Career Tales

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Berman Institute Faculty Discuss their Careers in Bioethics

In the hopes of providing valuable advice for students pursuing a career in bioethics, the Berman Institute of Bioethics interviewed faculty members and graduate students about their individual careers and studies.  The faculty members and students interviewed come from a variety of disciplines, including medicine, law, public health, and philosophy, and each interview offers a unique story and perspective.  In the following interviews, these faculty members discuss their initial interest and involvement in bioethics, and the paths which led them to their current positions.  Faculty members also give advice on the best bioethics resources, including academic and professional experiences to Internet resources, and critically look at the current bioethics world to determine what the future generation of bioethicist ought to bring to it. These interviews serve not as a strict model for students to follow to become a bioethicist, but rather reveal the many opportunities and possibilities for achieving a bioethics career.

Nancy Kass

kasssq-100x100Nancy Kass
Q: When and why did you become interested in bioethics?
A:  I took a medical ethics class in college. Of course I went to college when bioethics wasn’t a major, at the time this kind of class was offered only at the medical school. At that time I didn’t think I had a long term interest in bioethics, but for some reason I chose to take the class.  I was intrigued by the topic, and it took a little bit of extra effort to take it, as I had to travel to the medical school at my university.  Then I came to Hopkins as a public health student, and I still didn’t know I wanted to do bioethics.  I did know that I wanted to do public health and health policy, that I wanted research methods skills, and also that I was intrigued by a lot of the ethics questions within health policy. As a first year grad student, I took a class from Ruth Faden and fell in love with the material.  That year Ruth developed a justice class, and that got me increasingly interested in bioethics.  I switched in my doctoral program from a more general public health policy faculty member to have Ruth be my advisor instead, and I made the decision to add an ethics chapter to my dissertation.  At some point during my doctoral studies, I decided I would do a post-doc fellowship in bioethics at the Kennedy Institute at Georgetown.  Increasingly my portfolio became more and more bioethics, until 5 years after being on the faculty it was 100% bioethics.

Q: Do you identify your career as that of bioethicist, or academic and public health expert with an active interest in bioethics?
A: Yes, yes, yes! I don’t in any way feel like I have one title. I feel like a bioethicist: what I do is bioethics and public health. For me it has been equally important to put forward both my Berman Institute of Bioethics and Bloomberg School of Public Health affiliations. It’s not like I spend 50% of the time on each; I spend 100% of my time on the integration of the two.

Q: Do you feel that bioethics as a discipline lacks input from any academic field in particular?
A: I think what defines bioethics is the nature of the topic, not the method of inquiry.  I think bioethics questions refer to problems with moral elements that relate to health, healthcare, science, or technology.  I think that the lens or method of inquiry through which one examines moral questions in these topics is not what defines bioethics.  For example, one can look at bioethics through a philosophical lens, a legal lens, etc- bioethics isn’t defined by the approach — it’s defined by the nature of the question.

Q: What resources would you recommend to a student interested in pursuing a career in bioethics?
A: There are so many resources. Spending time looking at any one of them will be better than not looking at any of them.  To just begin to immerse oneself in bioethics thinking, or writing, or conferences will be helpful in figuring out what bioethics is, and how people in bioethics think.  Making the effort to get any exposure, even if it’s not the perfect exposure, is what is most important. Having said that, there are particular sites and opportunities that are good general resources.  The Hastings Center is one of the oldest ethics centers in the country.  It’s a free standing ethics institution and is a great place to start, so I might suggest if you’re a college student interested in bioethics, get a subscription to the Hastings Center Report.  They also have a blog, which is nice because it will introduce people to a wide variety of issues, and blogs are relatively less effort.  There are also bioethics groups which offer short-term, in-depth exposure. For example, the student bioethics groups often have faculty speakers.  Also, the ASBH has a student rate for its conferences. Their conferences move around the country where student can get exposure.  Another great conference is PRIM&R for students interested in ethics and human research.  These conferences give students great short-term, intensive opportunities to increase the learning curve significantly.

Q: Would you recommend formal training in bioethics or another area to a student who wishes to pursue a career in bioethics?
A:  I think there are two parts to this question: 1) does training in bioethics make a difference, and 2) does a degree in bioethics make a difference.  I think training in bioethics makes a difference, but that doesn’t mean that if you haven’t taken classes in bioethics, you can’t think about ethics issues.  Training does provide the discipline to do a lot of reading , analysis, and discussion in bioethics.  I think the experience of more reading, analysis and discussion will contribute to being a more sophisticated thinker within bioethics.  Of course, one can do reading, writing and analysis on one’s own without taking bioethics classes.  Could I be a great historian without a degree in history? I probably could, but the degree in history would be a rather efficient route to building the skill set and the literature background that would assist me.  I’m a purist enough with the precision of my language to never say that training is necessary. However,  I would say that the exposure, reading , discussion, analysis and experience one gets with formal training makes a difference.

Holly A. Taylor

holly_taylor-100x100Holly Taylor
Q: When and why did you become interested in bioethics?
A:  I had a general interest in public health and health policy, and did a number of health policy related jobs in the early 90’s. I ended up in a job at the National Institute of Allergies and Infectious Diseases.  I did a lot of policy related to HIV, and realized at some point in that period that the things I was really interested in were the things that had ethical dimensions.  All I knew was that these issues were exiting, interesting, and captured my attention, but I didn’t really have a framework to think about them in any systematic way. At the same time, I was thinking about getting a PhD.  If I wanted a career at NIH with decision-making power I needed to have, because at NIH and MD, or a PhD after my name. When I was looking at doctoral programs, I was looking at programs that were housed in a school of public health, because that was my training and orientation (I had completed an MPH a couple years after I finished college) and would be comfortable pursuing my interests in ethics in the context of population health.  Hopkins was really the only School of Public Health that had a doctoral program that had any of the words that were the words I wanted in it- at the time it was called the Program in Law, Ethics and Health.  I did my first year part-time, and then came to Baltimore to work on my degree full-time work.  All along I had planned to go back to NIH and use the bioethics skills, frameworks, and methods of analysis and apply them to the biomedical research setting, but I really enjoyed the freedom that academia provides.  I can set my own research agenda, and pursue my personal interests rather than pursue what my boss would like me to pursue.

Q: Would you recommend formal training in bioethics or another area to a student who wishes to pursue a career in bioethics?
A:  The content that was most interesting to me had to do with clinical trials, both therapeutic and vaccine trials.  That was my first exposure to ethics issues.  Most people who do human subject research and have been exposed to any training in ethics have read the Belmont Report. The Belmont Report gives you a basic framework for thinking about ethical issues that come up in the conduct of research. In terms of bioethics training more generally, there are all sorts of professions, certainly in public health, medicine and other biomedical science programs, where having all sorts of frameworks is helpful.  My degree is in health policy, so in addition to the ethics framework, I’ve had exposure to the different frameworks people use to assess and analyze public health policy issues.  I would recommend training in bioethics either as one of many lenses through which you want to look at public health policy issues.  Say I want to look at health policy issues through an econometric lens, there is no reason why I shouldn’t also know about how an ethics lens might be used. I think that we all try to contribute in different ways, or imagine that the particular lens we use may bring particular pieces into sharper focus.  I would never say an ethics framework is the be-all, end-all, because I think each framework brings something else to the table.  It is likely no surprise for you to hear that I think it would be great if all MPH students or the undergrads level studying public health were exposed to ethics in their training.  I can’t think of any good reason why they shouldn’t be.

Q: Do you identify your career as that of a bioethicist, an academic and public health expert with an active interest in bioethics?
A:  It depends on where I am. Sitting here in my office, I absolutely feel like an academic, in the sense that I really enjoy teaching and conducting research and taking on all the other types of service that academics are asked to do.  I was at a meeting yesterday, the Secretary’s Advisory Committee on Human Resource Protection (SACARP), and they pull together panels of experts on topics they would like an introduction to, so they can use the in their deliberations. I was there as an expert in how one would frame ethical quality in the context of human subjects’ protection review.  So in that setting, I very much feel like I’m an expert.  But it is also a particular academic interest of mine.  I wrote an article on the topic, they think it’s a interesting topic, they do a literature search, find that I’m the author of a paper on that topic, and they invite me to speak about it.  As an academic, that’s the way I want to have a role in policy.

Q: Do you feel that bioethics as a discipline lacks input from any academic field in particular?
A: As you know, bioethics is this highly interdisciplinary field.  The American Society for Bioethics and Humanities is the largest professional society related to bioethics and as a result is very diverse in its membership. There are lawyers, doctors, ethics consultants, even fiction writers, who apply their expertise to the training of medical students – exposing them to ethical dilemmas through fiction to prepare them for the ethical dilemmas they will face as clinicians.  In thinking about what input the discipline of bioethics may be lacking, economics comes up in discussions we have here at Hopkins and in other academic settings. If you take economics to the extreme, or use an economics lens to look at issues, it completely makes sense that X, Y and Z are true, but all things considered, is that really what we wanted to have happen? Did we really want this to lead to that?  It’s not that economics has an ‘a-ethical’ or amoral view of the world, but it is a very different view. I think it would be really interesting if we could find some more economists to bring their perspectives to the table, as a sort of reality check.   It’s not that we speak in fantasies, but I think the economists would ground us in a very different way than the moral philosophers do, or the way the lawyers do.

Q: What resources would you recommend to a student interested in bioethics?
A:  I think it’s really great that bioethics is even in a student’s vocabulary. When I was an undergrad, it really wasn’t something we were exposed to, just like public health wasn’t a field we were routinely exposed to.  Anyone interested in science and humans was directed into the pre-med program.  I fell into public health when I realized I didn’t want to be a doctor, but was interested in policy, health and environments. Then through public health, I found bioethics.  I got my undergraduate degree in Human Biology (Hum Bio). The Hum Bio program had an A-side, and a B-side. The A-side was science oriented, and the B-side was social science, psychology, etc. In retrospect it was “All things you need to know for a career in public health.” I would argue it’s the same way with “this is how you orient yourself to a career in bioethics.” It is very much the case today that almost everybody in bioethics is trained in a particular discipline and comes to bioethics with that perspective.  There aren’t very many people who say “I’m a bioethicist, period.”  My area of expertise is health policy and public health, and I am also a bioethicist. If I were an undergrad today, I would follow a very similar path, because so much of bioethics is grounded in medical science, social science, sociology and psychology.  Those topics are a natural place for people with interests in bioethics to spend their time.  Moral philosophy is certainly a place to do something similar.  Anything you learn in biology, psychology, chemistry, etc and anything you learn in moral philosophy would certainly be applicable to bioethics, though in very different ways.  If you told me you were very interested in marine life, but also bioethics, I would say go study all you can about marine life, and then at some point expose yourself to bioethics through formal coursework, connecting with a professor, seminars, etc.  Then that will influence your path in marine science; there are some really interesting questions about how we interact with animals, and then how those interactions lead to how we think about humans and experiments.  If it is the case that you have this general sense that bioethics is really cool, then there is something that resonates in you because you are interested in biology, or philosophy, or something else.  I would say pursue whatever it is that you are interested in and excited by, and then expose yourself to bioethics and figure out if there is a way for you to pursue that interest in the field you chose to pursue your doctorate, whatever the field may be.

Yoram Unguru

Yoram Unguru

Q: How did your undergraduate study prepare you for a career in bioethics? When and why did you become interested in bioethics?
A: I was a history and pre-med major.  I was fortunate enough to heed the advice of my wife who recommended a philosophy course taught by a professor of philosophy and ethics (Stephen Vicchio).  I took Prof. Vicchio’s class (and many others) and was intrigued by the nature of philosophical discourse.  Along with my interest in the history of medicine and medical ethics, which when combined with my pre-med and my philosophy courses, I began to develop an appreciation for the importance and necessity of bioethics in medicine.  In fact, I became so interested in bioethics and the history of medicine that I delayed starting medical school in order to pursue a graduate degree in the field.  Very early on in the course of my studies, I came to realize that medicine and bioethics not only go hand-in-hand and are inseparable from one another, but that bioethics lies at the core of medical practice and as such is foundational to the study of medicine itself.

Q: Do you identify your career as that of a bioethicist, or a doctor with an active interest in bioethics?
A: I see myself as a clinician (i.e., physician) who “does ethics” on a daily basis.

Q: Do you feel that bioethics as a discipline lacks input from any academic field in particular?
A: Bioethics has diverse representation from a host of academic disciplines and specialties, ranging from the so-called hard sciences to the professions (medicine, nursing, etc), social sciences (history, sociology), and philosophy.  As such, for the most part, I do not feel that bioethics lacks significant representation from any given field.

Q: Would you recommend formal training in bioethics or another area to a student who wishes to pursue a career in bioethics?
A: Yes!  For the field to continue to grow and to gain legitimacy, it is incumbent that future bioethicists (whatever that means) receive formal training just as other fields of inquiry do.  Early in my career when I was deciding upon my own path in bioethics, I was lucky enough to have the counsel of Edmund Pellegrino, who graciously met with me on more than one occasion.  Dr. Pellegrino kindly, yet firmly stated that if I wanted to “do bioethics right,” then I needed bona fide training in the discipline.  Having completed that training (graduate school, medical school, and the Greenwall Fellowship) I realize how truly important Dr. Pellegrino’s words were.  To acquire the requisite skills to “do bioethics right” formal training is a must.

Q: What resources would you recommend to an undergraduate student interested in bioethics?
A: Find a mentor; join ASBH and become involved in the undergraduate affinity group; begin to crystallize areas of interest in the field and don’t be afraid to reach out to the experts; read, read, read.

Q: What resources would you recommend to a graduate student interested in bioethics?
A:  Find a mentor;  join ASBH and become involved an appropriate subgroup; seriously consider a postgraduate fellowship and begin work while still a graduate student on a bioethics topic of interest; attend local and national conferences and introduce yourself to peers as well as to more senior bioethicists (network!);  consider an internship; read, read, read.

Maria W. Merritt

maria_merritt-100x100Maria Merritt

Q: When and why did you become interested in bioethics?
A: Nobody was talking about bioethics when I was in college. I was president of my college literary society, and I invited Leon Kass, probably the most well-known bioethicist for students in my circle, to speak for our group. After that I didn’t think much about bioethics for a few years.  I was pre-med, but had the chance to study moral and political philosophy at Oxford, and that was where I started to think it would be interesting to do some work in bioethics. After I decided to do graduate study in philosophy, I asked my advisor if I should do a PhD in bioethics. He said no, that I should do my PhD in philosophy at the best program I could get into, and then do bioethics, because of the credibility that comes from a traditional discipline such as philosophy. So I got my PhD from UC Berkeley and, once again, I didn’t think of bioethics again until I met Jodi Halpern and Jeff Burack, who are now prominent bioethicists. I was interested in talking with them about my work in philosophy, which had to do with ethical character, and they were interested in that too.  We met regularly to talk, and through them I made connections. I was able to serve on a local hospital’s ethics committee as a community member, but I didn’t think bioethics would have much to offer me as a career.  When I applied for jobs in philosophy departments, I also sent in an application to the NIH post-doc program in bioethics, but didn’t think much about it. The head of the program, Ezekiel Emmanuel, called me and encouraged me to interview for the fellowship. So I did, and I was fortunate enough to be offered the NIH post-doctoral fellowship. During that fellowship I became really immersed in bioethics. Bioethics proved to be more engaging to me than philosophy without bioethics had been.

Q: Do you identify your career as that of bioethicist, or philosopher with an active interest in bioethics?
A:  I certainly identify myself as a faculty member of the Berman Institute of Bioethics. I also identify myself as a philosopher who is working on the ethics of global health research.  The word ‘bioethicist’ isn’t always that helpful to characterize a person’s professional orientation, so I tend not to refer to myself that way.

Q: Would you recommend formal training in bioethics or another area to a student who wishes to pursue a career in bioethics?
A:  These days it probably is important to have some formal training in bioethics, because the field has advanced so much in the last 25 years.  Now there really is a body of material in bioethics that is important to master if you have ambitions to have serious accomplishments in the field.  For students who are now in college or high school, I would say it is important to take some classes, if not to get a degree in bioethics, but I also think it is important to have grounding in a field of more traditional academic standing, such as law, medicine, philosophy, theology, social sciences, history,  or literature.  You need that established skill set and a set of disciplinary standards which can then inform your study of bioethics, which is essentially a multidisciplinary field.

Q: Do you feel that bioethics as a discipline lacks input from any academic field in particular?
A:  Bioethics is probably overly dominated by philosophy, medicine and law. I think the voice of public health is gaining more attention, but it should be more developed in its representation in bioethics.  I also think ethnic and gender studies perspectives have something important to say in bioethics.  Racial, ethnic, religious and cultural minorities are very underrepresented in bioethics, and that’s not healthy. Our whole society is multi-racial, multiethnic, multi-religious, and multicultural, and we need to keep up with that.

Q: What resources would you recommend to a student interested in bioethics?
A:  I would recommend that students attend the annual ASBH meeting, and meet people, go to sessions, find out what people are doing. ASBH is also a good venue to survey leading publications because the journals and book publishers have extensive exhibitions on display.  If someone is sitting at home wondering what to look at, I would suggest taking a look at the Hastings Center Report, or the Kennedy Institute of Ethics Journal. Journals are a second-best if you are just starting out; it’s really better to go out and meet people. Then you will have a better-informed idea of what to look for in the literature.

Carlton Haywood, Jr.

Haywood_rightCarlton Haywood, Jr.

Q: When and why did you become interested in bioethics?
A: I went to college at the University of Virginia as an undergraduate pre-med student.  The first-year pre-med advisor had a meeting with us to discuss different strategies for being successful in the pre-med program.  On the topic of choosing a major he told us “Look, you don’t have to major in biology, chemistry, or physics to get into medical school. Medical schools want to see students from a wide variety of backgrounds, so feel free to major in whatever interests you, whether it’s in the sciences or humanities.”  At the time I was taking a religious studies class, which I loved.  I talked to the religious studies advisor to get information on how to fulfill a major and it looked like a good fit for me, so I became a religion major.  A class that fit the requirements for both the religion major and the pre-med students was Intro to Bioethics.  That was my introduction to the field, and I loved it.  From then on, my whole perspective shifted.  The short answer to the question is that just being introduced to the field and the kinds of questions that are asked in bioethics was enough to hook my interest.

Q: Would you recommend formal training in bioethics or another area to a student who wishes to pursue a career in bioethics?
A: I think so, particularly now since there are a lot more of those formal programs available than when I was coming through.  At the time, a bioethics minor was really as far as you could go at my undergraduate institution, but institutions have worked to develop their programs so that now you can be a bioethics major at the undergraduate level.  I think that the availability of formal coursework at the undergraduate level is very important for a person interested in bioethics. If you’re not going to major or minor in it, at least take some of the courses at the undergraduate level.

Q: Do you identify your career as that of a bioethicist, or an academic with an active interest in bioethics?
A: Honestly, it depends on what day it is! Some days I see myself as a bioethicist who has interests in health services research and public health, and other days I see myself as a health services researcher with a strong interest in bioethics. On the whole, though, I think I do see myself as someone in bioethics who has a particular set of interests in public health and health services.

Q: Do you feel that bioethics as a discipline lacks input from any academic field in particular?
A: Certainly medicine and law have a place in bioethics. I would also throw in public health, which is something we excel at here at Hopkins, but other institutions may lack.  Beyond that, I think that history, political science, sociology should have a larger place in bioethics. I think there are many opportunities for people with these as their home disciplines to make important contributions to bioethics work.  I think those areas are all very useful avenues for students to consider as they pursue interests in bioethics.

Q: What resources would you recommend to a student interested in bioethics?
A: If a formal program in bioethics isn’t available at the undergraduate level at your institution, I would recommend trying to volunteer at your local hospital. All hospitals are going to have some sort of ethics committee, so you could see if you could find a way to intern or volunteer with the faculty members who are on the ethics committee and gain exposure to bioethics. Then at the graduate level, you’ve already been exposed to people doing bioethics work and it will have helped you to see what it is they do, and what you might need to study as you move forward. Look for opportunities at your local health care institutions; see if other schools in your area have bioethics programs or clubs and get involved.

Opportunities for those interested in pursuing a career related to bioethics are expanding. These are examples of the sorts of opportunities available:

1) Academic bioethics: A wide variety of career opportunities engaging in teaching and generating new scholarship on policy and ethics issues within the purview of bioethics are becoming available within academically based bioethics institutes/centers. Similar work is conducted and, career opportunities are becoming available within independent organizations such as The Hastings Center or The American Medical Association. In addition, there are both liberal/conservative bioethics think tanks such as The Center for American Progress; and The Center for Bioethics and Human Dignity.

2) Research ethics: IRB/ESCRO/IACUC staff or committee members. Career opportunities are created by the need for various committees to review research proposals and ensure the ethical conduct of scientific/biomedical research.

3) Clinical Ethics: Hospital-based clinical ethicist/consultant/Hospital ethics committees. Hospital ethics committee members are typically not paid for their service. However, some few hospitals do employ consultants to serve as clinical ethicists, hearing cases with conflicts or ethically-challenging dimensions.

4) Be Creative: The expansion of careers in bioethics is a relatively new phenomenon – don’t be afraid to be creative in encouraging the integration of bioethics into existing career paths. Some obvious examples: cell biologist-bioethicist, NICU nurse-bioethicist, historian-bioethicist, hospital administrator-bioethicist. Careers offer significant exposure to the sorts of challenging issues that define bioethics can also bring novel and useful tools and experiences that can be added to the problem-solving armamentarium.