Emmanuel College Newsletter from the
Values-Based Education Program Fall 2012
Note from the Editor
in this issue
Raymond J. Devettere Professor of Philosophy and Director of Values-Based Education
Failure to Translate: Can We Improve This Problem with ValuesBased Liberal Arts and Sciences Education?...................................... 2 Faith and Science at Emmanuel....... 5 Campus Ministry: A Precious Value ............................ 6 Teaching Bioethics in a Catholic College.............................. 7 A Personal Reflection on Four Years at Emmanuel College........... 11
Contact: Raymond J. Devettere Department of Philosophy Emmanuel College 400 The Fenway Boston, MA 02115 valuesnews@emmanuel.edu
Welcome to the sixth annual edition of the Values-Based Education Newsletter. Our feature article this year is the important and thoughtful piece by our Vice President of Academic Affairs, Dr. Joyce De Leo, entitled “Failure to Translate.” She reminds us that the major value of medical research, especially the research sponsored by the federally-funded National Institutes of Health, is finding ways to help people live better lives by discovering new ways to prevent, diagnose and treat disease, disability and discomfort. Drawing on her experience as a researcher at Dartmouth Medical School, Dr. De Leo underscores the need for future scientists to begin absorbing a strong valuecentered ethical framework in their undergraduate years. In her view, the goal of publishing scientific results is not prestige, funding, tenure or promotion, but actually providing something important that will “translate” into helping people. All too often, she finds, this is not the case. For example, in some areas of research (on cancer, pain and neurodegenerative diseases), many treatments based on animal models “have been very disappointing,” yet many academic scientists continue to do them despite a history showing they do not translate well into human benefit. This suggests that some established standard experiments using and destroying animals should be challenged for ethical as well as scientific reasons. Her article highlights the importance of integrating ethics with scientific courses beginning at the undergraduate level. This, of course, is one aspect of what we try to do in our science courses at Emmanuel. Another article of importance is “Faith and Science,” a balanced approach to the ongoing faith and reason, science and religion debate. This article was written by Jon Paul Sydnor, Ph.D., Assistant Professor of Theology and Religious Studies. Universities established in the Catholic Intellectual Tradition have almost always welcomed science—Newtonian physics, evolution, relativity, quantum physics, genetics, neuroscience and so forth—as showing us important ways to understand creation. Also in this issue, Reverend John P. Spencer, S.J., our College Chaplain, and Samantha Ford, a member of the Class of 2012, share their thoughts about Emmanuel and its mission from two perspectives. Finally the issue contains a reflection on the unique and important role of bioethics courses at a Catholic college. Enjoy!
Ray Devettere
Failure to Translate: Can We Improve This Problem with Values-Based Liberal Arts and Sciences Education? Joyce A. De Leo, Vice President of Academic Affairs and Professor of Biology
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he U.S. government through funding agencies such as the National Institutes of Health (NIH) invests nearly $32 billion annually in medical research for the American people. More than 80% of the NIH’s funding is awarded through about 50,000 competitive grants to more than 325,000 scientists at over 3,000 universities, medical schools, and other research institutions in every state across America and around the world.1 The NIH’s mission is to seek fundamental knowledge about the nature and behavior of living systems and the application of that knowledge to enhance health, lengthen life, and reduce the burdens of illness and disability. To realize these goals, the NIH provides funding opportunities designed to improve the health of the nation by conducting and supporting research in the causes, diagnosis, prevention, and cure of human diseases.
. . . an undergraduate, liberal arts and sciences institution of higher education, such as Emmanuel College, should provide the scientific rigor and a strong ethical framework to educate future health care professionals and scientists. Translational research is medical research that facilitates the practical application of scientific discoveries into the development and implementation of new ways to prevent, diagnose, and treat disease. When we consider the enormous financial investment over many years, the translation of our scientific discoveries into new therapies to improve human
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health has been very disappointing. A first reaction is that scientists require more funding to conduct cutting-edge basic and translational research. This may be a naive solution, and alone may not produce the much-needed outcome of translating basic medical research into clinical practice to improve the health and well-being of our society and the world. The current pipeline for new drugs for the treatment and prevention of diseases is dismal. Research and development (R&D) budgets across large pharmaceutical companies and smaller biotechnology firms are shrinking with mergers, consolidations and significant down-sizing of the biopharmaceutical workforce. Does the onus for improved clinical translation lie within the scientific community—specifically scientists and physicians? If so, can we improve the educational process for these highly trained experts even before graduate and professional school? For example, I posit that an undergraduate, liberal arts and sciences institution of higher education, such as Emmanuel College, should provide the scientific rigor and a strong ethical framework to educate future health care professionals and scientists.
Role of Scientists To enhance the translation of basic science knowledge to patient care and improved quality of life, our nation’s scientists must conduct research with significant scientific rigor, cautious interpretation of data, and critical assessment of available animal models of disease. Scientists are rewarded and promoted by simple quantifiable metrics at most academic institutions: the number of papers published,
number of grants, and amount of indirect costs brought into the institution (an indirect cost or overhead is the additional percentage above the actual costs to do the research that is often a major part of operating budgets for institutions). Although high-quality research is conducted and disseminated to the scientific community, the current system for academic promotion can also lead to scientists publishing more articles containing only modest confirmatory data with little scientific impact. The founding of open access journals has provided the venue to publish any data with sometimes inadequate peer review. For example, Baishideng Publishing Group (BPG) has recently launched 37 openaccess, online medical journals. Their rationale is “to break the monopoly of few commercial publishers over the pricing of academic journals to defend the public’s right of free access to medical knowledge.” Unfortunately, this noble goal also produces thousands of publications without adequate peer-review. In addition, it has become a feat to read and assimilate all of the articles published in one’s own area and, to enhance discovery, it is most important to read beyond one’s own narrow field. Due to the sheer increased volume of published research, the quality and overall impact of scientific findings has diminished. The pressures to publish high-impact findings sometimes drive scientists to overstate their conclusions. Some results can achieve statistical significance due to low variation, but an impact on biological significance is often missing. Conversely, scientists often report on “trends” that
Emmanuel College – Newsletter from the ValueS-Based Education Program
do not reach statistical significance. The desire to assign clinical relevance to results sometimes overlooks the robustness of the data and limitations of the experimental approach and animal models. This is particularly evident in studies based solely on tissue or cell culture methods. The rigor of teaching the scientific method to design experiments to disprove one’s hypothesis should be encouraged and embraced in training programs and laboratories. Scientists have instead learned to “sell” their findings both in person and in press to increase funding opportunities and ensure interest in their area. This sales pitch sometimes misleads both the investigator and their audience, driving science in unfruitful directions. For many decades, scientists have used animal models as experimental surrogates for human disease. Their use has been a mainstay in most areas of biomedical research. However, in many areas of research including cancer, pain, and many neurodegenerative diseases, predictions of treatment based on animal models have been very disappointing. With increasing pressures of funding and publishing, it takes courage and integrity for scientists in any given field to question the use of established animal models for ethical and scientific reasons. Cancer researchers routinely utilize xenograft, immune-compromised tumor mouse models that do not possess an intact immune system. It is therefore not surprising that results obtained using these mouse models markedly differ from outcomes in patients with cancer. In a teaching environment that encourages discussion and introspection, such as is present at Emmanuel, I have witnessed our students challenge the standards of biomedical research. This is a major benefit of a liberal arts education with small classes that embraces questioning and critical thinking.
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Role of Pharmaceutical Companies Pharmaceutical companies and biotechnology firms have always been the backbone for developing drugs for human use. These companies drive the translation of basic discovery to clinical trials and drug production. Without industrial partnership for financial backing, drug formulation, and clinical trial expertise, it is very difficult to move a chemical or biological entity into the clinic. The pharmaceutical giant, Pfizer reduced its R&D budget by almost $2 billion in 2011. Many other pharmaceutical companies including Roche,
In a teaching environment that encourages discussion and introspection . . . I have witnessed our students challenge the standards of biomedical research. This is a major benefit of a liberal arts education with small classes that embraces questioning and critical thinking. AstraZeneca, Wyeth and GSK have also eliminated programs and significantly cut their R&D budgets. It is uncertain how these cutbacks will affect drug development but it seems very likely that this will decrease the drug pipeline and therefore possible therapies going to the clinical market. Many pharmaceutical companies are looking to outsource or partner with academia and contract research organizations to decrease costs and tap into a potential source of new targets or therapies. It has become too cost prohibitive for many drug companies to invest billions in novel target development with poor translation. Similar to scientists in academia, the scientists in pharmaceutical companies and smaller biotechnology
firms have sometimes overstated or misrepresented clinical trial findings to maintain public and financial interests. “Spin” and incomplete data reporting are unfortunately, too common in press releases and marketing. The absence of complete data information misleads successes and failures and hinders future experimental directions by all scientists. Failed expertly designed clinical trials are very often not published. Not broadly disseminating these results can lead to ill-conceived basic science investigations as well as other drug companies pursuing similar targets without an adequate knowledge base. Pharmaceutical and biotechnology firms, including small start-up companies have the capability of contributing to effective translation through innovation in study design. For example, a recent publication provides compelling data in support of enriched enrollment trial design for establishing proof of concept in neuropathic pain.2 Enriched enrollment trial designs aim to increase the number of positive responders in a clinical trial population by testing the intervention (e.g., a drug) in a subset of a population. There are many ways of doing this but one is titrating the dose until an effect is observed and another is to enroll patients in a large placebo controlled doubleblinded trial only after they have responded positively to the drug in an unblinded small trial. These novel trial designs appear sensitive and efficient for assessing novel therapies and could become templates for all clinical drug trials. Innovative enriched trial designs do challenge the norm but disruptive innovation is critical to improve the translation of scientific discoveries.
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Failure to Translate (continued) Role of Physicians and Health Care Professionals We have thousands of drug and non-drug treatments for numerous diseases and syndromes in clinical practice today. Unfortunately, we are not always certain of the efficacy
. . . engage more clinicians/ physicians to be key players with basic scientists and industry partners to help translate our discoveries to benefit human health. and benefit in individuals and across populations. The degree of effectiveness is often based on relatively small patient populations and/or only anecdotal observations. This significantly impacts understanding the needs of clinical care since practice variation is so great. For example, in pain management, many physicians have practice norms based on their patients and/or institutional practices. There are few universal algorithms for the treatment of acute or chronic pain. To inform scientists and fund necessary research, a clear unmet clinical need requires effective articulation and justification. Evidencedbased medicine aims to apply the best available evidence using the scientific method to inform clinical decision making. Evidence quality can range from large meta-analyses and systematic reviews of double-blind, placebo-controlled clinical trials to conventional wisdom. These carefully designed studies and results should be published and widely available on free access websites for the research community to easily obtain. NIH and other agencies need to consider funding these trials that may not meet the critieria of novel target identification
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but rather re-assess current practices without clear outcomes. The goal is to engage more clinicians/physicians to be key players with basic scientists and industry partners to help translate our discoveries to benefit human health. For scientists, increased scrutiny of one’s own data and approaches, the animal models used, and the conclusions drawn may lead to more cautious spending and higher success in moving scientific discoveries into the clinic. Academic promotion committees have begun to expand the metrics for achievement, stressing team science and impact. This approach will undoubtedly decrease the plethora of incremental, modest reports of findings. As more pharmaceutical companies partner with academic scientists, the incentives for both parties will need to equilibrate. And finally, physicians and all health-care providers should engage in rigorous evidencebased medicine at all levels. This will clarify and direct the compelling questions that need to be answered.
Role of Values-based Liberal Arts and Sciences Education Unfortunately, values-based education and training in ethics that shape a science career are often not present or underrepresented in graduate education. Biomedical ethics courses are now a requirement in many medical and graduate schools to fulfill government mandates for institutions that receive U.S. funding for student training. However, these courses are usually perceived by students as a minor requirement to check-off without any focus on life-long learning or engagement in these areas. Ethics across the full curriculum is rarely the norm in graduate education. I posit that obtaining strong ethical and critical
thinking skills should start much earlier in the educational experience. We are very fortunate at Emmanuel College that our community embraces a values-based educational model. Our mission is to educate students in a dynamic learning community rooted in the liberal arts and sciences and shaped by strong ethical values. Our core curriculum is based on achieving competency in five domains of knowledge: aesthetic inquiry, historical consciousness, social analysis, scientific inquiry and quantitative analysis and religious thought and moral reasoning. The integration of these domains into a science education will build leaders that embody the true scientific method into daily practice. Emmanuel College can become the beacon to educate students in ethical leadership. As the Vice President of Academic Affairs, I would like our graduates to challenge the status quo,
. . . obtaining strong ethical and critical thinking skills should start much earlier in the educational experience. review data analytically without any bias or preconceptions and seek the truth at all costs. In this economically volatile environment, it is timely that we consider the reasons and possible solutions to better translate our scientific discoveries into improved patient care and treatment. The burden to affect change rests not only on the scientific community. As we look to the future and continuous improvement, the unrealized opportunity may be in the education of our undergraduate students in environments that foster critical, ethical thinking. The goal of moving from memorizing facts and pathways to rigorous experimental
Emmanuel College – Newsletter from the ValueS-Based Education Program
Faith and Science at Emmanuel design, moral and ethical interpretation of scientific data and understanding the challenges of true scientific discovery may lead to a new generation of contemplative scientists in action.
References The National Institutes of Health website: NIH at a glance http:// www.nih.gov/about/index.html 2 Hewitt DJ, Ho TW, Galer B, Backonja M, Markovitz P, Gammaitoni A, Michelson D, Bolognese J, Alon A, Rosenberg E, Herman G, Wang H. Impact of responder definition on the enriched enrollment randomized withdrawal trial design for establishing proof of concept in neuropathic pain. Pain 152: 512–521, 2011. 1
Jon Paul Sydnor, Assistant Professor of Religious Studies
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mmanuel College is, as we all know, an educational outreach of the Sisters of Notre Dame de Namur, a Roman Catholic religious community. The Christian faith is central to its mission and identity. The ethical values we profess, the justice issues we embrace, and the academic challenges we welcome are all cherished aspects of the Catholic intellectual tradition.
Due to our Catholic identity and our scientific aspirations, we can become a sponsor of the dialogue between faith and science. Emmanuel College is also situated in one of the premier biological research centers in the world, the Longwood Medical Area (LMA). The LMA is home to Harvard Medical School, Massachusetts College of Pharmacy and Health Sciences, Beth Israel Deaconess Medical Center, Children’s Hospital Boston, Brigham and Women’s Hospital, Dana Farber Cancer Institute, Joslin Diabetes Center, Merck Research Laboratories, and of course Emmanuel College. Our location is a gift. Our faculty and students access and utilize the vast medical research capabilities of our neighbors. Indeed, with the completion of the state-of-the-art Maureen Murphy Wilkens Science Center, the hiring of new faculty with expertise in science, and the Merck Partnership, Emmanuel has entered the company of advanced biological research institutes. While our Catholic identity has not changed, our identity as a college with an extensive commitment to science has increased considerably, to the great benefit of the College.
Emmanuel’s simultaneous embrace of the Catholic tradition with an emphasis on science presents us with a tremendous opportunity. Due to our Catholic identity and our scientific aspirations, we can become a sponsor of the dialogue between faith and science. There is no better home for this dialogue than an educational institution. Most of the current faith and science discussion takes place in the popular media. Unfortunately, that conversation is dominated by fundamentalists on both sides of the issue. That is, it tends to be dominated by fundamentalist Christians who have no interest in scientific discoveries that challenge their traditional beliefs, and fundamentalist scientists who believe that all faith is harmful superstition from which no benefit derives. Neither camp is truly interested in dialogue, neither ascribes any potential truth value to the other, neither recognizes any ambiguity in its own position, both seem strident and angry, and both camps dream of a world in which everyone else is just like them—either all Christian or all scientific. Certainly, Emmanuel can do better than that. More importantly, as a Catholic college that is pursuing scientific teaching and research, we must do better than that. We must have a faith and science dialogue that is open-minded, open-ended, rational, civil, respectful, and, whenever possible, empirical. Only such conversations have a rightful place on a college campus. In a culture in which so much popular conversation is characterized by dogma and incivility, institutions of higher education must witness to the power of reason. continued on page 6
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Faith and Science at Emmanuel (continued)
Campus Ministry: A Precious Value
The outcome of this conversation will not be a universally accepted conclusion. Religious participants— scientists or not—will not all become atheists. Nor will atheists— scientists or not—convert en masse to religious faith. But conversion is not the proper goal for either side of the discussion. We will never achieve mutual agreement, but we can achieve mutual understanding, which may be the most helpful goal for all dialogue. Another goal should be the expression of our cherished intellectual virtues. As academics we should seek challenge by those with whom we disagree, respect the plausibility of other worldviews, correct inconsistencies in our own position, acknowledge evidence that confounds our assumptions, suspend long-held notions to imagine other possibilities, risk our own interpretations in the hope of better understanding, recognize the ambiguity inherent in all complex human thought, and resist the desire for a conclusive answer to the profound questions at hand. All the while we must respect our conversation partners even as we discuss emotion-laden topics. To discuss faith and science while expressing these intellectual virtues—that would be a worthwhile accomplishment. And it would be good for us, good for Emmanuel, and good for society at large. These virtues are rarely valued or expressed in our popular media, but they are essential to any truth-seeking discourse. As Emmanuel reflects on its identity as a Catholic institution of the liberal arts and sciences may we exemplify rationality to a world always in need of a little more enlightenment.
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Reverend John P. Spencer S.J., College Chaplain mmanuel College sees Campus Ministry as a “vibrant presence that lies at the soul of Emmanuel’s mission.” Campus Ministry not only “promotes a living community spirit on campus but also celebrates the unfailing belief of the Sisters of Notre Dame de Namur in the goodness of God made manifest in all God’s people.” Ideally, Emmanuel is an institution where the liberal arts and sciences inform all areas of learning and reciprocally enrich the understanding of the Christian Gospel message of love and compassion. Campus Ministry is an integral part of this endeavor offering students, faculty, and staff, alumni and families opportunities to probe the spiritual aspects of their lives and to ponder the fundamental questions of life. To this end the Campus Ministry Office sponsors days apart for prayer and meditation, spiritual direction, reflection groups focused on the volunteer experience of the students, staff and faculty, liturgical services, interfaith prayer services, sacramental opportunities and retreats. All are welcome regardless of religious affiliation. Affirming the Catholic Intellectual Tradition and fostering the charism of the Notre Dame foundress, Saint Julie Billiart, Campus Ministry continues to create a faith-centered community whereby all segments of Emmanuel College regard one another and the larger community as images of God’s goodness. Contemporary literature on the faith development of young high school and early adult college students notes that many students have withdrawn from the traditional ritual practices of their faith. This phenomenon cuts across all religious denominations. Volunteerism
and social justice involvement have replaced participation in the age old traditional religious practices. Many students feel that the churches simply do not speak to their experience. The Catholic Intellectual Tradition tells us, though, that the individual’s spiritual, intellectual, emotional, physical, cultural and psychological growth is of utmost concern to the Church. The challenge for Campus Ministry today therefore is to engage the student in an ongoing dialogue of faith and culture in the context of their developing selves. And certainly faculty and staff are involved in this
Campus Ministry is an integral part of this endeavor offering students, faculty, and staff, alumni and families opportunities to probe the spiritual aspects of their lives and to ponder the fundamental questions of life. challenge as well. Given the diverse background of faculty, staff and students here at Emmanuel there is a striking opportunity for just such an ongoing dialogue to emerge. It will involve an added personal commitment, apart from the purely academic, but one that will enrich the individuals involved. Ideally, Campus Ministry will collaborate with other college divisions, The Center for Mission and Spirituality, for example, in facilitating this dialogue, a dialogue that integrates the Notre Dame charism, the idea of a catholic college, and the context in which the institution sees itself. To be men and women of Notre Dame de Namur is to be thoroughly engaged in “the greatest work” of ongoing education, an education that
Emmanuel College – Newsletter from the ValueS-Based Education Program
Teaching Bioethics in a Catholic College Raymond Devettere, Professor of Philosophy and Director of Values-Based Education ideally transforms students into critical thinkers and ethical decision makers as Emmanuel College marshalls her unique resources in a unified effort to unfold and renew the Catholic Intellectual Tradition, the gospel’s call for social justice, and the dynamism of Saint Julie’s vision: “Qu’il est bon, le bon Dieu (How good is the good God).”
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ioethics is now a major academic field with its own books, journals, conferences, courses, graduate degrees (including doctorates), programs and professors. Courses in bioethics now exist in almost all colleges and universities, schools of nursing, medical schools and many law schools. A number of factors stimulated the emergence of this new academic field in the 1970s. First, in the 1960s abusive and deceptive medical and psychological research using human beings without their consent became public and led to calls for an emphasis on ethics in these fields. Congress responded by establish-
. . . the appearance of new life-prolonging treatments and technologies created new dilemmas . . . ing the National Commission for the Protection of Human Subjects (1974–1978) and directed it to identify the basic ethical principles that should govern clinical and behavioral research on human beings. The Commission’s reports, and the ethical principles it identified, still provide the basis in the United States for determining what is moral and legal in medical, psychological and social research using human beings. Second, the appearance of new life-prolonging treatments and technologies (for example, cardiopulmonary resuscitation, kidney dialysis, respirators and ventilators, organ transplantation and feeding tubes) at this time created new dilemmas: when is it right to withhold or withdraw interventions that are keeping
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people alive? Is the withdrawal of treatment needed to support a patient’s life a form of euthanasia? Third, bitter arguments over birth control and abortion arose about this time. These debates led to three Supreme Court decisions decriminalizing contraception for everyone, even minors. And these debates also led to the 1973 Roe v. Wade decision decriminalizing most abortions. Fourth, new developments in reproductive technology exploded in 1978 after the first baby conceived in a laboratory by in vitro fertilization (IVF) was born in England. This opened the door to a host of questions about human embryos. What is the moral status of a human embryo living in a laboratory the first few days of its life? Is it right to reproduce another human being this way? Is it right to freeze human embryos? Is it right to discard unwanted IVF embryos? Is it right to use them for research? Is it right to transfer embryos to a woman who is not the genetic mother? Is it right to screen embryos in a laboratory for genetic mutations or gender before transfer to the woman who will give birth? Fifth, the widespread movements about “rights” (e.g., civil rights, reproductive rights, women’s rights, and so forth) in the 1960s led to an appreciation of patient’s rights, especially the rights of patients and families to refuse life-sustaining treatments that physicians and hospitals wanted to employ to save the lives of their patients. Patient and family self-determination, often advanced as “autonomy,” began pushing the more traditional “medical paternalism” aside. This meant, continued on page 8
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Teaching Bioethics in a Catholic College (continued) of course, that patients and families were much more involved in decision making about employing, withholding, and withdrawing treatments and technology that preserve life or create new human beings. Sixth, it soon became apparent that most philosophical ethics of the mid-twentieth century was of little help determining what was ethical or unethical for people facing these new bioethical issues. Most philosophers in the English-speaking world were focusing either on normative moral theories, or on the analysis of ethical concepts and language, or on our sentiments or feelings about what was right or wrong. Anglophone philosophers had long since abandoned the ancient idea that philosophy was a way of life, a way of figuring out what behavior and communities will best help us live meaningful and worthwhile lives. The theoretical, analytical, and emotive approaches of twentieth century moral philosophy provided little or no practical help in resolving the explosive new issues emerging from the rapid developments in medicine and in research using human beings. In response, the creative multidisciplinary practical approach known as bioethics moved into the vacuum left by modern philosophy. The bioethics movement involved physicians, nurses, scientists, attorneys, pastorally minded theologians as well as some philosophers with an interest in “applied ethics.” Bioethics, at least in the United States, left questions of theory, conceptual analysis, and sentiments aside to focus on some core action-guiding moral principles just as the National Commission had suggested in 1978. It was thought that this principle-based approach could guide everyone’s actions regardless of the person’s commitment to a religious tradition or to a philo8
sophical theory. More recently other approaches have enriched the field of bioethics. Some have suggested that action-guiding principles are not enough and advocate a characterbased practical wisdom known as virtue ethics. Still others, especially Catholic moral theologians, advocate a religious foundation for the dignity of each person and advance a natural moral law approach to bioethical dilemmas. Emmanuel has been presenting bioethics to our students in a number of different ways for decades with courses in medical ethics or in health care ethics. For the past five years it has offered a team taught course (a biologist and a philosopher) on cur-
. . . the creative multidisciplinary practical approach known as bioethics moved into the vacuum left by modern philosophy. rent issues in biology, and in 2012– 2013 two of the capstone courses for seniors majoring in biology will be team taught by a biologist and a philosopher. The hope is that soon all senior capstone biology courses will be team taught by a scientist and an ethicist. In addition, various courses on ethics and moral issues in both the philosophy and theology departments cover topics such as euthanasia and physician-assisted suicide, abortion, reproductive interventions such as IVF, embryonic stem cell research, withdrawal of life-sustaining interventions, research using human beings, treatment of animals, genetic screening and testing, and so forth. Bioethics courses in a Catholic college will, of course, present the typical material found in any college bioethics course. Students taking these courses will learn about the
various major normative frameworks bioethicists rely on to make moral judgments about what is right or wrong, about new issues in medical and behavioral research using human beings, and about the major precedent-setting court cases that have shaped our thinking. In addition, students will learn about the work of the National Institutes of Health and various government commissions to present the ethical side of the medical and scientific advances, and about the sources available in print and online that deal with bioethics. Some primary examples of important sources of bioethics developments in the United States include the official website of the U.S. Department of Health and Human Services at bioethics.gov. This is the site for the Presidential Commission for the Study of Bioethical Issues (PCSBI) created by President Obama in November 2009. The PCSBI holds regular public meetings on various bioethical topics. Videos and written transcripts of the meetings, as well as reports issued by the Commission, are available online, as are background materials. The site also has links to the publications of former Bioethics Commissions dating back to the 1974–1978 National Commission mentioned earlier. Those interested in a Catholic voice in public discussion of bioethical issues will be pleased to note that one current member of the Presidential Commission is Daniel Sulmasy, a physician with a Ph.D in philosophy who is also a Franciscan friar. The National Institutes of Health also has a site (bioethics.od.nih.gov) with links to many bioethics resources on the web that offer professionals and the general public easy access to key documents and references in the field. Helpful materials are also
Emmanuel College – Newsletter from the ValueS-Based Education Program
available from the Hastings Center (thehastingscenter.org), founded in 1969 as the first research center devoted to bioethics. The Kennedy Institute of Ethics at kennedyinstitute.georgetown.edu is another good source of links to important material in bioethics. The American Medical Association provides an online journal of ethics called the Virtual Mentor [virtualmentor.ama-assn. org] which publishes a collection of articles on a different topic of ethical relevance every month. In addition to the typical material in any college course on bioethics we expect bioethics courses in Catholic colleges to do something more, something that reflects the mission of these colleges and the Catholic intellectual tradition in higher education. Bioethics courses in Catholic colleges provide some unique opportunities to present what many standard bioethics courses often omit. Among these opportunities are the following. • Bioethics courses in Catholic higher education can be expected to serve as a reminder that voices echoing religious and theological traditions belong in the public square when bioethical issues are being debated. Most of us do not want to live in a theocracy but neither do most of us want to live in a totally secular realm of bioethical law and practice. No voices, be they the voices of theology or the voices of secularism, should be marginalized if we are to have healthy debate in a pluralistic democratic society. We enrich public debate when voices from various viewpoints are part of the conversation. Diversity in public discussion in pluralistic democracies is an asset, not a liability.
• Bioethics courses in Catholic colleges can be expected to produce a cadre of people with an awareness of the Catholic moral tradition in health care and biology. This tradition is largely based on the “natural Fall 2012
moral law” first developed 2000 years ago by Roman jurists and Stoic philosophers, and then absorbed into early Christian theology. A key feature of this approach is its appeal to human reason. The natural law approach in morality is based on the premise that thoughtful people can arrive at objective moral truths by the power of natural reason. Hence, the moral law is, in a metaphorical sense, written in the human heart. One advantage of the natural law approach in Christian theology, when it is correctly understood, is that it provides a common ground for everyone, believer and non-believer alike, to discuss the issues.
No voices, be they the voices of theology or the voices of secularism, should be marginalized if we are to have healthy debate in a pluralistic democratic society. • Bioethics courses in Catholic colleges can also be expected to provide the opportunity for students to become aware of official Catholic teachings on bioethical ethics. Students will learn the Magisterium’s position on contraception, abortion, IVF, cloning, embryonic stem cell research, genetic engineering, euthanasia, physician-assisted suicide, palliative care, access to health care for all, the preferential option for the poor, and when a new human life should be considered equivalent to a person. Bioethics courses thus provide the opportunity to explain how church leaders believe that the natural moral law supports these positions.
• Bioethics courses in Catholic colleges can also be expected to explain something of the history of medical ethics in religious traditions, especially the Catholic tradition. Among the first people to wrestle with health care issues were thinkers in religious traditions. Even the famous writings of Hippocrates, who died in the fourth century BCE, came out of the Pythagorean tradition which was a quasi religious community. The Jewish, Christian, and Islamic religious traditions showed great concern for sick and suffering human beings, and their theologians delved deeply into questions at the edges of life. Reminders of their work exist in secular bioethics today. Some bioethicists, for example, still refer to the principle of the double effect or the distinction between ordinary treatment to preserve life, which one has a moral duty to accept, and extraordinary treatment, which one may morally opt to decline. These distinctions were first developed centuries ago by Catholic philosophers and theologians wrestling with bioethical issues. • Bioethics courses in Catholic colleges will also provide students with print and online resources for becoming acquainted with the resources explaining the Catholic traditions in bioethics. Online resources presenting the Catholic tradition include the Pontifical Academy for Life at academiavita.org/index, the National Catholic Bioethics Center at ncbccenter.org, the United States Conference of Catholic Bishops at usccb. org/issues-and-action/human-
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Teaching Bioethics in a Catholic College (continued) life-and-dignity (the fifth and latest edition of the Ethical and Religious Directives for Catholic Health Care Services is available on this site), and the Canadian Catholic Bioethics Institute at ccbi-utoronto.ca. A notable new book explaining the Magisterium’s positions is Catholic Bioethics for a New Millennium (Cambridge University Press, 2012) by Anthony Fisher, a member of the Pontifical Academy for Life, who earned a doctorate in bioethics at Oxford University and now serves as the bishop of a diocese in Australia. Perhaps the most unappreciated feature of bioethics courses in a Catholic college is the opportunity to explain how Catholic moral positions, especially at the edges of life, often show historical development. For example, the original position of the Catholic community was pacifist. Early Christians followed the teaching of Jesus to turn the other cheek and not to resist violent attacks with violence. In the fourth century, after Christianity became the official religion of the Roman empire, Saint Augustine advanced a new moral position. He restricted the traditional morality of pacifism: if one was personally attacked he should turn the other cheek as Jesus taught but, he argued, the Roman empire could take human life in some situations, most notably warfare defending the empire. To arrive at this position Augustine had to look outside the pacifist Christian moral tradition and adapt the just war theory of Cicero (d. 43 BCE ) Augustine’s approach was at first radical but the just war theory soon became a standard feature of Christian morality that continues to this day.
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Then, in the thirteenth century. Saint Thomas Aquinas advanced another novel moral position: he rejected the traditional Christian personal pacifism and taught that even an individual person could choose to use lethal force against his attacker if it was necessary to save his own life. Aquinas argued that some actions have two effects, one good and one bad. It is bad to kill another person but it is good to save my life. Soon Aquinas’ revolutionary teaching about killing in personal self-defense became a standard Christian moral teaching. What this example shows is the possibility of development in the Catholic moral tradition, even about ethics at the edges of life. This is something educated people should know. Another example of development in moral thinking is the debate over when a human fetus becomes equivalent to a person. The ancient position in the Hebrew Bible indicates a new person begins when a baby takes its first breath but the ancient philosophical position going back to Aristotle indicated a new person begins earlier, when a rational soul begins animating a fetus at some time weeks into the pregnancy. Christians actually adopted the secular position of Aristotle until the nineteenth century when reproductive science established that mammals, including humans, reproduce by fertilized eggs rather than by seeds. Only then did official Catholic teaching begin to consider fertilization and not ensoulment weeks into the pregnancy as the beginning of a being equivalent to a person. The field of bioethics will only expand in the future as morally sensitive people explore the moral implications of new breakthroughs in areas such as neuroscience, the personal genome project, synthetic biology, ge-
netic manipulation, the push to legalize physician-assisted suicide in more states, and the need for developed countries to provide basic health care for all its people as a matter of the common good. Bioethics courses in Catholic higher education thus provide the foundation for lifetime learning in an important and new field of study and provide an opportunity for learning about the long history of concern for ethics at the edges of life in the Catholic intellectual and moral tradition. There is also a personal dimension when we teach courses in health care ethics. Most of us will face moral questions about medical and biological issues in our personal lives as we make decisions for ourselves and our family members. And some of our students will face additional moral questions as they develop careers in health care or the life sciences. Bioethical decisions can be morally difficult—it is easy, for example to feel guilty about not “doing everything” to keep someone alive, yet “doing everything” can be so wrong. Hence it is the hope of those of us who teach bioethics that what we do might provide some personal benefit in the lives of our students by actually helping them become better ethical decision makers when they are faced with bioethical dilemmas in their personal lives and professional careers.
Emmanuel College – Newsletter from the ValueS-Based Education Program
A Personal Reflection on Four Years at Emmanuel College Samantha Ford, Class of 2012
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sat alone at the center of an empty stage. I looked out to the audience. Dozens of faces stared back, waiting for me. I felt a bead of sweat run down my neck. My curls, colored red for the part, hung in my face. I brushed them aside, and I sang. It was my first production with the Emmanuel College Theater Guild. Before that, I was always the athlete. In high school scoring a winning basket, diving for a volley ball, or jumping over hurdles on the track was what I did. I was used to people watching me perform but singing alone in front of an expectant crowd is a whole different beast. It was a first for me. Through my time at Emmanuel I had grown comfortable with myself and learned to try new things. After a year with the women’s basketball team, I traded in my comfortable sneakers and set out in new directions. If you asked me four years ago where I would be now, I never would have imagined that I would have become an orientation leader or a member of student government, or that I would be able to explain what it is like to study in a foreign country where I did not speak the language, or become a world traveler, a theater geek or a new writer. I discovered things about myself that I never knew, and for that I thank each person I met at Emmanuel. In the classroom I developed a passion for learning that did not exist in high school. Professors like Dr. Falvey, Dr. McGuire, and Dr. Craig sparked a new interest for me in language and analysis. They inspired me to engage not only with class material but with everything happening around me. The thirst for knowledge
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and the desire to participate in the world we live in will stick with me for the rest of my life. I think the most important value I learned in my four years at Emmanuel is friendship. Branching out and trying new things led me to people whom I never would have otherwise known. I plan to stay close to my group of Emmanuel friends for my whole life. I have come to believe what Dr. Rissmeyer, the Vice President for Student Affairs, told us when we first arrived: Emmanuel is a unique community, with unique opportunities. It truly is, and this unique atmosphere is what I will miss the most. And yet I almost did miss it. Early in my freshman year I had decided to transfer but then I changed my mind and stayed. I now realize that staying at Emmanuel was the best decision I could have made. Here I discovered new talents, improved existing ones, and made some of the best friends I will forever keep. There are so many valuable things I learned at Emmanuel that I cannot capture them with words. Emmanuel is the place where I grew into a woman that will make my parents proud. It is the place I consider my second home. Emmanuel showed me how to be the person I want to be. No wonder Emmanuel holds a very special place in my heart. I think of it as my place, the place where I truly found myself.
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