Mark Siegler: Medical Ethics
On April 24, Dr. Mark Siegler, MD ‘67 the Lindy Bergman Distinguished Service Professor in Medicine and Surgery and Director of the MacLean Center for Medical Ethics delivered the 32nd annual Nora and Edward L. Ryerson Lecture. Each year the faculty of the University of Chicago selects a Ryerson lecturer based on a consensus that a particular scholar has made research contributions of lasting significance. Below is an excerpt of Dr. Siegler’s speech, “At the Crossroads of Organ Transplantation and Medical Ethics: A Century of Innovation at the University of Chicago.”
Mark Siegler, MD ‘67
I reflect back on my own medical school experience here, and on my great teachers who contributed to the growth of knowledge and made amazing scientific discoveries. I was honored to be invited to join the faculty in 1972. My very first assignment as a young faculty member changed my career path permanently. My Chairman, Al Tarlov, asked me to establish and then direct the first medical intensive care unit in our hospital and one of the first such ICUs in the city. At that time, we didn’t have good ways to monitor patients; we didn’t have effective breathing machines to treat patients; and we didn’t have doctors who specialized in intensive care as we do now, doctors who know what they are doing. Instead, we had enthusiastic amateurs, physicians like me, who suddenly found ourselves facing a range of clinical and ethical issues in the ICU for which we were neither trained nor prepared.
I remember my residents and students asking me questions about whether we could ever stop a breathing machine after we had started using it, or about how truthful we should be when we told families the prognosis of their loved ones, or how we decided who got admitted to our ICU and whether we could move people out if sicker patients came along later. These three issues—end of life concerns, truth telling, and rationing of beds—were tough problems for which I could find no answers in medical journals or medical text books. My residents and I started to call this kind of practical, patient-centered work Clinical Medical Ethics. That is how the field got started.
In 1984, Dr. Seigler established the MacLean Center for Clinical Medical Ethics, one of the first programs in the nation devoted to this clinical specialty. Since 1984, the center has trained more than 120 physicians and nurses, and remains one of the best ethics programs in the country.
…We realized that clinical ethics was an important area for doctors and nurses and patients, and I have spent my entire career working to develop this new field, by teaching, training fellows, consulting for patients and hospital staff, and doing research and writing. In 1984, we started the MacLean Center for Clinical Medical Ethics at the University of Chicago and this work has been the Center’s mission for more than 20 years. In fact, the MacLean Center remains the first and leading ethics program in the world that is primarily devoted to research and training in Clinical Medical Ethics.
We know that we will see many more innovations in medicine and surgery in the next 100 years as diseases that today are incurable yield their secrets and become curable. Isn’t that the meaning of the University of Chicago motto: “Crescat Scientia: Vita Excolatur?” Professor Paul Shorey, who created this motto in 1910, translated it as follows: “Let knowledge grow from more to more; and so be human life enriched.” As a physician/ethicist, I am proud that our group will continue working with basic and translational scientists to assure that we develop and apply new cures quickly and that we do so while adhering to the highest ethical standards of medicine.
Dr. Siegler will be celebrating Reunion Week with the class of 1967.
