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05/27/2015

Roundtable Discussion: Improving Public Dialogue of Bioethics

The Presidential Commission for the Study of Bioethical Issues (Bioethics Commission) closed its discussion of democratic deliberation in bioethics and bioethics education with a roundtable discussion involving Commission members and presenters.

Amy Gutmann, Ph.D., Chair of the Bioethics Commission, kicked off the session by asking the panelists to share their thoughts on what the Bioethics Commission can do to improve the quality of public dialogue and deliberation on bioethics and the quality of bioethics education.

Following are highlights from the discussion:

Margaret Little, Ph.D., director of the Kennedy Institute of Ethics and associate professor in the philosophy department at Georgetown University, suggested that the Bioethics Commission help launch a series of experiments to promote informed deliberation on bioethics, both at universities and in communities. “This is a great model that is used in many places. Right now, there is an energy prize for $5 million to a community that reduces its carbon footprint,” Little noted. “So this is something with incentives and an aspirational mandate.”

“Watching is one thing; doing is another,” said James Fishkin, Ph.D., the Janet M. Peck Professor of International Communication and director of the Center for Deliberative Democracy at Stanford University. He urged the Bioethics Commission to undertake an exemplary project using democratic deliberation to spur public engagement in bioethics. “If you do it right, other commissions can follow in your footsteps,” he added.

F. Daniel Davis, Ph.D., the director of bioethics at the Geisinger Health System and former executive director of the President’s Council on Bioethics under President George W. Bush, said that there’s a need to make ethical knowledge more practical and less theoretical. He cited work he is doing with surgical residents, assessing their emotional intelligence as a way to reduce medical errors. The goal, he said, is to get the residents not only to recognize ethical issues but also to “operationalize that ethical knowledge and do so in a virtuous way.”

Jason Schwartz, Ph.D., M. Bioethics, the Harold T. Shapiro Fellow in Bioethics at the University Center for Human Values, Princeton University, asked the Bioethics Commission to think broadly in terms of the government entities that address bioethics issues. “Call attention to the fact that bioethics may not be the domain of bioethics alone,” he said, noting that many bodies that do not have bioethics in their name or mandate deal with bioethics issues. For example, bioethics is a factor in the how the Food and Drug Administration weighs the risks and benefits of pharmaceuticals, and in how vaccines are prioritized for development. “Ethical dimensions are largely ignored or cast aside or reshaped if they are exclusively technical or scientific questions,” Schwarz said.

Steven Joffe, M.D., M.P.H., the Vice Chair of Medical Ethics, Emanuel and Robert Hart Associate Professor of Medical Ethics and Health Policy and director of Penn Fellowship in Advanced Biomedical Ethics at University of Pennsylvania, emphasized the importance of promoting respectful public dialogues. As a model, he suggested presidential debates in which questions are asked by citizens sitting in a circle. “The citizens equip themselves incredibly well time after time after time. And those sorts of discussions, engaging the public about bioethical issues, I think, would be…incredibly powerful to promote the conversations we want to have.”

Connie Ulrich, Ph.D., R.N., F.A.A.N., an associate professor of bioethics and nursing in the Department of Biobehavioral Health Sciences at the University of Pennsylvania School of Nursing, cited a need for better communication. “Training and communication would absolutely help in bioethics education, so we can help people feel more confident to address the issues that they face.”

The Commission is scheduled to meet again on September 2 in Washington, D.C. For details, go to www.bioethics.gov.

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