Burgeoning Crop Of Bioethics Programs And Courses Reflects The Deepening Of Scientist's Moral Concerns

Today's researchers are being offered a host of opportunities to study philosophical implications of scientific activity As students at the California Institute of Technology arrive on campus for the fall semester, they're finding that a new ingredient has been stirred into the curricular mix. The Caltech catalog now lists an undergraduate major--a four-year degree program of required courses in science ethics and history--and a graduate minor called Science, Ethics, and Society. The courses--some new, some that have been taught before--cover subjects like weapons research and arms control, biotechnology, the environment, and scientific misconduct. A little more than a year ago, bioethicists became electronically linked with the Bioethics Online Service, an information resource administered by the Center for the Study of Bioethics and the Office of Research, Technology, and Information at the Medical College of Wisconsin in Milwaukee. Arthur R. Derse, associate director for medical and legal affairs at the center and director of the service, says he and colleagues started the resource because people from a variety of professions--lawyers, doctors, educators, social workers, and chaplains--contacted the center for information to help them resolve questions they had on medical ethics and bioethics. The service provides an accessible and centralized forum for ethics professionals, he says. According to Derse, more than 6,000 users from nearly 40 countries have consulted the service since it started in June 1993. The service offers the following features: Bioethics News Alert: breaking news stories that deal with medical and bioethics; Bioethics Database: abstracts of journal articles, news accounts, legislative actions, and court decisions; Bioethics Discussion Forum: an electronic discussion of current cases and topics open to anyone with a professional interest in bioethics; Bioethics Resources: an archive and clearinghouse for ethics-related policies; Bioethics Bulletin Online: articles of interest from the CenterUs publications; Bioethics Center News and Announcements: current reports from the Medical College of Wisconsin, the Wisconsin Ethics Committee Network, and other academic and professional sources; and links to other bioethics networks and professional organizations. Via modem (any speed) and telephone line: Dial (414) 266- 5777. At the prompt (MCW >), type c min . Choose the Bioethics Online Service from the menu. Via Internet gopher: Using a gopher client, type post.its.mcw.edu Via Internet telnet: Type telnet min.lib.mcw.edu. Choose the Bioethics Online Service from the menu. For more information, contact Arthur R. Derse, Center for the Study of Bioethics, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, Wis. 53226; (414) 456-8498. Fax: (414) 266-8654. E-mail: aderse@post.its.mcw.edu. --K.Y.K. Meanwhile, the University of Pennsylvania has established a new education and research institute called the Center for Bioethics. In addition to teaching ethics to medical students in the classroom and on hospital rounds, its faculty will conduct empirical research in such areas as informed consent and living wills. The center will also sponsor public-education forums on health-care issues. These are among the latest manifestations of a decade-long trend responding to a growing call for researchers to become more knowledgeable on philosophical matters, some extremely pertinent to and others quite far afield from the traditional focus of their lab activities. It is the study of such ethical issues that bears on the conduct, policy, and direction of scientific pursuits. Most of the courses, degree programs, seminars, and other educational and research activities cropping up in academia and other scientific and medical venues involve bioethics, which encompasses the life sciences and medical investigations and procedures. But some relate to all of science. According to figures compiled by the Hastings Center, a nonprofit bioethics research organization based in Briarcliff Manor, N.Y., and the Bioethics Online Service, a computer information source administered by the Medical College of Wisconsin in Milwaukee (see story on page 4), there are more than 100 bioethics programs and centers in the United States. Most are graduate training programs at universities; some are so-called study centers--primarily affiliated with medical institutions--which host a wide array of activities, including seminars, visits by scholars, research projects, and the development of publications. Since only a handful of such programs existed in the early 1980s, figures like those from the Hastings Center indicate that bioethics as a discipline in its own right is "here to stay now because it has received such broad institutional acceptance," says Arthur Caplan, the Penn Center's director. A number of factors have converged to stimulate this commitment to scientific and medical ethics. Spurred by increased attention to bioethical issues paid by the media, hospitals, and the research community, students and faculty- -from both science and philosophy--have been expressing a desire to have more discussion of ethics included in their classes, according to scientists and ethicists. A secondary catalyst, some say, has been increased governmental concern about ethical conduct in science, exemplified by a 1989 National Institutes of Health requirement that all recipients of NIH research training grants receive education in the responsible conduct of research (R. Eisner, The Scientist, Oct. 28, 1991, page 1). Although NIH does not specify a curriculum, format, or length of time spent in instruction, it does encourage institutions to cover the following areas: conflict of interest, responsible authorship, scientific misconduct, use of human and animal subjects, and data management. If there is one element common to all of these programs--new or well-established--it is that they are run by interdisciplinary teams from medicine, science and engineering, law, philosophy, theology, history, policy, and business, among other fields. For instance, Penn's center-- with a core budget of $500,000 per year--will eventually have 10 faculty members, from both philosophy and science. Daniel Kevlas, the J.O. and Juliette Koepfli Professor of Humanities at Caltech and coordinator of its new ethics program, stresses that his department's program is not a prescriptive, policy-oriented one. "To explain what we intend to do," he says, "I apply the analogy of basic vs. applied research. This is really investigating long-term basic issues in the relationship of science and society, both historically and philosophically." Medical schools have also instituted ethics programs that run beyond a semester's duration. John Balint, a professor of medicine at Albany Medical College in New York, coordinates Health, Care, and Society--a four-year ethics seminar course required for all medical students at the college. He says "the mainstay" of the course is a "cadre of about 12 people," half of them physicians, the other half composed of a psychologist, a social worker, a nurse, a theologian, a sociologist, and a lawyer. In the first and second years of the program, Balint and colleagues lead classroom, laboratory, and field studies with students on such issues as sex discrimination in health care, patient confidentiality, and aging and disability. The final two years involve discussions based on cases encountered in hospital wards and clinics. PP,11 There are several professional societies--some of them quite new--that facilitate communications in the field of medical and bioethics, each with its own mission and constituencies. Following is a sampling of societies dealing with bioethics. American Association of Bioethics: formed six months ago; interested chiefly in health-care issues. Arthur Caplan, president Kim Segal, executive director FHP Center for Health Care Studies University of Utah, 2127 Annex Salt Lake City, Utah 84112 Fax: (801) 585-5489 E-mail: ksegal@cppa.utah.edu American Society of Law, Medicine, and Ethics: incorporated in 1972; members are primarily lawyers and physicians. Karen Rothenberg, president Ben Moulton, executive director 765 Commonwealth Ave., 16th Floor Boston, Mass. 02215 Phone: (617) 262-4990 Fax: (617) 437-7596 Association for Practical and Professional Ethics: formed three years ago; interested in interdisciplinary scholarship and education for ethics practitioners. Brian Schrag, executive secretary 410 N. Park Ave. Bloomington, Ind. 47405 Phone: (812) 855-6450 Fax: (812) 855-3315 E-mail: appe@ucs.indiana.edu Society for Health and Human Values: started in 1969; broad interdisciplinary interests in medical humanities. Thomas Murray, president George Degnon, executive director 6728 Old McLean Village Dr. McLean, Va. 22101 Phone: (703) 556-9222 Fax: (703) 556-8729 E-mail: apava@access.digex.net Society for Bioethics Consultation: formed in 1986; interested in clinical consultation, education, and research. George Kanoti, president Department of Bioethics P-31 The Cleveland Clinic Foundation 9500 Euclid Ave. Cleveland, Ohio 44195 Phone: (216) 444-8720 Fax: (216) 444-9275 --K.Y.K. The motivation for institutions and individuals to commit resources to these programs is as broad as the array of issues they are addressing. Students, faculty, alumni, and administrators all play a part. For example, Courtney S. Campbell, an associate professor in the department of philosophy and director of the Program for Ethics, Science, and the Environment at Oregon State University in Corvallis, says, "Over the past few years, philosophy faculty have, with increasing frequency, been invited to science classes to give one-shot lectures on science ethics. We in the philosophy department] felt, and our colleagues in science agreed, that education in professional ethics of science needed to be more integrated and systematic." As a result, the program began offering an undergraduate certificate in applied ethics in 1993. Students complete courses in many different departments in addition to those taught in the program; the certificate, therefore, provides "a sense of breadth" on the certificate-holder's transcript and resume, Campbell says. Caplan says that Penn's center was started because of a similar push from the bottom up: "Medical students have been asking for a program here for some time." But, he notes, there also was "leadership among the dean of the medical school, the dean of the school of nursing, and the administration" in fostering formation of the center. Endowments, donations, foundation grants, and public monies all fuel the various centers and programs. Campbell says his department received "clear direction and donations" from Oregon graduates. "The alumni felt they didn't receive enough humanities or philosophy to equip them for some of the practical [ethical] problems that they encounterd in the real world" and that an ethics program might fill that void in the school's curriculum, he says. Broadly speaking, the centers serve one of two educational roles: teaching people who already have a background in such other disciplines as medicine, science, law, nursing, and business to apply ethical understanding to their work, and to act as a resource for others; and training and motivating faculty to include more ethics in their classes. The two-year-old master's degree program in bioethics at the Medical College of Wisconsin's Center for the Study of Bioethics in Milwaukee draws students primarily from medicine and law, says Arthur R. Derse, associate director for medical and legal affairs at the center. "We don't recommend getting the master's without combining it with some other discipline," he says. Derse reports that some graduates return to their original workplaces, such as hospitals and law offices, to set up in- house ethics programs. Still others go on to work in public service. At Penn, however, no degrees will be offered for the time being. "I think it's better to enter the field through an existing traditional discipline or profession," suggests Caplan. "My view is that it makes more sense to train doctors who can work bioethics and medical ethics into their teaching." The Center for Clinical and Research Ethics--headed by Richard Zaner, Ann Geddes Stahlman Professor of Medical Ethics at the Vanderbilt University School of Medicine in Nashville, Tenn.--has tracked the employment history of its graduates for the last decade. The center, a branch of the medical school, awards master's and doctoral degrees in medical ethics, among other activities. Since 1981, Zaner says, almost 200 students have come through the center's degree programs, with many of them now teaching in universities, medical schools, and hospitals. When hospitals started hiring staff ethicists about five years ago, he says, graduates started to work in that area, as well. Other programs, like the ones at Caltech and Oregon State, are aimed at students and faculty in branches of science other than biomedicine. Gary Comstock, coordinator of the Bioethics Program at Iowa State University, Ames, for example, heads a program in which philosophers teach science faculty--mostly in the life and agricultural sciences--how to teach ethics. "What we want to do is have an impact on existing courses. This is done so science students see that a healthy chunk of their instructors think that ethics is an important part of science--that it's right up there with meiosis and mitosis." According to Comstock, the program has had a "dramatic impact on the science curriculum at Iowa State." So far, 70 life scientists have introduced at least one hour-long discussion of ethics into more than 220 classes, reaching almost 11,000 students since the program started in 1991. The Center for Biotechnology Policy and Ethics, started four years ago at Texas A&M University in College Station, also instructs primarily science faculty. Acting director Susanna Hornig Priest says the center serves "as a facilitator for nurturing interdisciplinary activities." The center hosts informal faculty seminars that discuss various issues in diverse scientific fields, including environmental ethics. Caltech's Kevlas says his department's program has the potential to affect how future generations of scientists will approach their work: "The vast majority of students who come through here will go into technical work, at least in the early days of their careers. And it seems to me that those are the students who most need exposure to studies of this type. WeUre trying to infect those people who are going out to do bench science with a sensitivity to [ethical] issues."

Burgeoning Crop Of Bioethics Programs And Courses Reflects The Deepening Of Scientist's Moral Concerns

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