Posted on June 17, 2013 at 12:10 PM
Robert Baker, PhD
Medicine is the most scientific of the humanities and the most humane of the sciences.
On June 13, 2013 bioethics lost a member of its founding generation, Edmund D. Pellegrino. Pellegrino started life in Brooklyn as the studious son of a tailor. Graduating summa cum laude with honors in chemistry from a Brooklyn college, Pellegrino, like others in his generation, was initially barred from medical school by the vowels at the end of his name: telltale signs of his Italian heritage and Roman Catholic religion. Advised to shorten his name to remove the offending vowels, Pellegrino refused. His refusal to yield to prejudice, his embrace of his heritage, and his principled stance were characteristic of the man.
Eventually Pellegrino was admitted to New York University medical school, where he also did his internship and residency at Bellevue Hospital. After two years of service in the military medical corps and a short stint at a tuberculosis hospital in upstate New York, Pellegrino joined the faculty of NYU. In the mid-1960s he moved south to chair the Department of Medicine at the University of Kentucky. While there he began to write notable articles on medical education (“Beehives, Mousetraps and Candlesticks—A Dilemma for Medical Educators, 1963), medical ethics, and the philosophy of medicine (“Medicine, Philosophy and Man’s Infirmity,” 1966). In the mid-1960s Pellegrino moved back to New York as chair of the department of medicine and dean of the medical school at Stony Brook. In the 1970s he returned to the south to serve as vice president at the University of Tennessee, Memphis, where he helped to create a groundbreaking program in the medical humanities. By the end of the decade Pellegrino was championing the medical humanities to the World Council of Churches, on the pages of medical journals from JAMA to Pharos, and at the Medical College of Yale University, where he became president and chairman of the board. After that he became president of the Catholic University of America (1978-1982), stepping down to assume the directorship of the Kennedy Institute of Ethics at Georgetown University (1983-89), where he remained as James Carroll Professor of Medicine and Medical Ethics for the rest of his career. From 2005-09 Pellegrino chaired President George W. Bush’s Council for Bioethics.
Pellegrino’s career spans six decades (1950s to 2010s) during which he wrote about 600 papers; authored, edited, or co-edited twenty books; founded The Journal of Medicine and Philosophy; gave thousands of lectures and yet still found time to mentor innumerable students. He was awarded forty eight honorary degrees and innumerable prizes including the American Association of Medical College’s Abraham Flexner Award for Distinguished Service to Medical Education, the American Medical Association’s Benjamin Rush Award for Citizenship and Community, and the Hasting Center’s Henry Knowles Beecher Award for Lifetime Contribution to Ethics and the Life Sciences.
For Pellegrino, any medical ethics or bioethics not grounded in a philosophical understanding of medicine was fundamentally groundless. In his writings and those that he co-authored with his friend and fellow medical educator, David Thomasma (1940-2002), Pellegrino sought for “the philosophical basis of medical practice” (the title of their 1981 book). Several themes thread their way through Pellegrino’s writings: a keen appreciation for the fragility of life, the discernment that the healing arts are a humanistic response to patients’ vulnerability, and the insight that any comprehensive medical ethics must address virtues as well as duties. For Pellegrino, the core of medical humanism is encapsulated by the following line in the Hippocratic oath, “I will follow that system or regimen which, according to my ability and judgment I consider for the benefit of my patient and abstain from whatever is deleterious and mischievous.” He read this line as generating an internal morality for clinical medicine (the title of an essay in his 2008 book) with a profound commitment to human dignity and human life. Moving from theory to practice he championed the “humanities in medical education for a post-evangelical era” (to paraphrase a chapter title in his 2008 book), and urged fellow medical educators to challenge any medical curriculum that failed to convey to the next generation of physicians a reflective analysis of the humanistic foundations of medicine.
Pellegrino was a conservative and a Fellow of the Center for Bioethics and Human Dignity. Yet his was a humanistic conservatism that relished dialogue with open-minded liberals, like his colleague at the Kennedy Institute of Ethics, Robert Veatch. I last met Pellegrino four years ago on the occasion of a lecture he gave at a small Catholic college in Albany. President Obama’s Affordable Care Act was being vigorously debated at the time and a student in the audience asked Pellegrino for his opinion of “Obamacare.” Pellegrino’s reply startled many in the audience. “As a philosopher,” he observed, “I am not qualified to discuss funding mechanisms, but as a physician and a humanist I can only applaud the intent of the act, which is to insure that everyone needing healthcare receives it.”
Edmund Pellegrino personified the ideal of a medical humanism grounded in scholarship and reflected in medical education and clinical practice. He played a pivotal role in founding bioethics and reforming medical education; everyone in our field benefitted from his foresight and leadership.
Union Graduate College-Icahn Mt. Sinai Bioethics Program