e for and against sexual intercourse corresponds to the
physician's duty in the matter. It is, indeed, a duty which can
scarcely be escaped by the physician in many cases. Moll points
out that it can by no means be assimilated, as some have
supposed, with the recommendation of sexual intercourse. It is,
on the contrary, he remarks, much more analogous to the
physician's duty in reference to operations. He puts before the
patient the nature of the operation, its advantages and its
risks, but he leaves it to the patient's judgment to accept or
reject the operation. Lewitt also (_Geschlechtliche
Enthaltsamkeit und Gesundheitsstoerungen_, 1905), after discussing
the various opinions on this question, comes to the conclusion
that the physician, if he thinks that intercourse outside
marriage might be beneficial, should explain the difficulties and
leave the patient himself to decide.

There is another reason why, having regard to the prevailing moral
opinions at all events among the middle classes, a physician should
refrain from advising extra-conjugal intercourse: he places himself in a
false relation to his social environment. He is recommending a remedy the
nature of which he could not publicly avow, and so destroying the public
confidence in himself. The only physician who is morally entitled to
advise his patients to enter into extra-conjugal relationships is one who
openly acknowledges that he is prepared to give such advice. The doctor
who is openly working for social reform has perhaps won the moral right to
give advice in accordance with the tendency of his public activity, but
even then his advice may be very dubiously judicious, and he would be
better advised to confine his efforts at social reform to his public
activities. The voice of the physician, as Professor Max Flesch of
Frankfort observes, is more and more heard in the development and new
growth of social institutions; he is a natural leaders in such movements,
and proposals for reform properly come from him. "But," as Flesch
continues, "publicly to accept the excellence of existing institutions and
in the privacy of the consulting-room to give advice which assumes the
imperfection of those institutions is illogical and confusing. It is the
physician's business to give advice which is in accordance with the
interests of the community as a whole, and those interests require that
sexual relationships sh