By Celia B. Fisher, Ph.D.
In a recent article in the American Journal of Bioethics Kayhan Parsi of the Loyola University of Chicago Stritch School of Medicine exhorted bioethicists to address racism in their work. What the article did not address is why in 2016 it has taken bioethics so long to recognize a problem existing for more than 50 years since the field’s nascence.
One answer to the question is that training programs in bioethics continue to be grounded in the philosophical tradition that sees justice fulfilled through applying universal moral principles across diverse stakeholders. Even John Rawls’ revolutionary call for justice arrived at through imagining one’s social position behind a “veil of ignorance” unintentionally supports racial blindness, when bioethicists are required to simply “imagine” rather than actually investigate the needs and values of ethic minority stakeholders.
A more profound problem is the field’s lack of attention to the decades of social science research documenting patient perspectives on how the U.S. medical establishment has disenfranchised racial minorities through explicit and implicit biases resulting in inadequate diagnoses and care, continued health disparities and medical distrust. Parsi and commentators suggest that a greater training presence in historically Black colleges and the “moral courage” of individual bioethicists will increase bioethicists’ attention to systemic racism.
A bolder and more effective solution would be to bridge the training chasm between traditional theoretically-driven case-based bioethics and empirical evidence by requiring training in social-behavioral science approaches to understanding how bioethics consultation can reduce or exacerbate systemic racism.
Training a new generation in empirical approaches to bioethics that gives voice to the experiences of racial minority communities will lead to ethical decision-making that reflects the values and merits the trust of racial minority patients.
Celia B. Fisher, Ph.D. is the Fordham University Marie Ward Doty University Chair in Ethics and Director of the Center for Ethics Education. She is founding director of the NIDA-funded HIV/Drug Abuse Prevention Research Ethics Institute, which trains postdoctoral fellows in conducting research on ethics in research and treatment. She was awarded the Lifetime Achievement Award for Excellence in Human Research Protection in 2010 and was named a 2012 Fellow of the American Association for the Advancement of Science.
For read more on Dr. Fisher’s work in this area, please read:
Fisher, C. B., Busch-Rossnagel, N.B., Jopp, D.S., & Brown, J.L. (2012). Applied developmental science, social justice and socio-political well-being. Applied Developmental Science, 16(1), 54-64.
Fisher, C. B. (1999). Relational ethics and research with vulnerable populations. In Reports on research involving persons with mental disorders that may affect decision-making capacity (Vol. 2, pp. 29–49). Commissioned Papers by the National Bioethics Advisory Commission. Rockville, MD: National Bioethics Advisory Commission.
Fisher, C. B., & Yuko, E. (2015). The HIV and Drug Abuse Prevention Research Ethics Training Institute: Training Early-Career Scientists to Conduct Research on Research Ethics. Journal of Empirical Research on Human Research Ethics, December 2015 10: 470-480, doi:10.1177/1556264615614937