About Us
At the center of Harvard Medical School’s ethics activities, the Division of Medical Ethics is dedicated to improving medical care and education by building greater awareness and understanding of the moral, ethical, and social dimensions of medicine. Since its establishment in 1989 under its first director, Lynn Peterson, the Division has continued to explore the critical ethical elements of health and disease, the nature and meaning of illness, and the organization and delivery of health care.
Guided by a growing number of gifted faculty members, the Division has significantly expanded the scope and depth of the School’s ethics-related teaching and research initiatives, interfaculty dialogue, and outreach to practitioners and scholars worldwide. Their insightful and innovative work has shaped many of the Division’s most influential and successful courses and programs.
A financial commitment from former HMS Dean Joseph Martin expanded support for the Division and led to a number of changes that involve Center for Ethics faculty associates. Dan Brock became the Division’s Director in 2004, replacing Allan Brandt, who had provided skilled leadership since 1996 (Brandt was appointed Dean of the Graduate School of Arts and Sciences in 2008) A former University Professor at Brown, Brock also served as Director of the Center for Biomedical Ethics and was a senior scientist at the National Institutes of Health Department of Clinical Bioethics. Dr. Robert Truog, a longtime participant in the Division’s activities while a Professor of Anesthesiology and Pediatrics and Director of the Pediatric Intensive Care Unit at Children’s Hospital, assumed the position of Director of Clinical Programs in the Division. Christine Mitchell, who also directs the Children’s Hospital Office of Ethics, is now devoting half of her time to the Division, where she works with Truog as Associate Director of Clinical Programs. Mildred Solomon, an Associate Clinical Professor of Anaesthesia at Children’s Hospital, has become the Division’s Associate Director for Clinical Research. In addition, the Division welcomed two faculty members, Sadath Sayeed and Nir Eyal. Eyal has been named a Faculty Fellows in Ethics for 2009-2010.
Undergraduate Initiatives
In the Medical School’s undergraduate program, students are exposed to a wide variety of ethical issues and acquire the skills to systematically address moral and ethical dilemmas throughout their careers. For several years, the “Medical Ethics in Clinical Practice” course was offered as an elective to first-year students. The course was taught by a number of distinguished faculty over the years, beginning with Ed Hundert, and succeeded by Peterson, Walter Robinson, Truog, and Brock. Other elective courses have covered a wide range of issues, including living with life-threatening illnesses, pain and palliative medicine, and medicine and religion.
In 2004, the School began a comprehensive review of its four-year curriculum. Members of the Division of Medical Ethics are among those who are developing the curriculum, which is being phased in over a four-year period that began in 2006. A major change introduced into the curriculum is that, for the first time, “Medical Ethics and Professionalism” has become a required course for first-year students. The inaugural course was taught in six sections. As a follow-up to the course offered to first year students, the Division hosted a monthly journal club for medical students. Students direct the content of the course, with facilitation from the Division’s faculty.
In addition to this required course, each year between ten and twenty students submit essays in competition for the Henry K. Beecher Prize. These essays have examined topics ranging from fetal surgery to physician-pharmaceutical relations to facial surgery in children with Down Syndrome. A faculty committee from the Division meets to select the recipient of the prize, and the best offerings often merit publication in the medical ethics literature.
Graduate and Professional Initiatives
For professionals in a rapidly changing field that is linked so closely to the well-being of society, continuing education is essential. The Division offers an expanding slate of programs that enable health professionals and others from within and outside Harvard to study ethical issues as they evolve in the medical profession and in contemporary society.
The Fellowship in Medical Ethics, established in 1993 under the direction of Allan Brett and Robert Truog and now directed by Mildred Solomon, supports medical professionals with an early-career interest in ethics. Over the years, former Fellows have taken leadership roles in ethics programs across the University, as well as in other health care institutions, philosophy departments, and non-governmental organizations in the U.S. and abroad, including Gadjah Mada University School of Medicine in Indonesia and Medecins Sans Frontières-Holland. The Medical Ethics Faculty Seminar meets monthly and attracts a diverse constituency of Medical School faculty and others from across the University and affiliated hospitals. Under the direction of Division faculty member Marcia Angell, the seminars focus on a single theme. Topics have included the State of Bioethics, the Role of the Pharmaceutical Industry in American Medicine, and Ethics in Clinical Trials.
Monthly gatherings of the Harvard Ethics Consortium draw as many as 60 participants from across the Medical School’s affiliated institutions to critique recent ethics consultations by examining cases in detail. Facilitated by Mitchell and Truog, this important forum for peer review has considered complex topics such as putting a live donor at risk in liver transplantations, setting up a renal dialysis program in Cameroon, and stopping futile care in the face of family objections. Under the leadership of Sadath Sayeed, the Responsible Conduct of Research (formerly known as the Program in the Practice of Scientific Investigation) provides ethics training to postdoctoral research fellows on ethical issues that arise in the context of “wet bench” medical and biological research. Taught on an intensive basis over the course of a week, the program increases understanding of how established guidelines and ethical standards apply to actual research situations. A number of professional programs offered through the Division are strengthening connections among those who are doing important ethics-related work in the Harvard community. Established in 2004, the Harvard Ethics Leadership Group, under the direction of Truog and Mitchell, facilitates information sharing among the various ethics programs and consultation services at all Harvard-affiliated hospitals. The group collaborated to submit a multi-institutional grant to explore the quality and impact of ethics consultation in the Harvard teaching hospitals.
In the spring of 2005, the Division initiated a Harvard Bioethics Course to educate and support interested clinicians and staff at Harvard hospitals. Taught by Division faculty and colleagues from institutions connected with the Medical School, the course has consistently received overwhelmingly favorable reviews. The Scholars in Clinical Science Program is a federally funded ethics module that addresses subjects such as informed consent, subject selection and recruitment, and conflicts of interest, and is intended to help physicians at Harvard-affiliated programs prepare for careers in clinical research.
Public Programs
The Division’s public programs on medical ethics promote understanding, dialogue, and debate at Harvard and in society at large. Conferences and lectures, ongoing programs, community outreach, and media contacts all facilitate engagement with a complex and rapidly changing array of medical ethics issues.
The Medical Ethics Forums explore a range of contemporary issues at the intersection of medicine, ethics, and society. The forums bring together diverse groups of experts for discussion and debate and attract wide interest (one was filmed by ABC’s Nightline). Programs have looked at stem cell research, Abu Ghraib and Guantanamo, bioterrorism, organ solicitation over the Internet, access to drugs in the developing world, physician-assisted suicide, and the politicization of science. The Division also hosts numerous public lectures during the year, including the School’s oldest endowed lecture, the George W. Gay Lecture in Medical Ethics, which was established in 1917. Presenters have included Henry Louis Gates, Jr., Sissela Bok, Elie Wiesel, Dennis Thompson, Paul Farmer, Atul Gawande, Howard Gardner, and Dame Cicely Saunders.
In 2005, the Ackerman Symposium, an annually held gathering cosponsored by the Division, looked at the evolving consensus around professional values in medicine and examined the challenge of integrating those values in medical school education. Harvard Medical School is firmly committed to its broad, interdisciplinary agenda of examining the moral questions at stake in medicine and science. In recent years, remarkable progress has been made in the Division of Medical Ethics with the support and encouragement of students, faculty, Harvard-affiliated hospitals and schools, the broader medical community, and the Center for Ethics. Through its innovative programs, research, and teaching, the School is well positioned to enhance the medical profession’s ability to conduct science with integrity and deliver effective care with compassion.