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Daniel Callahan, 1930-2019

Daniel Callahan, a national voice for responsible health and science who pioneered the field of bioethics, died on July 16, three days before his 89th birthday. A prodigious author and one of the world’s preeminent bioethics scholars, Callahan cofounded The Hastings Center, the world’s first bioethics research institute, with Willard Gaylin in 1969. He served as its director from 1969 to 1983, president from 1984 to 1996, and president emeritus, publishing numerous essays until his death, during what he called his “so-called retirement.”

Bioethics is an interdisciplinary field that examines moral uncertainties and values questions in medicine, health care, and the life sciences.

Callahan’s work and writing responded to the social upheavals of the last half century, including civil rights and the women’s movement, as well as rapid medical advances. Dialysis, intensive care units, and organ transplantation were extending the lives of very sick people and, along with genetic testing and human assisted reproduction, were transforming the very definition of medicine, the conception of health, and the notion of what it means to live a life. “For someone educated as a philosopher those were irresistible morsels,” wrote Callahan in his memoir, In Search of the Good: A Life in Bioethics.

The topics of his research and writing were wide-ranging, beginning with Catholic thought and proceeding to the morality of abortion, the nature of doctor-patient relationship, the promise and peril of new technologies, the scourge of high health care costs, the goals of medicine, the medical and social challenges of aging, dilemmas raised by decision-making near the end of life, and the meaning of death.

Callahan’s approach to studying these controversial issues at The Hastings Center was to assemble work groups composed of people who disagreed with one another. He helped create traditions of respectful dialogue that facilitated–but did not force–consensus. His own scholarship beautifully illustrates this commitment to exploring commonalities, clarifying differences, and arriving at mutual understanding. A prime example is a book, Abortion: Understanding Differences, published in 1984, which he edited with his wife, Sidney Callahan, who was pro-life when he was pro-choice.

Callahan is the author or editor of 47 books, six of which won prizes or special citations. Setting Limits: Medical Goals in an Aging Society, a finalist for the 1987 Pulitzer Prize for Nonfiction, made the controversial argument for limiting life-prolonging medical care based on a patient’s age. His reasons appealed to quality of life–that a longer life is not necessarily better, as well as the economics of health care and the fair allocation of finite health care resources across generations. “The proper question is not whether we are succeeding in giving a longer life to the aged,” he wrote, but “whether we are making of old age a decent and honorable time of life.”

The New York Times Book Review praised the book: “Callahan addresses the problems of aging in a clear, comprehensive, sensitive, and compassionate manner. This is a pivotal work that poses hard questions and proposes provocative answers. Setting Limits promises to be the benchmark for future moral, medical and policy discussions of aging.”

In addition to his firm belief in setting limits on the use of medical technology, Callahan opposed physician aid in dying. Among other reasons, he objected to the idea that a physician’s assistance would make a person’s death dignified. “Physician assistance is sought, I believe, because it confers the legitimacy we usually ascribe to physician skills and competence,” he wrote in 2012. “But I am not enthused about that form of legitimacy: doctors are far more skilled than the rest of us in knowing how they can directly kill us or give us drugs to do it for ourselves, and their authority should be severely limited to do so.”

His views were always his own, and he was a remarkable mentor, precisely because he always encouraged Hastings staff to articulate their own views and argue for them rigorously. As Bruce Jennings, a longtime Hastings scholar, put it: “I worked with Dan steadily for 26 years and then off and on for 13 more. In him, I found a mentor who wanted me to have my own voice, not simply to echo his.”

Callahan received numerous awards. He was an elected member of the National Academy of Medicine and a member of the National Academy of Social Science, and he is a former member of the Director’s Advisory Committee of the Centers for Disease Control and Prevention and of the Advisory Council of the U.S. Department of Health and Human Services Office of Scientific Integrity. He won the 1996 Freedom and Scientific Responsibility Award of the American Association for the Advancement of Science. He was awarded the 2008 Centennial Medal of the Harvard Graduate School of Arts and Sciences.

Callahan’s achievements have “earned him recognition as one of a handful of thinkers who shaped the second half of the 20th century,” wrote Jonathan E. Moreno, David and Lyn Silfen University Professor of the University of Pennsylvania.

“It is hard to overstate the wise influence that Dan Callahan has had on American culture and values,” wrote Lawrence Gostin, University Professor and Director, O’Neill Institute of National and Global Health Law at Georgetown University.

Callahan was born on July 19, 1930 in Washington, D.C. to Roman Catholic parents. He distinguished himself as a swimmer in high school, leading to his acceptance at Yale University and a place on its swim team. He served in the Korean War as a volunteer in the Army’s counterintelligence corps assigned to the Pentagon. While in the army he married Sidney deShazo in 1954 and received a Master’s degree in philosophy at Georgetown University. He received a PhD in philosophy from Harvard in 1965. He received honorary degrees from several universities, including Charles University in the Czech Republic.

He published his first books while he was a student at Harvard: Christianity Divided, an edited collection of Protestant and Catholic essays, and The Mind and the Catholic Layman in 1963. In 1961, he became an editor of Commonweal, the liberal Catholic magazine. He lost his Catholic faith and left the magazine in 1969.

In a story he often told, the idea for The Hastings Center began at a Christmas party in 1968 in Hastings-on-Hudson, the Hudson River suburb of New York where Callahan lived. Talking with a neighbor, psychiatrist and author Willard Gaylin, Callahan proposed that they start a research center focused on medical advances and the many ethical issues that they raised. The next day, Gaylin agreed. The research center, established in 1969 and located in Hastings, was first called the Institute of Society, Ethics and the Life Sciences, but later formally assumed its informal name, The Hastings Center.

“In the mid-20th century, Dan recognized that, at precisely the moment when we were entering into a new and unprecedented era of biopower, gaining progressive control over body and world, we might also become tone-deaf and mute on matters having to do with patience and acceptance, community and mutual care, ambiguity, humility, fairness, and stewardship,” said Mildred Solomon, president of The Hastings Center, in an essay in Bioethics Forum. “The recent emergence of ever more powerful transformative technologies, like new forms of gene editing which will enable us to change the very nature of the human species and breathtaking advances in artificial intelligence, demonstrate his prescience.”

“His writings have greatly influenced the nature of the doctor-patient relationship, moving medicine away from its paternalistic history to the patient-centered approaches called for today,” Solomon said. “His work has also had a profound impact on our understanding of death and dying, presaging the palliative care movement; on the role of markets in health care policy so relevant to current debates; on the interplay between private and public sector contributions to the U.S. biomedical research enterprise; and on the wise use of numerous emerging biotechnologies.”

 “If everything else is distilled out, what my career in bioethics comes down to is simple and enduring,” Callahan wrote in his memoir. “It is an abiding fascination with the nature, scope, and validity of ethics as part of human life, and a similarly strong interest in the ways that scientific knowledge and technologies of medicine influence how we think about our health and morality and shape the ways we live our lives. Along the way, that means thinking about human finitude; about illness, suffering, aging, and death; and about the place of health in our individual and collective lives. It no less requires a recasting of our ethical traditions and ways of thinking about them.”

 

Published on: July 18, 2019
Published in: Bioethics, Science and Society

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