The Center for Biomedical Ethics and Humanities continues UVA’s flourishing tradition, dating from the late 1960s, of vigorously exploring and teaching innovatively about the complexities of human illness, suffering, and practices of healing, as well as the processes of research and policymaking. Our work, much of it collaborative and crossing professional lines, draws on methods and materials of philosophy, literature and language, history, law, religion, the social sciences, and the arts. Our history charts a longtime commitment to the indivisibility and productive integration of biomedical ethics and humanities.
1960s and 1970s
UVA School of Medicine’s longstanding commitment to and distinguished national reputation in biomedical ethics and medical humanities date from the 1960s. As medical education after the 1950s focused increasingly on biomedical science and molecular medicine, former medical school dean Thomas H. Hunter MD and visiting medical ethicist Joseph F. Fletcher STD, author of Morals and Medicine (1954) and Situation Ethics (1966), sought to ensure that UVA medical students-and their teachers-didn’t lose sight of big-picture issues concerning both medicine and society. With a grant from the Commonwealth Fund, Dr. Hunter and Professor Fletcher established the Program in Human Biology and Society. They also created what is now known as the Medical Center Hour, a public forum on medicine and society conceived as a variant of medicine’s traditional clinicopathologic case conference (TH Hunter and JF Fletcher, “Mutant CPCs,” The Pharos, 1972). By 1971 Medical Center Hour was a weekly event at which nationally known speakers debated topics from current headlines with an audience of students, faculty, clinicians, and community residents. This forum has continued uninterrupted since, for nearly 40 years, offering programs on Wednesdays through the academic year.
As subjects, biomedical ethics and health policy also prompted interdisciplinary and interprofessional inquiry around Grounds. Beginning in the early 1970s, religious studies professor James F. Childress PhD, coauthor (with Tom Beauchamp) of Principles of Biomedical Ethics (1979-2009), taught in both Arts & Sciences and the medical school and supervised religious studies graduate students working in bioethics. From the early 1970s, the law school’s Center for the Study of Science, Technology, and Public Policy fostered teaching and research in legal medicine and helped to forge strong ties between the medical and law schools, as did the Institute for Law, Psychiatry, and Public Policy, also established in those years. Several faculty – psychiatrist P. Browning Hoffman and legal scholars Walter Wadlington and Richard Bonnie among them – held joint appointments in law and medicine.
As biomedical ethics gained notice within clinical medicine, the medical school in 1981 invited philosopher E. Haavi Morreim PhD to be philosopher-in-residence in the clinical setting. University of Chicago physician-ethicist Mark Siegler MD visited as a fellow in religious studies and internal medicine for a year in the early 1980s. Former medical school dean and vice president for health sciences Kenneth Crispell MD studied the health crises of U.S. Presidents, writing (with Carlos Gomez) Hidden Illness in the White House (1988). Well into the 1980s, Professor Childress and internal medicine professor Oscar A. Thorup MD co-taught “Ethics and Public Policy in Health Care,” a seminar for medical, law, nursing, and humanities graduate students. After Dr. Hunter retired, Dr. Thorup and Professor Childress directed the Medical Center Hour.
In 1984, UVA Medical Center’s Ethics Committee was established, with internal medicine department head Edward W. Hook MD at the helm.
In 1987, John C. Fletcher PhD joined UVA’s faculty after serving for ten years as bioethics program chief at the National Institutes of Health’s Clinical Center. Professor Fletcher was appointed to the faculties of both religious studies and internal medicine, with the deans of Arts & Sciences and Medicine committing to an interdisciplinary, interschool program in biomedical ethics.
The Center for Biomedical Ethics was organized in 1988 as a division of the Department of Internal Medicine, with Professor John Fletcher as director. In 1989, a required course in clinical ethics was developed for first-year medical students.
In 1990, the Center for Biomedical Ethics, led by Professor Fletcher, became a division of the medical school dean’s office. Together with the religious studies department, the center developed an MA program and courses in bioethics. The center helped to establish and staff the UVA Medical Center’s interdisciplinary clinical ethics consultation service and also started outreach education for Virginia hospitals developing their own ethics committees.
Arts & Sciences’ Undergraduate Program in Bioethics was created in 1993, with philosopher-ethicist John Arras PhD (Ethical Issues in Modern Medicine, with Bonnie Steinbock, 2002) recruited to the Porterfield Chair in Biomedical Ethics. Undergraduates could choose to minor in bioethics.
In 1991, Dean Robert Carey established the Program of Humanities in Medicine as a division of his office, with Dr. Hook, now chair emeritus of internal medicine, as founding director. Humanities in Medicine offered medical school elective courses in humanities disciplines such as history, literature, and religious studies (with Arts & Sciences faculty teaching some courses), developed continuing education for practicing physicians, and published medical students’ creative writing (Veritas). Humanities in Medicine also assumed responsibility for the Medical Center Hour.
The biomedical ethics and medical humanities programs occupied adjacent office suites in the Barringer building. In 2000, this space was renovated to become a single suite of offices with shared teaching, resource, and administrative support space.
In 1996, literature scholar Marcia Day Childress PhD and internal medicine professor Julia E. Connelly MD became co-directors of Humanities in Medicine, succeeding Dr. Hook. In 1998, when Professor Fletcher retired, philosopher-ethicist Jonathan D. Moreno PhD was appointed Kornfeld Professor in Biomedical Ethics and director of the Center for Biomedical Ethics; Professor Moreno is author of, among several books, Deciding Together: Bioethics and Moral Consensus (1995). Education initiatives for medical students, university undergraduate and graduate students, and practicing clinicians continued to develop in both programs, with increasing overlap of faculty research, teaching, and service interests. New core faculty included rehabilitation physician and ethicist Walt Davis MD, lawyer-historian Paul Lombardo JD PhD (Three Generations, No Imbeciles: Eugenics, the Supreme Court and Buck v. Bell, 2008), pediatrician and religious ethics scholar Margaret Mohrmann MD PhD (Medicine as Ministry, 1995; and Attending Children: A Doctor’s Education, 2005), and medical humanities scholar David Morris PhD (The Culture of Pain, 1991; and Illness and Culture in the Post-Modern Age, 1998).
In 2000, capitalizing on nationally acclaimed institutional strength in ethics scholarship and teaching, UVA established the Institute for Practical Ethics and Public Life, a university-wide program to facilitate interdisciplinary exploration of ethical dimensions of individual and social choices in professional life and public policy. The institute is led by James F. Childress PhD, Hollingsworth Professor of Ethics, and faculty from Medicine are strong partners in the institute’s activities.
In 2005, Dean Tim Garson reorganized the Program of Humanities in Medicine into the Center for Humanism in Medicine to build on the medical humanities program’s work, foster professionalism and renewal in students and faculty, and create faculty development opportunities. Internal medicine professor Daniel Becker MD MPH MFA was appointed center director.
In 2005, the Program in Ethics and Policy in Health Care, with Patricia Tereskerz JD PhD and Ann Mills Msc(Econ) MBA, was established within the Center for Biomedical Ethics to promote scholarly work on ethical issues in health care organizations, biotechnology, and health policy.
2007 and beyond
The Center for Biomedical Ethics and Humanities was created in May 2007 to unite the medical school’s biomedical ethics, medical humanities, and medical law programs. Dr. Daniel Becker directs the center. Dr. Margaret Mohrmann succeeded Professor Moreno as Kornfeld Professor of Biomedical Ethics from 2009 until 2012, when Professor Mary Faith Marshall joined the UVA faculty from the University of Minnesota; she is now Kornfeld Professor and director of programs in biomedical ethics. Professor Marcia Day Childress leads the medical humanities and arts programs and the Medical Center Hour. Lawyer-bioethicist Lois Shepherd JD (If That Ever Happens to Me: Making Life and Death Decisions after Terri Schiavo, 2009) and psychiatrist-ethicist Dr. Donna Chen MD MPH joined the faculty in 2008.
Over the years, the roster of core faculty has changed. Dr. Julia Connelly and Professor David Morris retired in 2012, as did Dr. Margaret Mohrmann in 2015. Professor John Arras, Porterfield Professor of Biomedical Ethics, was a core faculty member in the center from 2013 until his untimely death in March 2015. Emeritus professors Robert Boyle MD and Eugene Corbett MD became part of the center in 2014-2015, and nurse-ethicist Elizabeth Epstein RN PhD joined the center’s core faculty in 2015. All center faculty engage collaboratively with programs and peers in other UVA schools—Arts and Sciences, Law, Nursing—and the Institute for Practical Ethics and Public Life and, within Medicine, in public health, geriatrics, palliative care, physician wellness, medical education, chaplaincy services, several clinical departments, and Historical Collections of the Claude Moore Health Sciences Library. The work of the center, in education, research, and service, is increasingly an integrated enterprise.