Bioethics Program: Translating Philosophy Into Real-World Impact

Who should be first in line for a COVID vaccine? How should medical care be allocated? When should a patient be taken off of life support? Those working in the field of bioethics are grappling with these thorny questions, among others—and so are students participating in the Special Program in Bioethics at Rivers.
There’s perhaps never been a better time to ponder bioethics, but the program long predates the COVID crisis. Students apply to the rigorous program, which falls somewhere between a class and a club, because they want to delve deeper into the kind of issues that are discussed and decided by public-health policymakers at the highest levels.

The force behind the program is faculty member Julian Willard, chair of the interdisciplinary studies department. Willard has long been engaged with questions of bioethics, serving as a member of the Community Ethics Committee (CEC) at Harvard Medical School, a group that meets regularly to provide public input into the ethical aspects of health care.

That endeavor connects Willard to the wider network of those engaged in bioethics. So when Lori Bruce, who chairs Yale’s version of the CEC, wanted input about an issue that can touch the lives of teens, she thought of Willard and the Rivers group. Bruce was preparing a community feedback report for a recent national conference on Safe Haven laws – laws that allow mothers to surrender their newborns anonymously, without legal consequences.

In her request to Willard, Bruce wrote, “This is a policy that can certainly impact high schoolers … As far as I know, I’ve never heard of a policymaker asking high schoolers for their views on 1) how to let expectant mothers know about the policy, 2) how it could be revised to increase the likelihood it would be used, and 3) whether pediatricians should discuss this patients at annual checkups.”

So, with those three specific policy questions in mind, the students in the bioethics program set about tackling the issue. Willard sent out several articles on Safe Haven laws in advance of a group meeting, and the students had a thoughtful and wide-ranging conversation.

“We decided unanimously that an annual physical would be a good place to discuss Safe Haven laws,” said Keira Thompson ’22, a participant in the program. But, she added, there is much about the initiative that remains challenging or unresolved. “There is ambiguity in the laws, which vary from state to state, and there are areas where the safe haven laws come into conflict with other laws.”

In the end, the Rivers group submitted a thorough report to Bruce, allowing her to incorporate their perspective into her presentation. Afterwards, Bruce said that the students’ feedback would help shape the deliberations of the National Safe Haven Alliance as it works with legislators on policy recommendations.

The experience was valuable on many levels, said Willard, not least of which was that it allowed students to see pragmatic, real-world outcomes stemming from philosophical discussions. “It’s exciting to see them relate philosophy to policy-making, as well as to science,” he said.

“It was an amazing opportunity to have our voices heard outside of our own meetings,” says program participant Elizabeth Butter ’21.

Students in the program have also stepped outside the classroom by joining meetings of the Harvard Community Ethics Committee. “They’re getting to see that community input into bioethics is increasingly sought-after,” said Willard.

Both Butter and Thompson say their engagement with bioethics is an offshoot of their own long-standing interest in science. The pandemic has just added yet another facet to that engagement. “One really pertinent topic we discussed was the allocation of scarce resources for COVID,” says Thompson. Butter adds, “We’ve spent a lot of time discussing ventilator distribution and trying to form opinions on who should get a vaccine.”

But perhaps most important of all, say the students, the program gives them the chance to experience the real-life ambiguity often inherent in bioethics considerations. “We’re getting exposure to the fact that, in the real world, things aren’t always black and white,” says Thompson. “It’s a way to practice that mindset and grapple with the fact that the conversation may not always reach a defined resolution.”
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