Bioethics Matures: The Field Faces the Future

Modern bioethics is now approaching the forty-year mark, and bioethics centers and programs have proliferated in universities around the country. Yet as these programs are becoming more established, seeking to tenure their faculty, to graduate students, and to secure their funding, a set of questions and concerns is arising that all of them share. Has the field of bioethics matured to the point that centers and programs should become academic departments? Should they grant tenure in bioethics, or instead provide a home for faculty tenured in traditional disciplines—law, medicine, and philosophy, for example? Should more universities offer master's degrees and doctorates in bioethics? How secure is the future of bioethics within the academy anyway?

To address these issues, the University of Minnesota's Center for Bioethics and Consortium on Law and Values in Health, Environment & the Life Sciences convened a meeting in Minneapolis on May 5 for the directors of approximately fifty major bioethics centers and programs around the country, as well as several in Canada. Sixteen bioethics programs cosponsored the meeting (from Case Western Reserve University, University of Chicago, Georgetown University, The Hastings Center, Johns Hopkins University, University of Louisville, Loyola University Chicago, Medical College of Wisconsin, Michigan State University, Northwestern University, University of Pennsylvania, Stanford University, University of Texas Medical Branch at Galveston, Tuskegee University, University of Virginia, and University of Washington). The meeting was funded by The Greenwall Foundation and the University of Minnesota's Consortium. The authors moderated.

Programs represented at the meeting included not only bioethics centers housed in academic health centers or medical schools but also programs based in law schools, schools of public health, and elsewhere within universities. They also included centers and programs not affiliated with universities, such as those at the National Institutes of Health (NIH) and the Veterans Health Administration. The programs also varied in their scope, with some focusing on clinical bioethics, some on health law and human rights, and some on medical humanities. Minnesota's Consortium exemplified a program focusing not only on traditional bioethics issues in biomedicine but also on issues in environmental, agricultural, veterinary, and life sciences.

The day began with the leaders of five programs discussing the issues they face, beginning with the core question of whether bioethics remains an interdisciplinary field or is becoming its own discipline. Ruth Faden of Johns Hopkins asked, for example, whether bioethics is following or should follow the trajectory of epidemiology, which has become its own field. Many participants felt that the answer to this question would tell us much about the wisdom of granting degrees in bioethics and reconfiguring programs as tenuring departments. Jeffrey Kahn of the University of Minnesota pointed out that many bioethics programs have faculty whom they house and fund but who are tenured and promoted by other units. Should work environment, salary support, and tenure home be merged?

The third panelist, Stuart Youngner of Case Western Reserve, asked how secure the future of bioethics really is. A number of others echoed this concern, pondering not just how secure programs are financially and administratively, but also what political challenges programs face in a time of contentious partisan politics. Vanessa Northington Gamble of Tuskegee University commented that in light of the country's changing demography, the relative lack of racial and ethnic diversity at the meeting suggested that the future of bioethics was not in the room. She discussed the impetus for an upcoming conference on creating a Black agenda in bioethics. She urged that bioethics programs should devote resources to public education and activism. Ezekiel Emanuel concluded the opening panel by challenging the group to consider the goals of doing work in bioethics. If the goals include improving medical practice and influencing how people approach issues of health and science, then bioethicists have to think pragmatically about how to achieve that. He indicated that the NIH may reevaluate its investment in bioethics research and education, and suggested that the field might seek to collaborate with the NIH in improving the way bioethics work is supported and carried out.

Open discussion followed this panel...