Sharing the untold story of an overlooked pioneer in bioethics

In the mid-1960s, James M. Gustafson, a professor of Christian ethics at Yale Divinity School, mentored a cohort of remarkably talented students. Many of those young scholars, united by their admiration for Gustafson, would help found the field of bioethics, the multidisciplinary study of the social, ethical, and legal issues that arise in medicine and life sciences.

A half-century later, those same scholars remained loyal to their former teacher, who often worked behind the scenes to help them establish and define their field. While many of Gustafson’s students, including Jim Childress, Al Jonsen, Tom Beauchamp, LeRoy Walters, Jim Drane, and Stanley Hauerwas, are considered luminaries of bioethics, their teacher’s contributions to the field were largely forgotten. Until now.

“Before The Birth of Bioethics: James M. Gustafson at Yale,” an essay published recently in the peer-reviewed Hastings Center Report, documents Gustafson’s work as a teacher, scholar, and facilitator, and how it paved the way for a field in which scholars grapple with many of the day’s most vexing ethical and moral dilemmas.

Kaiulani “Kai” S. Shulman ’22, a senior in Yale College, co-authored the essay with Dr. Joseph J. Fins, the E. William Davis, Jr., M.D. Professor of Medical Ethics, and Visiting Professor of Law and Solomon Center Distinguished Scholar in Medicine, Bioethics and the Law at Yale Law School. Their research involved exploring archival materials at Sterling Library’s Manuscript and Archives Department and other repositories, and interviewing or corresponding with Gustafson’s former students, including Jonsen, Beauchamp, Walters, Drane, and Hauerwas, among others.

Fins first learned of Gustafson’s influence a few years ago while interviewing Jonsen ’67 Ph.D., a pioneer of the field whose 1998 book “The Birth of Bioethics” inspired the essay’s title, for an earlier scholarly project.

Jonsen, who died in October 2020, mentioned all the bioethics luminaries in his Yale cohort who, like him, flourished under Gustafson’s tutelage.

“I always wondered what was in that pedagogical sauce,” said Fins, who also serves as chief of the Division of Medical Ethics at Weill Cornell Medical College. “How did that happen? These were the founders of the field. It stuck with me as something to dig into one day.”

In the summer of 2020, Shulman participated in the Sherwin B. Nuland Summer Institute in Bioethics, an annual program hosted by the Yale Interdisciplinary Center for Bioethics. Fins gave a talk on neuroethics, brain injury, and disorders of consciousness, his usual area of scholarship. She later contacted him about pursuing a career in medicine and bioethics.

When Fins learned that Shulman was a religious studies major, he proposed a project about Gustafson's career and impact on the field. She was game.

“I have always loved stories and it sounded like an incredible opportunity to tell an untold story about the origins of bioethics that might be hidden in the archives,” Schulman said.

Yale’s Department of Religious Studies supported the project as an independent study course for class credit with Fins serving as her tutor.

The essay’s opening provides biographical details about Gustafson, who was born in Michigan in 1925. He served in the U.S. Army Corps of Engineers from 1944 to 1946 and saw combat during World War II. He taught in the Divinity School and in the Department of Religious Studies from 1955 to 1972 and later at the University of Chicago and Emory University. He died in January 2021.

The essay describes Gustafson’s approach to teaching, focusing on “Religion 220,” a year-long core course at the Divinity School centered on Christian ethics. In leading the class, Gustafson encouraged students to learn to think deeply about topics such as “the nature of the Christian moral life.”

The essay describes his syllabus as “an open-ended map that allowed students to find their own way, both theologically and practically, in all ‘spheres of life,’ through an applied ethics undergirded by foundational work in Christian ethics.”

Shulman and Fins explored the bond Gustafson formed with his students both inside and outside the classroom.

“Jim read very widely in multiple disciplines,” Walters, whose research has probed ethical issues in human genetics, recounted to Shulman and Fins. “Somehow, he transmitted that breadth of vision to us as his students. Second, Jim always considered ethical questions to be complex, with multiple points of view each having a certain validity. As a result, he was suspicious of glib or easy answers.”

Drane, who has authored 20 books on bioethics and related issues, recalled that it was outside the classroom where Gustafson truly shined as a mentor and friend.

“I had lunch with him,” he recounted in the essay. “I was at his house with his children, with his wife and with the family, and I became part of the family almost.”

A milestone in the establishment of bioethics occurred in 1969 when Gustafson invited his friend and colleague Paul Ramsey, who taught Christian ethics at Princeton, to deliver the Divinity School’s annual Lyman Beecher Lectures. Ramsey’s talks formed the basis for “The Patient as Person,” a seminal book in the field of bioethics. The essay details Gustafson’s efforts to convince Ramsey that the lectures were worthy of publication and to help his friend publish the groundbreaking book.

The essay discusses Gustafson’s scholarly work relating to bioethics, particularly his 1970 article “Basic Ethical Issues in Biomedical Fields,” which offered an analysis of the ethical propriety of research. It also describes his involvement in the establishment of The Hastings Center, one of the world’s most prestigious bioethics research institutes. Gustafson had a vibrant correspondence with Daniel Callahan ’52, the center’s co-founder.

“The historical origins of The Hastings Center reside in Yale’s gothic-style Sterling Memorial Library,” they wrote. “In the Daniel Callahan Archives, we found letters dating back to early 1969 that chronicle his relationship and consultation with Gustafson about the center. They were in frequent contact, and Gustafson was a trusted confidant. Again, he [Gustafson] played a pivotal but unappreciated role in an enterprise that was vital to the birth of bioethics.”

Shulman enjoyed reading Callahan and Gustafson’s correspondence in the Manuscripts and Archives reading room. (Due to the pandemic, most of the archival research at non-Yale archival repositories was performed online with the support of industrious research librarians. The interviews were largely conducted over Zoom.)

“The idea that all of this information — and there’s a huge wealth of it — is literally sitting in cardboard boxes waiting for someone to discover it is kind of mind-blowing,” she said of the experience. “Reading Gustafson’s handwritten letters made him so relatable.”

Asked why Gustafson’s contributions to bioethics have been overlooked, Shulman suggested that he was a humble man who considered himself a Christian ethicist, but not necessarily a bioethicist.

“Most of the people I interviewed noted his humility,” she said. “I think that had a lot to do with his religious faith. He expressed a huge amount of respect for his mentors in his writing, which is something I really admire about him. It’s cool to see that his former mentees, these pioneers of bioethics, have great respect for him.”

By interviewing Gustafson’s mentees, Shulman can share their history with a new generation of scholars, Fins noted.

“She spoke with several founders of the field,” he said. “Most folks in Kai’s generation will never meet these people. She will become a historical link to the past, which I think is so vitally important.”

Shulman, who will graduate from Yale College on May 23, plans to apply to medical school and continue to develop her interests in the history of science and medicine, something that she came to appreciate through her work in the archives.

“Gustafson taught me the importance of superb mentors,” Shulman said.  “Dr. Fins found his mentors in Al Jonsen and Dan Callahan and working with Dr. Fins has linked to that academic legacy.”

Fins, in the spirit of Gustafson, is glad to guide Shulman on her academic journey.

“Learning from your students is the best thing that can happen to a professor,” he said. “To assist an emerging academic is a great contribution to the academy writ large.”