Revisiting A Theory of Medical Ethics:
Main Themes and
ROBERT M. VEATCH
In the mid-1960s, when I chose to devote my career to the study of biomedical ethics, there was no such thing as a formal theory of medical ethics. There were, of course, bits and pieces of theory— the Hippocratic oath and the American Medical Association (AMA) Code of Ethics in professional medicine; various theologically based stances about medical morality; and some volumes by secular and religious authors on specific topics in medical ethics. It rapidly became clear to me that doing medical ethics from various religious or secular ethical traditions would produce radically different answers to moral dilemmas than those that could be derived from the fragments of theory available within the health care professions.
When I completed graduate school and joined Dan Callahan and Will Gaylin as the first member of the staff of the Institute of Society, Ethics and the Life Sciences (The Hastings Center), my first assignment was to coordinate the development of a medical ethics teaching program at Columbia University's College of Physicians and Surgeons. I quickly became frustrated with the topically oriented quandary approach to medical ethics in which someone presented a case dilemma about what to tell a dying patient or whether to spend resources dialyzing a man whose social support network suggested the therapy would fail. I began seeking some more systematic way of thinking about problems in medical ethics, a search that eventually led me to write A Theory of'Medical Ethics (1981). Since I am currently beginning a long-term project to completely revise