Both physician and philosopher, Dr. Pellegrino was recognized as a founder of bioethics as a formal academic pursuit. The questions he explored, such as whether and when to let a patient die, had existed for millennia. But they became more urgently important as medical advances gave doctors ever greater power to extend and alter human life.
“He certainly had a huge impact on the field,” said Arthur L. Caplan, director of the division of medical ethics at New York University’s Langone Medical Center. He cited Dr. Pellegrino as among the “major pioneers” not only in bioethics but also in the philosophy of medicine as a whole.
Dr. Pellegrino’s credibility derived in part from his extensive academic record. As Catholic University president from 1978 to 1982, he was among the few medical doctors leading an American university at the time.
He chaired the President’s Council on Bioethics from 2005 to 2009 and served on UNESCO’s International Bioethics Committee, organizations that advised leaders on controversial issues such as human cloning and genetic engineering.
Before settling in Washington, he was the first president of the Yale-New Haven medical center and helped develop medical programs at the University of Kentucky, the State University of New York at Stony Brook and the University of Tennessee.
But his gravitas derived perhaps in larger part from his clinical work. Even as his academic duties became more pressing, Dr. Pellegrino continued seeing patients — a practice that kept him intimately connected to the realities of medicine.
As a philosopher, he was deeply concerned with the fundamental doctor-patient relationship. Medical ethics, he argued, matter as much in everyday bedside treatment as they do in dramatic choices involving organ donation or ventilators.
A doctor “binds himself to competence as a moral obligation” and “places the well-being of those he presumes to help above his own personal gain,” Dr. Pellegrino wrote, according to a 1986 profile in The Washington Post. “If these two considerations do not shape every medical act and every encounter with the patient, the profession becomes a lie: The physician is a fraud and his whole enterprise undiluted hypocrisy.”
He recalled with chagrin that when he went to medical school, the concept of medical ethics was taught in about two hours. He began teaching the subject in 1959 at the University of Kentucky. “I don’t want to claim to be the first,” he told a Georgetown University publication, “but I didn’t know of anyone doing that, certainly not a chairman of the department of medicine.”