Where is the profession of medicine going? Has it become simply applied biology, another “job” among equally good ways of earning a living? What kind of person should the physician be? What about bioethics? Is patient autonomy the only viable moral absolute?

Dr. Edmund D. Pellegrino:

The Medical Philosopher and Prophet

 By James R. Harden, M.Div 

He died on June 13. I will never forget our first meeting at his Georgetown office. It was a Thursday. 

At age 91, his piercing eyes and attentive demeanor were surprisingly intense during our ninety minute conversation. His was a soul “haunted by conscience” as he put it. He said this by way of assuring that he would get back to us on some of material he promised to review despite the crowding demands. 

Dr. Edmund D. Pellegrino possessed an Arthurian vision for the profession of medicine which forced a soldier-like responsibility, a restless watchman for the well-being of his practice. 

Having almost singlehandedly created the field of study known as the “Philosophy of Medicine,” he understood that medicine, like all professions, operates based on philosophical assumptions. 

Dr. Edmund D. Pellegrino And when those assumptions change, the profession will change. Some say he was one of the founders of the field of bioethics. If that is true, then his recent observation to my colleague and I during a conversation is all the more startling, “Bioethics is a bastard.” This was a diagnosis devoid of all bravado, not a colloquialism. 

What he meant was that the “study” has no moral basis, no mutually accepted objective standard by which to consider the application of new discoveries and technologies in clinical care in any meaningful or consistent way. 

Be that as it may, I remember sitting in his Spartan office, only later finding out that his walls could have been auspiciously covered with his fifty plus honorary doctoral degrees. I

 was humbled by his deference, earthy and genuinely interested in the person in front of him. Ever the physician ready to act on his profession’s promise, he stretched out his hands using his elbows as fulcrums on the arms of his chair. 

With his native New York accent still discernible, he invited us in to his practice, “What seems to be the problem? How can I help you?” “I believe medicine has lost its soul,” I said. 

With his elbows still firmly planted on the arm rests and his folded hands held to his chin he observed me. Then came his careful affirmation: “I agree.” 

Before he died I had the honor of getting to know this man who many considered to be the father of modern medical ethics. 

His colleague, H. Tristram Engelhardt, Jr., was so convinced of his importance that he edited a book The Philosophy of Medicine Reborn distilling Pellegrino’s writings insisting in the introduction that, “Bioethics and the medical humanities . . . cannot be understood apart from Edmund D. Pellegrino.” 

Why was Pellegrino such a pivotal character in the study of medicine?

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