Holocaust Museum Houston Series Explores Medical Ethics

Curriculum and student interest group at UT Medical School address similar issues

As rapidly as medical science breaks new ground, new ethical dilemmas arise, challenging those in the health sciences to apply the best of its humanitarian principles to questions that may never have been posed before.

One scenario that springs immediately to mind is a distraught family member confronting hospital staff in a medical futility decision, but there are scores of other arenas in which medical ethics are a necessity and not a luxury. Allocating scarce health care resources entails applying ethics on a broad scale; deciding whether a procedure falls into the purview of nursing requires examination of professional ethics.

At The University of Texas Health Science Center at Houston, ethics are applied to clinical practice, medical and scientific research, and medical education. But the health science center also serves as a resource for the community at large, participating in such special events as the groundbreaking lecture series, “Medical Ethics and the Holocaust,” which runs through January 2008 (see http://www.hmh.org for more details).

The series began Sept. 9 with a distinguished panel moderated by Ferid Murad, M.D., Ph.D., professor and John S. Dunn Distinguished Chair at The Brown Foundation Institute of Molecular Medicine for the Prevention of Human Disease (IMM) and 1998 Nobel Laureate in the physiology of medicine, who also has an appointment at the UT Graduate School of Biomedical Sciences. Two other Nobel Laureates, James Watson, Ph.D., honored in 1962 for the physiology of medicine and renowned for his role in the discovery of DNA; and Eric Kandel, M.D., the 2000 Nobel Laureate whose work on cell communication in the brain has been seminal in neuropsychiatry were lecturers that evening. Their lectures for “Science and Medicine: After the Holocaust,” helped remind the audience that medicine without ethics can produce the kind of monstrous results seen in Adolf Hitler’s regime.

Sponsored by the Holocaust Museum of Houston, the lecture series undertakes an examination of the profoundly disturbing ethical choices made by some physicians in this dark period of history, and the implications for the choices faced today, as genetic medicine develops as a field, as health outcomes continue to reflect racial disparity and as government intersects with science in decisions that become politicized.

Watson stated in his talk that the scientific community, rather than government, has a responsibility to lead the discussion on the ethical implications of its discoveries.

With such provocative questions to ponder, the health science center is fortunate to have the resources of the John P. McGovern, M.D., Center for Health, Humanities and the Human Spirit, which was made possible by a 2004 gift from the McGovern Foundation. The center incorporates medical ethics in its broader mission to bridge the gap between the humanities and medicine.

Its dedicated faculty bring a wide range of expertise to the field of medical ethics, and are responsible for the medical ethics education of students at UT Medical School at Houston, where all students take Ethics and Professionalism in their second year. The six lectures and a series of small group tutorials examine the most significant ethical issues in medicine as well as questions that arise across the life cycle of a patient.

Thomas Cole, Ph.D., the Center’s director and John P. McGovern, M.D., Chair in Medical Humanities, says the ethics of medicine are embedded in every role, from clinician to teacher to student, so ethical training must be broad and encompassing.

Cole’s own expertise is the ethics of aging, a field that is emerging as the demographic shift toward an older population occurs. Here, the issues are not only those of society’s obligation to care for frail and possibly demented individuals, but also the responsibilities of the elderly to society: those of mentorship, volunteerism, self-care, prudent use of resources and service as role models on how to age wisely.

Such complexities find their way into all four years of the medical school curriculum, Cole said.

“They are essential in the training of doctors,” said Cole.

At UT Medical School, students take an active role in the course, designing parts of the curriculum and participating in informal presentations on a wide variety of topics.

UT Medical School students Gaia Muallem and Chirag Patel, are deeply involved, having served as the organizers of the topics in ethics elective courses last spring. The two are currently co-chairs of the Student Interest Group of the American Society of Bioethics and Humanities (ASBH). They view medical ethics as one of the most important components in their professional development and recognize the importance of putting their classroom lessons into practice in their patient and professional interactions in the years to come.

“Because medical ethics is not an either-or science, it is important for us to explore the intersection of law, ethics, and morality in each of our patient cases,” Patel said.

This fundamental need is echoed by Cole, who says that the field of ethics in some ways is very basic: “At its core, ethics is about examining questions of right and wrong in our relationships with other people.”

By Leslie Gerber, for Institutional Advancement