Title:Bioethics, mentorship, and the telos of medicine

Author: By Michael Simms Jr. (G'19, '24)
Date Published: December 1, 2022

As the world continues to steadily emerge (and gather the pieces, as it were) from the numerous stages of the global pandemic, we would be remiss to go without acknowledging June 22, 2020: the 100-year anniversary of Dr. Edmund Pellegrino’s birth.

Dr. Pellegrino‚ÄĒafter whom Georgetown‚Äôs Pellegrino Center for Clinical Bioethics is named‚ÄĒenjoyed an illustrious, legendary career as a physician and administrator. He passed away in 2013, having served Georgetown in a number of leadership positions over several decades, including his latest post as Professor Emeritus of Medicine and Medical Ethics. Through his numerous books, articles, and academic papers on topics ranging from bioethics to the physician-patient encounter, and his indispensable faith in Jesus Christ and the Catholic Church, he has offered messages that still challenge and animate the medical community, specifically concerning the telos of medicine.

Though the Greek word telos is employed in philosophy to signify an end (or an ultimate aim), my beginnings with Dr. Pellegrino came by way of another physician and mentor: Dr. Leonard Morse, himself a living icon in the fields of public health and epidemiology. I met Dr. Morse during my undergraduate experience at the College of the Holy Cross, and he encouraged me to make contact with his friend and colleague at Georgetown.

I first visited Dr. Pellegrino’s office at the Kennedy Institute of Ethics in Spring 2011. He had just arrived back from teaching an ethics class to a group of undergraduate students. I held a half-read biography of Albert Schweitzer, and conflicting notions about my experience as a double major in the humanities (classics and music), my challenges with pre-med classes, and my desire to better ascertain the nature of the medical profession.

Dr. Pellegrino kindly and boldly engaged with my reflections, with the curiosity of a new acquaintance and the familiarity of an old friend. Over the next two years, I would make visits to his office (announced and unannounced), where ‚Äúgratitude‚ÄĚ and ‚Äúamazement‚ÄĚ hardly express my surprise at finding him, over and again, willing to entertain my queries and support my journey to study health and medicine. I would join him at the hospital‚Äôs Bioethics Clinic, and I was heartened to receive his encouragement concerning my interest in the well-being and equitable treatment of older adults.

michael sims and dr. Pellegrino
Photo: Courtesy of Michael Simms Jr.

In the years since Dr. Pellegrino’s passing, especially as I wrestled with key issues surrounding the philosophy of medicine and health care economics for the M.S. in Aging and Health at Georgetown I completed in 2019, I have engaged in a kind of conversation with him through his written works. Especially as recent trends in bioethics scholarship have shifted towards virtue ethics, I have found Dr. Pellegrino’s writings on the topic to be no less fresh and rewarding.

Dr. Pellegrino has centered the physician professional ethic on the physician-patient encounter, as all of health care is to build from it. With this as the end (i.e., the telos, the purpose), economic considerations in themselves are means, which render the managed care ideology and its myriad manifestations especially worrisome.

Of particular note are Dr. Pellegrino‚Äôs concerns about what are now generations of young physicians being fed a social construct where numerous nondollar costs profoundly affect the quality and satisfaction of the ‚Äúcare‚ÄĚ provided. How sobering is his observation that the carefully constructed patient history and physical examination have become a scarce commodity!

From Dr. Pellegrino we can therefore receive a cautious reminder that what we as a people consider ‚Äúworthwhile‚ÄĚ speaks to the sort of people we desire to be.

In having the opportunity to celebrate Dr. Pellegrino’s life and legacy, together with having experienced a recent global health crisis which served to further indicate and amplify these concerns, may we find hope in pursuing the telos, and in such a pursuit, to better discover the good.

Michael A. Simms Jr. is currently pursuing a Master of Science in Clinical and Translational Research‚ÄĒwith a concentration in Health Disparities and Community Engagement‚ÄĒat the Georgetown Howard Universities Center for Clinical and Translational Science (GHUCCTS). He also completed a Master of Science in Aging and Health at Georgetown in 2019. His interest in finding sustainable solutions to the imminent demographic shift to an aging population has him delving into various, seemingly disparate topics, ranging from social cohesion and the political ‚Äúculture of contempt‚ÄĚ to health care financing and the Danish concept of hygge.

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