Surgeons, Hernia Surgery and Informed Consent in the Seventeenth Century Ottoman Istanbul

Area of Science:

• Medical History
• Surgical History
• Ottoman Studies

Background:

• In 17th-century Ottoman Istanbul, Greek surgeons notably specialized in hernia surgery.
• Both Muslim and non-Muslim patients engaged in formal contracts with surgeons.
• These contracts were established in sharia courts prior to surgical procedures.

Purpose of the Study:

• To analyze Ottoman-era informed consent documents for hernia surgery.
• To investigate the patient-physician relationship and contractual agreements in 17th-century Istanbul.
• To understand the legal and financial aspects of surgical practices during the Ottoman period.

Main Methods:

• Primary data sourced from Istanbul Sharia Court Registers (Istanbul Sicils).
• Examination of twenty-nine 17th-century registers.
• Identification and analysis of twenty-one informed consent documents (rıza senedi) related to hernia surgery.

Main Results:

• Five male surgeons (four Greek, one Muslim) and twenty-one patients were identified.
• Contracts documented patient consent after informing them of potential surgical complications.
• Agreements stipulated that no blood-money would be claimed if a patient died; operation costs ranged from 500 to 2100 aḳče.

Conclusions:

• The Ottoman patient-physician relationship was characterized as a business transaction.
• Medical procedures were formally recorded in courts before payment, ensuring clarity on fees.
• These court records served to protect both patients and physicians from criminal liability.