Given the advances in medical technology and knowledge over the past 20 years, training to become a physician has become more complicated than ever. Yet the focus of those advances and that training remains the same as it was millennia ago: the patient.
With everything physicians can do now, a key question becomes whether they should or can do everything that’s possible today—or how best they can fulfill the Hippocratic Oath’s most famous instruction: “First, do no harm.”
Personally, I have had to deal with family issues that required end-of-life decisions to be made. However, quality-of-life issues can weigh upon anyone who oversees a loved one’s care at any stage of life. In Johns Hopkins’ exceptional neonatal intensive care unit, for example, such issues can arise shortly after birth.
Our physicians face many other difficult situations. With pharmaceutical companies demanding increasingly outrageous prices for some drugs, occasionally we have to ask clinicians and physicians-in-training to seek alternative medications. We also may face times when our resources will not allow us to apply every treatment possible to every individual case.
As president of The Johns Hopkins Hospital and Health System, I have thought about this a lot. That is why I was so pleased when Ruth Faden and Jeremy Sugarman of the Johns Hopkins Berman Institute of Bioethics contacted me seven years ago and proposed offering ethics education for Johns Hopkins Hospital house staff.
Every year since, I have budgeted funds for the Berman Institute to train interns and residents in the departments of Medicine, Surgery and Pediatrics on ethical questions they will face while here and as practicing physicians later. In fiscal year 2015, internists Joseph Carrese and Mark Hughes joined pediatrician Margaret Moon in teaching Ethics in Clinical Practice to approximately 370 residents at The Johns Hopkins Hospital and Johns Hopkins Bayview Medical Center.
This initiative’s importance is recognized in other departments as well. Gifts from foundations now support ethics education in neurosurgery, neurology, ophthalmology, gynecology and obstetrics, and child and adolescent psychiatry.
Since its founding in 1995, the Berman Institute has become one of the largest centers in the world for training future leaders in bioethics, health and science. I am glad that with the support that The Johns Hopkins Hospital and others have given, the institute’s faculty members can also train young physicians on the “everyday ethics” they will have to practice throughout their careers.