Edmund D. Pellegrino, a physician and former Catholic University president who was a leading figure in bioethics, a field of inquiry that has pushed doctors, patients and society at large to confront essential quandaries of caring for the sick, died June 13 at his home in Bethesda. He was 92.
His death was announced by Georgetown University, where he was a longtime professor and former director of the Kennedy Institute of Ethics. The university did not cite a specific cause.
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.”
He championed constant examination that involved not only doctors, but also theologians, lawyers, social scientists, patients and their families. He was strongly influenced by his Catholic faith and opposed euthanasia and abortion — not only for religious reasons but also, he argued, because they violated the physician’s Hippocratic oath to first, do no harm.
In the health-care debate, he argued in favor of national health insurance and coverage for the indigent. For-profit hospitals, he said, presented troubling ethical questions; community health-care centers, in his view, were better.
His critics at times found Dr. Pellegrino’s views naive and out of touch with real-world economics. He was insistent.
“We keep talking about the cost of dialysis, which is $2 1 / 2 billion a year, but we spend that much a year on dogs at the track,” he told The Post in 1986. “We have to decide. . . . What kind of society do we want?”
Edmund Daniel Pellegrino was born June 22, 1920, in Newark, the son of a wholesale grocery salesman. He received a bachelor’s degree in chemistry from St. John’s University in New York and a medical degree from New York University in 1944 before serving in the Air Force.
While completing his residencies, Dr. Pellegrino contracted tuberculosis — a pivotal experience, he said, in his development as a physician and philosopher.
He was the founding editor of the Journal of Medicine and Philosophy, wrote hundreds of academic articles and was the author and co-author of numerous books, including “A Philosophical Basis of Medical Practice.”
Dr. Pellegrino cited his devotion to scholarship when he stepped down as president of Catholic University, where he was credited with enforcing austerity measures that improved the school’s finances. In 1982, he officially joined Georgetown, where he founded initiatives including the Center for Clinical Bioethics, later renamed in his honor.
His wife of 67 years, Clementine Coakley Pellegrino, died in 2012. Their son Stephen Pellegrino died in 1980, and their son Thomas Pellegrino died in 2011. Survivors include five children, Virginia Pellegrino of Huntington Beach, Calif., Michael Pellegrino of La Plata, Andrea Pellegrino and Leah Pellegrino, both of Arlington, and Alice Pellegrino of Malvern, Pa.; two grandchildren; and a great-grandson.
“The capacity to make moral judgments, and to be self-critical, is part of being an educated person,” Dr. Pellegrino told The Post. “That’s what I do with ethics. I don’t set out to make trouble, but, when I do cause a stir, it’s only because I raise questions that strike me as unavoidable.”