Public Bioethics

6 October 2004

in memory of John C. Fletcher

 

Among the tasks of bioethics is the analysis and assessment of public policies related to science, medicine and health care. While the phrase "public bioethics" has many possible meanings, it often refers to the activity of official public bodies established by federal or state governments to address – in public, with public participation – bioethical issues arising in public policy or public culture.

In recent decades, U.S.  Presidents have created such public bodies to advise them on critical bioethical issues. In the late 1970s and early 1980s, a commission begun by President Jimmy Carter carried over into the Reagan years as it deliberated about an extensive list of "ethical problems in medicine and biomedical and behavioral research." Each of the last two U.S. presidents has established his own bioethics commission, with President Bill Clinton appointing the National Bioethics Advisory Commission (NBAC) early in his second term and President George W. Bush creating the President's Council on Bioethics (PCB) shortly after he took office. The two groups have had very different identities and ways of working, and they have arrived at strikingly different recommendations about issues like human reproductive cloning and human embryonic stem-cell research. In this Medical Center Hour, two members of these presidential commissions – Jim Childress (NBAC) and Bill May (PCB) – discuss the possibilities and perils of public bioethics.

One strong proponent of public bioethics was the late John C. Fletcher, in whose memory this Medical Center Hour convenes. While praising public bioethics as an important way for society to come to terms with complex bioethical issues, Fletcher also warned of its very real risks, which include political co-optation and bioethics orthodoxy.


William F. May , Ph.D., a Fellow at the Institute of Practical Ethics and Public Life at the University of Virginia , is the former chair of the religion department at Smith College, founder of the Department of Religious Studies at Indiana University, later ranked among the top departments in the nation, and was the Cary M. Maguire University Professor of Ethics Emeritus at Southern Methodist University before coming to the University of Virginia. While at SMU, he was the founding director of the Maguire Center for Ethics and Public Responsibility . 

Dr. May was a member of the President's Council on Bioethics until earlier this year.  He is past president of the Society for Christian Ethics , has published widely on medical ethics and served, in 1993, on the subgroup on Ethical Foundations for the Clinton Task Force on National Health Care Reform.  Dr. May is a founding fellow of the Hastings Center and former co-chair of their  research group on death and dying.  His last book is titled Beleaguered Rulers: The Public Obligation of the Professional.

Dr. May earned degrees from Princeton and Yale universities, and served as the Joseph P. Kennedy, Sr., Professor of Christian Ethics at Georgetown University's Kennedy Institute of Ethics. He received the Distinguished Teaching Award from Indiana University in 1970, the Scholar/Teacher Award from Southern Methodist in 1989 and the Outstanding Teaching Award from the American Academy of Religion in 1993.


James F. Childress, Ph.D., is the Hollingsworth Professor of Ethics and Professor of Medical Education at the University of Virginia, where he directs the Institute for Practical Ethics . He served as Chair of the Department of Religious Studies from 1972 to1975 and from 1986 to 1994; as Principal of UVA's Brown College at Monroe Hill from 1988 to 1991; and as co-director of the Virginia Health Policy Center 1991-1999. In 1990, he was named Professor of the Year in the state of Virginia by the Council for the Advancement and Support of Education.

He is the author of numerous articles and several books in biomedical ethics, including Principles of Biomedical Ethics (with Tom L. Beauchamp), Priorities in Biomedical Ethics; Who Should Decide?; Paternalism in Health Care; and Practical Reasoning in Bioethics . His other books include Dictionary of Christian Ethics (2nd ed.), co-edited with John Macquarrie, Civil Disobedience and Political Obligation, and Moral Reasoning in Conflicts.

Childress was vice chair of the national Task Force on Organ Transplantation, and he has also served on the Board of Directors of the United Network for Organ Sharing (UNOS) , the UNOS Ethics Committee, the Recombinant DNA Advisory Committee , the Human Gene Therapy Subcommittee , the Biomedical Ethics Advisory Committee, and several Data and Safety Monitoring Boards for NIH clinical trials.  From 1996 to 2001, he served on the presidentially-appointed National Bioethics Advisory Commission .

Childress is a fellow of the American Academy of Arts and Sciences and, in 1998, was elected to membership in the Institute of Medicine of the National Academy of Sciences . He is also a fellow of the Hastings Center . He has been the Joseph P. Kennedy, Sr., Professor of Christian Ethics at the Kennedy Institute of Ethics at Georgetown University (1975-79) and a Visiting Professor at the University of Chicago Divinity School and Princeton University.

He received his B.A. from Guilford College, his B.D. from Yale Divinity School, and his M.A. and Ph.D. from Yale University.
 

John Caldwell Fletcher was Professor Emeritus of Biomedical Ethics in Internal Medicine at the University of Virginia  School of Medicine. H e retired as Kornfeld Professor of Biomedical Ethics and Director of the Center for Biomedical Ethics in September 1997. Until June 1, 1999, he co-directed a master's program in Clinical Ethics at the University’s Northern Virginia campus.  

He earned a B.A. optime merens in English literature from the University of the South in 1953 and a Master of Divinity degree cum laude from the Virginia Theological Seminary in 1956. As a Fulbright Scholar at the University of Heidelberg in 1956-57, he translated Dietrich Bonhoeffer's Creation and Fall  into English. He earned a Ph.D. in Christian Ethics at Union Theological Seminary (New York ) in 1969. His dissertation, "A Study of the Ethics of Medical Research," was completed at the Clinical Center of the National Institutes of Health from 1966 to 1968.

In the late 1960s, Fletcher served both the new field of bioethics and in reform of theological education. He was a Founding Fellow of the Hastings Center and the founding President of the Interfaith Metropolitan Theological Seminary in Washington,  D.C. (1970-77). In 1977, he became the first chief of the Bioethics Program, Clinical Center, NIH.  He joined the faculty of UVA in 1987.

With sociologist Dorothy C. Wertz, he conducted an international survey in 1985-86 of medical geneticists in 19 nations on their approaches to ethical problems in screening, counseling and prenatal diagnosis. They co-authored Ethics and Human Genetics: A Cross-Cultural Perspective (Springer-Verlag, 1989). Dr. Wertz and he completed a second NIH-supported study in 37 nations in 1995.

Author or co-author of more than 250 articles or book chapters, he gave congressional testimony on in vitro fertilization, human genetic engineering, advance directives, and fetal tissue transplantation research. He served on the editorial boards of seven professional and scientific journals. He testified and wrote commissioned papers on the location of the Office of Protection from Research Risks and on ethical issues in stem cell research for the National Bioethics Advisory Commission.

His alma mater , the University of the South, awarded him a honorary degree of Civil Laws in 1993. A Festschrift to Dr. Fletcher, edited by Franklin Miller, was published in 2000, from University Publishing Group. John C. Fletcher died in May 2004.