Posted on the IRB Forum
March 1, 2009

To our colleagues in bioethics:

We need your help. We need you to write letters, and we need it fast.

Here at the University of Tennessee medical school, the Dean has informed us that he intends to eliminate our entire department. Last summer he informed our chair, Dr. Terry Ackerman, that he wanted to do this, and now the machinery to effect his plan is in motion.

Earlier today the UT Board of Trustees approved a revised policy for “discontinuing academic units,” thereby activating the process in earnest.

A final decision about us will ultimately require the approval of the Chancellor at this campus, the President of UT, and finally the Board of Trustees.

UT’s medical ethics department (“Human Values and Ethics”) is one of the oldest in the country. It began as a program in the mid-’70s and became a full-fledged department of the medical school in the mid-’80s. All three of us (Terry Ackerman, Carson Strong and Haavi Morreim) are tenured at the rank of professor and, other than “for cause,” the only way that tenured faculty can be removed is if their positions are eliminated.

Here are the dean’s exact and complete words, as communicated to the Trustees, for including our department in his list of units to be
discontinued:

“Primary goals of this department are to teach and do research to increase awareness of ethical and moral issues associated with healthcare. Human Values & Ethics, with 3 tenured faculty, is under consideration for discontinuation as it has minimal funded research programs and limited teaching of medical students. Training of human values and ethics is necessary in medical school; however this will continue to be done primarily by experienced physicians as students go through clinical rotations. Immediate plans call for retaining one faculty at half-time to coordinate this training. Long-term effects of discontinuance on UT and the State of Tennessee are anticipated to be minimal.”

First problem: the Dean’s proposed alternative is a clear violation of LCME standards (Liaison Committee on Medical Education) for accrediting medical schools. In ED-23 and ED-17A (http://www.lcme.org/functions2008jun.pdf), LCME requires that students receive ethics instruction in preclinical years, and *formally* during clinical rotations. The dean’s plan eliminates preclinical instruction and provides only informal teaching during clinical rotations. To our knowledge, there are no MDs or other PhDs who have any advanced qualifications in ethics at this institution.

Second problem: contrary to the Dean’s statement, our primary goal is not merely to “increase awareness.” We co-teach a required course for the first- and second-year students that has a major ethics component; conduct seminars for third-year students rotating through pediatrics and ob/gyn; and participate extensively in clinical teaching during regular patient-focused rounds and conferences for such departments as pediatrics, ob/gyn, and internal medicine. We also have a substantial involvement in teaching residents.

Third problem: the dean’s comment on research does not discuss the quality of our work, only its lack of extramural funding. We have informed him that funding for research in bioethics is very limited, particularly as compared to the monies available for medical research; also, that much of what is available is directed toward social science exploration of topics of relevance to ethics (e.g. empirical studies of informed consent), rather than the more purely philosophical and ethics-oriented research that this department has historically produced.

We ask you to write letters to the Chancellor, to the President and to the Trustees. Their names and addresses are just below‹one letter will do it for all the Trustees. We have known our campus’ Chancellor, Dr. Pat Wall, to be a fine human being with a strong sense of value and priorities. He is no moral coward. We believe he in particular will take seriously your thoughtful expressions. Letters to the President and Trustees will provide him with important reinforcement.

The content of the letter can be the same for each recipient, but:

• sending one letter to one person will not be as helpful as sending that letter to all three (Chancellor, President, Trustees);
• sending one letter from a department/program as a whole is good, but not nearly as good as if each willing member of the department sends letters.

We would deeply appreciate an earnest letter explaining why saving money by eliminating ethics is unwise for a medical school. It would also be helpful to comment on our national reputations, as that is one of the factors to be considered.

Please help. We send our heartfelt thanks to you all.

Terry Ackerman
Carson Strong
Haavi Morreim

========================================

Chancellor:
Pat Wall, M.D.
Chancellor, UTHSC
409 Hyman Administration Building
University of Tennessee Health Science Center Memphis, TN 38163

President:
Jan Simek, Ph.D.
Interim President, University of Tennessee Office of the President
831 Andy Holt Tower
University of Tennessee
Knoxville, TN 37996-0180

Trustees:
You can use one letter for all trustees. When your letter is received in the Trustees’ office, they’ll scan it an e-mail it to all members.

Address:
Board of Trustees Office
University of Tennessee
719 Andy Holt Tower
Knoxville TN 37996-0170

If you wish to do so, it would be helpful to us if you would send a copy of your letter to:
Dr. Terrence F. Ackerman
Chair, Dept. of Human Values and Ethics
910 Madison Avenue, Suite 311
University of Tennessee Health Science Center Memphis TN 38163