Edmund Pellegrino’s list of titles and bestowed honors is long enough to fill this entire page, but the experienced man of medical ethics prefers the more unassuming title of physician.
At a Thursday morning lecture, MU’s Acuff Auditorium was filled with men and women, many in white lab coats, who had come to hear Pellegrino’s thoughts on whether the profession needs new medical ethics. Beepers went off incessantly, but Pellegrino talked on without taking notice.
“Profession,” he said, emphasizing that the word is an action, not a description. “It is an oath to the community that you will serve them, in return for your training in medical knowledge.”
Every time a doctor asks a patient, “Can I help you?” that doctor is professing fidelity to that oath, Pellegrino said. It is a pledge that the doctor will be benevolent, will set aside selfish interest and be compassionate in his or her healing practices, he said.
Pellegrino radiates an enviable inner energy. His 85 years show on the exterior; he makes his points with fingers turned crooked by arthritis, and his frequent smiles are permanently etched with wrinkles.
“Your primary obligation is to your patient, not to society,” he said addressing the medical personnel in the audience.
Pellegrino said the modern health-care system is so bureaucratized and commercialized that patients might get the perception that the staff is not interested in them unless they can pay.
The system has to some extent deprived the doctors of their authority and autonomy to provide the best care; he said they should reclaim their act of profession.
Pellegrino was invited to present the fifth annual Carlos Perez-Mesa Lectureship in Medical Humanities on Thursday night. Throughout his three-day stay, however, he maintained a breakneck schedule, speaking publicly on several occasions and twice leading rounds at University Hospital.
Pellegrino’s involvement with MU goes back more than 30 years. He was an adviser when the medical ethics center on campus was established, and he was awarded an honorary doctorate in the humanities in 1984.
He retired five years ago, but the retirement did not decrease his activities noticeably. He still does medical rounds at Georgetown University Medical Center, where he is a professor emeritus of medicine and ethics. He also accepted an appointment to UNESCO’s International Bioethics Committee.
“I love what I do,” Pellegrino said in an interview. “There was no reason why I should not keep on doing it after I retired.”
The biotechnology revolution is promising longevity; children free of genetic disease; and stronger, smarter, more beautiful people, but will it make us better human beings? This was Pellegrino’s concern.
“Good and evil comes of all technology,” he said at the beginning of the Perez-Mesa lecture.
In that address, he emphasized there is a significant difference between medicine, which is restoration of normal functioning and health to a person, and enhancement, which is enabling a person to have functions beyond normal and healthy.
Pellegrino gave several examples of enhancements that already are in common use. The examples included athletic doping and drug modification of mood and behavior.
The discussion is serious enough to have been considered by the President’s Council on Bioethics. The council has published a report called “Beyond Therapy,” which served as a basis for Pellegrino’s lecture.
Pellegrino said that America will be divided in the discussion on enhancements. Even members of the president’s council had limited themselves to posing the questions in their report because they were divided as well.
Pellegrino opposes the cloning of humans and all stem-cell research that involves destruction of a human embryo. He is critical of human enhancement because of its ethical dangers, and he is well aware of the allure of the promises enhancement makes.
“We will be undoing all the mistakes the creator made when he created the human species,” he said with a smile. “But, remember that Nemesis always followed Hubris. She takes care of those that are full of hubris.”