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[Obituary] Daniel John Callahan

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Philosopher, bioethicist, and co-founder of the Hastings Center. He was born in Washington, DC, USA, on July 19, 1930, and died of chronic obstructive pulmonary disease in Dobbs Ferry, NY, USA, on July 16, 2019, aged 88 years.

Speaking 10 years ago at a biotechnology industry meeting, Daniel Callahan is reported to have remarked that, so far as he knew, there were no fatal diseases that the US National Institutes of Health (NIH) found acceptable. The NIH, he added, while not officially in favour of immortality, had yet to reveal any fatal illness that it was willing to tolerate. This was not a joke; Callahan was serious. For well over a decade, he had been arguing that medicine has—and should have—limits. His 1987 book on the theme was titled Setting Limits: Medical Goals in an Aging Society.

Thomas Murray, President of the Hastings Center from 1999 to 2012, sees Callahan's book as a seminal contribution: “With respect to individual patients, there are times when medicine can't hold off death any longer”, he says. “Patients ought to be aware of this. Medicine isn't going to forestall death indefinitely, and patients should be given the opportunity not to pursue curative care indefinitely.” The use of new technologies in old age, Callahan suggested, should be limited to those that improve the quality of life rather than merely extending it. Such arguments are more familiar now than when Callahan first advanced them. “Even into the early 1980s, there were still physicians who were unwelcoming, who thought that you couldn't opine about medical care if you weren't yourself an MD…doctors did not like philosophers treading on their turf”, says Murray. Callahan was not deterred.

“Dan was always interested in the big issues”, according to Arthur Caplan, Professor of Bioethics at New York University Langone Medical Center. “What makes life valuable, what makes for a quality of life, whether science should move forward unfettered.” On this last point, Caplan adds, Callahan did not believe that scientific progress was an unmitigated good, a view formulated during the early days of the Hastings Center and in a period of great technological optimism. WHO's description of good health as a state of complete mental, physical, and social wellbeing troubled him. “It opened the door to a lot of medicalisation problems that Dan found disturbing”, Caplan says.

Raised as a Roman Catholic, Callahan studied English at Yale University and philosophy at Georgetown University, before completing a philosophy PhD at Harvard in 1965. By this time, he was already working as Executive Editor of Commonweal, a liberal Catholic journal of opinion. He left in 1968, abandoned his faith, and looked for a new vehicle through which to explore his ideas.

The idea for the Hastings Center originated in a conversation with psychoanalyst Willard Gaylin. Meeting at a party, the pair discovered they had shared interests. Callahan wanted to broaden the applications of philosophy while Gaylin, having cut back on his psychoanalytic practice, was eager to branch out into something new. Callahan's idea was to set up what he called the Institute of Society, Ethics and the Life Sciences. It launched in the late 1960s as a modest series of group discussion meetings in Gaylin's home. “We were two amateurs [in bioethics]”, recalls Gaylin, who is still a Hastings Board member. “Both of us had found academia dry and stultifying…It was a time when interdisciplinarity wasn't fashionable. We felt it was essential.” The new group thrived and renamed itself the Hastings Center after the small town in New York state where it was located. It grew into one of the leading centres for the study of ethics in science, medicine, and technology.

Murray describes Callahan as broadly curious, highly disciplined, and relentless. “He was also very competitive”, he adds, “He even competed against people who worked for him…But at the same time, he encouraged us. He created an environment where intellectual curiosity was immensely valued…When he organised a project he wanted to get the best people from an array of expertise…He welcomed many different moral perspectives.” Did Callahan's early Catholicism continue to influence his thinking? No, says Gaylin. “Not at all.” Caplan, though, is not so sure. He cites Callahan's morally torn view of abortion: “He understood the conservative position, and he was constantly trying to wrestle with it. It wasn't like he just abandoned it.” On this, as on other issues, he was an effective communicator, a skill he had acquired at Commonweal. Callahan leaves a wife, Sidney, and children David, John, Sarah, Mark, Peter, and Stephen.

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