<iday’s convocation speaker, Dr. Edmund Pellegrino, presented his position on the restructuring of medical ethics and explained why this must be of great concern to us all. The speech was one of the many events that took place on campus this past week as part of Carleton’s “Bioethics Week.”
A leading authority in the field, Pellegrino is the current Chairman to the President’s Council on Bioethics, and as student Carmen Ross ‘10 stated, “an instrumental figure in shaping our understanding of bioethics and the philosophy of medicine.”
With over sixty years of service in the medical profession, Pellegrino has been Director of The Kennedy Institute of Ethics, The Center for the Advanced Study of Ethics at Georgetown University and The Center for Clinical Bioethics. To date, he has published 585 articles and 20 books and is the founding editor of The Journal of Medicine and Philosophy.
Pellegrino’s talk began by addressing the need for re-establishing the commitments of The Hippocratic Oath. According to Pellegrino, the Oath was founded over 2,500 years ago, when a group of Greek physicians felt compelled to publicly commit themselves to a set of moral principles that would guide patient care. The propositions thus spelled out a physician’s moral commitments and beliefs of right and wrong or good and bad in a patient-doctor relationship.
“Since the onset of the bioethical era, philosophers and ethicists began to be critical of those commitments. Today, every single one of those precepts has been questioned and there is no such thing as agreed upon common moral precepts,” Pellegrino said.
It is therefore important for people to understand what has happened to the way today’s physicians are looking at this ancient commitment. “Since all of you have been or will be patients at some point, you need to know what it is you can expect,” he said.
Pellegrino proposes that the restructuring of medical ethics should be rooted in the most important reality of medicine, the patient-doctor relationship.
His descriptions of a patient’s predicament were something almost everyone can attest to. “A patient experiences loss of freedom in his daily routine,” Pellegrino said. “The patient is also vulnerable, as he must place himself in the hands of another human being. This is the foundation of the physician’s obligation.”
Pellegrino went on to stress that doctors therefore do not have special privileges, but instead special obligations.
However, as Pellegrino said, assessing what is “good” for the patient is a complex matter. Aside from the medical “good,” doctors must also consider facets such as the patient’s personal values and human rights. Only when the doctor takes all levels of the patient’s interest into account can he make a medical and moral decision.
“The decision has to be both,” Pellegrino said. “Thus, in order to use medical knowledge in a morally defensible way, you need to study ethics before and in medical school. Medicine has power for good and evil, and much will depend on the physician’s character.”
In his concluding remarks, Pellegrino reminded the audience that the physician’s obligations can be extrapolated to any and all professions. Whether in law or engineering, implicit is the professional’s promise that they are competent and will do their best to act in the interest of those they are helping.
“What am I here for? Have I made an honest commitment? These are all consequential questions related to concrete realities,” Pellegrino said. “I hope young people here will take this to heart as you enter these professions.”