In Memory of Edmund D. Pellegrino

I cannot claim to have had anything more than a casual and intermittent personal acquaintance with Professor Pellegrino, whose passing this last week is a great loss for bioethics, medicine, academia, and the church alike. I did, however, have the privilege of meeting him on several occasions (always at CBHD summer bioethics conferences!), as well as, more recently, the honor of serving as a co-editor of an edited book volume to which he contributed a chapter.[1] In all my interactions with him, he was always the epitome of graciousness and generosity of spirit.

As several other bloggers have noted on this site, one of Pellegrino’s chief contributions was to draw our attention, repeatedly and consistently, to persistent and fundamental questions and concerns that are all-too-often neglected in this age in which the “technological imperative” so frequently carries the day. Questions such as: what exactly are the “ends” of medicine? And how do our present medical practices square with those ends? Concerns such as: what does it mean to be a physician? To be a patient? To encounter one another, as physician and patient, respectively, in the clinical context?

Chief among these concerns was an increasingly countercultural commitment to the notion that medicine, as both an art and a profession, really does possess an “internal” morality—that is, a coherent set of moral principles and ethical guidelines arising out of the nature of the medical practice itself, and embodied in a shared set of assumptions (moral and otherwise) and values to which members of the medical profession are (or ought to be) committed. This contention of Pellegrino’s, central as it was to so much of his work, naturally attracted much criticism—and, to be sure, one cannot help but suspect that, for all practical purposes, medicine as an institution today increasingly looks more and more like a “vending machine” responsive primarily to the vagaries of consumer demand and sociopolitical agendas, rather than the robust, ethically-constrained profession to which Pellegrino continued to call its practitioners throughout his career. To his credit, however, he stayed true to his convictions on this matter, even in the face of opposition—a strength of conviction that is worth emulating in its own right.

Importantly, as a Catholic believer, Pellegrino was both courageous and consistent in his insistence that a proper understanding of medicine as a practice can be attained only in the context of a theologically-informed understanding of reality. For Pellegrino, this meant a continual return not only to the philosophical underpinnings of medical practice, but ultimately, the theological foundations upon which all of human experience—including the clinical encounter—is grounded.

For his rigorous, consistent, and persistent insistence that bioethics be approached from within a philosophical-theological framework that attends to the deep, fundamental “first things,” Pellegrino is to be admired and emulated. For his unfailing personal graciousness, he will be missed. And for his contributions to bioethics, medicine, academia, and the church, he will be cherished.

Rest in Peace, Edmund Pellegrino.

[1] See The Development of Bioethics in the United States (Springer, 2013). Pellegrino’s essay, entitled “Medical Ethics and Moral Philosophy in an Era of Bioethics,” addresses four issues in particular:

First, it examines the sociocultural context that gave birth to bioethics, which is characterized by the rejection of traditional moral authority and the rapid development of biomedical sciences and biotechnology. According to Pellegrino, this particular milieu recast traditional medical ethics outside its philosophical foundation and paved the way for the emergence of bioethics. The second issue relates to the decline of medical ethics as the source for the professional ethics of physicians. Bioethics reconfigured medical ethics within the particular socio-cultural and scientific context of the 1960s. Pellegrino deplores this shift because it redefines the patient-physician relationship in term of social mores instead of the traditional foundations of medical ethics. Third, Pellegrino looks at the meaning of the word “ethics” in the terms “medical ethics,” and “bioethics,” each presupposing different moral visions. Medical ethics, he contends, presupposes rigorous classical philosophical ethics whereas bioethics, in its latest iteration (i.e., “progressivist bioethics”), combines the values of liberalism and pragmatism to advance its socio-political agenda. Pellegrino sees the latter development of bioethics as problematic because it conflates social mores and political ideology with ethics. In his view “ethical discourse must go beyond activism or political ideology,” whether in its progressivist or conservative conceptualization. The fourth and final issue Pellegrino addresses is the plea for a “more rigorous adherence to classical philosophical ethics” to ground ethical reflections in concepts such as the good, the right, and the just, rather than in particular ideologies. To this end, he makes a call for a reconsideration of the potential role of moral philosophy in bioethical and medical ethics debates.

Jeremy R. Garrett, Fabrice Jotterand, and D. Christopher  Ralston, “The Development of Bioethics in the United States: An Introduction,” in J. R. Garrett, F. Jotterand, & D. C. Ralston, eds., The Development of Bioethics in the United States (Springer, 2013), p. 12.

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