Debating Bioethics

Participants express a range of ideas, beliefs and opinions — some often diametrically opposed to others. But it remains a respectful environment.

Bioengineers tend talk a lot about how new technologies work. BME Lecturer Barry Belmont also wants to discuss their implications, and he isn’t the only one. 

“It’s one thing to learn the mechanics of gene therapy, for example, like how CRISPR works; it’s another to talk about some of the potential uses and the ethics around them,” Belmont says. “If you hang around biomedical engineers long enough, you’ll hear many say they wish we were talking more about these kinds of issues.” 

“IF YOU HANG AROUND BIOMEDICAL ENGINEERS LONG ENOUGH, YOU’LL HEAR MANY SAY THEY WISH WE WERE TALKING MORE ABOUT THESE KINDS OF ISSUES.” 

Barry Belmont

Now, a forum for such discussions exists. In September 2017, Belmont launched the Bioethics Discussion Group and its accompanying Tuesday night discussions. Shortly after, he partnered with the Biointerfaces Interlaboratory Committees (BIONIC) to create a set of Bioethical Lunches. Both have grown in attendance, and the slate of future discussion topics extends to 2043. 

The Bioethics Discussion Group has come to be a popular alternate-Tuesday-evening event, drawing anywhere from one to three dozen participants on average — and often many more, depending on the topic — but it didn’t start out that way. 

Belmont recalls his excitement while promoting the very first event almost two years ago, hoping for a full room. 

“We had six people, including me. Three were students from my classes,” he says. “But I’ve been in bands and played for smaller crowds, so I took it on the chin,” he jokes. Slightly deflated but undeterred, he continued hosting the discussions. 

It didn’t take long for word to spread and attendance to rise. Now participants hail from across the university and the wider community as well — from high school students and their parents to U-M alumni; individuals working in industry to University staff, faculty, researchers and students from Medicine, Dentistry, Law, Kinesiology, Music, Theatre & Dance, and others. 

A small group discusses ethical issues of medical-related topics in the Star Wars universe.

Topics, too, run the gamut. That very first event, “First do no harm,” covered the Hippocratic oath, the nocebo effect of informed consent, and the doctor-patient relationship in different cultures. Subsequent discussions have focused on organ and body donations, human experimentation, animal experimentation, drugs, big data, vaccination, assisted reproduction, regulation, the replicability of medical studies, death, gender, race, circumcision, pain, and extinction. 

Some of the most well-attended discussions have been Bioethical Lunches related to pop-culture. A discussion about Star Wars addressed the ethics of use of The Force. A Harry Potter-themed discussion touched on the implications of Polyjuice potion and whether it’s ethical to take on the identity of another. A Game of Thrones discussion spent significant time debating at what point a herd, such as the House Stark or the House Targaryen, can demand immunity. 

Belmont selects the topics, designs the posters promoting them and moderates each session. He tries to schedule them in a logical order, often by underlying philosophical theme or by tying them to a relevant day or timeframe.  For example, he scheduled a discussion on universal healthcare on the anniversary of the Affordable Care Act. In 2020, a discussion entitled, “Love. A discussion on the chemistry of our biology” will take place the week of Valentine’s Day. A November 2020 discussion will cover “Democracy. A discussion we will choose to have.”

“I DON’T MIND TALKING ABOUT THIRD-RAIL TOPICS. CONTROVERSY IS OKAY AS LONG AS WE DON’T INSULT EACH OTHER,”

Barry Belmont

As is clear from the list of past and future topics, Belmont doesn’t shy away from controversy. “I don’t mind talking about third-rail topics. Controversy is okay as long as we don’t insult each other,” he says.

Rarely is there a consistent chorus of opinions; more often than not, participants express a range of ideas, beliefs and opinions — some often diametrically opposed to others. But it remains “a respectful environment,” he says. “Even when there’s complete disagreement, like during a discussion about abortion, people spoke cordially. Some got passionate, but everyone said their piece and listened attentively to the others.”

Another contentious discussion focused on the subject of animal experimentation. Even in the midst of passionate disagreement, Belmont says, people were careful to debate ideas and not attack others’ positions. The discussion took place right before Thanksgiving break. “At the end of the evening, people were wishing each other a happy holiday and a good break.” 

The one type of topic that would be off limits, he adds, is one that’s too easily answered, that doesn’t lend itself to multiple perspectives. “I want people to talk substantively. If there’s an easy answer, we don’t need to spend too much time talking about it, at least in these discussions.” 

CREATING A FRAMEWORK TO GO WITH THE FLOW

Prior to each evening session, Belmont curates and shares a list of readings with an email list and develops a list of questions to keep on hand during the discussions to spur conversation in case of a lull. But quiet spells are less common, says Belmont, who facilitates but for the most part encourages participants to take the topic and run with it. “Everybody who’s there wants to be there. After the initial 10 minutes or so, the conversation really starts to take off.” 

The mid-day Bioethical Lunches are more structured, typically organized around a brief talk or presentation by an expert — often professors or clinicians — on the topic of focus. Following that, participants ask questions. 

“What’s nice about that,” Belmont says, “Is that we get a gut check. We might talk about some crazy things, and the expert can provide us with the reality of the situation.” 

Belmont comes prepared to pose ethical questions to ponder on each topic. Discussion on the ethics of Star Wars centered around cloning.

Partnering organizations also help widen the perspective. Partners have included BIONIC and the Transforming Engineering Education co-Laboratory (TEEL). Over the next two years, during two-hour “Let’s Fix Healthcare Lunches,” the Bioethics Discussion Group will partner with the Universal Healthcare Group to address the many aspects of universal health care. The goal is to create a policy paper on what an optimal healthcare system for the United States might look like and share it with policymakers as they weigh the issues. 

“Healthcare right now is this big, hairy topic with a lot of talk about universality and ‘Medicare for all,’ but a lot of people don’t understand what it means,” Belmont says. 

FOSTERING INTELLECTUAL CAMARADERIE

As he reflects on the past two years of the Bioethics Discussion Group, Belmont is pleased with how it’s evolved. “I’ve been pleasantly surprised at how naturally people foster this intellectual camaraderie around these issues.”

Even people who haven’t attended are taking part, reading some of the articles he’s shared and letting him know they’ve been thinking about the issues or raising them in lab meetings, for instance. 

“IF THESE DISCUSSIONS DO NOTHING ELSE BUT GET PEOPLE THINKING ABOUT THEIR PERSPECTIVE ON A TOPIC, THAT’S GOOD ENOUGH,”

Barry Belmont

“If these discussions do nothing else but get people thinking about their perspective on a topic, that’s good enough,” he says. “It doesn’t need to be any grander than that.”

The next Bioethical Discussion Group will take place on November 12, 2019. The topic will be: Body/politics. A discussion on government.

For more information, visit https://belmont.bme.umich.edu/bioethics-discussion-group/.