW YORK

Sunday was not observed in New Netherland with any such rigidity
as in New England. The followers of Cocceius would not willingly
include Saturday night, and not even all of the Sabbath day, in their
holy time. Madam Knight, writing in 1704 of a visit to New York,
noted: “The Dutch aren’t strict in keeping the Sabbath as in Boston
and other places where I have been.” This was, of course, in times of
English rule in New York. Still, much respect to the day was required,
especially under the governing hand of the rigid Calvinist
Stuyvesant. He specially enjoined and enforced strict regard for
seemly quiet during service time. The records of Stuyvesant’s
government are full of injunctions and laws prohibiting “tavern-
tapping” during the hours of church service. He would not tolerate
fishing, gathering of berries or nuts, playing in the street, nor gaming
at ball or bowls during church time. At a little later date the time of
prohibition of noise and tapping and gaming was extended to include
the entire Sabbath day, and the schout was ordered to be active in
searching out and punishing such offenders.
Occasionally his vigilance did discover some Sabbath disorders.
He found the first Jew trader who came to the island of Manhattan
serenely keeping open shop on Sunday, and selling during sermon
time, knowing naught of any Sunday laws of New Amsterdam.
And Albert the Trumpeter was seen on the Sabbath in suspicious
guise, with an axe on his shoulder,—but he was only going to cut a
bat for his little son; and as for his neighbor who did cut wood, it was
only kindling, since his children were cold.
And one Sunday evening in 1660 the schout triumphantly found
three sailors round a tap-house table with a lighted candle and a
backgammon-board thereon; and he surely had a right to draw an
inference of gaming therefrom.
And in another public-house ninepins were visible, and a can and
glass, during preaching-time. The landlady had her excuse,—some
came to her house and said church was out, and one chanced to
have a bowl in his hand and another a pin, but there was no playing
at bowls.
Still, though he snooped and fined, in 1656 the burgomasters
learned “by daily and painful experience” that the profanation of “the
Lord’s day of Rest by the dangerous, Yes, damnable Sale or Dealing
out of Wines Beers and Brandy-Waters” still went on; and fresh
Sunday Laws were issued forbidding “the ordinary and customary
Labors of callings, such as Sowing, Mowing, Building, Sawing wood,
Smithing, Bleeching, Hunting, Fishing.” All idle sports were banned
and named: “Dancing, Card-playing, Tick-tacking, Playing at ball, at
bowls, at ninepins; taking Jaunts in Boats, Wagons, or Carriages.”
In 1673, again, the magistrates “experienced to our great grief”
that rolling ninepins was more in vogue on Sunday than on any other
day. And we learn that there were social clubs that “Set on the
Sabbath,” which must speedily be put an end to. Thirty men were
found by the schout in one tap-huys; but as they were playing
ninepins and backgammon two hours after the church-doors had
closed, prosecution was most reluctantly abandoned.
Of course scores of “tappers” were prosecuted, both in taverns
and private houses. Piety and regard for an orderly Sabbath were
not the only guiding thoughts in the burgomasters’ minds in framing
these Sunday liquor laws and enforcing them; for some tapsters had
“tapped beer during divine service and used a small kind of measure
which is in contempt of our religion and must ruin our state,”—and
the state was sacred. In the country, as for instance on Long Island,
the carting of grain, travelling for pleasure, and shooting of wild-fowl
on Sunday were duly punished in the local courts.
I do not think that children were as rigid church attendants in New
York as in New England. In 1696, in Albany, we find this injunction:
“ye Constables in eache warde to take thought in attending at ye
church to hender such children as Profane ye Sabbath;” and we
know that Albany boys and girls were complained of for coasting
down hill on Sunday,—which enormity would have been simply
impossible in New England, except in an isolated outburst of Adamic
depravity. In another New York town the “Athoatys” complained of
the violation of the Sabbath by “the Younger Sort of people in
Discourssing of Vane things and Running of Raesses.” As for the city
of New York, even at Revolutionary times a cage was set up on City
Hall Park in which to confine wicked New York boys who profaned
the Sabbath. I do not find so full provisions made for seating children
in Dutch Reformed churches as in Puritan meeting-houses. A wise
saying of Martin Luther’s was “Public sermons do very little edify
children”—perhaps the Dutch agreed with him. As the children were
taught the Bible and the catechism every day in the week, their
spiritual and religious schooling was sufficient without the Sunday
sermon,—but, of course, if they were not in the church during
services, they would “talk of vane Things and run Raesses.”
Before the arrival of any Dutch preacher in the new settlement in
the new world, the spiritual care of the little company was provided
for by men appointed to a benign and beautiful old Dutch office, and
called krankebesoeckers or zeikentroosters,—“comforters of the
Sick,”—who not only tenderly comforted the sick and weary of heart,
but “read to the Commonalty on Sundays from texts of Scripture with
the Comments.” These pious men were assigned to this godly work
in Fort Orange and in New Amsterdam and Breuckelen. In Esopus
they had meetings every Sunday, “and one among us read
something for a postille.” Often special books of sermons were read
to the congregations.
In Fort Orange they had a domine before they had a church. The
patroon instructed Van Curler to build a church in 1642; but it was
not until 1646 that the little wooden edifice was really put up. It was
furnished at a cost of about thirty-two dollars by carpenter
Fredricksen, with a predickstoel, or pulpit, a seat for the magistrates,
—de Heerebanke,—one for the deacons, nine benches and several
corner-seats.