Edmund Pellegrino is the Professor Emeritus of Medicine and Medical Ethics at the Center for Clinical Bioethics at Georgetown University Medical Center. He was the John Carroll Professor of Medicine and Medical Ethics and the former director of the Kennedy Institute of Ethics, the Center for the Advanced Study of Ethics at Georgetown University and the Center for Clinical Bioethics.

He received his B.S. degree from St. John's University and his M.D. from New York University. He served residencies in medicine at Bellevue, Goldwater Memorial, and Homer Folks Tuberculosis Hospitals, following which he was a research fellow in renal medicine and physiology at New York University. During Pellegrino's 50+ years in medicine and university administration, he has been departmental chairman, dean, vice chancellor and president.

Edmund Pellegrino is the author of over five hundred published items in medical science, philosophy, and ethics and a member of numerous editorial boards. He is the author or co-author of nineteen books, and the founding editor of the Journal of Medicine and Philosophy. Pellegrino is a Master of the American College of Physicians, Fellow of the American Association for the Advancement of Science, member of the Institute of Medicine of the National Academy of Sciences, and recipient of forty-four honorary doctorates in addition to other honors and awards including the Benjamin Rush Award from the American Medical Association, the Abraham Flexner Award of the Association of American Medical Colleges, and the Laetare Award of the University of Notre Dame.

Edmund Pellegrino's research interests include the history and philosophy of medicine, professional ethics, and the physician-patient relationship.

Notwithstanding the extraordinarily rich as well as diversified academic and professional career of Edmund Pellegrino, the dean of bioethics, his introduction would remain utterly incomplete without a word about him as a person, in the most absolute coherence between his life and his works. The ethical reflection is not only an always renewed academic challenge, but also a constant demand of his own existence in his relation with others. Those, like us, who know Pellegrino, know him as brilliant and thorough as an academic, as kind and generous as a person.

M. Patrão Neves - You not only witnessed the birth of bioethics but actively participated in the process of its rise. Still, in a period called by Albert Jonsen "prehistory" of bioethics, you surely followed the publication of Joseph Fletcher's Morals and Medicine, in 1954, or the constitution of the first ethics committee (God's Committee), in 1962. Later, you accompanied the activity of the Society for Health and Human Values, followed by the institution of The Hastings Center and of The Kennedy Institute - organisms that acted as true motors for the emergence of bioethics. What importance these and other events precursor of bioethics had effectively for its rise and in what form did they influence the profile of North American bioethics?

E. Pellegrino - I was not aware of Joseph Fletcher's book when it appeared in 1954. My own interest in medical ethics began while I was still in college in 1939-40. I studied general and medical ethics as part of my Catholic college curriculum, which required four years study each of philosophy and theology although my major study was chemistry. Knowing of my interests in medicine, my teachers introduced me early to special reading in the then 400-year-old Catholic medical moral tradition. I was much attracted to the Aristotelian and Thomistic philosophy I was taught. I have studied it on my own ever since. In medical school I found the Catholic moral tradition especially pertinent to the issues of medical practice. I read most of the works then available in English on medical and nursing ethics.

At the time Fletcher's book was published, I was a very young Chairman of a newly founded academic department of internal medicine. I had continued my interest in Thomistic philosophy and theology throughout my medical and post-doctoral training. I began to teach some of these principles as they applied to clinical medicine to my students and resident physicians in 1954. This was most informal but, given my position as departmental chairman, I could engage students in ethics even though very little if any was then taught in American medical schools.

My recollection is that Fletcher's book was familiar to only a few medical educators and that it had its major influence in divinity schools. Later I came to know Professor Fletcher personally as a fine person and scholar. I found interesting observations in his work but its bias toward "situational ethics" was not congenial to my point of view. Fletcher did, however, broaden the scope of medical ethics and set the field on its way to becoming "Bioethics."

While I was sympathetic to some of Joseph Fletcher's observations, my own study deepened in the Aristotelian Thomist tradition of moral philosophy. Few of my colleagues in medical academia who were interested in medical ethics mentioned Fletcher's book. The separation of medical and religious-based ethics was already becoming manifest, except in Catholic medical schools. This antipathy was widespread although courteous in spirit. Even in the Catholic medical schools (four to five in number) medical ethics was taught in a very limited fashion, and not as a critical exercise.

The first real stimulus to medical ethics as a serious contemporary study came from the religious side in the work of Richard MacCommick, Paul Ramsey, and James Gustafson - one Catholic and two Protestants. Their work was of a high order intellectually and it influenced secular as well as religious development in medical ethics. There was still at that time in America enough sense of the connections of ethics with religion - especially in medicine - to make the work of these three pioneers widely influential. Fletcher's work assumed a place along with theirs. It was the full force of the social revolution of the sixties in America that gave great impetus to secular, or at least non-religious, medical ethics.

The three most powerful forces in the burgeoning of medical ethics and its transformation into Bioethics were the Hastings Center, the Kennedy Institute, and the Society for Health and Human Values through its Institute on Human Values in Medicine. Jonsen has carefully detailed the history of the first two . McElhinney and I have just published a history of the last in Theoretical Medicine and Bioethics . I will comment only briefly on your question about the importance and contribution of each.

The Hastings Center developed outside academia. Under philosopher Dan Callahan's inspired leadership the Center developed as a "think-tank" bringing together scholars from a variety of fields to study the new problems in medical ethics emerging from the unprecedented expansion of medical science in post-World War II America. The Center's "Bulletin" (now the Hastings Center Report), and the writings of its members, gave visibility to the issues of "Bioethics." The Hastings Center initiated the expansion of ethical concerns beyond the doctor's ethics. That influence continues to this day as Bioethics continues to broaden the scope of its concerns beyond the ethics of the medical profession.

The Kennedy Institute of Ethics, under the equally inspired leadership of physician Andre Hellegers, played a similar role in academia. In contrast with the Hastings Center, the Kennedy Institute scholars pursued their studies as individuals taking a more strictly philosophical approach and thus giving the field a critical intellectual rigor it much needed. Biomedical ethics became a branch of moral philosophy. The Journal of the Kennedy Institute was a late development and has not yet had the wide influence of the Hastings Center publications. The work of individual scholars was the chief mission of the Kennedy Institute. Beauchamp and Childress' Principles of Biomedical Ethics has given the Kennedy Institute worldwide prominence. That work continues to have worldwide influence.

The Kennedy Institute was one of the two institutions both credited with coining the name "Bioethics" in 1972 . The other was the University of Wisconsin, where Van Rensselaer Potter led the way. The Kennedy Institute focuses more narrowly on biomedical ethics. This rubric was enormously strengthened by the publication of Beauchamp and Childress' Principles of Biomedical Ethics. No single publication has shaped the field worldwide more than the Principles. Much of the bioethical literature is a reaction, response, and criticism of the Principles with competing methodologies like casuistry, narrative, hermeneutics, and phenomenology challenging their supremacy.

The third equally powerful stimulus to Bioethics was the Society for Health and Human Values. This story is less well known . The Society grew out of a series of experimental programs in about a dozen American medical schools in the decade of the 1960s. These schools sought to balance the highly technical bias of American medical education in the decade following World War II. Their aim was to do so by teaching humanities, human values, and ethics in the medical curriculum. This history is just beginning to be appreciated.

Just about the same time as the founding of the Hastings Center and the Kennedy Institute the Society for Health and Human Values was founded by a small group of medical educators and medical campus ministers, most of whom were Protestant. The Society served to bring together scholars and teachers from the humanities, ethics, and social sciences who had been interested in humanizing medical education. The Society provided a forum for the exchange of ideas and curricular methods, a place for scholarly presentations, and a source of encouragement for those entering this new field of research and teaching. It continues today as the American Society for Bioethics and Humanities.

In 1976 the Society for Health and Human Values established the Journal of Medicine and Philosophy, which I had the honor to edit. A dialogue and dialectic was generated between medicine and philosophy that has given scholarly and intellectual substance to both theoretical and practical issues in both biomedical ethics and Bioethics more broadly considered. The Journal's emphasis was philosophical. Only later did journals taking the theological perspective specifically with reference to Bioethics begin to appear.

Thus each of these three organizations made its own contribution to the growth of "Bioethics" - the Hastings Center as a "think tank" outside academia, the Kennedy Institute as a research center inside academia, and the Institute on Human Values and Medicine inside and outside academia under auspices of the National Endowment For the Humanities as an instrument for introducing interdisciplinary teaching of humanities, human values, and ethics to medical and then nursing students. Together the Hastings Center, Kennedy Institute, and the Society for Health and Human Values proved the stimulus to broadening medical ethics to make it the expansive interdisciplinary field of study it is today.

These three institutions certainly had a major positive effect by encouraging young and even established scholars and teachers to enter the field of Bioethics since they gave this field visibility, stature, and public recognition. Medical schools began to employ teachers and scholars from the humanities and to train physicians in ethics. New institutions for ethics and Bioethics were founded, in medical schools primarily. The whole apparatus of a discipline - a body of knowledge, scholars, a literature, students, and teachers - emerged and soon became the still changing field we know today.

M. Patrão Neves - How would you describe the atmosphere then lived in the academic and professional environments involved in this process that would end in the appearance of what today is called "bioethics". What did encourage, then, the personalities involved in this process? Is it still a same purpose that inspires those who today devote their efforts to bioethics? Were the initial expectations met?

E. Pellegrino - The question now is not whether expectations have been met, but how far they can be exceeded and still remain within the domain envisioned as "Bioethics." What started as a movement within or closely tied to medical academia has become for many a broad social movement. Some are asking what remains of the ethical core of "Bioethics."

M. Patrão Neves - Among the various areas of knowledge that participated in the rise of bioethics were medicine, theology and philosophy. How was this convergence of interests processed? In what measure was the relationship among these domains maintained to the present? What benefits were reached, in general as well as for each of these specific areas of knowledge? In what way did each of those areas of knowledge shaped bioethics and in what way did bioethics, in return, determine changes in these domains?

E. Pellegrino - So far as the relationship between philosophy and theology in the evolution of Bioethics is concerned, they have not been in close cooperation to date. Despite the close association of medical and biomedical ethics with religious ethics in the early days of the field there is not much convergence at least in today's academia. Indeed, in academia Bioethics, even philosophy, is for many being replaced by psychology, literature, law, sociology, cultural, and ethnic studies.

Confining myself to just the relationship between philosophy and theology about which you asked, I would say that they are too often, on the whole, antipathetic to each other. The general tone of American academic Bioethics is secular, non-religious, and at times anti-religious. American academia at first opted for the Enlightenment project of a religion-free and metaphysics-free ethics that left no room for theological argumentation. It was held too that in America's pluralistic society Bioethics could not align itself with any single one theology and therefore it foreswore all theologies.

With the emergence of the post-modern temper in academic philosophy not only was theology further discredited it has been disenfranchised from the debate. But soon reason too was disenfranchised. For the post-modernist, truth was not ascertainable by human reason, so philosophy and ethics therefore were forced to rely on procedural approaches. Moral truth was considered transitory and could only be arrived at by social convention, cultural consensus, or "reflective equilibrium". Many ethicists have given up the quest for the right and the good in clinical ethics. The best ethics they say is what "works," i.e. what can be agreed upon as "useful". This is the only "right" answer to ethical dilemmas. Praxis replaces theory or at least a theory of praxis dominates contemporary moral discourse.

The only exception to the dominant academic view is the centuries-old Catholic moral tradition based in the compatability of fides et ratio. But here too there are "conservative" and liberal viewpoints. Conservative thinkers hold firmly to the roots of Catholic moral philosophy in Aristotle and Aquinas, albeit modified by contemporary concepts drawn from phenomenology, transcendental Thomism, and Personalism. More "liberal" moral theologians to varying degrees try to adapt to the trends in modern ethics. As a result we find Catholic theologians accommodating to aberrant biological conceptions like the "pre-embryo". Some appeal to the ethical notion of "premoral" states, rejecting such things as intrinsically wrong and evil or universal norms.

The strongest voice for a consistent synthesis of faith and reason is the mainstream of traditional Catholic moral philosophy. Most influential in this regard are the seminal encyclicals of John Paul II - Evangelium Vitae, Veritatis Splendor, and Fides et Ratio. The opinions on Bioethical issues of the day expressed in the teachings of the Magisterium are increasingly counter-cultural.

Where the growing divergence between academic Bioethics and the theological ethics of the Catholic Magisterium will lead is problematic. All one can say for the moment is that the original convergence of religion and Bioethics is no longer evident. Roman Catholic ethicists and some fundamentalist Christians, on the other hand, are closer in some respects than in the past. Both are diverging from the more liberal Protestant viewpoints especially on the human life issues of abortion, assisted suicide, IVF, and artificial reproductive technologies.

M. Patrão Neves - When in the origin of bioethics we find a wide convergence of interests and dialogue among several areas of knowledge, stating that bioethics is of interdisciplinary and even transdisciplinary nature, how shall we see the growing specialization of bioethics in the different domains of its intervention? On the other hand, following the proliferation of different models of theoretical analysis during the 80's and of an intense critical dialogue among them during the 90's, how should we interpret the tendency we witness for modalities of convergence, at the theoretical level?

E. Pellegrino - With respect to your fourth question regarding the interdisciplinarity of Bioethics I have spoken of this at some length in volume 50 of Engelhardt and Spicker's Philosophy and Medicine Series . To summarize, I would say that the entry of the humanities and social science as well as law, psychology, cultural anthropology, etc. into Bioethics has enriched it in some ways and weakened it in others.

The enrichment has been in the contribution these other disciplines make to the concrete details, particularities, and existential realities of the moral life. The weakening has been in the normative and philosophical thrust of ethics as a formal discipline. Particularities like those in narrative ethics, for example, help us to understand the lived experiences of moral choice, their personal challenges, and complexity. But stories, and the other humanities disciplines mentioned above - i.e. the disciplines of particularity - do not per se establish what is right and good. Stories cannot be self-justifying.

Something beyond description, explanation, drama, or story is required - we must be able to judge which story is morally defensible and which is not. To this end ethics as a formal discipline is still necessary. The same applies to the various newer methodologies - hermeneutics, praxis, dialogue, etc. They are methods through which certain aspects of the moral life may be discovered but they are not per se normative.

Indeed, as one looks at the way Bioethics in my country has developed it appears that Bioethics has swallowed ethics whole. The task ahead is how to retrieve the notion that Bioethics is after all simply ethics applied to the questions and issues generated by the advance of human biological knowledge. This perspective will not be congenial to present day enthusiasts but I do believe that the time for some economy in pretensions about the reach of Bioethics is in order.

M. Patrão Neves - What do you think about the importance of bioethics in the evolution of societies, that is, do you believe that bioethics contributed to the improvement of society and, in this case, how? What do you think about the evolution of bioethics and how do you see it will evolve in the near future?

E. Pellegrino - Bioethics is still young both as a field of scholarly endeavor as well as a social movement. In the matter of some 35 years, it has become a source of debate, policy and professional activity with far reaching consequences for societies and individuals. Some measure of its global significance can be gleaned from the fact that UNESCO this past year, 2004, has seen fit to charge its International Bioethics Committee with the task of developing a Declaration on Universal Norms for Bioethics. Its impact on society as a whole is just becoming manifest.

At the time of this writing I would consider that Bioethics has had both beneficial and questionable influences on society.

On the side of societal benefits, I would begin with the following. First, and foremost, Bioethics has brought the attention of the world bear on some of the most significant ethical questions facing humankind as a result of the prodigious advances in biomedical science. For the first time in human history, humans are gaining the knowledge and technology that enables them to control every aspect of their bodily existence. We already see the promise of the progress of molecular medicine and genetics on human disease. Beyond this, there are enormous future possibilities for enhancing functions beyond therapy and normal functioning. Some are already speaking of post-human and trans-human possibilities.

The central ethical question is whether, or not, our new capabilities will be used to advance or to imperil the good for humans as humans. Like all genuine power, biotechnology can be used for good or harm. The question before humankind - the central ethical issue of Bioethics - is whether biotechnology can be contained within ethical constraints, and what those constraints will be.

Human history does not provide assurances that wise or humane use of our new powers over nature will prevail. Bioethics has done society a great service by raising sensitivities on these issues. They are now hotly debated in academic and individual opinions and in public policy. This widespread interest and concern is a first and necessary step if humanity is to avoid being overcome by its own ingenuity or the ethics of its technicians and technocrats.

Bioethics has grown far beyond its origins in medical and professional ethics and properly so. It now boasts its own set of "professionals," persons with varying degrees of expertise in ethics who are regarded, or regard themselves as "experts" in what is good and bad, right and wrong. A vast literature, a cadre of scholars, a host of media gurus, professional societies, courses and degree programs in Bioethics - all of today's widespread realization of the human significance of ethical issues we must all confront.

Sooner or later every person in developed countries, and later in all countries, will confront moral decisions of a bioethical nature in their private lives. These decisions range from how to have babies, how to treat babies who are less than perfect, how to manage death and dying, how to manipulate the genome to eliminate diseases, or produce a new generation of super humans, etc. Some of these decisions are only speculative at present; some are alive in daily challenges at the bedside.

There can be no question, therefore, about the impact of biotechnology on human societies. The societal impact will exceed that of the industrial revolution and the market ethos. The only comparable challenge is that of nuclear energy, the ethical issues of which have yet to receive the deep attention they deserve.

On the negative side, Bioethics has created some dubious and dangerous effects on society. For one thing, in my experience, there is today an over-reliance on Bioethics experts that tends to discourage the kind of critical thinking in the general public on which freedom ultimately rests. Our society has come to rely on experts to provide answers. In a technologically driven society like ours, experts proliferate - some genuine, some self-appointed.

To be sure, experts who seriously and critically examine the issues are essential in laying out the issues, answering the fact questions and making arguments for and against one moral decision or another. But to prevent the tyranny of expert opinion from dominating public policy, an educated citizenry is crucial. There are technocratic demagogues as there are political demagogues. Everyone must recognize that moral accountability cannot be delegated by individuals or societies. All must participate in public discourse and in policy formulation.

This question of expertise is now most acute in bedside decision-making. When and how vigorously to treat, when to withdraw treatment and how to allocate scarce resources are daily choices that cannot be escaped by calling in an "expert." Bona fide experts do exist, they can be asked to help clarify the issues, but they cannot, and should not, make the decision.

On this point, one sees Bioethics consultants and Bioethics committees exceeding their social role. Some assume moral authority and some apodictically "advise" patients and families on what is in the best interests of an incapacitated sick person. Today, good and bad usage of experts is in evidence. What we must guard against is the creation of a secular priesthood who will excuse us from the onerous work of making our won ethical decisions.

Another perilous fallout of Bioethics is the creation of local, national and international committees to make recommendations and policies for societies and nations. These committees and commissions are important and helpful. They are subject to the dominance of experts on the one hand and the confusion of law and ethics on the other. The mistake of giving moral status of the moral opinions of national committees is bad enough. When the moral opinion of such a committee is binding in law, the dangers are multiplied.

Finally, the interdisciplinary nature of Bioethics is admirable. It provides access to the moral philosopher about the insights and perceptions of the social sciences, the humanities, politics, economics, etc. However, in the enthusiasm for interdisciplinary, there is a tendency to forget that ethics is a normative enterprise. Eventually decisions must be made about right and wrong, good and bad. Multiplication of concrete existential details, while very important, cannot end up in a moral statement without moral justification. Ethics and moral philosophy must retain their identities.

The second part of your question about the future of Bioethics is even more difficult than the first which deals with the impact on society. I believe some of my answer has already been covered in the first part of this question about societal impact. The issues I have listed clearly will need some resolution if Bioethics is to make its considerable benefits available and its frailties minimized.

There is no doubt that a variety of forces will continue to converge in the future to make Bioethics or something like it a permanent phenomenon in human society. If we do not destroy ourselves and our world by the misuse of our technology-biological or otherwise-human biology promises to continue its uncovering of deeper and deeper intricacies of the human body and mind. This can only mean that the ethical issues, i.e. the question of how to use our new knowledge wisely and humanely will persist and assume an even greater importance than today.

This means that Bioethics will have to become an element in the general education of all humans. This is too complex a topic to open up here. Suffice it to say that an essential element will be to relate the "expert" and the educated public in some synergistic way. The same applies to the relationships between moral philosophy and the other disciplines. Preserving, enriching and deepening the identity of each is crucial. For some of us Bioethics is already losing much of its "ethical" content. This will need to be retrieved.

The biggest problem for Bioethics in the future is moral and cultural diversity which grows in extent and intensity daily. The power of cultural diversity is just beginning to be recognized in international committees and councils. Language differences and variations of meaning within, and between, countries with the same language make common consent and understanding increasingly differences. Yet Bioethics is now an enterprise and will be so increasingly. The ethical issues arising out of biotechnology cannot be contained within the cultural or national boundaries.

Even more profound is the growing gap between those who believe in a source of morality beyond man, i.e. those whose ultimate source or moral justification is religious, and those who believe man is himself the ultimate arbiter of right and wrong, good and evil. The intensity of disagreement between and among these two groups grows daily and makes only a minimal source of agreement possible.

How this tectonic collision is to be dealt with is highly problematic at present. One step forward would be made if Bioethics were to address the unavoidable foundational question - what is man? What is it to be human? What is good for humans? The President's Commission on Bioethics in the United States has recognized the importance of an underlying anthropology even though it is sharply divided on what that anthropology should look like.

The difficulties notwithstanding, Bioethics must eventually turn to the question of what it is to be human, to those things we all share as the kind of beings we are. This means confrontation with the question of the good - a most unpopular question with contemporary ethicists. However, without some elements of an agreed upon anthropology, i.e. on an idea or image of man, no ethical system can be elaborated that is equal to the enormity of the bioethical issues facing us or capable of reversing the trajectory of increasing dissonance already in motion.

M. Patrão Neves - In your already very long activity and literary production in the area of bioethics, you structured from very early a fundamental orientation to your reflection. What orientation was that? How was it unfolding and developing along your successive more outstanding works? Which was your major goal in this area? Have accomplished it already?

E. Pellegrino - This leads me to your next question about the orientation of my own reflections to Bioethics. That orientation, as my response to your first question indicates, was shaped by the Aristotelian perspective on ethics as a philosophical discipline, enhanced by Aquinas' conjunction of faith and reason. This has been supplemented in later years by a very limited realist phenomenological methodology (without taking the transcendental turn). Thus my quest is for a medical ethics and Bioethics grounded in a moral philosophy. Its characteristics for me are a moderate realism, grounded in a philosophy of medicine insofar as Biomedical ethics is concerned.

This approach classically holds that moral truths are discoverable, that they are objective and demonstrable and universal. This is therefore a natural law approach based in a philosophical anthropology. As for Biomedical ethics (which is of course not the whole of Bioethics), I have begun with a philosophy of medicine grounded in the phenomena of medical practice and especially the clinical encounter rather than in an a priori philosophy like Kantianism, Utilitarianism, or Emotivism, for example.

I cannot speak only of "my perspective" since my major work has been done in collaboration with David Thomasma. I do not suggest that he shares totally in the views I have summarized here. He does indeed share in the production of the major portions of it in our joint work...

Thomasma and I were preparing a second revised edition of the Philosophical Basis for Medical Practice when he died suddenly. We were expanding the portions of societal ethics and organizational ethics and trying to respond to questions raised over the years by our colleagues. We believe that our work taken as a whole is a step toward a comprehensive philosophy of medicine and Bioethics. In our last chapter we looked to expand the ecological aspects of our philosophically-based Bioethics, Biomedical ethics, and medical practice.

M. Patrão Neves - Which is the most outstanding message of your last publication, Physician & Philosopher - the Philosophical Foundation of Medicine?

E. Pellegrino - As for the very kind and generous sampling of my essays collated by Daniel Sulmasy and John McGovern, I can only say that they do me more honor than I deserve. I am not a professional philosopher nor have I suggested that I possess philosophical expertise. From the beginning I have always thought of myself as a physician reflecting philosophically on matters medical. This is a classical, pre-professional idea of philosophers. I have called repeatedly on my years as a clinician in internal medicine, investigator in certain chemical and physiological phenomena of human metabolism, and as senior administrator of medical schools, hospitals, and medical centers. The realities in these lived experiences have been the terminus a quo of my thought. Its terminus ad quem, yet to be reached, is a moral philosophy for medicine .

I have also approached my work as a Catholic Christian firmly convinced on the indissoluble convergence of faith and reason. I have been willing to argue philosophically with those who reject all faith presuppositions and theologically with those who accept such presuppositions. I have accepted magisterial teaching as authoritative.

I am aware of the unpopularity of these perspectives in today's Bioethics scene. I am also aware of many if not all the objections my critics have offered, I have learned much from them. I have no illusions about the ultimate value of anything I have written. I do hope I have stimulated some, encouraged others, and offered an occasional insight from the bedside to what it is to be sick, to be healed, to offer to heal, and to try to heal, in an ethically defensible and exemplary manner.

Works Cited

• Jonsen, Albert, The Birth of Bioethics, New York, Oxford University Press, 1998.
• McElhinney, Thomas K., and E.D. Pellegrino, "The Institute on Human Values in Medicine: Its Role and Influence in the Conception and Evolution of Bioethics", Theoretical Medicine and Bioethics, 22, 2001: 291-317.
• Pellegrino, E.D., "Bioethics as an Interdisciplinary Enterprise: Where Does Ethics Fit in the Mosaic of Disciplines in the Philosophy of Medicine and Bioethics?", Ronald Carson and Chester Burns [ed.s], Bioethics: A Twenty Year Retrospective, Dordrecht, Kluwer, 1997: 1-23.
• Pellegrino, E.D., and David C. Thomasma, The Christian Virtues in Medical Practice, Washington, Georgetown University Press, 1996.
• Pellegrino, E.D. and David C. Thomasma, For the Patient's Good: The Restoration of Beneficence in Health Care, New York, Oxford University Press, 1987.
• Pellegrino, E.D., "The Internal Morality of Clclass="main_menu"inical Medicine: A Paradigm for the Helping and Healing Professions", Journal of Medicine and Philosophy, 26, 2001: 559-579.
• Pellegrino, E.D., and David C. Thomasma, A Philosophical Basis for Medical Practice, New York, Oxford University Press, 1981.
• Pellegrino, E.D., and David C. Thomasma, The Virtues in Medical Practice, New York, Oxford University Press, 1993.
• Reich, Warren, "The Word Bioethics: Its Birth and the Legacies of Those Who Shaped It", Kennedy Institute of Ethics Journal, 4, 1994: 319-335.
• Jonsen, Albert, The Birth of Bioethics. New York: Oxford, 1998.
• McElhinney, Thomas K., and E.D. Pellegrino. "The Institute on Human Values in Medicine: Its Role and Influence in the Conception and Evolution of Bioethics." Theoretical Medicine and Bioethics, 22 (2001): 291-317.
• Reich, Warren. "The Word Bioethics: Its Birth and the Legacies of Those Who Shaped It." Kennedy Institute of Ethics Journal 4 (1994): 319-335.
• McElhinney and Thomasma, o.p. e.t.
• Pellegrino, E.D. "Bioethics as an Interdisciplinary Enterprise: Where Does Ethics Fit in the Mosaic of Disciplines in the Philosophy of Medicine and Bioethics?" Bioethics: A Twenty Year Retrospective. Eds. Ronald Carson and Chester Burns. Dordrecht: Kluwer, 1997, 1-23.
• Ibid.
• Pellegrino, E.D., and David C. Thomasma. A Philosophical Basis for Medical Practice. New York: Oxford University Press, 1981.
• Pellegrino, E.D. and David C. Thomasma. For the Patient's Good: The Restoration of Beneficence in Health Care. New York: Oxford University Press, 1987.
• Pellegrino, E.D., and David C. Thomasma. The Virtues in Medical Practice. New York: Oxford University Press, 1993.
• Pellegrino, E.D., and David C. Thomasma. The Christian Virtues in Medical Practice. Washington: Georgetown University Press, 1996.
• Pellegrino, E.D. "The Internal Morality of Clinical Medicine: A Paradigm for the Helping and Healing Professions." Journal of Medicine and Philosophy, 26 (2001): 559-579.