The intellectual quarantine of American medicine

Powerful forces, which are increasing in number and intensity, are causing unexpected changes in medicine. The biological revolution offers opportunities for intervention of a magnitude unknown previously, while at the same time, society is concerned with the increasing costs of medical care. Access to such care and its equitable distribution are the subject of public debate. All of these are issues for ethical consideration. With so many forces acting, there is the opportunity for both effective change and catastrophe. Medicine must be studied in the whole university where such forces can be considered in an appropriate scholarly fashion with the perspective of history and the methodology of the many academic disciplines. Multidisciplinary units within the university must be formed to consider the complicated issues and the consequences of suggested courses of action. Surely this is better than the advocacy positions of the various parts of organized medicine, regulatory bodies, or insurance companies. Medicine must return from the often intellectually and geographically separated medical school to the center of the university's intellectual life.