St Mary’s University College Twickenham London
At a glance The Ethics of Biomaterials Excelling in the “How To” of Teaching Bioethics Activities in Brief The Emergence of Consciousness
Issue 8 Summer 2013 www.smuc.ac.uk
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CBETBulletin
Newsletter for the Centre for Bioethics & Emerging Technologies
sacrificing the animal after a pre-determined amount of time to study the effect. Animals need to be treated humanely if the experiments are to have any validity, but this does not mean that all ethical issues are solved. The question of the relevance of the animal model remains. Unfortunately, real tissues of the type for which replacement materials are needed are complex. Studies cannot readily use cell cultures to obtain information about interactions between living systems and materials because not all relevant cell types can necessarily be cultured together in vitro. Nonetheless, there is widespread use of cell culture, at least for initial screening of new materials, and experiments using cultures of cells such as human osteoblasts (a type of bone cell) are frequently reported in the scientific literature.
Human Subjects
The Ethics of Biomaterials
Eventually devices made of biomaterials must perform in human patients and need to be tested for this purpose. This raises critical issues, not least because placement
Prof John Nicholson
surgery is typically highly invasive and puts a strain on the body; also the device cannot be readily removed if things go wrong.
Biomaterials science can claim successes in a variety of
engineering. The latter is concerned with the fabrication
surgical fields, ranging from dental implants to
of functioning organs, such as the skin or liver, and
A further problem is that devices are expected to last for many years in service. Artificial hip and knee joints, for
replacement hip and knee joints, and also artificial heart
involves the deployment of synthetic biomaterial scaffolds
example, are expected to last at least 15 years, and
valves and intra-ocular lenses. However, like all medical
(to provide the architecture of the body part) and cells,
testing materials and devices over this kind of lifetime
technologies, the subject raises important ethical issues
together with appropriate biological growth factors and
cannot be done prior to bringing a new device to the
and these are not always recognised by researchers in
signalling molecules that will cause the cells to
market. This leads to the situation where new materials
the field. Biomaterials are materials employed in a biological
differentiate and colonise the scaffold so that the finished
and devices may have been tested extensively in vitro but
device has the desired biological function.
only briefly, if at all, in living patients. The kind of
Animals in Research
the sorry saga of the metal-on-metal hip replacement.
setting, typically to repair parts of the body damaged by disease or trauma. They may be artificial or of biological
problems that result from this approach are illustrated by
origin, and include ceramics, metals, polymers and
Animals are used in biomaterials research, as they are in
composites. The latter typically consist of a continuous
drug research, and similar issues arise in both fields.
polymer phase filled with a particulate ceramic. The subject of biomaterials science is very broad and
Hip replacement surgery uses a system comprising an artificial femoral component, the so-called pin, which
Questions that arise include “Is the animal model relevant
has a polished metal head smaller in diameter than the
to humans?” and “Is the outcome of the experiment
head of the natural femur. This part is now typically made
includes elements of cell biology and biomechanics, as
sufficiently important to justify the sacrifice the animal’s
of a titanium alloy, because titanium has been found to
well as traditional aspects of materials science.
life?” Animal studies typically involve the implantation of a
be extremely biocompatible inside the body.
Biomaterials science includes concepts from
test piece of the experimental material into a relevant
bioengineering and also from so-called tissue
tissue, such as bone or cardiovascular tissue, then
Continued page 2 >
CBET Bulletin Issue 8 Summer 2013 | 1
The Ethics of Biomaterials Continued from page 1 ... In the artificial hip joint, the polished metal head
type of metal-on-metal bearing, generally with excellent
articulates with a plastic cup made from ultra-high
results, therefore, it seemed worth exploring for use in
molecular weight polyethylene. This cup is fixed into the
orthopaedic surgery. Initial experiments, testing devices in
pelvis at the part called the acetabulum. Over time, surgical procedures have improved and
to allow proper mobility. It is not clear who is responsible for this situation, nor how it is going to end. The Regulatory Agencies have
mechanical simulators, gave really promising results.
approved the product for clinical use in the light of a
Wear was minimal, and the components of the joints
wealth of positive data from the manufacturers, and as a
also parts of the device have been modified
moved easily with each other. Studies were carried out at
result the manufacturers have proceeded in good faith to
incrementally, so that this is now a very safe procedure.
various universities, typically involving bathing the joint in
bring the product onto the market.
Millions of patients throughout the world have found relief
biological fluids, and results continued to be highly
from the pain and immobility of osteoarthritis as a result
promising. Indeed, the approach appeared to have no
of this development. However, the polyethylene cup
drawbacks.
suffers from wear. This is caused by minor scratches on
Metal-on-metal hip replacement devices have now been withdrawn by the manufacturers, and are no longer permitted for use. But the problem is not going away, as several thousand were placed before the problems
the polished metal femoral head, which result in
New Product?
became apparent. As far as ethics is concerned, the
microscopic ridges on the metal surface. These behave
A new product was then launched; a new artificial hip
case highlights a profound dilemma: How do we ensure
like blades, and scrape away at the plastic inside the
joint consisting of a metal acetabular cup, with a polished
that devices are safe enough to use without curbing all
acetabular cup, creating small polyethylene particles. In
metal receiving surface, designed to provide a wear-free
attempts at innovation? What should the role of the
rare cases, these particles can cause problems to the
metal-on-metal joint. Unfortunately the in vivo results
regulatory agencies be, and what sort of data should
patient, such as discomfort and inflammation. This may
have been terrible. People do not move in a regular and
manufacturers provide in order to demonstrate the safety
need surgery to remove the damaged tissue and to
continuous way, as modelled by the artificial hip
of their materials and devices? Anyway, how safe is
replace the biomaterial components.
simulators designed by engineers. More importantly, they
“safe”, and how safe should it be?
To address this problem, experimental designs were
do not load their hips uniformly. The unexpected results
developed in which the polyethylene cup was replaced
in real patients are that wear rates are many times
John Nicholson is Professor of Applied Science at
with a metal one. The central part of this metal device
greater than those found in in vitro experiments and,
St Mary’s University College, and Acting Head of the
was also polished to match the polish on the head of the
worse, the metal wear debris is of a size that causes
School of Sport, Health and Applied Science. He is a
femoral pin, so that the resulting joint involved the
major damage to living tissues. Bone cells are killed, the
biomaterials scientist who has published over 150 papers
articulation of one polished metal surface on another.
joint becomes painful as the adjacent bone loses its
in the field, and is a former President of the UK Society
Many different engineering technologies now use this
structural integrity, and the joints have become too weak
of Biomaterials.
Excelling in the “How To” of Teaching Bioethics Dr Trevor Stammers An innovative and multidisciplinary bioethics education
ensured the whole event ran smoothly. This year,
consortium meeting in Paris in June explored the use of
breakfast and lunch were provided on site enabling
multi-media, film and arts, as well as multidisciplinary
further networking over meals. The wondrous delights of
group teaching, outcome measures and standards of
nearby Rotunde restaurant were also sampled, but only
training, curriculum development and methodology, and
once this year!
special topics such as bioethics teaching in multicultural settings and teaching ‘compassionate resilience’. I had the opportunity to attend the Third Cambridge Consortium for Bioethics Education, facilitated annually
The morning of the first day was given over to examining virtues in medical ethics teaching. Dr Paquita de Zulueta's presentation on teaching compassionate resilience was especially interesting for UK delegates in
by Cambridge University Press and held at Reid Hall, the
the wake of the Francis Report on the Mid-Staffordshire
delightful Columbia University Centre in Paris.
hospital scandal. That afternoon in the session on new
At its heart, the consortium recognises that although
approaches to bioethics education, it was a special
as bioethicists we represent a variety of disciplines, there
delight to hear one of our MA graduates, Dr Chris
are certain truths we hold in common. First, the future of
Willmott, give a scintillating presentation on using multi-
our discipline rests on the foundation of bioethics
media in bioethics teaching and demonstrating his own
session got perhaps rather over-intensively embroiled in a
education. Secondly, ensuring the strength of this
innovation – the Biobytes website, which I will certainly
debate between US delegates about current local
foundation requires a bold exploration of where we are
be including in the list of programme resources for this
controversies in regulation and assessment, which left
now and what future directions should be pursued.
forthcoming academic year.
those outside of the US context rather bemused.
The focus of this third consortium was on "how to"
The next morning session comprised of 4 sessions
The first session of the final day of the conference
methods of teaching bioethics. Around 60 academics in
on using film and arts in bioethics teaching – a highly
bioethics education, drawn mainly from the US and
relevant issue for St Mary's as the MA programme
contained at least from my point of view, two of the most
Europe but also this year from as far afield as Australia
migrates this year to the new Arts and Humanities School
novel and interesting talks of the whole conference. Prof
and Uruguay, gathered for three days of short
here. It was during this session that I presented a short
Ken Kipnis from Hawaii University talked about teaching
presentations from over 34 speakers with discussion and
paper on Edinburgh Bioethics Film Festival: A Model for
medical and nursing ethics in a multicultural setting and used Samoan reverence for the paterfamilias as a
was on curriculum development and methodology and
debate. I greatly enjoyed last year’s conference but this
Cloning?, which explored this annual event, now in its
year I enjoyed it even more, since I knew the format and
ninth year, as a paradigm for engaging with the public in
gripping case study. Alistair Campbell, Prof of Medical
was able to renew friendships made the previous year –
bioethical debate. This was followed by sessions on
Ethics at the National University of Singapore, then gave
especially with Dr Thomasine Kushner from the
multidisciplinary group teaching and, following lunch, on
an instructive account of the practicalities of teaching
Cambridge Quarterly, whose self-effacing efficiency
outcome measures and standards of training. The latter
ethics to large groups of students in their hundreds.
2 | CBET Bulletin Issue 8 Summer 2013 Continued page 4 >
Activities in Brief European COST project Professor Geoff Hunt presented an overview of the ethical aspects of the irradiation of food at the workshop of European COST-FA0904 project, in which St Mary’s University College is a funded partner. This took place in Wädenswil, near Zurich on 21st March 2013. He also reported to the project management team on the progress of Working Group 4 (ethics and science-society
Questions programme presented by Nicky Campbell on
theology, marriage and family life, social relationships and
dialogue) of which he is the chair. The roundtable for
6th January, this time engaging in debate on the question
healthcare issues to various parishes in the Catholic
Early Stage Researchers was assisted by Dr Yasemin
of 'three parent' IVF. ‘Combined Oral Contraceptive’ for
Dioceses of Arundel and Brighton and Southwark. She
Erden.
under-age girls was the subject of an interview he gave
also recently gave a reflection on Ministry for the Sutton
for BBC Radio Humberside on 14th January.
Diocese of Southwark.
Biomedical ethics ‘Evidence Live’ conference is a unique event for learning
Around 60 academics in bioethics education, drawn mainly from the US and Europe but also this year from as
As part of the Year of Faith a question time for Chester parishes was recently convened on 19th April on
about the latest advances in evidence-based healthcare
far afield as Australia and Uruguay, gathered for three
issues ranging from the social teaching of the Church,
and finding out how they can be best applied in clinical
days at the end of June for the Third Annual Cambridge
Scripture interpretation, assisted dying, abortion, the new
practice. It brings together leading speakers in evidence-
Consortium for Bioethics Training in Paris. Dr Stammers
liturgy and sacramental questions. Dr Matthews was a
based medicine from all over the world, from the fields of
delivered a plenary presentation on Edinburgh Bioethics
member of the three team panel for the debate. In June
research, clinical practice and commissioning. Dr Trevor
Film Festival and engaging the general public in bioethics.
Dr Matthews attended a conference in Rome organised
Stammers attended this year’s event in Oxford, 25-26th
Dr Pia Matthews presented a paper in November
by the International Association of Catholic Bioethicists
March, where he presented a poster and delivered an
2012 on The Body in Christian Spirituality for an INSPIRE
and promoted by the Knights of Malta where she
oral presentation on the Edinburgh Bioethics Film Festival
event held in collaboration with St Mary’s University
presented papers on disability.
as an exemplar of public engagement with bioethics. Dr Stammers again took part in BBC1’s Big
College and Heythrop College. Dr Matthews has Continued page 4 >
continued to engage in a number of lectures on moral
The Emergence of Consciousness CBET Publications Janet Gibb The third workshop of The Society for the Study of
Dr Yasemin J. Erden’s chapter on ‘Ethics,
Artificial Intelligence and the Simulation of Behaviour
communication and safety in the use of PNFP’ has now
(AISB)* was jointly organized with the Centre for
appeared in Ecosustainable Polymer Nanomaterials for
Bioethics & Emerging Technologies (CBET) and hosted at
Food Packaging, January 2013, CRC Press.
St Mary’s University College on 9th May 2013. The theme was ‘The Emergence of Consciousness’.
Dr Erden’s paper on implants has been submitted to the
The St Mary’s day event set out to examine current
special issue of Philosophy & Technology journal.
understanding of consciousness: what is it, and is it unique to humans? Did it emerge, and if so how, when
Dr Matthew’s new book Pope John Paul II and the
and why? Is there a continuum between consciousness
'Apparently' Non-acting Person was published in April.
and non-consciousness, and is there something special about self-consciousness? The symposium consisted of
than themselves – and the likely concomitance of
four keynote presentations, two in the morning and two
'superconsciousness'. He posed the question as to
Prof Hunt and Dr Erden has been accepted for
in the afternoon. Running in between these key notes
whether or not we are working towards a race of
publication in the peer reviewed journal, Nanotechnology
were three sessions, each consisting of four short paper
electronic beings who will eventually afford us the same
Perceptions.
presentations.
ethical and moral consideration we currently give to the
The first keynote speaker addressed questions of consciousness in animals and machines. Murray
A paper on nanovaccines co-authored by Dr Stammers,
Dr Matthews has had two articles published in The
higher animals. The second pair of keynote speakers considered
Tablet and Catholic Medical Quarterly as well as one
Shanahan (Computing, Imperial College, London)
what cognitive archaeology and palaeoanthropology can
forthcoming in the Journal of Religion, Disability and
presented the concept of Global Workspace
contribute to the debate. James Steele (Archaeology,
Health. She has also had two book reviews published in
Architecture, and showed how the wiring of many animal
University College, London) presented studies on the
Faith and New Blackfriars.
brains appears to fit this structure, raising the probability
development of human physiology as compared with
that machines endowed with equivalent 'brains' would
early hominids and extant ape species, with the aim of
Geoffrey Hunt’s The Lambda Limit: The Incompletability
become conscious. Steve Torrance (Informatics,
exploring what this might tell us about the emergence of
of Science has appeared in the Journal of Biological
University of Sussex) pursued the concept of
language and, perhaps, consciousness.
Physics & Chemistry, 2012, 12, 121-128.
'superintelligent' machines that could arise as machines recursively create new machines a little more intelligent
Continued page 4 >
Continued page 4 >
CBET Bulletin Issue 8 Summer 2013 | 3
CBET resident staff Technology ethics Prof. Geoffrey Hunt CBET Director and Professorial Research Fellow Tel: +44 (0)20 8240 2311 Email: huntg@smuc.ac.uk Dr Yasemin J. Erden Lecturer in Philosophy Tel: +44 (0)20 8240 4250 Email: erdenyj@smuc.ac.uk Dr Stephen Rainey Research Fellow in Philosophy Tel: +44 (0)20 8240 4250 Email: stephen.rainey@smuc.ac.uk
Biomedicine ethics Dr Trevor Stammers Programme Director in Bioethics Tel: +44 (0)20 8240 4310 Email: stammerst@smuc.ac.uk
Additional staff Prof. David Albert Jones Visiting Professor of Bioethics Email: director@bioethics.org.uk Dr Wendy Hiscox Lecturer in Medical Law Tel: +44 (0)20 8240 4250 Email: w_hiscox@yahoo.co.uk Dr Pia Matthews Lecturer in Healthcare Ethics Tel: +44 (0)20 8240 4250 Email: pia.matthews@smuc.ac.uk Prof. Rodney Taylor Visiting Professor Tel: +44 (0)20 8240 4250 Email: taylorr@smuc.ac.uk Ms Elena Driver Visiting Research Associate Tel: +44 (0)20 8240 4250 Email: elena.driver@smuc.ac.uk Mr Matthew James CBET Administrator Tel: +44 (0)20 8240 4250 Email: jamesm@smuc.ac.uk
4 | CBET Bulletin Issue 8 Summer 2013
Emergence of Consciousness Geoffrey Hunt (Philosophy, St Mary’s University
Continued from page 3 ...
were reviewed in light of their use by subsequent
College) offered a critique of M. J. Rossano’s
research. The final session focused on social aspects of
‘Archaeology of Consciousness’, which proposes that
consciousness, including aspects of agency and
the development of hand-axe technology is evidence of
community, how self-awareness is mediated by other
developing consciousness. Dr Stammers of CBET also
minds and an evolutionary approach to morality and
contributed a paper on Locke and Consciousness at the
ethics.
joint CBET-AISB symposium at St Mary's on ‘The Emergence of Consciousness’. Researchers at all levels from MSc student to
The workshop proved to be a highly engaging and thought provoking day, providing a fertile ground for the exchange of fresh ideas and perspectives. Those who
established professor, presented papers offering
attended look forward to future collaborations like this
empirical and theoretical research, and one speculative
one with CBET and St Mary’s University College.
position paper on the role of time and ‘runningness’ in consciousness. The question of emergence was
* The Society for the Study of Artificial Intelligence and
addressed from a range of perspectives, including when
the Simulation of Behaviour (AISB) is a learned society
and why the concept of consciousness arose in
for AI, Cognitive Science and related fields. The AISB
scientific thought. Questions were raised on physicalism
has recently started to host a series of member
and substance dualism; and an alternative duality of
workshops held across the country, covering a wide
abstract versus concrete was proposed, with the
range of themes pertinent to the aims of the AISB and
intriguing concept of 'panabstractism'. Developments
designed to promote the sharing and discussion of
were presented on Dennett's intentional stance in the
current work which span various areas of interest. The
light of contextual emergence and on Davidson’s
first two workshops addressed Sensorimotor Theory
account of the role of language in rationality, as well as
and Distributed Thinking respectively (see AISB for
what enactivism has to say about Mary, bats and
further details: www.aisb.org.uk/events/members-
zombies. Some ‘relatively neglected’ writings of Locke
workshop-series).
Activities in Brief Continued ...
CBET Publications
Emerging Technologies
Continued ... Also now available is: Geoffrey Hunt, Richard D. Handy,
Dr Yasemin Erden has recently been invited to act as an
Flemming Cassee, Teresa F. Fernandes, Iseult Lynch,
Independent Expert in Ethics for the European
Markus Berges, Thomas Kuhlbusch, Maria Dusinska,
Commission review of security projects. In April she
Michael Riediker (2013), ‘Towards a Consensus View on
attended the AISB Convention in Exeter, where she co-
Understanding Nanomaterials Hazards and Managing
chaired the Symposium on ‘The Scandal of
Exposure: Knowledge Gaps and Recommendations’,
Computation’ and also presented a paper.
Materials, 2013, 6, 1090-1117 (Open Access).
Dr Erden and Prof Geoff Hunt organised a workshop on
The latest edition (18.1) of the new CBET journal, ‘The
‘The Emergence of Consciousness’, which was a joint
New Bioethics’, is now available online at
event on 9th May between the Society for the Study of
http://maneypublishing.com/index.php/journals/hrg/.
Artificial Intelligence and the Simulation of Behaviour
Dr Trevor Stammers, editor of the journal, commented,
(AISB) and CBET. See the report in this issue.
"I am very excited about the potential of this new
CBET has been joined by Visiting Research Associate,
with our new publisher, Maney." If you wish to subscribe
multidisciplinary UK bioethics journal and the partnership Ms Elena Driver, who has a background in physics and
to this new peer-reviewed publication, further details can
microfluidics.
be found on the journal’s website.
Centre for Bioethics & Emerging Technologies St Mary's University College Waldegrave Road, Strawberry Hill Twickenham TW1 4SX Tel: 020 8240 4250 Fax: 020 8240 2362 www.smuc.ac.uk/cbet