Ethics and Medicine

Sherwin Nuland, M.D. 
Yale Medical Center

Date: November 14, 2000 

 Boisi Center, 24 Quincy Road


On November 14, 2000, the Boisi Center hosted an interdisciplinary faculty roundtable discussion with Sherwin B. Nuland, clinical professor of surgery at Yale School of Medicine and author of How We Die: Reflections on Life’s Final Chapter (Knopf, 1994; National Book Award Winner, 1995).

The discussion group included faculty from Boston College’s law school, school of social work, school of nursing, theology department and Center for Ignatian Spirituality as well as Christine Mitchell, director of the office of ethics at Boston Children’s Hospital. They discussed how their professions view what it what it means to "die well," as well as the complex issues that arise in one’s experience as patient, doctor, caregiver and family member.

The discussion centered around questions such as who possesses the authority to determine how we die, how and when quality of life concerns counter balance (research) interests in keeping a patient alive at all costs, and how the economics of health care affects end of life decision making. Discussants offered both personal accounts of accompanying loved ones through end of life decisions as well as professional perspectives on the subject. They also talked about the social changes in recent history in terms of doctor-patient relationships and approaches to fatal illness: from a basic paternalism, to an increased emphasis on autonomy and informed consent, to a recent shift toward an ethics of care, with a more contextual understanding of how responsibility is shared.

Dr. Nuland’s discussion at the Boisi Center was part of the first annual symposium on belief and non-belief held at Boston’s Copley Theater later that evening. The symposium featured Dr. Nuland along with Dr. Jerome Groopman, professor of medicine at Harvard Medical School and author of The Measure of Measure of Our Days: A Spiritual Exploration of Illness. The symposium, sponsored by Boston College and cosponsored by The Atlantic Monthly, addressed the ways in which issues involving religious belief or non-belief and divergent understandings of the meaning of life intersect with medical decisions.