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Reflecting the growing national interest in such bioethical health policy issues as cloning, physician-assisted suicide, managed care, and the regulation of clinical research in genetic engineering and the neurosciences, Weill Cornell Medical College is establishing a Division of Medical Ethics in the Departments of Public Health and Medicine.

Dr. Joseph J. Fins will be Chief of the new Division. He is an Associate Professor of Medicine, an Associate Professor of Medicine in Psychiatry, an Associate Professor of Public Health, and Director of Medical Ethics at the New York Weill Cornell Medical Center of NewYork-Presbyterian Hospital. Dr. Fins, a recipient of a Project on Death in America Faculty Scholars Award and a Woodrow Wilson National Foundation Visiting Fellowship, has served on many medical advisory boards, including the White House Commission on Complementary and Alternative Medicine Policy.

In the new Division, Dr. Fins will be joined by a number of faculty members in what is already a substantial program and set of activities in medical ethics at both the Hospital and the College. Recognizing the importance of medical ethics, New York Weill Cornell established an Ethics Committee in 1994 and has supported it fully. The Committee consists of professional staff and lay members from the community, and it serves as a forum on policy development, on promoting compliance with standards set by the state and the Joint Commission on Accreditation of Healthcare Organizations, and on considering ethical issues that arise in clinical practice. In addition to case consultation, the Ethics Committee, which meets monthly, is a venue for a wide range of educational efforts for medical students, nurses, chaplains, and postgraduate and attending medical staff.

Also since 1994, the Medical Center has had available an Ethics Consultation Service, which, in consultation with the Office of Patient Services, helps patients, families, and staff work through difficult ethical questions that arise in clinical practice. Approximately 120 to 150 cases are addressed each year.

The Ethics Program of the Medical Center includes formal classes and rounds in most of the Center's services. A graduate level seminar in medical ethics has been conducted. Research and publication have taken place, resulting in a new method of medical ethics that Dr. Fins calls "clinical pragmatism." Clinical pragmatism seeks to bridge ethical theory and clinical practice, and its importance is being recognized in national scholarly publications.

The new Division of Medical Ethics will support the growing place of ethics in the Medical College's curriculum. An important third-year clerkship at the College focuses on palliative and end-of-life care. In addition, the new Division will take advantage of ties to Cornell University's Ithaca campus and its resources in law, philosophy, religious studies, the basic sciences, and other disciplines relevant to bioethics.

Dr. Fins says the new Division will also be an important resource to the many scientists and physicians at Weill Cornell and throughout the NewYork-Presbyterian Healthcare System engaged in clinical or basic research. "Faculty members applying for grants often ask for consultation on the ethical dimensions of their research," he says. "They wish to demonstrate to funders that they are sensitive to these issues. To answer this need, the new Division will be extremely helpful."

The new Division has received its first grant: $150,000 from the Fan Fox and Leslie R. Samuels Foundation for a project, "Integrating Palliative Care into Hospital Practice: Development of Educational Materials for the Goals of Care Assessment Tool."

In a joint statement, Dr. Alvin Mushlin, Chairman of the Department of Public Health, and Dr. Ralph Nachman, Chairman of the Department of Medicine, said, "The Division of Medical Ethics adds an important new dimension to our institution's pursuit of the improvement of human health."