There’s a section of the new book “Everybody Wants to Go to Heaven but Nobody Wants to Die” in which the authors—Penn President Amy Gutmann and Penn Integrates Knowledge Professor Jonathan Moreno—describe the ongoing debate surrounding abortion as emphasizing a particularly important notion: that bioethics often finds itself “immersed in political as well as ethical controversy.”
“And it is, in fact, everybody’s business to weigh in on those controversies,” writes Gutmann, a moral and political philosopher, and Moreno, a professor of medical ethics and the history and sociology of science.
Such is an example of the meshing of political science and bioethics, two fields of particular interest to Isabel Perera, a fellow in the Department of Medical Ethics and Health Policy, who earned her doctorate in political science from Penn last year.
“When discussing how to build an ethical health care system,” Perera said, “bioethics and political science can come together and offer something productive for policy, and also for practice.”
Perera was chatting at a reception at the Smilow Center for Translational Research after an hourlong book talk that featured Gutmann and Moreno, with moderator Antonia M. Villarruel, the Margaret Bond Simon Dean of Nursing. Steven Joffe, the interim chair of and professor in Medical Ethics and Health Policy, offered introductory remarks. Most attendees of the Tuesday afternoon event were students, faculty, and staff with interests and experiences in medicine and bioethics, providing the co-authors a chance to dive a bit deeper into their book’s details than they’ve been able to with more general audiences.
“I often say that if you pull up any health or science story in the newspaper [or on TV], there’s almost always a bioethics angle to it, and often it’s the bioethics angle in those stories that make them so interesting,” Joffe said. “It’s really very topical and timely.”
Gutmann, Moreno, and Villarruel’s conversation flowed freely, covering issues including how medical ethics came of age; their own, personal family stories related to bioethics; access to affordable health care; and how doctors have, over time, been taken off their “pedestals.”
“When I was in high school, I asked my father what I should do and he said, ‘Well, you should go to medical school because doctors have the most influence,’” said Moreno. “That was the mid-1960s, and I don’t think any physicians in this room would feel that way today. It’s just incredible how that’s changed.”
A good change, indeed, Gutmann noted, as this shift has allowed for a patient-centric movement.
“Since we are at Penn, it really is important to see how this parallels our ethos of collaboration across boundaries,” Gutmann said. “There is only ethical health care when there can be a dialogue between nurses, doctors, patients, and other caregivers and family.”
They also discussed the rules and guardrails that have been put in place, such as requirements for obtaining informed consent and special protections for vulnerable people, to protect individuals who volunteer for research studies and heighten trust in medical professionals and their research.
Gutmann explained how clinical trials today—in which we “dot every ‘i’ and cross every ‘t’”—are saving lives, like Emily Whitehead’s, who benefited from Carl June and his Penn Medicine team’s engineered T-cell therapy.
“When science partners with ethics, great things can come,” said Gutmann. “To have Emily Whitehead, who was on her deathbed at 7 years old now cancer free at 14 years old … that has saved now thousands of lives and will continue to save more and more in different areas.”
Gutmann continued, “That is why I think bioethics is so important, because it’s part and parcel of how we do medical science to surge it forward. Some people have written about bioethics as if it’s a break, that it’s stopping medical progress. That couldn’t be any more wrong. It is part of the fuel that makes medical progress, progress.”
Gutmann and Moreno, who worked together on President Barack Obama’s Bioethics Commission (Gutmann was chair and Moreno was a senior adviser), also discussed nudging for good, moral distress affecting doctors and nurses, “Medicare for more,” and the ultimate impact they hope their book, released in August, makes: to help folks prepare for the difficult conversations and decisions related to health care they’ll inevitably face.
Three questions from the audience concluded the event, with one from Edward Rodriguez Caceres, a senior in the Biological Basis of Behavior Program, who asked Gutmann how her responsibility of the University of Pennsylvania Health System, alongside J. Larry Jameson, Penn’s Executive Vice President for the Health System and Dean of the Perelman School of Medicine, and Health System CEO Kevin B. Mahoney, has influenced her views on the ethics of health care.
Gutmann, clearly passionate about the question, said even though she’s taught and written about bioethics for decades, such a leadership role has profoundly influenced her, specifically as it pertains to an even more engaged understanding of the importance of bringing basic research to the patient, as well as ensuring the very best health care is made more accessible to all.
Rodriguez, who hopes to get his master’s in bioethics at Penn, and someday become a medical doctor, was encouraged by the talk. “It’s made me hopeful for the future,” he said.
“The title of the book might seem like it’s for a specific audience, but it really isn’t,” Rodriguez said. “It’s for everyone. It’s something that fits into everyone’s life.”
Perera noted a similar sentiment: “Bioethics touches everyone’s life at some point, even in ways you might not even realize.”
“It can really be a life or death conversation,” she said.