Al Jonsen produces sourcebook and history of bioethics

Al Jonsen with his two new books. Photo by Jordan Rehm

The date is March 9, 1960 and a team of UW physicians and engineers led by Dr. Belding H. Scribner is about to save the life of a man whose kidney can no longer filter toxins from his blood. They implant a Teflon tube that allows his blood to be repeatedly filtered by a machine, an artificial kidney. As a result, the man lives for another 11 years. Long-term kidney dialysis is born.

The event is a defining moment in the battle against kidney disease for a number of reasons. Not only does long-term dialysis save thousands of lives, it makes it possible for patients to live until a transplant is available. Chronic kidney failure, once considered fatal, is now treatable.

But let’s back up for a moment. The procedure took place during a clinical trial, making Scribner’s patient among the first to receive long-term kidney dialysis. It would be some time before long-term dialysis was available in virtually every hospital in the country.

Then, why this man? On what basis was he, specifically, selected for the clinical trial? Out of thousands of people dying of chronic kidney failure, who else would be chosen to participate?

Those questions took center stage in what became a national debate, says Dr. Albert R. Jonsen, professor of ethics in medicine and chair of the Department of Medical History and Ethics. The debate became a defining moment for bioethics. “It was a very important moment; it aroused the first national discussion about the ethics of applying new medical technologies,” Jonsen says.

Jonsen discusses this debate and its impact on bioethics in The Birth of Bioethics (Oxford University Press, Oxford, UK, 1998, 430 pp.), which recently hit bookshelves. Jonsen’s second major publication this year, the book spans the history of bioethics from the end of World War II to contemporary arguments about cloning human beings.

Jonsen spent four years working on the book, which is written for a general audience.

The Birth of Bioethics is the first broad history of the growing field of bioethics. Jonsen examines the origin and evolution of the debates over organ transplantation, genetics, care of dying patients, new reproductive technologies and research involving humans.

Jonsen is also the principal editor of a major collection of the most significant documents in bioethics, Source Book in Bioethics (Georgetown University Press, Washington, D.C., 1998, 500 pp.). The source book is a historical resource of the principal legal and policy issue documents relative to bioethics, from documents on the trial of Nazi physicians in Nuremberg to recent NIH policy on the use of fetuses in research.

Jonsen is a member of the Institute of Medicine of the National Academy of Sciences. He came to the UW in 1987 from the School of Medicine, University of California, San Francisco. He is the author or co-author of five other major works and has written chapters in more than 40 books on medicine and health care. The fourth edition of Jonsen’s widely used text, Clinical Ethics, also appeared during the past year. ¶ Will Morton