|  or 
            many years, M. D. Anderson has been a leader in discussing the importance 
            of ethical issues that are inevitable in a complex patient care and 
            research environment.   In 
              1984, the institution was the first cancer center to adopt a Code 
              of Ethics, which was updated a decade later and continues to 
              bond patients and staff together in the difficult task of contending 
              with cancer.   The 
              appointment in 1993 of Dr. Rebecca D. Pentz as the first clinical 
              ethicist signaled a new era for focusing on ethical dilemmas. The 
              Clinical Ethics Committee she developed now includes 26 members 
              from several disciplines, who can provide consultations 24 hours 
              a day.   Teams of committee members that include one physician, one 
              nurse, one other staff member and me are always reachable by beeper, 
              no matter the time of day. Right now, I am reviewing and responding 
              to about 20 calls concerning ethical issues each month. An average 
              of three of those requires a formal consultation, Dr. Pentz 
              explains.   At 
              least a quarter of the ethics consults involve patients in the medical 
              intensive care unit, where family members often struggle with unfamiliar 
              medical treatments and complications. Dr. Pentz routinely rounds 
              with medical staff there so she can keep abreast of the complicated 
              issues that confront faculty, staff and patients who are seriously 
              ill. | 
              
 
                
                  | Dr. Rebecca Pentz (center) 
                    and Dr. Alan Valentine, chairman of the Clinical Ethics Committee, 
                    consult with Dr. Vickie Shannon, a staff physician in the 
                    intensive care unit, about a patients progress. |    |