Loma Linda University TheScholarsRepository@LLU: Digital Archive of Research, Scholarship & Creative Works Update Loma Linda University Publications 9-1989 Update - September 1989 Loma Linda University Center for Christian Bioethics Follow this and additional works at: http://scholarsrepository.llu.edu/update Part of the Bioethics and Medical Ethics Commons Recommended Citation Loma Linda University Center for Christian Bioethics, "Update - September 1989" (1989). Update. http://scholarsrepository.llu.edu/update/19 This Newsletter is brought to you for free and open access by the Loma Linda University Publications at TheScholarsRepository@LLU: Digital Archive of Research, Scholarship & Creative Works. It has been accepted for inclusion in Update by an authorized administrator of TheScholarsRepository@LLU: Digital Archive of Research, Scholarship & Creative Works. For more information, please contact [email protected]. LOMA LINDA UNIVERSITY ETHICS CENTER ( tions without, Waitzkin contended, in­ Gerald and Betty Winslow creasing overall expenditures. Accept Positions at Waitzkin, Kirkendahl and Kirkendahl and Likens agreed that Pacific Union College Likens Debate National in the United States patterns of deliver­ Health Plan ing and financing health care are ill; After having served at Loma Linda they doubted, however, that the group University for two years, Gerald and Howard Waitzkin, a physician and of physicians represented by Doctor Betty Winslow have accepted positions economist who teaches at the University Waitzkin has discovered an economic at Pacific Union College. in Northern of California at Irvine, George Kirkendahl, cure. Kirkendahl feared that the pro­ California. Gerald Winslow will chair the an administrator at San Antonio Commun­ posed plan would stifle medical entre­ department of religion at PUC, a school ity Hospital, and James Likens, a pro­ preneurship with a resulting adverse of liberal arts and sciences that Seventh­ fessor of economics at Pomona College impact upon research and development. day Adventists have operated at Angwin, in Claremont, California debated a pro­ Likens doubted the efficiency of the about an hour's drive north of San posed national health plan at the May 5 proposed plan. He particularly ques­ Francisco, since 1909. He will lead a session of the Ethics Center's monthly tioned the creation of another govern­ group of theologians at PUC who pro­ Medicine and Society Conferences. mental bureaucracy that might be more vide general education classes in reli­ Waitzkin, a member of the group of sensitive to its own preservation and ex­ gion as well as courses for majors in physicians who published the proposal pansion, and to political pressures im­ religious studies and ministerial studies. in the January 12, 198~Hssue of The New posed by special interest groups, than to He will also continue writing, consulting England Journal of Medicine, made the the medical needs of citizens. and lecturing in the field of biomedical primary presentation. Kirkendahl and Audio and video tapes ofthe exchange ethics. Betty Winslow will teach in PUC's Likens responded. James Walters, direc­ are available from Media Services, Loma nursing and adult education programs tor of the Medicine and Society Con­ Linda University, Loma Linda, CA 92350. as well as continue her doctoral studies ferences, moderated the discussion. at the University of Denver. Waitzkin pointed to mushrooming Gerald Winslow made several notable costs, millions of medically uninsured Edmund Pellegrino contributions during his two years at and expanding medical bureaucracies Delivers Loma Linda. In addition to teaching as indications that in the United States Jack Provonsha Lecture substantial numbers of students through the present system of financing and the university's school of religion, he delivering medical care should be re­ Edmund D. Pellegrino, John Carroll lectured extensively both on and off placed. Waitzkin advocated a compre­ Professor of Medicine and Medical campus. Winslow was very active in the hensive system that would be mandated Humanities at Georgetown University, deliberations that established LLU's by the federal government but funded and until recently the director of the protocol regarding the use of transplant­ and administered by states and com­ Kennedy Institute of Ethics at that insti­ able organs from anencephalic new­ munities. Among other things, this plan tution, delivered the second annual Jack borns. An upcoming issue of The Journal would eventually eliminate private medi­ W. Provonsha Lecture at LLU's School of Pediatrics will contain his views on cal insurance; however, medical care of Medicine Alumni Postgraduate Con­ this controversial subject. He also author­ facilities would be privately owned and vention to a capacity audience at the ed several other scholarly articles and the salaries of physicians would not be Randall Visitors Center on February 15. chapters that will appear in forthcoming lowered. Because of its greater efficiency, Since then, Pellegrino has been ap­ publications. Winslow collaborated with the proposed plan would be funded by pointed director of Georgetown Univer­ James Walters in developing plans for a taxes and mandatory employer contribu- sity's new Center for the Advanced / major project oh "Ethics and Aging" that Study of Ethics of which the Kennedy -' is currently scheduled for the 1989-1990 Institute will be a part. school year. He 'serves on the Human Pellegrino arrived with a formal lecture Life Committee of the General Confer­ entitled "Character, Virtue and Self­ ence of Seventh-day Adventists which, Inside this Issue: Interest in the Ethics of the Professions," among other things, is reviewing the from which major excerpts will be pub­ denomination's guidelines on abortion. Clinical lished in a subsequent issue of Update. But the Clinical Intensive in Biomedical But on the occasion of his lecture he Ethics, which attracted a number of Medical Ethics accepted an invitation to do something scholars for eight weeks of full-time continued on page 8 continued on page 8 Gerald Wins~ow led an eight-week "Clinical Intensive in Biomedical Ethics" at Loma Linda University that began in January of this year. The purpose of the seminar was to expose students of bioethicalliterature to the moral challenges and dilemmas that occur in modern medical centers. The seminar attracted the full-time attention of the following individuals for two months: Beryl Bull (pre-medical student, Walla Walla College); Luz Diaz-Schreiber (chaplain trainee at UCLA Medical Center and doctoral student at LLU's School of Education); Mary Hardy (a physician in Glendale, California); W. Noel Keyes (emeritus professor of law at Pepperdine University); Sister Francesca Lumpp (a nursing administrator from St. Louis, Missouri); Marylee Meehan (a graduate student of biomedical ethics from Cape Cod, Massachusetts); Beverly Sloane (author and lecturer); Julie van Putten (an assistant professor of health education at LLU); and Sue Wholmes (a student of philosophy and classics at the University of British Columbia). Paul R. Johnson, the author of the following essay, was an Ethics Fellow at Loma Linda University for the month of June. He received his doctorate in Christian ethics from Duke University and now serves as a professor of religious studies at O'Youvil/e College in Buffalo, New York. He is the author of several articles on ethical issues in neonatology. INSIGHTS AND INQUIRIES: that follow are primarily personal reflections on my medical ethics internship, I hope to outline an agenda for my own future thinking in Reflections on a Clinical bioethics and to invite others into such analysis as well. Medical Ethics Internship The Clinical Setting and Moral Decision Making By Paul R. Johnson Ethics Fellow Within the clinical setting, three interrelated factors become quickly apparent: technology, complexity, and uncertainty. One is struck immediately with the technological sophistication and dependency of modern medicine. Technology has become Like many teachers of bioethics, my knowledge of the field central to all steps in the medical process. Highly refined developed primarily at the theoretical level. A doctorate in instrumentation is used in patient assessment and diagnosis. Christian ethics, years ofteaching at a college with several health­ Powerful computers generate and store data and transfer infor­ related major programs, and participation in a National Endow­ mation quickly to terminals throughout the hospital. Technology is ment for the Humanities Summer Seminar on bioethics led me to crucial to therapy as well, being the means to carry out treatment adapt general moral theory to ethical concerns of health pro­ and monitor patient progress. Thus, technology has become a fessionals in the classroom and in several articles. But, as Robert powerful ally in a more rapid, accurate, and effective fulfillment of Veatch has written, "Teachers should, when possible, have not medicine's goal of extending and enhancing life. But questions only full qualification in ethics or the medical sciences, but also also arise. Does technology carry out our deciSions, or does its 'competent amateur' status in the other field. In other words, presence begin to make decisions for us? Does it implement our philosophers should know their way around the hospitaL" values or obscure them? Does technology carry its own impera­ Recognizing the value of such exposure to the clinical setting, I tives, and how do