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The age-old conflict between preserving life and alleviating pain was especially acute for mid-19th century American physicians, who were trained in a tradition hostile to pain-relieving efforts that involved any risk to life, but who practiced in the age of anesthesia. Advances in anesthesiology, along with new statistical methods of calculating drug safety, competition from alternative healing sects, and public criticism of professional callousness, gave rise to the "conservative" or "rational" school of medicine, which sanctioned the balancing of risks against the relief of suffering. This utilitarian calculus of suffering constituted a major revolution in the techniques of medical decision making. (KIE abstract)
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