The event began with a more-or-less formal discussion of Dworkin's forthcoming book, Limits: The Role of the Law in Bioethical Decision Making, due from IU Press next fall. The book's thesis is that the primary contribution of the law in this area is to provide procedures and processes for resolving controversy.
Dworkin postulates a hierarchy of legal responses to bioethical challenges, from "Do nothing" through less intrusive interventions (e.g., administrative response, noncriminal legislation and criminal law) to the "big gun" -- the U. S. Constitution. Failure to tailor the response to the problem, he argues, is costly.
In successive chapters, the book specifically addresses legal response to issues such as abortion, sterilization, assisted reproduction, genetics, death and dying amd research funding. In each case, Dworkin analyzes legal responses that have or have not "worked well" -- i.e., have managed to mediate between "right and right," to sacrifice competing goods to the most limited degree possible and to produce results that all parties can accept.
The lively discussion began immediately after a brief presentation by the honoree and continued after dinner.
The Poynter Center will go global this spring, as Dworkin will spend the spring and early summer teaching in London and Kiel. Although he deserves a break after his year in the director's chair here, we are hard at work on devising trans-Atlantic computer links, ensuring his continued active role in our Human Genome project.
During his tenure as Center Acting Director, Roger more than fulfilled his self-imposed paramount goal: "Keeping the Center from collapsing during Smith's absence." Our heartiest thanks to him for a wonderful year, a hearty bon voyage and our best wishes for a successful year abroad!
The Poynter Center will team up with the Kennedy Institute of Ethics, Georgetown University, this spring to sponsor a three-day conference on "Ethical Issues of Animal Research." The jointly sponsored conference is part of a series of meetings on animal ethics organized by the Kennedy Institute. The fee will be $300.
Scheduled for May 30 - June 1, the conference will offer a multi-disciplinary agenda for those broadly interested in the profound ethical questions that surround the use of nonhuman animals in scientific research. Well-balanced, contrasting viewpoints concerning the use of animals in biomedical and agricultural research will be presented. Leading experts in the field will address the moral standing of animals; arguments for and against animal research; ethical decision making on animal care and use committees; personal ethical conflicts in animal research; and genetic manipulation of animals.
A flier about the conference will be mailed to everyone on the Poynter Center's mailing list. Additional information is available from Kenneth D. Pimple, Poynter Center for the Study of Ethics and American Institutions, Indiana University, 410 N. Park Ave., Bloomington, IN 47405; 812/855-0261; FAX 812/855-3315; email: pimple@indiana.edu.
Teaching Research Ethics -- Year Three
Most scientists ask human subjects to sign forms describing the risks and benefits of the research. But the forms are written from the point of view of the scientist -- not the subject. What is a risk? a benefit? Which risks and benefits are significant?
Participants will tackle these and other questions at a one-day seminar June 28 on the Bloomington campus. "Beyond Consent: What risk? Whose benefit?" will be relevant to anyone interested in the ethics of human subjects research in the sciences, the social sciences or the humanities.
The keynote speaker is Joan E. Sieber, Professor of Psychology at the University of Southern California-Hayward. Recipient of the USC-Hayward Outstanding Professor Award for 1991, she is a fellow of the American Psychological Association, and author of Planning Ethically Responsible Research: A Guide for Students and Internal Review Boards (Sage Publications, 1992).
Sieber's keynote address will be followed by comments by respondents and general discussion. Participants also will work on at least one case study in small groups over lunch.
Issues to be discussed include: How can researchers understand the research from the subjects' perspective? What does privacy entail from the subjects' point of view? What benefits do the subjects want to derive from the research? What counts as risks and benefits for the subjects? What special problems may arise in international work? How can a researcher learn the answers to these and similar questions?
This seminar is the third on a topic related to research ethics that the Poynter Center has sponsored in conjunction with the Teaching Research Ethics Workshop, which will meet June 23-28. The aim is to enable science faculty to incorporate research ethics into their graduate courses.
Nominations for the TRE workshop are being accepted from schools in the Committee on Institutional Cooperation (CIC). The workshop essentially will repeat last year's format, featuring sessions on ethical theory and pedagogy. The core faculty consists of Kenneth D. Pimple, Research Associate and workshop director; David H. Smith; Karen M.T. Muskavitch, Biology; and Muriel J. Bebeau, Education Director of the Center for the Study of Ethical Development at the University of Minnesota.
The TRE workshop is limited to about 30 invited members from the CIC (the Big Ten universities and the University of Chicago). The "Beyond Consent" seminar, however, is open to the academic public.
The seminar will meet from 10 a.m. to 2 p.m., including lunch. The $10 seminar fee will be waived for current and past TRE workshop participants. Space is limited; persons interested in attending are encouraged to register early.
To register, please send your name, address, phone number, FAX number, and e-mail address, along with a check for $10 (if appropriate), to Pimple at The Poynter Center. Please indicate dietary restrictions or mobility impairments. Registration deadline: May 15, 1996. The registration fee will be refunded if written cancellation is received by June 9, 1996.
TRE is in its final year of a three-year grant from the Department of Education's Fund for the Improvement of Postsecondary Education (FIPSE). Additional sponsors are IU's Office of Research and the University Graduate School.
The Poynter Center Fellows met twice during the fall semester.
On September 21, Karen Hanson, Philosophy, led a discussion of her manuscript, "How Bad Can (Good) Art Be?" The manuscript wrestles with two different claims that art can be immoral. The first emphasizes the continuity of life and art, contending that some artistic productions may corrupt those who experience them. Arguments that pornography leads to rape fall in this camp. In direct contrast is the claim that art is removed from life, or that it removes the person experiencing the art from real life, and thus from the moral rules and obligations that properly bind us.
For a change of pace, the Fellows welcomed an outside speaker on October 31, when Rudolph J. Marcus spoke on "Ethics of Scientists and Ethics of Science." Marcus is a contributing editor of Chemtech and a popular American Chemical Society Tour Speaker on ethics topics. At the Office of Naval Research, he initiated cooperative basic research programs in photochemistry and in computer-controlled experimentation, and he served as scientific director of ONR Far East. Now retired in the Sonoma wine country, Marcus writes and consults on cross-cultural technology transfer.
Marcus argued that scientists face a crisis of ethics for three major reasons. (1) All the easy things have been done. Doing original science today demands more elaborate apparatus, more personnel, more expense, more stress, higher stakes -- and more tempations to unethical behavior. (2) More scientists are competing for diminishing financial resources. (3) Mentorship, the traditional method for ethical training in the sciences is no longer viable because senior scientists are never in the lab; they are writing grant applications, networking and keeping the enterprise going.
Moral Issues in America's Professions
The Poynter Center's seminar on "Religion, Morality and the Professions in America" (RMPA) convened for the last time on September 13-15 for a final collective review and discussion of participants' research papers. Project directors David Smith and Richard Miller presented their drafts of introductory and concluding essays to the collection of fourteen essays by seminar participants, which are to be edited for publication.
The seminar closed with a wide-ranging discussion of options for research that will build on what has been learned about studying ethics and religion in the professions by ethnographic methods of inquiry. Ideas included in-depth community studies of professional responses to important issues, and the extension of this kind of study of ethics to areas of work outside those traditionally considered professions (e.g., artists, craftspersons or workers in technical fields such as computer programming). Other options would be to study a variety of the kinds of work associated with a single profession, or to extend such studies explicitly to other religious and cultural traditions in American life or in other societies. Two of RMPA's goals are to open new directions for inquiry in professional ethics, and to invigorate the field with new research methodologies.
RMPA participants are now engaged in final revisions of their essays. After this work is completed early next year, the collection will be submitted for publication. A final decision on the publisher has not yet been made.
The RMPA seminar has taken a revisionist approach to the study of professional ethics, which has relied traditionally on philosophical analysis without much reference to the actual experience in the workplace. RMPA successfully combined traditional studies with the field research methods of ethnography and oral history in an effort to get a closer to life picture of morality and the professions. The seminar was unique in its effort to look at the role of religion and morality in professional life. Prior studies have dealt little with religious values in relation to the professions. Finally, the seminar made an effort to extend the traditional definition of what "profession" to other areas of work (such as advertising executives and creators, and financial analysts) and to other cultures (physicians in India).
The three-year project has been supported by the Lilly Endowment.
The Association for Practical and Professional Ethics will convene its Fifth Annual Meeting February 29 through March 2, meeting at the Stouffer Renaissance Hotel in St. Louis. The Annual Meeting will be bracketed by two accompanying events. It will be preceded by a colloquium for directors of ethics centers and followed by a one-day conference on "Public Service Ethics and the Public Trust."
Open to members and nonmembers, the Association's Annual Meeting provides an opportunity for persons from various disciplines and professions to discuss shared concerns in practical and professional ethics. Individual sessions will interest practicing professionals concerned with ethics, faculty who wish to incorporate ethical issues into their regular courses, and scholars and theoreticians in specific areas of practical ethics.
Keynote speaker will be Amy Gutmann, Dean of the Faculty and Laurrance S. Rockefeller University Professor of Politics, Princeton University. She is the co-author (with Dennis Thompson, Harvard University) of Democracy and Disagreement (forthcoming from Belknap Press of Harvard University Press). This year's case study, from the Kennedy School of Ethics, Harvard, is entitled "A Policewoman's (Non) Use of Deadly Force."
The Colloquium on Ethics Centers and Ethics Programs was designed in response to the Association's survey of center directors in June. The goal is to provide an opportunity for center or program directors to share their concerns. A panel on "Issues in Ethics Institute Leadership" will feature Ron Brown, Director, Institute for the Study of Applied and Professional Ethics, Dartmouth; Vivian Weil, Director, Center for the Study of Ethics in the Professions, Illinois Institute of Technology; and Gary Edwards, President, Ethics Resource Center.
"Public Service Ethics and the Public Trust" will appeal to all who are interested in ethics in public life. Convenors are Stuart Gilman, Special Assistant to the Director, U. S. Office of Government Ethics; Guy Adams, Department of Public Administration, University of Missouri; and Harold Gortner, Department of Public Affairs and International Development, George Mason University. The opening session of the conference will meet concurrently with the last session of the Annual Meeting and is open to Annual Meeting participants. Participation in the March 3 schedule requires a separate registration.
The program also features a special symposium on casuistry. The first of its two sessions will feature a discussion of "Casuistry and Moral Theory"; the second session will focus on "Casuistry in Practice."
Breakfast with an Author will feature casual discussion with nine authors or co-authors who have published books during the year. This year's featured authors and titles are David H. Smith, Entrusted: The Moral Responsibilities of Trusteeship; Dennis F. Thompson, Ethics in Congress: From Individual to Institutional Corruption; John Rohr, Founding Republics in France and America: A Study in Constitutional Governance; Robert Ladenson, Ethics in the American Workplace; John Lincourt, Ethics Without a Net: A Case Workbook in Bioethics; Brendan Minogue, Bioethics: A Committee Approach; Michael Vocino, Lynn Pasquerella and Alfred Killilea, Ethical Dilemmas in Public Administration: Cases and Commentaries; Thomas Simon, Democracy and Social Injustice: Law, Politics, and Philosophy.
The Friday evening banquet will feature a demonstration of "Ethics Bowl," with students who have participated in the intercollegiate event sponsored by Illinois Institute of Technology. Deni Elliott will provide opportunities to preview videos and discuss their use in teaching ethics at two Video Fairs. The resource room will display books from publishers, materials from ethics centers and pedagogical materials. For the first time, some books will be sold at the end of the conference at a 20 percent discount; proceeds will go to the Association.
For more information on the conference schedule, accommodations and logistics, contact Association for Practical and Professional Ethics, 410 N. Park Ave., Bloomington, IN 47405; 812/855-6450; FAX 812/855-3315; Internet: appe@indiana.edu.
One of Roger Dworkin's tasks during his tenure as Acting Director was to plan a series of guest speakers for the spring semester. He succeeded in recruiting a stellar trio.
The spring speaker season begins March 6, when we will play host to William Galston, School of Public Affairs, University of Maryland. Galston's topic is to be announced.
On April 1, Patricia King will present a lecture entitled "Contextualizing Bioethics: Where Do Race and Gender Fit?" King is Professor of Law at Georgetown University Law Center. Her talk will be co-sponsored by the Poynter Center and Afro-American Affairs.
On April 10, our speaker will be Richard Beresford, Cornell Law School. Beresford holds both the J.D. and M.D. degrees. His talk is entitled "Mind Over Matter: Ethics in Brain Science."
Year 2 of "Ethical Guidance for Family Studies in Human Genetics," the Poynter Center's NIH-funded project, began with an inventory of eighteen case studies focused on Huntington disease. During the year, we attempted to broaden our focus by soliciting cases from centers that are conducting presymptomatic testing. Roger Dworkin interviewed staff at Vanderbilt University, and Kimberly Quaid visited the University of British Columbia, the University of Washington-Seattle and Boston University School of Medicine.
Ultimately, the working group completed analyses of twelve additional cases, which feature autosomal dominant polycystic kidney disease (ADPKD), familial adenomatous polyposis (FAP) and familial breast cancer in addition to HD. We presented our work in progress to a meeting of genetic counselors and patients or families at risk of HD in September and to the project's four consultants at a meeting in May.
Our thirty cases raise profoundly challenging issues. For example, how may conflicts be resolved between one individual's right to know his or her genetic status vs. another individual's right to remain ignorant, if testing the first person will disclose the status of the second? May an individual seeking testing dictate the conditions under which testing will be provided (e.g., anonymous testing, modifications of testing protocols), or may professional care providers determine the circumstances of testing? Are family members entitled to know they are at risk for a serious genetic disease, or are counselors obligated to protect a consultand's privacy? When a research protocol bars informing research participants of significant information such as genetic status, does that constitute a promise to participants? If significant information is found, how should researchers balance beneficence with the obligation, if any, to withhold information? How should genetic counselors approach consultands who have received results from linkage testing that are contradicted by direct gene testing?
In our first year's series of cases, our conclusions were significantly affected by the fact that no cure or treatment is available for HD. As anticipated, our recommendations may differ in cases that involve diseases for which therapy or other interventions (e.g., increased monitoring) are available. For example, a majority of our group opposes presymptomatic testing of children under 18 for HD; however, we do not oppose such testing for FAP, where a negative test may relieve children and their families of burdensome and costly surveillance.
In the project's third and final year, we will be extrapolating formal guidelines from the cases and writing commentary to explicate the guidelines. Dworkin is drafting the guidelines, and Smith is writing the explication; both are receiving substantial feedback from the group's other members. (Fortunately, our practice of meeting at two-week intervals for more than two years has produced a high level of comfort in terms of group dynamics.)
We agree that it is essential for clients to receive more than factual information during the pre-test counseling process. We conclude that the primary ethical obligation of genetic counselors is to provide information and create an atmosphere that will facilitate clients' informed decision making rather than leaving them in a decision-making vacuum, although we acknowledge that that position represents a movement away from the conventional ethic of nondirective counseling.
Several cases illustrate the importance of anticipating ethical problems at the beginning of research programs or the first encounter with a potential client. Failure to think through the ethical ramifications inhibits professionals' ability to handle problems and prevents them from creating optimum circumstances for confronting these situations.
The Poynter Center's assault on the electronic age continues: We now have a full-fledged World Wide Web site as well as several listservs. (Everything on the Web can still be found via Gopher and anonymous FTP.) Listservs enable sending a single e-mail message to many people at once. Here's how to find us on-line:
"Ethical Issues in Managed Care"
The Association for Practical and Professional Ethics will convene a major national conference entitled "Resources, Rationing and Responsibility: Ethical Issues in Managed Care" on April 12-13. The conference will be held at Jacksonville University, Jacksonville, Florida Physician participants may obtain ten hours of Continuing Medical Education credits (CMEs) through the Indiana University School of Medicine's Division of Continuing Medical Education; nurses may earn 10 hours of Nursing Continuing Education Units (CEUs) through the University of Florida Health Sciences Center/Jacksonville.
The conference, designed for physicians, nurses, social workers and administrators of managed care programs, will provide a forum to explore the fundamental ethical issues raised by managed care. Its goals are to enable participants to identify and assess the ethical issues raised by the managed care system; to define and evaluate the impact of managed care on the roles and responsibilities of patients and health care givers; to assess the appropriate scope of patient autonomy in managed care systems; and to evaluate the moral mission of managed care.
Speakers will include Ezekiel Emanuel, Assistant Professor of Medicine, Social Medicine and Epidemiology, Harvard Medical School; Gregory Gramelspacher, Associate Professor of Medicine, Indiana University; Colleen Scanlon, Director, Center for Ethics and Human Rights, American Nurses Association; and Paul S. Monson, Regional Vice President of Medical Affairs, Blue Cross and Blue Shield of Florida.
The $175 registration fee will include conference materials, Friday lunch, Saturday continental breakfast, coffee breaks and a social hour. Registration fees will be refunded in full if cancellation is received before March 29; partial refunds will be available for cancellations received by April 5.
For more information about the conference, contact: Brian Schrag Executive Secretary, Association for Practical and Professional Ethics, 410 North Park Avenue, Bloomington, IN 47405; Telephone 812/855-6450; FAX 812/855-3315; Internet: appe@indiana.edu.
Last updated: 22 January 1996
URL: http://www.indiana.edu/~poynter/nl1995-2.html
Comments: pimple@indiana.edu
Copyright 1996, The Trustees of Indiana University