Miller School’s Bioethics Institute Will Confront Broad Range of 21st Century Challenges

The University of Miami Faculty Senate has unanimously and enthusiastically approved the establishment of the Miller School of Medicine Institute for Bioethics and Health Policy. The Senate legislation was signed by President Donna E. Shalala in April.

“The Institute replaces the 23-year-old University of Miami Bioethics Program, which in many respects had been functioning as an institute by establishing a crucial presence in the life of the School,” said Kenneth W. Goodman, Ph.D., professor of medicine, who will continue as Director of the Institute. “For a quarter-century, it pioneered and supported research in new technologies, and it provided education and service to medical and science students, hospital clinicians, scientists, administrators and many others in the community.

“Our Bioethics Program became an emblem of our excellence, achieved international recognition, and helped in a small way to transform and enrich the institution that embraced it.”

The creation of the Institute is seen as an opportunity to propel the former program to a new level of visibility and growth.

“The establishment of this Institute is the next step in the Miller School’s long-standing activities in ethics education, research and service,” said Pascal J. Goldschmidt, M.D., Senior Vice President for Medical Affairs and Dean of the Miller School of Medicine and CEO of UHealth. “I am excited by this opportunity, given the program’s long track record of important accomplishments.”

The Institute will rest on four pillars: education, practice, research and service. Its mission will be to:

• Prepare future generations of physicians and scientists in ethics, and promote education and training for students, investigators, scientists, policymakers, health care professionals and the general public.

• Conduct and publish innovative and interdisciplinary research, and cement global leadership in several areas of excellence.

• Provide guidance and support in the shaping of institutional and public policy.

• Serve the larger community that depends on and supports the Miller School.

• Contribute to the institution’s international and global aspirations.

“Bioethics education is essential to the preparation of future physicians and scientists,” said Laurence B. Gardner, M.D., professor of medicine and Executive Dean for Education and Policy. “Over the years, the numerous education projects developed by the bioethics faculty have become a vital component of the medical students’ learning experience. This endeavor will become ever more critical as the health care environment continues to grow more complex with difficult ethical challenges and scrutiny.”

Goodman agrees that the ethical challenges are growing greater, and that the establishment of the Institute will help address those challenges.

“We often complain that science and technology move faster than ethics,” said Goodman. “This is a bold initiative to make sure that ethics is at the forefront and not lagging behind. The new issues include exciting new biological therapies, ranging from stem cells to genomics, technologies that include intelligent machines that can make decisions, and complex research challenges facing the global community and, as important, South Florida. Each of these raises difficult and interesting ethical issues.”

Goodman deals with some of these issues in a book coming out later this year from Cambridge University Press — Ethics, Medicine, and Information Technology: Intelligent Machines and the Transformation of Health Care. He edits a section on ethics and information technology that will debut this summer in the Cambridge Quarterly of Healthcare Ethics.

“The challenge in health care informatics is how to take the ancient tools of applied ethics and make them relevant to 21st century clinical and research challenges,” Goodman said. “For example, if there is a machine that can render a diagnosis more accurately than a human, we need to identify the circumstances in which that machine is used, and which people are permitted to use it.”

Another important part of the Institute’s work will be a continuation of the former program’s presence in the international arena.

Goodman directs one of seven World Health Organization collaborating centers in ethics in the world. “We do a lot of work in Latin America and with the European Commission and others,” he said. “That’s distinctive of the Miller School.”

Much of the international credit, he noted, goes to Sergio Litewka, M.D., M.P.H., of the Department of Surgery, whose work in Latin America has been instrumental in the Miller School having a serious presence there. Litewka will direct international programs for the Institute. He has a similar role with the UM-based Collaborative Institutional Training Initiative Program; the two units have a history of collaboration, and CITI was identified as a source of support for the new Institute.

Goodman acknowledged “the extraordinary support” of Elaine Van der Put, Ph.D., the Miller School’s Chief Strategy Officer, and her team for their help coordinating the application for creation of the Institute. He also thanked the unit’s earliest supporters, including Gardner; Norman H. Altman, V.M.D., professor of pathology, Director of the Division of Comparative Pathology and the School’s Ombudsperson; Lawrence Fishman, M.D., professor emeritus in the Division of Endocrinology; Richard Bookman, Ph.D., Senior Advisor for Program Development and Science Policy; and, on the Coral Gables campus, Anita Cava, J.D., professor of business law and Co-Director of UM Ethics Programs; and Steven G. Ullmann, Ph.D., professor of management and economics and Director of the Center for Health Sector Management and Policy.

Put simply, Goodman added, the time is right for the Institute.

“UM’s peer institutions all support a robust bioethics center or institute,” he said. “This initiative continues the Miller School’s history of service in bioethics, and it further exemplifies the outstanding institution the School has become.”

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