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History

The 1970s

The DHMC Clinical Ethics Program was begun in the mid-1970s by DHMC psychiatrist Charles M. Culver, MD, PhD and Dartmouth College philosophy professor Bernard Gert, PhD Its prominent activities in the late 1970s were an ethics study group that led to the formation of the Mary Hitchcock Memorial Hospital (MHMH) Ethics Committee and a course in medical ethics for Dartmouth medical students.

The 1980s

The MHMH Ethics Committee was among the first fully functioning hospital ethics committees in the United States. In the 1980s, its consultation service became integrated into the clinical and teaching activities of the hospital. Professors Charles Culver and Bernard Gert, both of whom served on the committee, wrote an early textbook on medical ethics and several scholarly articles about clinical ethics and moral theory. The Ethics Committee sponsored numerous educational seminars including a national conference on the teaching of medical ethics attended by academics from leading American medical schools.

During the 1980s, the MHMH Ethics Committee was active politically in promoting state laws improving ethical patient care. The Committee was instrumental in the New Hampshire state legislature enacting the Terminal Care Document and the Durable Power of Attorney for Health Care acts.

During the 1980s, the Committee also was active in helping community hospitals in New Hampshire and Vermont to establish their ethics committees. The V. A. Medical Center in White River Junction, VT began its ethics committee in 1980. The program grew to be so successful that, in 1991, they were awarded the contract for the V. A. National Center for Clinical Ethics.

The 1990s

In 1992, Dr. Charles Culver left DHMC and psychiatrist Charles Solow, MD became chairman. In 1994, neurologist James L. Bernat, MD assumed the Ethics Committee chairmanship and remains chairman.

Under Dr. Bernat's leadership, three essential functions of the Ethics Committee were formalized through individual subcommittees.

  • The Ethics Education Subcommittee is charged to assure that the ethics educational needs of DHMC professionals are met as well as the educational needs of the DHMC Ethics Committee members, and similar members of community hospital ethics committees.
  • The Ethics Policy Subcommittee reviews hospital policies with an ethical dimension, and advises hospital leadership.
  • The Ethics Consultation Subcommittee performs the clinical ethics consultations requested on inpatients and outpatients.

Dr. Bernat integrated the various ethics educational, clinical, research, administrative, and community outreach activities into the formation of the DHMC Clinical Ethics Program that he directs.

He began and chairs the New Hampshire-Vermont Hospital Ethics Committee Network, an organization of ethics committee members from nearly 40 hospitals in the bi-state region, that meets twice yearly at DHMC for an educational program.

He also chaired the DHMC committee in 1991 that drafted the DHMC Code of Professional Conduct and was the first chair of the DHMC Code of Professional Conduct Advisory Panel, currently chaired by Dr. Judith E. Frank.

The 2000s

In 2013, Dr. Bernat joined forces with Dr. Gregg Meyer (then DHMC Chief Operating Officer) to found and co-chair the DHMC Institutional Ethics Committee.

Starting in 2013, Dr. Tim Lahey (an HIV physician and researcher and medical educator) succeeded Dr. Bernat as chair of the DHMC Bioethics Committee, which was renamed to the Clinical Ethics Committee.

The Present

For a description of the current educational, clinical, research, and administrative activities of the Clinical Ethics Program, see our What We Do page.

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