Dr. Clif CleavelandDonald Klinefelter, who died on Oct. 10, fulfilled many public roles as university professor, church leader, counselor, public lecturer and medical ethicist. No matter the setting or situation, he increased our knowledge and lifted our spirits.
My contacts with Don ranged from brief conversations in hospital and UTC hallways to chance encounters in grocery stores or at swimming pools. Lengthier chats could occur anywhere. Short or long, each meeting always improved my outlook for the rest of the day. Don never seemed in a hurry. The person with whom he might be talking was his principal concern at that moment.
Our most sustained contacts took place in relation to Don's engagement with medical ethics. His scholarly background was in philosophy, which inspired his research and informed the various classes he taught at his university. He repeatedly reached beyond the academic environment to teach health-care providers, especially physicians, about the ethical dimensions of health care. His classroom had no walls.
Medical school curricula include numerous lectures and seminars on the latest innovations in diagnosis and therapy. In some respects, the ever-expanding scientific content of clinical medicine is easier because of the objective data that inform decisions and actions. A problem in treating diabetes can be researched online, experts can be consulted and therapy modified as more information is gathered.
Lectures in medical ethics are sprinkled through the four-year curriculum. At graduation, medical students take an ethical oath of one sort or another. Another oath may be administered later by professional societies.
In contrast to biomedical science, medical ethics deal with less objective and more complex situations. In his lectures at medical conferences and grand rounds, Don defined for his audiences how ethical principles of autonomy, justice and kindness should apply to the care of sick and injured people. His style of lecturing was no less personal than a one-on-one encounter.
I worked with Don on the ethics committee at Erlanger hospital. Don was a mainstay. I was a shorter-term member. The committee had representatives from law, clergy and clinical medicine, as well as other community representatives. Don with his scholarly background in medical ethics was our navigator. He had a wealth of theoretical and practical information at his command that could be applied to unique problems presented to the committee.
We met at short notice when conflicts or uncertainty arose regarding the ethical aspects of a patient's care. Family members might have conflicting concerns about the care of a loved one who was comatose after a severe stroke. One group would favor continued intensive care, while the other wanted comfort care only. A patient might decline treatment that his family believed he should have. Religious differences among family members might lead to conflict.
Don could clarify the most complex issue. Always the teacher, he infused our committee's discussions with clarity and compassion. Often, there was no right or wrong answer in a dispute. Fatigue, misunderstanding and stress among a patient's loved ones could lead to hurt feelings and decisional paralysis.
Under Don's leadership, our committee could sort through conflicts and return the focus to the care of the patient. What course of action would contribute to his comfort and well-being? Our committee could not issue directives, but we could offer a fresh analysis or approach to the problem at hand. Sometimes, we simply created an interval in which tempers might subside or hurt feelings heal.
Don interpreted medical ethics as the striving for peace and understanding in clinical medicine. Patients and their care-givers were the beneficiaries of his gentle guidance.
Contact Clif Cleaveland at ccleaveland@timesfreepress.com.