Professor seeks to establish ethics center

Ethics and the humanities are essential components of education and practice in the health professions. That's the view of Henry Perkins, MD, associate professor of medicine/general medicine at the Health Science Center. Perkins is spearheading creation of a new Center for Ethics and the Humanities in Health Care at the Health Scien#e Center.

According to Dr. Perkins, some of the humanities that relate to health care education and delivery include history, literature, social sciences, economics, jurisprudence and the philosophy of the health care professions.

"For example," he said, "to properly treat patients at the Brady/Green Community Health Center downtown, or at any other hospital or clinic, a caregiver may need to know the sociology, economic values and ethics of the population that visits the clinic.

"Caregivers need to know at what point the patient thinks he is sick, at what point he presents himself for care, how he responds to the caregiver and how the caregiver should respond to him to make sure the care is the most efficient, most effective possible."

Armed with a dream and the approval of the Health Science Center executive committee, Dr. Perkins and other Health Science Center faculty are bringing the ethics and humanities center into reality.

Dr. Perkins, interim director for the new effort, has been active in bioethics since his arrival on the faculty 10 years ago. He is also a bioethics consultant for the Ecumenical Center for Religion and Health, located across from the Health Science Center campus.

The Health Science Center needs to seize the opportunity to become the leader in health care ethics and the humanities in South Texas, he said. To accomplish this, Dr. Perkins is seeking stable funding to make the center a permanent and visible part of the Health Science Center.

Specific goals for the center include conducting research on ethics and humanities issues as they affect San Antonio, South Texas and the Health Science Center. "We should especially focus on cultural issues, given the multi-cultural population of this area," he said.

Other goals include providing advice and support for faculty teaching at the Health Science Center; providing a mechanism for systematic faculty development in ethics and the humanities ("There is a body of knowledge in this area and health care providers should know it," Dr. Perkins said); and providing consultations and other services to the Health Science Center and affiliated hospitals.

The medical, dental and graduate schools already have required courses in ethics, Dr. Perkins said. "We have ethics scholars spread around campus who don't interact with each other. Perhaps the new Center for Ethics and the Humanities in Health Care can help bring them together to share insights and collaborate on research and teaching."

Core faculty who are currently donating their time to the effort include Miguel Bedolla, MD, family practice, with expertise in history and the philosophy of medicine; Stewart Reuter, MD, JD, radiology, with expertise in jurisprudence; and Helen Hazuda, PhD, medicine/epidemiology, with expertise in medical sociology.

There is also an advisory committee representing all five schools that includes Corrine Sherman, PhD, nursing; Jim Thrash, DDS, dentistry; Marvin Forland, MD, medicine; Terry Mikiten, PhD, graduate school; and Shirlyn McKenzie, allied health sciences.

"We also hope to develop a group of affiliated faculty with similar interests," Dr. Perkins said.

Even as this new center for the ethics and humanities in health care develops, some people might ask, "Why should I know about ethics and the humanities?" Dr. Perkins gives two reasons in response.

"First, today's health care professionals and educators face numerous questions challenging their ethics and humanities: Should I assist a pain-racked, terminal patient to die? What should I do if I suspect a student is cheating in class? What do I think future health care reform should be? Technology cannot help us answer these value-laden questions; only ethics and the humanities can do that," Dr. Perkins said.

"The second reason to know ethics and the humanities is that they unlock the dimensions of life where the human spirit dwells," Dr. Perkins said. "Spirit is inseparable from human experience, and there is a lot going on with the spirits of our patients and ourselves that we may never touch.

"Patients struggle with the loss of control over their bodies, demoralizing dependence on others, and the meaning of their suffering," he said. "Scientists, teachers and students search for purpose in their lives and wonder how much to compromise some values to realize their life goals."

Dr. Perkins said that ethics and the humanities provide access to these vital dimensions of our lives. "Health care education must teach more than technology and the attributes of the physical world. It must also teach ways to access the world of the human spirit."