Center for Ethics and Humanities
in the Life Sciences

College of Human Medicine

 

 

About the Center


Program to Close Gap between Thinkers, Doers

The gap between thinkers and doers is sometimes a wide one.

If philosophers are the thinkers and physicians are the doers, can their polarized positions meld to produce a thinking doer? More practically, can medical educators aided by humanists, produce a physician who treats more than the disease -- one who treats the whole person?

This is the crux of a new program on medical humanities, headed by MSU’s long time Dean of the College of Human Medicine, Andrew Hunt.

Officially approved by the Board of Trustees in September, the fledgling formal program is based on an approach to medical education that has been in the informal seminar-discussion-study stage at the University for several years.

Its proponents believe that medicine is one of the humanities. In a small, but growing national trend, educators are beginning to look at the totality of the education a medical doctor receives and the subtleties that should be included in that education.

MSU’s earliest plans for the College of Human Medicine emphasized a multidisciplinary approach to medical education, the core on which the new program is based. Hunt calls the interdisciplinary effort “an almost characteristic Michigan State way. At Michigan State,” he says, “we have fairly low department barriers -- a long history of easy collaboration.”

But Hunt himself confesses a little surprise at the early innovative plans. “They were talking about utilizing the existing departments of anatomy, physiology and biochemistry which were already here for vet medicine,” Hunt says, explaining that medical schools normally have their own departments in these areas.

“This was very innovative at the time,” he continues. “Actually, it was a little scarey because it was so new, but President Hannah was very dynamic and compelling -- and it was going to work.”

Hunt’s inclinations were the same as Hannah’s, however, and when he found that the behavioral sciences were interested in participating in the same ways as the biological sciences, he remembers, “I made it almost a condition of recruitment that I'd come if they would add these (anthropology, sociology, psychology) to the pre-clinical 2-year program.”

The curriculum of the college from the beginning was more related to social needs Hunt says, and in the process of its formation, innovative faculty and students looking for this approach were attracted.

About four or five years ago, Hunt says, MSU faculty began to get interested in some of the issues being talked about nationally -- issues he calls “really enormous.” He lists “obvious ethical decisions and serious technological problems, the life and death of mentally deficient infants, old people kept alive by machines.

“There’s a whole area of informed consent,” he continues, “doctor-patient relationships, respecting the feelings of the patient which we haven’t done very well in the past, ethics of research programs, ethical issues of controlled experiments on human subjects, public policy issues like abortion, and so on.”

“During that period, Martin Benjamin, associate professor of philosophy and his departmental colleagues began holding ethics conferences in area hospitals,” Hunt says. A medical student on campus, Howard Brody, became well known nationally with his deep involvement in the expanding informal medical humanities program. “Potchen came,” Hunt says of James Potchen, chairman of radiology, “and he was interested in it and it was under his department’s aegis that the evening seminars on the subject of medical humanities began.”

Now after two years of these multidisciplinary seminars which have created a growing interest among students and other faculty, came the formalized program “complete with coordinator, an office and an account number,” says Hunt.

The changes planned for this year are minimal. “We’ll continue much the same this year,” Hunt says. “We will try to create a policy board, with representation from the colleges of medicine, nursing, University College, arts and letters, the Honors College and others.” The evening seminars and ethics conferences will continue.

But as the years progress so will the emphasis on humanities in training physicians and Hunt believes that other disciplines will benefit from their involvement in the process.

Potchen, a firm believer in “treating the sick people instead of their diseases” says “one thing we've never done is to effectively crystallize a lot of the resources of this institution to bring to bear on problems in medical education.

“Of all the institutions I’ve been in, this institution has the biggest chance of pulling off the big difference,” Potchen says.

Hunt believes that this sharing of the medical student’s education can offer shadings to doctors not previously experienced.

“Philosophers approach problems in a different way,” he says. “In a scholarly way, they understand the history, human thought, the logic and morality of a subject. They argue conceptually about problems and disagree violently with each other, but still maintain respect for each other,” he says. “They dissect issues logically, which physicians just don’t do.”

Hunt says the medical profession is in trouble with “what looks like greed . . . with what looks like callousness . . . with what looks like a very conservative political position.”

His idea is not to basically change the doers that physicians must be, but to tone them with colors from the humanists and to offer them culture within the medical school
complex. “Medical school has a way making people into terrible drudges and that isn't what we want,” he says.

If this humane approach to educating a physician is working or will work Hunt doesn't know. “Whether it really makes a measurable difference, in our graduates, I don't know, but we can really get our faculty thinking in these kinds of terms and imparting them to students.”

“Somehow it’s bound to make a difference.”

The next evening seminar is tonight (Thursday, Nov. 10) 105 Kellogg Center. Hunt and Harold Blumenstein, Bay City radiologist, will speak on “The delivery of health care: physician’s, patient’s and society’s rights.”

-- JANICE HAYHOW

Michigan State University News-Bulletin
November 10, 1977

A Quarter Century's Worth of Furniture

What is it like leaving the place that has been my home for the past quarter century? I grew up here, as a professional and in other ways. New vistas and new challenges are exciting, but it is very difficult to leave behind my housemates who have been with me this for so long.

One of the colleagues in the new home I am going to paid me a nice compliment. He had last spent time with me up close about 14 years ago. He had thought that back then I showed a number of good qualities, but he was also pleased to see that today some of the rough edges had been rubbed off. If he’s right, I have no doubt that my housemates helped a lot with the sandpaper.

As much as I will miss my housemates, they have made me a very handsome offer. They are going to let me take some of the furniture from the old place with me. In my new home, I’ll be able to look fondly at these furnishings and remember my former associates all the more clearly.

So what do I plan to take with me?

First off, there is competence and professional responsibility. My housemates are teachers down to the marrow of their bones. They care deeply that those who come into contact with us take away something of value. I have never done teaching with any of them when I have not taken away some new tips on how to become a better teacher.

Next, I had thought of taking honesty. When I was starting to think about leaving, I took the first opportunity to talk with all my housemates about my thoughts, plans, and concerns. It would have been unfathomable to treat them any other way. Any hesitation or prevarication on my part would have been a churlish recompense for the way that they have treated me for so many years.

I definitely want to take compassion. This past year, which caused me to consider leaving the place that had been my home for so long, was in some ways very painful. At every step, I felt the support of my housemates. When one of our beloved housemates died recently, the sense of loss and the concern for her family were palpable as one walked though the rooms of our house. I hope to live up to this standard of compassion in how I treat all my new colleagues in my new place.

Respect for others is another thing I want to bring with me. In our house, we have taken many actions and made many decisions. I cannot recall when, if ever, we did anything by vote. We have talked and discussed and listened, and always have found ways to agree on what was best. Again, I hope to be able to rise to that standard in how I treat my new colleagues.

Finally, there is social responsibility. My housemates have always been concerned for those who are ignored by our society, those whose voices have not been heard. They have taught me that this thing we call bioethics and humanities in health care is not worth calling as such if it does not welcome the voices that have not been heard and adopt the concerns that have not been addressed.

I hope that some of our students in the College of Human Medicine read what I have written here. They will, I trust, recognize my furniture inventory. In the College, we call this list the virtues of professionalism. We hope that they will strive toward these virtues in how they treat their patients.

I hope that my faculty colleagues in other departments are as fortunate as I have been. I hope you can say that you treat each other the same way that my housemates have treated me—that as faculty, we model for ourselves and our colleagues, as well as for our students, this list of virtues. (If not, I invite you to imagine how things could change.)

There is one immensely rewarding thing about my furniture inventory. I can take as much of this furniture with me as I can possibly haul away, and plenty will still remain in the house that I am leaving.

-- HOWARD BRODY

Medical Humanities Report
Volume 28, No. 1, Summer 2006

Mission

The Center is committed to supporting reflective practice in health care and in science, by bringing to these fields the resources of ethics and the humanities. We do this through teaching, writing, public speaking, conducting research and working in many other ways with students, practitioners, and the general public. Our work is integrative: each activity informs the others, and all draw upon (and draw together) the humanities, the arts, and the sciences. We seek to deepen our field's response to cultural diversity and to increase the diversity of those active within it. We are an educational resource for the university and the state, and for national as well as international audiences.

Teaching

Our principal teaching commitment is to medical, nursing and veterinary students at Michigan State University; we also teach other groups, especially graduate students, medical residents, and undergraduates. In all of our teaching, from semester-long courses through one hour lectures, from drawing up curricula to conducting workshops, we try to collaborate with other faculty in the colleges we serve. In our teaching, as in all our work, we emphasize the ways in which theory and practice illumine one another. Having helped establish bioethics curricula in several colleges, we now seek to strengthen the presence of other humanities and disciplines in the health care and science programs. Toward this end we work closely with the Undergraduate Minor in Bioethics, Humanities and Society (BHS) in the Colleges of Human Medicine, Social Science and Arts and Letters.

Research and Scholarship

Our writing and research projects are intrinsically interdisciplinary, drawing upon the insights of the humanities and the findings of science to support reflective practice. Because of our practical and integrative commitments, we highly value collaborative work which reaches a diverse audience, both professional and public.

Public Service

Community outreach is at the core of all we do: we are proud to be part of a major land grant institution and of health care colleges which are community-based. Our public service activities -- workshops, public speaking, advising or consulting, and so on -- are varied, chosen in part for their contribution to our teaching and scholarship, but also for their usefulness to practicing health care professionals and researchers. These involvements help us understand the institutions about which we teach and write, and help us develop fruitful working relationships with practitioners. We especially hope to deepen the level of public, democratic deliberation about health and science policy.

 

Center History

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Founding

With support of a grant from the National Endowment for the Humanities, the Program hired several new faculty who developed required ethics curricula in the Colleges of Human Medicine, Osteopathic Medicine, Nursing and Veterinary Medicine. Supported at the time by six different colleges, the Program had the additional advantage of functioning as a cross-university resource with an interdisciplinary approach.

Read an interview with Dr. Hunt about the formation of the Medical Humanities Program.

 

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Evolving

When Dr. Hunt retired in 1985, Howard Brody, MD, PhD, assumed the helm. In 1988 the program was granted "Center" status, and renamed the Center for Ethics and Humanities in the Life Sciences (CEHLS) to mark its involvement in disciplines beyond biomedicine. 

Under Dr. Brody’s 20-year guidance, CEHLS expanded its identity, its faculty, and its scope. The Center’s mission statement opens with the words, "committed to supporting reflective practice in health care and in science, by bringing to these fields the resources of ethics and humanities."

The discipline of medical ethics and humanities evolved from those seminal ethical issues associated with the doctor-patient dyad, life-extending technologies and the ethical treatment of human subjects to include micro/macro level social policy questions such as: What economic issues most affect health care? How can physicians best deliver health care in a pluralistic society? How can physicians contain costs while preserving a trusting relationship with their patients? And legal questions as well: Who should make medical decisions for minors? What should be the relationship between industry and medicine? Notably, issues that had the appearance of exotic science fiction in the 1970s, such as cloning, and mapping the human genome, are today’s twenty-first century realities. These and other developments in medicine and health introduce ever-more challenging questions for bioethics consideration.

Read Dr. Brody's farewell article, published in the Medical Humanities Report; Volume 28, No. 1, Summer 2006.

 

Image of Tom Tomlinson
Today

Today, under the guidance of Center Director Tom Tomlinson, PhD, the Center’s six core faculty members direct their ongoing attention to understanding varied aspects of the human condition including chronic illness, birthing, aging, disability, international research ethics, and spirituality, to name only a few. 

To address the rapidly expanding bioethics agenda, and also to meet its many teaching responsibilities, CEHLS highly values the collaborative support from within as well as outside of the University.

What is Bioethics?

No Easy AnswersBioethics is an activity; it is a shared, reflective examination of ethical issues in health care, health science, and health policy. These fields have always had ethical standards, of course, handed down within each profession, and often without question. About forty years ago, however, it became obvious that we needed a more public, and more critical, discussion of these standards.

Bioethics is that discussion. It takes place in the media, in the academy, in classrooms, and in labs, offices, and hospital wards. It involves not just doctors, but patients, not just scientists and politicians but the general public. Traditional ethical standards have been articulated, reflected on, challenged, and sometimes revised; standards for new issues have been created – and then challenged and revised. The conversation is often sparked by new developments, like the possibility of cloning. But bioethics also raises new questions about old issues, like the use of placebos and the treatment of pain.

What is its Impact?

Bioethics has brought about significant changes in standards for the treatment of the sick and for the conduct of research. Every health care professional now understands that patients have a right to know what is being done to them, and to refuse. Every researcher now understands that participants in their studies have the same rights, and review boards to evaluate proposed research on those grounds are almost universal.

Our understanding of what is ethical has grown, but it is never complete. Ethical advances open new questions: We now see that getting “informed consent” does not rule out exploitation (for instance, of the desperately poor or the desperately sick); exploitation is hard to define. Scientific and technological success also force new choices: What, for instance, do we do with “unused” embryos created in fertility labs?

Finally, political and economic facts are just as challenging: One example is the fact that we are able to hire doctors and nurses away from the world’s poorest countries – but should we? These are urgent, practical questions. Bioethics makes a difference; it advances slowly; and it is not finished.

Bioethics Resources

Follow our blog at MSUbioethics.com for current news stories in the realm of bioethics, new publications from the Center faculty, announcements for upcoming events, and more. You can also follow @MSUbioethics on Twitter as a resource for current bioethics issues, Center news, and upcoming events. Read some of our recent Bioethics in the News articles: