Bioethicist urges shifting focus to street-level issues
■ A professor calls on colleagues to tone down cloning and genetics talk and embrace issues more relevant to practicing physicians.
By Andis Robeznieks — Posted April 12, 2004
Some may think that Canadian bioethicist Leigh Turner, PhD, is biting the hand that feeds him, but that's not stopping the assistant professor of biomedical ethics at Montreal's McGill University from voicing his opinion that the field needs to change its focus or risk "becoming a source of entertainment."
"I'd have to suspect that there are a lot of physicians that, if they were to go to a week-long bioethics conference or look at the bioethics literature, they would find it completely irrelevant to what they're doing and what they focus on at work," he said.
While bioethicists can be seen on TV opining on the latest cloning news or genetic enhancement technology, Dr. Turner calls for more ethical study on subjects such as gun violence, poverty, the breakdown of communities and access to food, clean water and shelter.
He also urges his colleagues to quit "following the circus" connected to the Raelians and other fringe groups that claim to have cloned humans, and to embrace global issues relating to health and illness.
"I'm criticizing something I'm also a part of," said Dr. Turner, whose 1997 editorial on the creation of Dolly the cloned sheep was published in the Canadian Medical Assn. Journal. "But what you find being discussed are issues that matter to people in fairly wealthy, technologically advanced societies, such as end-of-life care and ICUs where enormous resources are being dedicated to extend someone's life -- sometimes whether they want it or not."
The inspiration for his callings has a somewhat odd beginning: The frequent sound of evening gunfire that serenaded him during the mid-1990s while he earned his PhD in Religion and Social Ethics at the University of Southern California Los Angeles.
"It became part of a backdrop for my life that I never really had encountered before, so that got my attention," Dr. Turner said. "I think it's one of the classic issues that comes up in bioethics and philosophy having to do with the tension between individual liberties and the public good. It's a topic that gets tremendous attention in epidemiology, public health and emergency medicine, but no one in bioethics really sees it as an issue worth talking about. Emergency room doctors certainly see ethical and legal issues having to do with it."
While impressed with the tone of the discussions held by President Bush's Council on Bioethics, Dr. Turner believes the group falls into the same trap of discussing esoteric points while ignoring street-level issues.
"Their work is pitched in terms of this great discussion with Aristotle and other thinkers about living a finite life or being immortal, and there's not really much attention given to the whole political economy of illness," he said. "All you have to do is look at the public health literature and you realize that mortality gradients have an enormous amount to do with things like access to clean water, access to adequate nutrition, some kind of safe housing, per capita GDP -- all kinds of things that don't really make it into their discussion."
Part of the problem, Dr. Turner believes, is that bringing in grant money has replaced educating students as the prime reason for academic employment. The topics he endorses can bring in grants in the $5,000 to $15,000 range, while colleagues engaged in genetics-related study can generate grants in the $300,000 range.
"Often they have this big grant having to do with genetics or biotechnology and, if you press them and ask a few questions, it seems they're not that interested in the subject," Dr. Turner said. "They never were, but they are in a research-intensive university environment where there's big pressure to bring in research grants, and if your research has something to do with genetics or some other flashy, highly visible issue, you get a few more zeroes to your grant.
"It's almost like the name 'professor' still exists, but the actual job has changed tremendously," he added. "I did my undergrad at a small, liberal arts college where the professors were much more engaged in the lives of their students. ... Whereas, in a research university, I think one of the big prizes is to bring in enough research grant money so you never have to step in a classroom again."