History of the Center for Healthcare Ethics at Duquesne
The first conversation about healthcare ethics at Duquesne took place between Dr. David F. Kelly, professor of Theology, and Dr. John Hoyt, chair of the ethics committee at St. Francis Medical Center and director of the St. Francis ICU. Kelly was on sabbatical during academic year 1989-1990, and Hoyt had asked him to serve as ethicist-in-residence at St. Francis while he worked on his book, Critical Care Ethics: Treatment Decisions in American Hospitals. Dr. Hoyt wanted a strong multi-course program to train the residents at St. Francis in medical ethics. This was the start of the interdisciplinary Certificate in Health Care Ethics at Duquesne.
Planning took place over the next two years. The certificate program would be directed by Dr. Kelly, but would not be as such a Theology program. It would consist of five courses: a graduate level introduction to philosophical ethics or to moral theology, a course in health care ethics, a course in health care law and ethics, a course in health care communication and structures, and a clinical practicum. Dr. Hoyt and St. Francis acquired a start-up grant to help with the program's initial costs. The certificate program was approved in the Fall semester of 1991, though the clinical practicum had been offered in Spring, 1991, to one student, Mary Therese Connors, who would later become coordinator of the clinical courses. The Theology department integrated the HCE certificate into its Ph.D. program as an optional specialization.
During the planning process it became apparent to Dr. Kelly that the certificate program would not draw sufficient students, and he added plans for a Masters degree program that would require the same five courses as its required core and would add electives to be chosen by the student from courses offered in the University that would be germane to a bioethics degree. Even though the University had not yet formally approved the MA, during early 1992 inquiries began to come in not only from the Pittsburgh area, but from as far away as New Orleans, and nine students applied for the MA by Summer of that year. The certificate program started officially in Fall, 1992, and these nine students, anticipating that the MA would be approved, were accepted into the certificate program and began their studies that semester. The MA was approved by the Graduate School of Liberal Arts in September, 1992, and by the University the following year. By Fall, 1993, it was possible to begin national publicity for the MA program.
Ironically, none of the medical residents from St. Francis, for whom the program had originally been conceived, were able to complete the certificate, though one or two did begin it. Medical work for their residency left too little time for graduate courses in ethics. But MA students included St. Francis professionals, and a number of Theology doctoral students opted for the HCE certificate.
On May 12, 1993, Dr. Kelly and a committee of personnel from St. Francis and Mercy Hospitals presented the first of a series of annual one-day conferences on bioethics and religion. With funding from both hospitals and from other sources, these symposia invited top scholars from different religious traditions (Catholic, Protestant, Jewish, Orthodox, and Muslim) and from secular perspectives to speak on a topic of medical ethics. The conferences were held for several years until it was no longer possible to obtain the necessary funding.
The doctoral programs (Ph.D. and DHCE) had a beginning eerily similar to that of the certificate and MA. Sometime in 1994, Dr. Hoyt suggested that he might be able to get a large foundation grant for developing medical ethics. What would Kelly suggest doing? Kelly thought of a Ph.D. program. The funding never materialized, but the program did. Discussion and planning began in late 1994. It was Dr. Michael Weber, Provost and Academic Vice President, who thought of the idea of adding a professional, non-dissertation doctorate, which became the DHCE. With his support, and that of Dean Constance Ramirez, of Dr. James Hanigan, Chair of Theology, and of University President Dr. John Murray, Kelly began designing the curriculum and budget for the doctorates. It had become apparent by this time that a strength of the MA program was its direct clinical engagement. Building on this, Kelly designed a doctoral curriculum that would add three further clinical rotations, one a second practicum to supplement that in the MA, and the other two internships where students would practice in clinical settings under supervision both from Duquesne and from personnel in the chosen institution. St. Francis would continue to offer clinical experience and Duquesne doctoral students would provide ethical guidance and education to the institutions of The St. Francis Health System. In addition, other institutions would be asked to participate. Kelly realized the importance of hiring a clinical coordinator to supervise the practica and internships. The position was advertised in December, 1994, with an anticipated starting date for the doctoral programs in the Fall of 1996. Mary Therese Connors, who would be the first DHCE graduate in Fall, 1999, was hired for this position and began her work in Fall, 1996. Over the next ten years, HCE students did clinical work in at least 18 hospitals, ten nursing homes, and eight other health care services.
There would be three new doctoral courses. One, in Jewish Health Care Ethics, was possible because in the Fall of 1994 the Theology Department had hired Dr. Aaron Mackler, an expert in that field. He would also teach the course in Justice and Health Care Delivery, and Dr. Lisa Parker of the University of Pittsburgh agreed to teach the new course in the Ethics of Genetics and Reproductive Technology. These courses would enable Duquesne to claim to approach HCE from Christian, Jewish, and Secular perspectives, with faculty specializing in each of the three major approaches to American medical ethics.
In December, 1994, Dr. Kelly requested a formal establishment of a Center for Health Care Ethics. This was accepted by Dr. Weber. The official title became the "Duquesne University Health Care Ethics Center." The Center would have its own budget, primarily to hire part-time faculty, but including lines for library purchases, office expenses, and so on. Unlike a department, however, the Center would not propose faculty for promotion and tenure. Faculty would be part-time in HCE and tenured in other departments or other universities.
The Ph.D. and DHCE programs were quickly approved and began in Fall, 1996. Faculty included Kelly, who directed the programs, advised its students, and taught Health Care Ethics; Mackler and Parker, who taught the new doctoral seminars; the law course was taught by different faculty such as Drs Giannetti and Kristofik of the School of Pharmacy and Rhonda Hartman, JD; Dr. Geoffrey Gurd of the Communications Department (he had replaced Dr. Susan Scherpereel, the first to teach Communication Ethics); faculty in the Theology and Philosophy Departments who taught the foundation courses in those disciplines (Dr. Eleanor Holvek, Chair of Philosophy, and Dr. James Bailey from the Theology Department taught these courses regularly and contributed in other ways to the program); Dr. Moni McIntyre; and Dr. Connors as clinical coordinator. Except for Gurd, who was replaced by Dr. Pat Arneson and later by Dr. Janie Harden Fritz to teach the communications course, this faculty remained stable for the next 10 years.
President Murray asked Dr. Kelly to develop an on-line program in HCE, and in 1999 he agreed to try. Kelly asked for a budget line for a graduate assistant to help with this, and Murray approved. This assistantship enabled HCE to offer a Ph.D. student free tuition and a stipend. Kelly designed his own Health Care Ethics course for asynchronous distance learning over the next few years. It was taught online successfully a few times to students who found this easier than attending the classroom, but even after national advertising the online certificate program never attracted students. The interactive course notes, however, became the basis for Kelly's next book, Contemporary Catholic Health Care Ethics.
In 2004, Dr. Kelly was appointed to the Vernon F. Gallagher Chair for the Integration of Science, Philosophy, Theology, and Law, the first fully endowed chair in the McAnulty College and Graduate School. After publishing Medical Care at the End of Life: A Catholic Perspective, he retired Emeritus in June, 2006. Dr. Mackler replaced him as Director of the Center.
In summer 2007 Gerard Magill, PhD was appointed as the Vernon F. Gallagher Chair in the Center with Dr. Mackler continuing as Center Director. Dr. Magill had been the Executive Director & Department Chair of the Center for Health Care Ethics at Saint Louis University in St. Louis, Missouri for the previous decade, holding appointments in the Division Directors of the Department of Internal Medicine in the University Hospital, and as Professor in the University’s School of Medicine and in its School of Public Health.
In Fall 2007, the Center (with the revised title of Center for Healthcare Ethics) was awarded faculty tenure and promotion. In summer 2010, Henk ten Have, MD, PhD, was appointed as the new Center Director. Prior to this appointment, Dr. ten Have had been Director of the Division of Ethics of Science and Technology at the United Nations Educational, Scientific and Cultural Organization (UNESCO) in Paris, France since 2003. Previously, (1991-2003) Dr. ten Have was Professor of Medical Ethics and the Director of the Department of Ethics, Philosophy and History of Medicine in the University Medical Centre Nijmegen, the Netherlands.
Recent program developments in the Center include the following. A new online Graduate Certificate Program of 9-credit hours was established in Fall 2008, attracting a robust cohort of students from across the nation. As the Center plans ahead, in Fall 2011, the online Graduate Certificate will be expanded to become an 18-credit program. The two doctoral degrees (PhD and DHCE) will be offered both on-site and online as the Center develops a new focus on Global Bioethics with international outreach under the leadership of Dr. ten Have. New courses on Global Bioethics, Research Ethics and Public Health Ethics have been introduced in the program.
The Healthcare Ethics Alumn Association was formally established in Fall 2010 at a Lecture by David Kelly that was also used to establish the David F. Kelly Bioethics Lectures. The second lecture in this series was given by Dr. Jos Welie of Creighton University in Omaha. Dr. Kelly generously donated his extensive collection of books on bioethics and theology, to become the David F. Kelly Library in the Center.
The new global outreach of the Center is reflected in the creation of an international network of partners in the field of bioethics, as well as the establishment of the International Association for Education in Ethics and the NGO Bioethics Beyond Borders.