 Our next speaker this morning is Dr. Richard Gunderman. Richard and I, you may have to help me on this one, Richard. Richard and I go back a long way. I met Richard before he applied to the University of Chicago Medical School. Do you remember this, Richard? He came up from Wabash College at the invitation of Jim Gustafson in the Divinity School to consider coming to the University of Chicago Medical School instead of alternative choices. And I remember Jim Gustafson calling me that day to say that he had a wonderful potential applicant to the medical school. Would that have been in 78, 79, 83? And so Richard came over and again, this is before he filed an application. It was quite clear that Jim Gustafson and Richard had made a good decision to head for the University of Chicago. At the University of Chicago, Richard got his MD degree as well as a PhD degree and the PhD degree came from the Committee on Social Thought. For those of you who know the Committee on Social Thought, you know that still to this day, the average time to get a PhD is probably six to seven years. And Richard is still regarded with awe of having finished that PhD in the midst of his medical education in three years. I mean, that's a wonderful achievement. Richard now is a professor. I want you to listen to this of radiology, pediatrics, medical education, philosophy, liberal arts at Indiana University. He also is a correspondent for the Atlantic. And today he's going to speak to us on the topic, the perils of professionalizing ethics. Richard Gunderman. Mark's a master of the euphemism. What he refers to as all I think should better be called disdain. So this is about the perils of professionalizing ethics. Are we professional ethicists? Are there professional ethicists in this room at this time? And if the answer to that is affirmative, how do we know that to be the case? I bet like you I'm quite concerned about the status of the notion of professionals and professionalism today. How would we verify our professional status? Could we pull out our wallets and pocketbooks and produce a membership card? When we think of a professional, are we talking about somebody who's compensated for their labors as opposed to an amateur? Just think what's happened with professional sports, say the Olympics over the last few decades. And we all know about the oldest profession. What exactly does it mean to be a professional? So I wanted to tell you about somebody we all know. Born Lance Gunderson in Plano, Texas in 1971. He was the son of a secretary and a newspaper route manager. His parents divorced when he was two years old and he took his stepfather's name by which we all know him. And he's refused to this day to meet his birth father. Who is this? Of course it's Lance Armstrong, who goes on to win seven Tour de France cycling races. There's something to be learned from Lance Armstrong about the notion of professionalism. It could be a kind of gut-check opportunity for us as people interested in ethics and what it might mean to be a professional ethicist. I hope some of you saw Oprah's interview of Lance in January of this year. I was trying to think of something that would tie together Indianapolis and Chicago. Of course Oprah has deep, deep roots in Chicago. How is Lance connected with Indianapolis? Yeah, well the answer is he went there for treatment of a stage four testicular cancer. So it is at least sub-connection between the two cities and this is part of the transcript from their interview in January. Oprah said, the USADA, what's that? The US Anti-Doping Agency issued a big report the CEO says you pulled off the most sophisticated professional and successful doping program sport has ever seen. Was it? No. It definitely was professional. It was smart, it was conservative, risk averse. It was very aware of what mattered. And that of course was winning that one race, not once, but seven consecutive times. What does Lance mean? It definitely was professional. What does he mean? It was very aware of what mattered. To what would we appeal as people with interests in ethics regarding what it means to be a professional and what it means to tend to what matters most? Well you know Lance was really dogged his entire career by allegations that he was involved in doping. He proudly cited the fact that he'd taken over 600 tests, never failed one. He called himself the most tested athlete in the world but there was this rumor of a cancer and cycling. Lance himself felt moved to say that he had zero tolerance for anyone using or prescribing performance enhancing drugs. But then in January Lance admits I'm a flawed character. I viewed this situation as one big lie that I repeated a lot of times. I'm a guy who expected to get whatever he wanted and to control every outcome and it's inexcusable. Is that a description of a professional? If this reflects some departure of our notion of what it means to be a member of a profession or to uphold the ideals of professionalism what exactly is missing? It definitely was professional. What do you think he means? I suspect he means it was technically very sophisticated and until the 11th hour it was remarkably successful. Nobody ever had such a technically successful widespread and ruthlessly enforced system of doping as the one Lance played a crucial role in helping to assemble. But surely that's not what we mean by professional. No amount of technical knowledge, no depth of a fund of knowledge would ever render any of us a professional when it comes to the domain of ethics. It might be very useful but it doesn't get to the core of the challenge. Here's somebody I first learned about from Marx or William Osler. Is professionalism a matter of technique? Would producing the most sophisticated or well referenced or deeply thought out argument constitute as having one in a conflict or dispute or something else needed in professionalism and particularly professionalism in the sphere of ethics? This is Osler. You are in this business as a calling, you're in this profession as a calling, not a business as a calling which exacts from you at every turn self-sacrifice, devotion, love and tenderness to your fellow men. If we had to describe the attributes of a professional in the field of ethics or medical ethics or biomedical ethics, to what degree would we appeal to terms like self-sacrifice, devotion, love and tenderness? I have a sense, a certain kind of sophistication, a certain kind of depth of knowledge would be important but would love, for example, be a distinguishing characteristic of somebody recognized as an expert in the field of ethics. At least from Osler's point of view, he said we need to work in the missionary spirit. How many of us would consider ourselves missionaries? Anybody remember Jake and Elwood? Who are they? Jake and Elwood? The Blues Brothers. Yeah, what are you guys doing? Are you nuts? What's their answer? We're on a mission, right? A mission from God. That might be stating things a bit too starkly but what kind of mission are we on and to what degree does it summon from us a breadth of charity that could raise us above the petty jealousies of life? One way to put that would be to what degree does aspiring to be an ethicist require us to be good? To be good not only when we're at the bedside or in the classroom but 24-7, 365. Is ethics a profession? Something we can establish with a credential membership card or might it be something deeper and in a sense radically different? I don't know what it means to be an ethicist. I've never been comfortable with the title for myself but I'm truly much less knowledgeable and skilled than at least most and perhaps everybody in the room when it comes to ethics. But I've become convinced that it can't just be a credential. I mean, we might credential people. We might offer a certificate of degree, a concentration and a master's or doctoral degree program but surely it's not primarily a credential. Some of us might collect some or all of our salary from work as an ethicist but surely that's not it and I'm not even surely its expertise exactly and I've come to think that Sir William Osler I'd encourage you if you haven't to read Michael Bliss' wonderful biography may have thought of matters ethical fundamentally as something like a way of life. Just as one could say I'm a Jew. I'm a Christian. I'm a Muslim. Is that okay? Or might we need to say I'm an aspiring Jew. I'm an aspiring Christian. I'm an aspiring Muslim. Would we need to say I work in ethics but don't call me an ethicist. Perhaps an aspiring ethicist. Somebody who feels called to deal with these matters that lie at the core of medicine and biological science but also to an important degree at the core of what it means to be human. So on the one hand we've got Lance Armstrong who, you know, the number seven, one seven times. He called himself a professional. He regarded himself as the epitome of a racing professional. It may not have been about the bike but it was definitely about the professionalism of Lance Armstrong. Our contemporary discourse is at least confused and perhaps deeply even seriously misguided about what it means to be a member of a profession and what it means to call ourselves professionals. But if we heed Osler's warning, if we answer Osler's call, I think we would have to say that to be an ethicist is not so much to be an expert in the field of ethics as to be somebody who aspires to be a good doctor or a good nurse or a good chaplain and somebody who aspires above all to be a good human being and tries to put that aspiration into practice every day whether they happen to be in the hospital or not. Thanks very much.