Bioethics – a discipline without a natural home?

This post is inspired by this excellent and challenging article by Carl Elliot where he asks why should students study bioethics at scandal plagued institutions such as his own University of Minnesota (I said it was challenging).

One of the problem he notes is that bioethicists in scandal plagued departments such as medical schools rarely speak out publicly or critically about the scandals and suggests in this lovely paragraph that there might just be a conflict of interest at play:

“Many university administrators seem to think that leaving a stack of cash on the table for the bioethicists is a good way to make amends for wrongdoing. Bioethicists don’t usually complain.  When the Presidential Commission for the Study of Bioethical Issues looked at the issue of making reparations to victims of unethical research, it suggested that reparations do not necessarily have to mean monetary compensation to victims. Instead, they may mean more funding for bioethics. For example, when the Clinton administration apologized on behalf of the federal government for the Tuskegee syphilis study in 1997, it also announced a grant initiative to establish a bioethics center at Tuskegee University.  Whether the victims of unethical research see a bioethics program as fitting compensation is not for me to say.”

Relatively recently we have seen an explosion of new bioethics centres in the UK, fuelled in part by funding bodies desires to establish Centres of excellence, which saw much funding in bioethics consolidated into very large amorphous grants. I wondered at the time whether this was good for the discipline – since it effectively left isolated ethicists out in the cold in regards to seeking funding.

With no disrespect intended for those in Centres funded in this way it doesn’t seem to me that this has worked as a strategy – those who were doing good work continued to do good work, those who weren’t… So it seems the idea of an Ethics Centre is in twilight, after what happened at Keele, and in other places the idea itself seems to be going out of fashion. I doubt we will see the end of ethics centres altogether, no doubt Oxford will keep inventing new ones to get even more pots of money, and some of the strongly established ones will survive, but will we see new ones? Or more posts at existing ones?

Outside of centres there seem to be three main places where work in bioethics is located in UK universities (I’ve excluded sociology since with rare exceptions most of the work carried out in bioethics by sociologists is either non-normative in nature or at least ought to be non-normative in nature):
1. Medical Schools
2. Law Schools
3. Philosophy departments

And while each of these has strengths they also have significant weaknesses. The first challenge bioethics faces is that it lacks an obvious home in regards to the REF – without a specific category people will tend to be submitted under whichever department they are associated and there are legitimate concerns about whether bioethics will be fairly evaluated under any of these categories.

Medical Schools offer the advantage of being at the coalface – however as Elliot notes this face can be pretty ugly. I know in my times at the coalface I was asked (and refused) to do some fairly questionable things – including trying to bias the outcome of a supposedly independent audit. They can also be academically isolating – unless you are in a centre that is part of a medical school you are unlikely to have colleagues who are directly interested in your research. Even in such a centre you can expect to be a small part of the overall school – the sort of money, respect and influence a bioethics centre can bring in pales in comparison to other units in a medical school typically.

Law Schools are where many of the existing centres are based and can be fruitful homes for bioethics since they facilitate a particular approach to bioethics – namely a case driven legal analysis approach. There can be some strong synergies here between lawyers and philosophers and good collaborative work. However there is also the risk that bioethics is not typically central to the concerns of a law school or more importantly its undergraduate students, so without a strong postgraduate offering it is unlikely that law will be a comfortable home for a bioethicist.

Philosophy departments are where historically most bioethics was based, and given that many approach bioethics from this perspective it provides a natural home for bioethics. Except of course there are worries about how well applied ethics will do in a philosophy REF submission, a risk of being too “philosophical” ie losing touch with the coalface and perhaps a certain amount of snobbishness about the topic area – I’ve heard it suggested by colleagues that the courses I teach mustn’t be as hard as their courses since three times as many students take mine.

So it seems like there isn’t an easy natural home for bioethics – perhaps unsurprising given the inter-Disciplinary nature of the topic area. I have some sympathy for the idea of a virtual centre – where individuals in the institution in different schools or departments form an alliance and come together regularly to discuss papers, apply for grants and work together, but that typically requires some institutional support to make it work.

So what do you think? Where should bioethics be based?

  • John Coggon

    Hi, David.

    This is an interesting post.

    I think that possibly, though, you frame the problem wrongly, and thus your question doesn’t straightforwardly permit of a useful answer.

    It’s hard to accept that bioethics is a discipline in the first place – indeed you note at the end its interdisciplinarity. At its most coherent, I would think, bioethics can be said to be a field, but even then a field that covers such a vast terrain, both in terms of the practical matters that are looked at, and in terms of potentially relevant disciplinary insights that may be brought to it. I thus just can’t see it having a single, ‘natural’ home, because *it* is not one thing in the right sort of sense.

    This is perhaps most stark to me in your description of medical schools as presenting ‘the coalface’. They may present that for people working in medical ethics, but not for bioethics scholars interested in the many non-medical questions that a lot of us put under the spotlight.

    I would imagine that even if ‘Ethics Centres’ are going to diminish in number, we will still find more groupings emerging, both as centres within departments, as well as in cross-institutional networks as you describe.

    However, perhaps these will not be billed as all-encompassing ‘Ethics Centres’ (was this ever the way?), but as more narrowly focused (eg centres focused on new technologies, public health, neuroscience, etc.).

    And perhaps we should welcome this – such refinement doesn’t necessarily imply the emergence or singularity of disciplinary approaches (and thus no ‘natural home’ for each and all), but it might invoke greater academic discipline…

  • David Hunter

     Hi John, thanks for the response. Happy to accept I may have framed it wrongly – and drawing a distinction between disciplinary method and topic is useful – we might see bioethics (broad and amorphous as it is) as a topic of study rather than an approach to thinking about something – hence as you suggest its natural home might be in many places depending more on disciplinary method used to study it.

    I want to argue against this slightly though and suggest the nature of the topic leads to particular methods – particularly normative methods needing to take primary place in any useful analysis (I’ll happily concede that useful normative methods aren’t limited to philosophical methods)

    So let me reframe somewhat tendentiously if I may. “Where do normatively focused bioethicists find a home?”

    All that aside your point about the broadness of bioethics and that medicine might not be the coalface is a good one, and one I’ll happily endorse since while I have worked on clinical ethics it is by no means my main focus, and something that I think focusing on for too long has distorted bioethics.

    I’m not sure though that I like your more narrowly focused centres idea though – I’m worried about splintering and in particular the duplication of argument that often occurs when people aren’t aware of what is going on in the broader discipline (see for example debates about nanotechnology and synthetic biology – most of the issues here are very similar, yet debates are just being repeated with little reflection on what came before.)