PCCS availability and growth throughout the hospital may have influenced EC consult requests. EC consults regarding family opposition to withdrawing LST and EC recommendations for patient/family support declined.

In this essay we argue that Richard Cabot developed a unique approach to medical practice and medical ethics that has been largely overlooked in the history of medicine and philosophy. His impact was significant both in terms of transforming medicine and in encouraging philosophy, particularly ethical theory, to shape the delivery of healthcare. Cabot's approach was defined by the principle of fallibilism, a unique understanding of virtue ethics, and the ethics of care, all of which he inherited from the classical American philosophers who were his teachers and friends in the second half of the nineteenth century (principally Ralph Waldo Emerson, C.S. Peirce, William James, and Josiah Royce). Cabot translated this philosophical legacy into medical practice at Mass General and Harvard Medical School, insisting that his students understand case medicine as fostering virtuous clinical practice. His support of the Clinicopathological Conferences and his creation of the first department of social work were extensions of this basic sentiment. Cabot's was a holistic practice that treated patients as genuine individuals, a practice that remains in scarce supply in today's medical field. Returning to Cabot and the classical American tradition stands to revive virtue ethics and the ethics of care in medical practice and education.

The philosophy of Josiah Royce (1855–1916) has recently begun to regain attention; Griffin Trotter, in particular, has utilized Royce in questions concerning medical ethics. This resurgence in attention is for good reason—Royce's philosophies of loyalty and community provide both a descriptively accurate picture of the self and a prescriptively solid ethical system. Royce recognized, as do all pragmatic philosophers, that persons only exist socially, and this sociality will necessarily influence the individual ethically, but also epistemologically. What we know, how we act, how we think we ought to act are not individual questions, but rather questions that arise for individuals only in the context of a larger community.