Abstract

Ethicists in American medical schools feel increasingly discouraged these days. In the 1960s, 1970s, and 1980s, society's enthusiasm for teaching about medical ethics flourished as new medical technologies posed new ethical perplexities. Americans eagerly sought ethics advice and looked to medical schools to provide it. As the sites where many of the new technologies were developed and future physicians were trained, medical schools were the logical place for medical ethicists to work and teach. A few schools recognized society's need and instituted explicit medical ethics teaching—allocating funds, hiring ethicists, creating departments, and trumpeting their accomplishments. But most schools responded to the need with indifference or even hostility. They distrusted outside “experts” and feared a zealous reform movement aimed at the character or practices of modern medicine. Yet even those schools were forced to create ethics programs to meet powerful accreditation requirements adopted around 1990. Complying reluctantly, these schools allocated few personnel and minimal budgets. The resulting programs struggled.