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Why I Chose Bioethics as a Profession
Q & A with Felicia Cohn, PhD, director of medical ethics, University of California, Irvine, School of Medicine.
Q: Why did you decide to go into bioethics as a profession?
A: It's an interesting question, because it's not like a physician, where you can say, "I've wanted to do this since I was five, and when you're five, you don't even know how to spell it, much less that it exists.
And even now, I tell people I'm a bioethicist and I get these perplexed looks, like, "What does that mean, what do you do?"
So, now, I've just started telling people I meet at parties that I'm a teacher, or a professor.
I ended up in it, like a lot of people of my generation and older, by accident. I was a pre-law student in college, and when I started actually investigating what it was I would have to do — the kinds of jobs I would likely have when I finished — I no longer was interested.
But I really liked parts of it. And I loved health law, and environmental law, and the issues I would get to deal with in those areas. Unfortunately, you can't go to law school and just study those kinds of things. You have to do contracts and torts and tax law , and I really didn't want to do that.
I had taken a course — you know, every university has its list of professors whose courses you should take because of their interest in their subject matter, and because the professor is just that great. We had a few of those, and one of those professors was a man named Jim Childress, who is, I think, the father of bioethics. He and Tom Beauchamp wrote Principles of Biomedical Ethics . . . it's probably the premier bioethics textbook.
And it's just one argument about how bioethics should work. It's one theory, but it's probably now the dominant theory of principles. They developed this system of principles, really from the convergence of a couple of other theories — or what they claim is the convergence.
He was just a phenomenal teacher, and I loved the content. And I thought, How can I go to grad school to study this? There weren't really any programs at the time, but I started looking into different types of programs — the philosophy of science and other ethics — general ethics programs, not really applied ethics, in philosophy departments, political and social thought — I think was the program I was looking into at Berkeley — and just a way I could get at this subject area without having to go to law school or medical school.
I ended up actually staying at the University of Virginia, where I had been in undergrad, so I could study with Jim Childress. Then there was another man there at the time, named John Fletcher, who worked in the hospital and in the medical school. So, I was fortunate to have both of them as my mentors, so I could combine the theory and the clinical practice.
Q: It's interesting that you thought about what you wanted to study and what you wanted to learn vs. a position.
A: I think this is similar to what happened to the people sort of above my generation. All of them were already in other fields; they were philosophers, theologians. The pioneers were mostly all theologians, or people in religious studies. But some philosophers, legal scholars, physicians — even anthropologists/sociologists, who were intrigued by some particular issue that raised ethical questions, and sort of became bioethicists, not on purpose, but just on the basis of what they were doing.
So, those were the founders of our field.
Q: What time was this?
A: Well, you can date it probably back to the 1960s. Joseph Fletcher and Paul Ramsey, and there are a number of others…those are probably two of the biggest names.
And then there were things happening in the world. You know, it was post-World War II, post-the Nuremberg Trials, research ethics was becoming a big problem, and we were developing codes [of conduct, such as] The Belmont Report, and with a president's commission were addressing some of these issues.
So, there was just kind of this whole almost hurricane of things going on that propelled our field into existence.
So, it was all these people who would never have called themselves bioethicists, who were actually doing bioethics. And then other people became intrigued by the stuff that they were doing and decided, "I'd kind of like to do that."
But they still went into PhD programs in philosophy and religious studies and went to law school and went to medical school, and they're coming at it situated from those professions.
There began to be this kind of core of knowledge that we still argue about the finer points of, but everybody agrees that this set of philosophical theories we should understand, some basic religious precepts, and then know a little about clinical medicine — at least so that you can speak the language — and you know, there's this core set of cases — they are legal cases, or big clinical cases that you need to know about as sort of paradigms.
And so based on that, there started to be master's programs and undergraduate concentrations, if not majors, and now there are even some PhD programs.
The people of my generation are probably among the first who will actually call ourselves bioethicists — to call ourselves that and to recognize it in that way, as a profession unto itself.
And now there are students who are actively looking for bioethics programs.
Q: So, that's a change from when you first looking at what you would study?
A: Right. And I haven't decided if it's an entirely good thing.
Q: What do you mean by that?
A: Well, it's been really helpful to be in a self-consciously multidisciplinary field. You know, when I go to the table for a debate, I'm bringing my religious studies background with me, and it's fascinating to have someone from law school and somebody from medical school and an anthropologist and a sociologist all sitting at the table with me.
And we're all doing bioethics, but yet we're situated in these very different professions . . . and bringing those perspectives with us. I think some of that richness and nuance will be lost if we have people who study just bioethics.
Q: Because they don't have the range of education and experience?