Military Medical Ethics: Issues Regarding Dual Loyalties: Workshop Summary (2009)

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D Biographical Sketches of Workshop Speakers and Planning Committee Members WORKSHOP SPEAKERS Daniel D. Federman, M.D., is the Senior Dean of Clinical Teaching at Harvard Medical School. An endocrinologist by training, Dr. Federman maintains active clinical practices at Brigham and Women’s Hospital and Harvard University Health Services. Dr. Federman served on the faculty of Harvard Medical School from 1960 to 1972 and was simultaneously on the staff of Massachusetts General Hospital. From 1972 to 1977 he was chairman of the Department of Medicine at Stanford Medical School. He then returned to Harvard Medical School as Dean for Stu- dents and Alumni and Professor of Medicine. In 1989 he was appointed Dean for Medical Education and in 1992 was named the Carl W. Walter Professor of Medicine and Medical Education. Dr. Federman has served as Chairman of the American Board of Internal Medicine and President of the American College of Physicians and is a member of the Institute of Medicine. He was one of the founding editors of Scientific American® Medicine. Dr. Federman has received from the American College of Physicians both the Massachusetts Physician of the Year and the Distin- guished Teacher awards, as well as The Endocrine Society’s Distin- guished Educator Award. In 2001 the Association of American Medical Colleges honored him with their Abraham Flexner Award for Distin- guished Service to Medical Education. Born in New York City, Dr. Fed- erman received his A.B. from Harvard College and his M.D. from Harvard Medical School. Harvey V. Fineberg, M.D., Ph.D., is President of the Institute of Medi- cine. He previously served Harvard University as Provost and as Dean of 49 

50 MILITARY MEDICAL ETHICS: ISSUES REGARDING DUAL LOYALTIES the School of Public Health. Dr. Fineberg also has served as President of the Society for Medical Decision Making and consultant to the World Health Organization. His research has included assessment of medical technology, evaluation of vaccines, and dissemination of medical innova- tions. He is the author or coauthor of numerous books and articles on subjects ranging from AIDS prevention to medical education. Dr. Fine- berg holds four degrees from Harvard, including an M.D. and a Ph.D. in public policy. Myron Harrison, M.D., M.P.H., is the Senior Health Adviser for ExxonMobil and a member of its corporate Safety, Health and Environ- ment staff. Previously he served as the Medical Director of Exxon’s U.S. Medicine and Occupational Health Department. Before specializing in the field of occupational medicine, he practiced emergency medicine for 10 years. Dr. Harrison earned a master of public health degree at Colum- bia University and is a Past President of the Texas College of Occupa- tional and Environmental Medicine. He is an Adjunct Professor at the University of Texas School of Public Health, where he teaches “Ethical Dilemmas in Occupational Medicine.” Joshua M. Hauser, M.D., is an Assistant Professor in Medicine and Pal- liative Care; Director of the Education Section and Assistant Director of the Buehler Center on Aging, Health & Society; and Director of the Edu- cation in Palliative and End-of-life Care Project at Northwestern Univer- sity. He graduated from Harvard College with an A.B. in social studies and from the University of Cambridge with an M.Phil. in philosophy and received his M.D. from Harvard Medical School. After graduation from medical school, Dr. Hauser completed his residency in primary care in- ternal medicine at the Brigham and Women’s Hospital in 1998 and com- pleted the Robert Wood Johnson Clinical Scholars Program and a fellowship in clinical medical ethics at the University of Chicago in 2001. At Harvard, the University of Chicago, the University of Illinois at Chicago, and Northwestern University, he has helped to develop success- ful courses in end-of-life care, medical humanism, and research ethics. His research and educational interests are in understanding the experi- ences of family caregivers in palliative care, developing novel teaching innovations, and evaluating professionalism. He currently chairs the pro- fessionalism competency committee at Northwestern. Clinically, he prac- tices in the Palliative Care and Home Hospice Program at Northwestern Memorial Hospital. In professional organizations for palliative care phy- 

APPENDIX D 51 sicians, internists, and bioethicists, Dr. Hauser has held leadership roles in palliative care and ethics, including recent co-chairman for the Ethics and Humanism workshop selection committee of the Society for General Internal Medicine, co-chairman for the program committee of the Ameri- can Society of Bioethics and Humanities, and member of the ethics committee for the American Academy of Hospice and Palliative Medi- cine. He was also recent co-chair for an NIH study section on research ethics. Joseph E. Kelley, M.D. (U.S. Air Force Major General, retired), is the Deputy Assistant Secretary of Defense for Clinical and Program Policy. Prior to this appointment, Dr. Kelley served as Joint Staff Surgeon, the Pentagon, Washington, DC. He served as the chief medical adviser to the Chairman of the Joint Chiefs of Staff, providing advice to the Chairman, the Joint Staff, and combatant commanders. Dr. Kelley has served as the U.S. delegate to the NATO Council of Medical Directors and served on the congressionally directed Future of Military Health Care Task Force. Dr. Kelley graduated from the U.S. Air Force Academy and received his M.D. from Rush University Medical School. He completed his residency in general surgery at David Grant Medical Center, Travis AFB, Califor- nia, in combination with the University of California, Davis. He served as Chief of General Surgery at Nellis AFB and at Misawa Air Base, Japan, as Chief of Hospital Services, Chief of Surgery, and interim Chief of Aerospace Medicine. In 1986 General Kelley was reassigned as Commander of the 90th Strategic Hospital, Francis E. Warren AFB. He commanded the Ehrling Berquist Hospital at Offutt AFB, Nebraska, served as Chief of Medical Resources in the Office of the Surgeon Gen- eral, and was Command Surgeon for Pacific Air Forces. He then served as Commander of the Wright-Patterson Medical Center, Wright- Patterson AFB, Ohio, and concomitantly as Assistant Dean for Govern- ment Services at the Wright State University School of Medicine. Prior to assuming the Joint Staff Surgeon position, the general was Assistant Surgeon General for Healthcare Operations, Office of the Surgeon Gen- eral. General Kelley is board certified by the American Board of Surgery and is a Fellow of the American College of Surgeons. David Ozar, Ph.D., is Professor and Co-Director of Graduate Studies in Health Care Ethics in the Department of Philosophy at Loyola University of Chicago and from 1993 to 2006 was Director of Loyola’s Center for Ethics. In addition, he is Adjunct Professor of Medical Humanities in 

52 MILITARY MEDICAL ETHICS: ISSUES REGARDING DUAL LOYALTIES Loyola’s Stritch School of Medicine, where he has served as Acting Director of Medical Humanities. He earned his B.A. and M.A. degrees from Loyola and received his Ph.D. in philosophy from Yale University in 1974. In addition to his work at Loyola, Dr. Ozar is Associate Director of the Medical Ethics Program, a member of the Institutional Ethics Committee, and consulting ethicist at Evanston Hospital in Evanston, Illinois. He has served on the Research Review Committee of the Chi- cago Department of Health and is currently a member of the Executive Committee of the Chicago Region Advance Care Planning Coalition. He was the founder and first President of the American Society for Den- tal Ethics and has held offices in the Society for Health and Human Val- ues, the American Philosophical Association, and other profession- al organizations. Dr. Ozar has published numerous articles in profes- sional journals and books. He coedited Philosophical Issues in Human Rights: Theories and Applications (Random House, 1985) and, with co-author David Sokol, D.D.S., published Dental Ethics at Chairside: Professional Principles and Practical Applications, 2nd edition (George- town University Press, 2002). Hernan Reyes, M.D., is a physician, originally trained in OB/GYN, who has been working with the International Committee of the Red Cross since 1982. His particular interest in humanitarian work has always been health issues in detention and he has visited prisoners in over 50 coun- tries. He specializes in a series of issues, all related to health or “hazards” to health. He has published on torture and ill-treatment, tuberculosis in prisons, ethical issues such as hunger strikes and dual loyalties, HIV in prisons, and many other topics. Elspeth Cameron Ritchie, M.D., M.P.H., is a Colonel in the U.S. Army and holds a master’s degree in public health and a medical degree. She trained at Harvard University, George Washington University, Walter Reed Army Medical Center, and the Uniformed Services University of the Health Sciences, where she is an associate professor of psychiatry. Her assignments and other missions have taken her to Iraq, Israel, Korea, Somalia, and Vietnam. She brings a unique public health approach to the management of disaster and combat mental health issues and is interna- tionally renowned as an expert on the subject. She also has published numerous articles on forensic, disaster, and military operational psychia- try. Dr. Ritchie recently completed tours as the psychiatry consultant to the U.S. Army Surgeon General and the Proponency Director of Behav- 

APPENDIX D 53 ioral Health and is now the Medical Director, Strategic Communication, Army Medical Department. Leonard S. Rubenstein, J.D., is President of Physicians for Human Rights (PHR), an organization that mobilizes the health professions to advance human rights. Prior to coming to PHR, he directed the Bazelon Center for Mental Health Law, which advocates for rights and services for people with mental disabilities. A graduate of Harvard Law School and Wesleyan University, Mr. Rubenstein has spent 30 years engaged in investigation, scholarship, and advocacy relating to human rights; health and medical ethics domestically and internationally; and questions relat- ing to medical ethics and human rights, including the role of health pro- fessionals in detainee operations. He was project leader for an international working group on the problem of dual loyalty and human rights in health professional practice, which produced the report Dual Loyalty and Human Rights in Health Professional Practice: Proposed Guidelines and Institutional Mechanisms, and has written extensively on questions of medical ethics and human rights, both for scholarly publica- tions and in major media such as The New York Times, Washington Post, and Boston Globe. Mr. Rubenstein is a member of the Council of Foreign Relations and the Committee on Scientific Freedom and Responsibility of the American Association for the Advancement of Science. He serves on the Board of Directors of the International Federation of Health and Human Rights Organizations and the Governing Council of the Ameri- can Public Health Association. He has served as an adjunct professor at Georgetown University Law School and lectures regularly at Harvard Medical School. He is the recipient of numerous awards, including the Congressional Minority Caucuses’ Healthcare Hero Award; the United Nations Association of the National Capital Area’s Louis B. Sohn Award; the Physicians Forum Edward K. Barsky Award; the National Mental Health Association’s Mission Award; and the Political Asylum Representation Project’s Outstanding Achievement Award. Kenneth W. Schor, D.O., M.P.H., is currently an Assistant Professor in the Department of Preventive Medicine and Biometrics, Uniformed Ser- vices University of the Health Sciences (USUHS), Bethesda, Maryland, and also serves as Associate Program Director, National Capital Consor- tium, General Preventive Medicine Residency. Dr. Schor has over 26 years of active duty service with the U.S. Navy Medical Corps. He re- ceived his doctor of osteopathic medicine (DO) degree from the Phila- 

54 MILITARY MEDICAL ETHICS: ISSUES REGARDING DUAL LOYALTIES delphia College of Osteopathic Medicine; is a Distinguished Graduate of the National Defense University’s Industrial College of the Armed Forces; and received a master of public health (MPH) degree from USUHS. His graduate medical education includes completion of a family practice residency at Naval Hospital Jacksonville Florida, and comple- tion of a general preventive medicine residency at USUHS. He is a Dip- lomate of the American Board of Preventive Medicine. Dr. Schor is the USUHS Course Director for “Joint Medical Operations and Humanitar- ian Assistance” and Course Director for “Public Health Issues of Disas- ters in Developing Countries.” A pertinent collateral duty involves serving as Mission Director of an initiative for providing continuing health education (CHE) aboard Navy hospital ships. In support of the CHE mission, he was deployed July–August 2008 aboard the USNS Mercy as it conducted humanitarian assistance operations in the western Pacific for operation Pacific Partnership 2008. Jack Smith, M.D., is the Director for Clinical and Program Policy Inte- gration in the Office of the Assistant Secretary of Defense (Health Af- fairs). Dr. Smith’s responsibilities include providing medical informa- tion, policy formulation, clinical program oversight, and consultation to senior Defense officials, congressional committees, and other govern- ment agencies. His office also provides oversight and guidance for clini- cal quality, patient safety, and medical management programs in the Military Health System (MHS). Dr. Smith is a graduate of the University of Virginia School of Medicine and holds a master of medical manage- ment degree from Tulane University. He served more than 30 years in the U.S. Navy and retired in 2005. He is a board-certified family physi- cian with more than 15 years of executive medicine experience including Command of Naval Hospital, Yokosuka, Japan, and service as Group Surgeon for Second Force Service Support Group, Fleet Marine Force, Atlantic. He has been involved in a number of operational and humani- tarian operations over the course of his career, including Haitian and Cu- ban migrant operations in Guantanamo Bay, Cuba, where he served as the Joint Task Force Surgeon in 1994, and more recently provision of support for medical-sector reconstruction projects in Afghanistan and Iraq. He is currently a leader in the MHS in strategic planning, patient safety initiatives, quality improvement, and support for wounded warri- ors. Dr. Smith is a Certified Physician Executive of the American Col- lege of Physician Executives, a Fellow of the American College of 

APPENDIX D 55 Healthcare Executives, a Fellow of the American Academy of Family Physicians, and a member of a number of other professional associations. Kurt Spindler, M.D., is Professor and Vice Chairman of the Department of Orthopaedics and Rehabilitation at Vanderbilt University School of Medicine, Director of the Vanderbilt Sports Medicine Center and the Orthopaedic Patient Care Center, and Head Team Physician for Vander- bilt University’s NCAA Division I varsity athletes. He completed medi- cal school and an orthopedic residency, including one year of basic research training, at the University of Pennsylvania. He then completed a one-year orthopedic sports medicine fellowship at the Cleveland Clinic Foundation in 1991. His practice and clinical research include prospec- tive long-term follow-up of anterior cruciate ligament reconstructions, and he initiated the Multicenter Orthopedic Outcomes Network in 2001. Dr. Spindler is an active member of numerous regional, national, and international orthopedic and sports medicine professional organizations. He is a board member of the American Orthopedic Society for Sports Medicine (AOSSM) and Chairman of NFL Charities Grant Review Committee. His educational activities include co-chairmanship of the Advanced Team Physician Course of the AOSSM in 2000–2002 and the Complex Knee Course of the AAOS in 2002 and 2003, co-editor of Sports Medicine Digest, and participation on the editorial board and in the review of articles for several scientific journals. Mahmud Thamer, M.D. M.P.H., is Assistant Professor of Medicine (retired) at Johns Hopkins University. Born in Iraq and sent after high school on a scholarship to study medicine in the United States, Dr. Thamer studied pre-med at the University of California at Berkeley and medicine at Harvard Medical School. He completed his residency and fellowship in medicine at the Johns Hopkins Bayview Medical Cen- ter and received his master of public health degree from the Johns Hop- kins School of Hygiene and Public Health. Dr. Thamer returned to Iraq as a member of the Faculty of Medicine at the Baghdad Medical School and remained there for 10 years until the takeover by the Baath party. In Iraq he conducted clinical and epidemiologic studies on rheumatic heart disease, acute and chronic renal disease, and cholera. He returned to the United States as a member of the full-time faculty at the Johns Hopkins University, working in the fields of cardiac rehabilitation, cardiac consul- tation, and non-invasive cardiac assessment. After the overthrow of the Iraqi government in 2003, Dr. Thamer returned to Iraq for six months to 

56 MILITARY MEDICAL ETHICS: ISSUES REGARDING DUAL LOYALTIES serve as an adviser to the Iraqi Minister of Health on medical schools and medical education. Since retirement, he remains keenly interested in monitoring developments in Iraq and in the broader areas of Islamic- Arabic-Western understanding and dialogue. PLANNING COMMITTEE MEMBERS James F. Childress, Ph.D. (Chair), is the John Allen Hollingsworth Professor of Ethics and Professor of Medical Education at the University of Virginia (UVA), where he teaches in the Department of Religious Studies and directs the Institute for Practical Ethics and Public Life. He served as Chair of the Department of Religious Studies, 1972–1975 and 1986–1994; as Principal of UVA’s Monroe Hill College from 1988 to 1991; and as Co-Director of the Virginia Health Policy Center from 1991 to 1999. In 1990 he was named Professor of the Year in the state of Vir- ginia by the Council for the Advancement and Support of Education, and in 2002 he received the University of Virginia’s highest honor—the Thomas Jefferson Award. Dr. Childress was Vice Chair of the National Task Force on Organ Transplantation, and he has also served on the Board of Directors of the United Network for Organ Sharing (UNOS), the UNOS Ethics Committee, the Recombinant DNA Advisory Commit- tee, the Human Gene Therapy Subcommittee, the Biomedical Ethics Ad- visory Committee, and several Data and Safety Monitoring Boards for NIH clinical trials. He was a member of the presidentially appointed Na- tional Bioethics Advisory Commission from 1996 to 2001. Dr. Childress is a member of the Institute of Medicine and a fellow of the American Academy of Arts and Sciences. He is also a fellow of the Hastings Cen- ter. He received his B.A. from Guilford College, his B.D. from Yale Di- vinity School, and his M.A. and Ph.D. from Yale University. Dr. Childress chaired the IOM Committee on Increasing Rates of Organ Do- nation, co-chaired the NRC Subcommittee on Use of Third Party Toxic- ity Research with Human Test Subjects, and has served as a member of the IOM Committee on Establishing a National Cord Blood Stem Cell Bank Program and the Committee on Assessing Genetic Risks: Issues and Implications for Health. He currently serves as a member of the IOM Board on Health Sciences Policy and the IOM Committee on Conflicts of Interest in Medical Research, Education, and Practice. 

APPENDIX D 57 Scott Allen, M.D., is the co-director of the Center for Prisoner Health and Human Rights at Brown University and Clinical Assistant Professor of Medicine at the Alpert Medical School. Dr. Allen has worked in the correctional field for the past decade, including seven years as a full- time physician at the Rhode Island Department of Corrections, including three as Medical Program Director (2001–2004). He has spoken and written about a number of correctional health and human rights issues, including hepatitis C in prisons and the obligations of health profession- als in protecting the human rights of inmate patients. He has served as a court-appointed expert to the federal courts in prison health cases. He is a former Medicine as a Profession Fellow and currently an adviser for Physicians for Human Rights in Cambridge, Massachusetts, and an at- tending medical physician for an inpatient psychiatric ward at Eleanor Slater Hospital in Cranston, Rhode Island. Paul S. Appelbaum, M.D., is the Elizabeth K. Dollard Professor of Psy- chiatry, Medicine, and Law and Director, Division of Psychiatry, Law, and Ethics, Department of Psychiatry, College of Physicians and Sur- geons of Columbia University. Dr. Appelbaum is Past President of the American Psychiatric Association, the American Academy of Psychiatry and the Law, and the Massachusetts Psychiatric Society and serves as Chair of the Council on Psychiatry and Law for the American Psychiatric Association. He was previously Chair of the Commission on Judicial Action for the American Psychiatric Association and a member of the MacArthur Foundation Research Network on Mental Health and the Law. He is currently a member of the MacArthur Foundation Network on Mandatory Outpatient Treatment. He was the Fritz Redlich Fellow at the Center for Advanced Study in the Behavioral Sciences and has been elected to the Institute of Medicine of the National Academy of Sciences. Dr. Appelbaum is a graduate of Columbia College, received his M.D. from Harvard Medical School, and completed his residency in psychiatry at the Massachusetts Mental Health Center in Boston. He is a member of the workshop planning committee and also currently serves on the IOM Committee on Health Research and the Privacy of Health Information. Thomas E. Beam, M.D., retired from the U.S. Army in 2001 after 30 years of service as a general surgeon. He held several clinical positions, including Assistant Chief, Department of Surgery, during his time at Walter Reed Army Medical Center. While he was on active duty, he di- rected the Borden Institute, Office of the Surgeon General, producing the 

58 MILITARY MEDICAL ETHICS: ISSUES REGARDING DUAL LOYALTIES Textbook of Military Medicine series and other special projects for the Army Surgeon General. He produced the Textbook of Military Medical Ethics for that series. He was the consultant to the Army Surgeon Gen- eral in medical ethics. He represented the Army on the Tri-Service Ethics Consultants Board and continues to serve with this group. Dr. Beam was also the Chairman, Hospital Ethics Committee, for the Walter Reed Army Medical Center for almost 10 years and continues to work with this committee. He has done extensive work in ethics education, ethics consultation, and policy formation in military medical ethics. He is a Fel- low of The Center for Bioethics and Human Dignity and member of the Christian Medical and Dental Associations, currently serving on their Ethics Commission. Dr. Beam received his B.A. summa cum laude from Western Maryland College and his M.D. from the University of Virginia. He served a residency in general surgery at Walter Reed Army Medical Center and received the Erskine Award as outstanding resident at Walter Reed for 1980. He is an Assistant Professor of Surgery in the Uniformed Services University of the Health Sciences and a diplomat of the Ameri- can Board of Surgery and fellow in the American College of Surgery. Richard J. Bonnie, LL.B., is the Harrison Foundation Professor of Medicine and Law, Professor of Psychiatry and Neurobehavioral Sci- ences, and Director of the Institute of Law, Psychiatry, and Public Policy at the University of Virginia. He teaches and writes about criminal law, bioethics, and public policies relating to mental health, substance abuse, aging, and public health. Among many other positions, he has been As- sociate Director of the National Commission on Marihuana and Drug Abuse, Secretary of the first National Advisory Council on Drug Abuse, chair of Virginia’s State Human Rights Committee responsible for pro- tecting rights of persons with mental disabilities, and chief adviser for the ABA Criminal Justice Mental Health Standards Project. He is currently chairing a Commission on Mental Health Law Reform at the request of the Chief Justice of Virginia. Professor Bonnie has served as an adviser to the American Psychiatric Association Council on Psychiatry and Law since 1979, received the APA’s Isaac Ray Award in 1998 for contribu- tions to forensic psychiatry, and was awarded a special presidential commendation in 2003 for his contributions to American psychiatry. He has also served on the MacArthur Foundation Research Network on Mental Health and the Law. Professor Bonnie is a member of the Insti- tute of Medicine, has chaired numerous Academy studies on subjects ranging from elder mistreatment to underage drinking, and just com- 

APPENDIX D 59 pleted chairing a major IOM study on tobacco policy. He received the Yarmolinsky Medal in 2002 for his contributions to the IOM and the Na- tional Academies. In 2007 Professor Bonnie received the University of Virginia’s highest honor, the Thomas Jefferson Award. Lonnie Bristow, M.D., is a former President of the American Medical Association, after earlier serving as Vice Chair and Chair of the AMA’s Board of Trustees. Dr. Bristow has written and lectured extensively on medical science as well as socioeconomic and ethical issues related to medicine. He is a board-certified internist who received his M.D. from New York University College of Medicine. He is a member of the Insti- tute of Medicine and was a member of its Quality of Health Care in America Committee, which in 1999 and 2001, respectively, authored the widely read reports To Err Is Human and Crossing the Quality Chasm. He chaired the IOM Committee on Strategies for Increasing the Diversity of the U.S. Health Care Workforce, which issued its report, In the Na- tion’s Compelling Interest: Ensuring Diversity in the Health Care Work- force, in 2004. In 2005 the IOM appointed Dr. Bristow to chair a committee formed in response to our government’s request to ascertain what improvements are needed, specifically from the medical perspec- tive, in meeting our nation’s responsibilities to its disabled veterans. The committee’s 2007 report, A 21st Century System for Evaluating Vet- eran’s Disability Benefits, with its recommendations, is under considera- tion by Congress for legislative action. Dr. Bristow’s research interests and expertise are eclectic and, over the decades, his writings have in- cluded papers on medical ethics, socialized medicine as practiced in Great Britain and Canada, health care financing in America, professional liability insurance problems, sickle cell anemia, and coronary care unit utilization. Dr. Bristow, by presidential appointment, served from 1996 to 2001 as Chair of the Board of Regents of the Uniformed Services University of the Health Sciences. He recently retired from private prac- tice but continues his other activities as a professional consultant. Linda Emanuel, M.D., Ph.D., is the Buehler Professor of Geriatric Medicine and Director of the Buehler Center on Aging, Health & Society at Northwestern’s Feinberg School of Medicine. She is the founder and principal of the national Education in Palliative and End-of-life Care (EPEC) Project and the Patient Safety Education Project (PSEP). She is also a professor at the Kellogg School of Management at Northwestern University, where she works on organizational ethics and on economic 

60 MILITARY MEDICAL ETHICS: ISSUES REGARDING DUAL LOYALTIES modeling of and resilience options against the illness–poverty trap. Prior to joining Northwestern University, Dr. Emanuel was Vice President of Ethics Standards and Head of the Institute for Ethics at the American Medical Association. Until 1996 Dr. Emanuel was the Assistant Director, Division of Medical Ethics, and until 1998 the Glessner Lee Associate Professor of Medical Ethics at Harvard Medical School. She has pub- lished and lectured extensively on clinical ethics, including end-of-life care, the patient–physician relationship, academic integrity, accountabil- ity, organizational ethics, and professionalism. Dr. Emanuel was trained at Cambridge University, University College London, Oxford University, Harvard Medical School, and Harvard University. She is a board- certified general internist with board-level specialization in palliative care, fellowship training in public health research methodology, and fel- lowship training in professional ethics. Prior to her clinical career, Dr. Emanuel was a research neurophysiologist, in which field she earned her Ph.D. Edmund Howe, M.D., J.D., is a Professor of psychiatry at the F. Edward Hebert School of Medicine of the Uniformed Services Uni- versity of the Health Sciences (USUHS) in Bethesda, Maryland, and is Director of the Programs in Ethics. He is a Senior Scientist at the Center for the Study of Traumatic Stress, USUHS, and the founding Editor-in- Chief of the Journal of Clinical Ethics. Dr. Howe did his undergraduate studies at Yale University and received his M.D. from Columbia School of Medicine in 1970. He did his rotating internship at Harlem Hospital in New York and attended law school at Rutgers University and Catholic University in Washington, DC, receiving his J.D. in 1976. Dr. Howe did his psychiatric residency at Walter Reed Army Medical Center, Wash- ington, DC, from 1973 to 1976. Dr. Howe serves on the ethics commit- tees at the National Naval Medical Center, the Walter Reed Army Medical Center, and the Montgomery Hospice Association. He chairs the institutional review board at USUHS. Dr. Howe has published exten- sively on ethical aspects of military medicine and international health law, including serving as co-editor of the textbook Military Medical Ethics. Sandral Hullett, M.D., M.P.H., is Chief Executive Officer and Medical Director of Cooper Green Hospital in Birmingham, Alabama. She earned her undergraduate degree in biology at Alabama A&M University, her medical degree from the Medical College of Pennsylvania, and her mas- 

APPENDIX D 61 ter’s in public health from the University of Alabama at Birmingham. She completed her residency in family practice and has focused her work on rural health care, including health care planning and delivery to the underinsured and poor. Dr. Hullett was honored with the National Rural Health Association’s Rural Practitioner of the Year Award in 1988, the National Association of Community Health Centers’ Clinical Recogni- tion Award for Education and Training in 1993, Leadership Alabama’s Distinguished Leadership Award in 1996, and the National Black Churches Family Council’s Rural Leadership Image Award in 1998. Dr. Hullett served for 19 years on the Board of Trustees of the University of Alabama. She was elected to IOM membership in 1995. Dr. Hullett has served on the IOM Committee on Environmental Justice and the IOM Committee on the Changing Market, Managed Care, and the Future Vi- ability of Safety Net Providers. She currently serves on the National Academies’ Committee on Human Rights. M. E. Bonnie Rogers, Dr.P.H., COHN-S, FAAN, is an Associate Pro- fessor of Nursing and Public Health and Director of the North Carolina Occupational Safety and Health Education and Research Center and the Occupational Health Nursing Program at the University of North Caro- lina, School of Public Health, Chapel Hill. Dr. Rogers received her di- ploma in nursing from the Washington Hospital Center School of Nursing, Washington, DC; her baccalaureate in nursing from George Mason University, School of Nursing, Fairfax, Virginia; and her master of public health degree and doctorate in public health from the Johns Hopkins University School of Hygiene and Public Health. Dr. Rogers was a visiting ethics scholar at the Hastings Center in New York and is an ethics consultant. She is certified in occupational health nursing and as a legal nurse consultant and is a Fellow in the American Academy of Nursing and the American Association of Occupational Health Nurses. Dr. Rogers serves as Chairperson of the NIOSH National Occu- pational Research Agenda Liaison Committee and is a member of the American College of Occupational and Environmental Medicine Ethics Committee. She has served on numerous Institute of Medicine commit- tees including Nursing, Health and the Environment and the Committee to Assess Training Needs for Occupational Safety and Health Personnel in the United States. Dr. Rogers is Past President of the American Asso- ciation of Occupational Health Nurses. 

62 MILITARY MEDICAL ETHICS: ISSUES REGARDING DUAL LOYALTIES Adviser to the Planning Committee Elena Ottolenghi Nightingale, M.D., Ph.D., is a Scholar-in-Residence at the Institute of Medicine of the National Academy of Sciences and Adjunct Professor of Pediatrics at both Georgetown University Medical Center and George Washington University Medical Center. For more than 11 years she was Special Adviser to the President and Senior Program Officer at Carnegie Corporation of New York and lecturer in social medicine at Harvard University. She retired from both positions at the end of 1994. Dr. Nightingale earned an A.B. degree in zoology, summa cum laude, from Barnard College of Columbia University, a Ph.D. in microbial genetics from the Rockefeller University, and an M.D. from New York University School of Medicine. With Eric Stover, she co-edited The Breaking of Bodies and Minds: Torture, Psychiatric Abuse and the Health Professions, published in 1985, one of the earliest efforts to discuss this topic. She has also authored numerous book chapters and articles on microbial genetics, health (particularly child and adolescent health and well-being and health promotion and disease prevention), health policy, and human rights. Dr. Nightingale continues to be active in the protection of human rights, particularly those of children. Currently she serves on the Advisory Committee of the Children’s Rights Division of Human Rights Watch. Dr. Nightingale is a member of the Institute of Medicine of the National Academy of Sciences. In her role as Scholar-in-Residence, Dr. Nightingale serves as adviser to the President and Executive Officer of the Institute of Medicine.