A Conversation With Jonathan D. Moreno, Bioethicist and Professor

Moreno-Post.jpgA former member of President Obama's transition team; a professor of medical ethics and health policy, of history and sociology of science, and of philosophy at the University of Pennsylvania; a national associate of the National Research Council; and a senior fellow at the Center for American Progress in Washington, D.C., Jonathan Moreno wears many hats. His most recent project, the new book The Body Politic, explores how bioethical issues -- stem cells, genetics -- have become a part of our political discourse.

Here, Moreno discusses how neuroscience and globalization are both affecting his chosen field; the problem with medical schools across the U.S. backing off on their commitment to bioethics; and why he's trying to integrate bioethics with the history of ideas, technology, and public affairs.

What do you say when people ask you, "What do you do?"

My short answer is that I'm a professor at the University of Pennsylvania and a fellow at the Center for American Progress, a Washington, D.C.-based think tank. The longer and more descriptive answer is hard because, intellectually speaking, I'm a mutt. I'm trained as a philosopher but I live in academic departments of medical ethics and of history and sociology of science. Professionally, I'm mainly seen as a bioethicist but what I've been trying to do for years is integrate bioethics with the history of ideas, technology, and public affairs. So, when people ask me, I say that I teach, write, and do research at the intersection of bioethics and policy with a strong sense of the American cultural context.

What new idea or innovation is having the most significant impact on the bioethics world?

I'd suggest that there are two: globalization and neuroscience. The preoccupation with globalization has clearly affected my own work. In my new book, The Body Politic, I argue that the battle for control over the power of experimental biology is partly shaped by the fact that science is a globally networked enterprise of scientists and their sponsors. In the new paperback version of my 2006 book, Mind Wars, I'm reviewing the way that the global war on terrorism has influenced the growth of research on the brain. Right now, I'm a senior adviser to the president's bioethics commission, which has been digging up the facts about the venereal disease experiments in Guatemala in the late 1940s. That commission report is being followed by an assessment of the international protections for human research subjects today. Globalization pushes us to think more about justice and fairness, which have been concerns more typical of non-U.S. bioethicists.

The other area that is having a big impact on bioethics is neuroscience, which has undergone remarkable growth by just about any measure over the last 15 years. One of the keys has been the advent of new imaging devices that make it possible to do experiments with healthy persons rather than during neurosurgery. Another is invasive implants that can alleviate distressing symptoms of brain disorders like Parkinson's. "Neuroethicists" even have their own professional organization in which I am active. I'm especially interested in the national security implications of cognitive enhancements that might be developed, though I think we're far from some of the science fiction scenarios about "super soldiers" and the like. I'm sure we're in for some surprises along the way.

What's something that most people just don't understand about your area of expertise?

Bioethicists are caught in an interesting dilemma. Some doctors and medical scientists tend to see us as cops who just say no to important experiments. Others see us as co-opted by the medical and science establishment. I see the task for academic bioethicists as inherently a critical one, as in but not of the establishment. But we also have a responsibility to explain the rationale for a particular treatment or study when we think it's justified, even if the explanation doesn't fit on a bumper sticker. I don't know that there's any way to avoid this dilemma but as long as we have critics on both sides I'd say we're doing our job.

What's an emerging trend that you think will shake up the bioethics world?

That's exactly the topic of The Body Politic: Bioethical issues that were the province of academic discourse since the 1970s are now permanently part of the political discourse, which I call the new biopolitics. The most obvious example is the way that the embryonic stem cell debate became an issue in three presidential campaigns. Already we've seen a little dustup among the Republican presidential candidates about science. These controversies are often related to but distinct from abortion politics because they involve sophisticated new ways of manipulating cells and genes, raising the question of how far experimental biology should go.

Most people in bioethics are academics. To see our issues caught up in the rough posturing of politics is disconcerting compared with the nuances that occupy us. Similarly, I'm sure economists cringe at loose talk about government debt and monetary policy, and many of them find it annoying to be pigeon-holed as on the left or the right. We'll just have to get used to it, as other disciplines have, because bioethical issues are now so much a part of the public conversation.

What's a bioethics trend that you wish would go away?

I have the sense that a few medical schools are backing off their commitment to bioethics. The field grew out of social reform movements in the late 1960s when patients started to appreciate the growing power of modern medicine and insisted that they wanted to be in charge of the goals of their care. That '60s generation of leaders in reforming medical education is retiring. Of course, there are also serious funding problems in many universities, especially state institutions, and it only gets more expensive to educate doctors. And people in fields like bioethics don't usually bring in big grants, so there are other reasons for funding cuts. On the other hand, there are lots of new medical schools opening up, all with students who will need to learn some bioethics. I'm hopeful they will establish high-quality programs.

What's an idea you became fascinated with but that ended up taking you off track?

I can't think of one recently. In the kind of work I do now I'm always looking for details that inform my understanding of the role of the history of the financial system to pop music. I can say that in the course of figuring out how to write my new book I spent a few months bouncing around between a memoir of my experience as an academic in the world of public policy and a more historical and philosophical treatise on modern progressivism. My editor helped me find my voice so I think the result is just about right.

Who are three people or organizations that you would put in a Hall of Fame for your field?

The two pioneering bioethics organizations were The Hastings Center, a free-standing think tank in New York that was founded in 1969, and the Kennedy Institute of Ethics at Georgetown University, which started in 1972. They deserve a great deal of credit for their vision. At the risk of sounding self-serving I'd add the University of Pennsylvania, which has tremendous strengths both specifically in bioethics and in complementary fields like the history and sociology of science, philosophy, neuroscience, and stem cell biology, as well as across the university. Penn's president, Amy Gutmann, is a political philosopher who chairs President Obama's bioethics commission; my new colleague Zeke Emanuel is a philosopher and physician who worked on health care reform in the White House; and my old friend Art Caplan is easily the most visible person in the field. There's great excitement about bioethics at Penn.

What other field or occupation did you consider going into?

For a while in college I considered a career in public interest law, but as soon as I stepped in front of a class I knew I loved teaching. My romance with ideas began in high school, though I didn't recognize that until I took my first philosophy course. And I love to write and felt at home in the academic environment, so my career choice was over-determined. I've always been fascinated by standup comedy. Perhaps I would have tried that if the opportunity presented itself when I was young. As a teacher I get some of the same satisfaction when I go for a laugh but my "performance" doesn't depend on that reaction. If a joke doesn't go over I just tell myself that I'm not there to entertain my students. But I can't keep myself from trying.

What website or app most helps you do your job on a daily basis?

I'm an old-fashioned guy that reads the New York Times and the Washington Post every day. I travel a lot, work in several offices, and am writing something almost all the time, so cloud computing has greatly simplified my life. I also love the fact that I can go on the Web and nearly always find a video of some scholar whose work interests me.

What song's been stuck in your head lately?

"Sunday, Bloody Sunday," by U2. It reminds me that there's nothing worse than cruelty and that, as frustrating as politics often is, it's the only alternative to violence in resolving our differences.