The MacLean Center’s clinical medical ethics fellowship program is the oldest, largest, and most successful ethics fellowship program in the world. Since beginning the fellowship program in 1981, the center has trained over 440 fellows, including more than 325 physicians. Graduates of the MacLean fellowship have served as directors of more than 40 ethics programs in the United States, Canada, South America, Europe, the Middle East, Africa, Australia, and China. A former trainee, Dr. Kenneth Iserson, an emergency medicine physician, is currently the only clinical medical ethicist to have practiced in Antarctica. MacLean Center fellowship graduates have held faculty appointments at more than 60 university programs. More than 25 fellowship graduates have held endowed university professorships. Former fellows of the MacLean Center have written more than 180 books and thousands of peer-reviewed journal publications. Many of the graduates of the fellowship programs are leaders, scholars, and mentors who represent a network of expertise that advances scholarship in clinical medical ethics and works to improve patient care.

The center’s original associate director was Dr. Steven Miles, who was succeeded as associate director by Dr. John Lantos. Currently, the center has five outstanding associate directors: Drs. Peter Angelos, Marshall Chin, Monica Peek, Lainie Ross, and Daniel Sulmasy. Each of these leaders of the MacLean Center has made important contributions to develop the field of clinical medical ethics.

Beginning in the 1970s, the University of Chicago hospitals pioneered the development of ethics consultations to assist patients, families, physicians, and the health team. MacLean Center faculty and fellows wrote much of the early literature on ethics consultations, including the first book on the topic Ethics Consultation, in 1994 [8].

In a landmark article in 1989 in the New England Journal of Medicine [9], reprinted on page 382 in this book, the MacLean Center introduced the concept of research ethics consultations, an innovative approach to the ethics of clinical and translational research. The New England Journal of Medicine article described research ethics consultations as follows: “Research-ethics consultation is the process in which the ethical issues raised by an innovative therapy are analyzed before a protocol is submitted to the institutional review board. This process has been an essential part of our liver-transplantation program in recent years” (p. 620). Research ethics consultations have now been widely adopted by many research groups, including the Clinical and Translational Science Award program and the National Institutes of Health [10].