SHE Pod Season 3 Episode 6: Chris Mayes on the History of Bioethics in Australia

2:32AM Jun 9, 2022

Speakers:

Kathryn MacKay

Chris Mayes

Keywords:

bioethics

monash

australia

centre

paper

peter singer

guess

interesting

australian

monash university

question

medicine

history

laughs

debates

interested

established

american

early

polemic

Hello, and welcome to the SHE Research Podcast. I'm your host Kathryn McKay. And today I'm joined by Christopher Mayes to discuss his paper 'Co Producing Bioethics: How Biomedical Scientists and Applied Philosophers Established Bioethics in Australia'. And this paper has recently been published in the Journal of Social History of Medicine. Hi, Chris.

Hi, Kathryn, how are you?

I'm good. How are you doing?

Good. Thanks.

Good thanks so much for joining me on the podcast today.

Thanks for having me. It's so exciting to me on the other side of things.

(laughs). Yeah, well, we should put a little plug for your podcast and at the end of the episode.

Yeah.

To get us started off could you give the listeners a bit of a summary of the paper, what its about.

Sure, I guess on just the, you know, straight up kind of summary would be that it is a paper about the emergence of bioethics in Australian universities in the 1980s. So looking at the establishment of the first bioethics centre, the Monash Centre for Human Bioethics, as it was called initially. And I do that through drawing on some interviews that I did... oral history interviews with some of the early figures involved in establishing that centre, as well as archival materials, made available through Monash University, as well as stuff that I foundd in Peter Singer's archives and the National Library, about exchanges between him and others, about how to get the centre established. So I guess, you know, that's, that's essentially telling that story. With a few, I guess, theoretical flourishes here and there.

Yeah, that's super interesting. And what got you interested in this question of the history of bioethics in Australia?

I guess. Well, it came out of my DECRA research. And so that project, which I received funding for back in 2017... the thing that motivated me to put in that project and to explore the history bioethics in Australia was the way that so much of the bioethics history that has been written is has a very sort of assumed American focus or an explicit American focus. So there are some that will be you know, the history of American bioethics with that sort of national prefix, but... or qualification, but most of the history is just like, this is the history of bioethics. And it's all about America. And I remember also just teaching undergraduate bioethics. And, you know, we teach about things like the case of Roe v. Wade, obviously, quite topical now. But, and it was always and I remember sort of getting responses back, or students saying, oh, what would happen if Roe v Wade got overturned in Australia? And there was this kind of assumption that it was kind of an Australian law. Maybe that's an indicator of how poorly I was teaching these students (laughs). But just so many of our examples in sort of early... in my undergraduate bioethics curricula, you know Karen-Ann Quinlan, all of these things very important. I'm not sort of wanting to dismiss them, but they're all very American focused. I mean, I'd be interested in your perspective on those sorts of historical questions, especially as someone who is from Canada... I'm right in that aren't i?

Yeah.

And whether you sort of have experienced a similar sort of US dominance of the sort of bioethics narrative.

Yeah, I would say that I have, actually, and that, I don't know the history of bioethics in Canada. I think that it's actually quite an interesting question. I think that the question of Roe v. Wade is a really interesting one, because it has such an impact. And I was saying this recently about how like, I'm interested to see what this will do now that it's potentially... it is going to be repealed, it seems. So what's that going to do in Australia? What's that going to do in Canada? In Canada, there is no law. There's an absence of law around abortion, which is quite good. It means that it's just sort of an in practice policy. And governments have been hesitant to put any law in place. But I think that that similar confusion prevails like that... not that Roe v. Wade is a Canadian law, but that somehow there is a law, that it's somehow connected or reflective of this thing, that there's something that could be undermined or toppled. But yeah.

And potential I guess for people to go from the US to Canada to seek those treatments could be an eventu... you know what happens for some states, at least?

Absolutely. And I believe Prime Minister Justin Trudeau said something encouraging Americans to do just that, which is confusing, because it's not obvious that it's that easy to do that, you know, with health insurance, and it is an international move.

Yeah. Yeah. So that's some of the motivations, just that sort of the way... and that, yeah, as far as I could tell, and so far have been proven right, that that hasn't really been written that Australian history.

The other prominent history that I hear about the origin of bioethics is that it comes about as a result of the Nuremberg trials. And is that do you think, more of like the British slash European story?

Yeah, I mean, that's certainly a massive event. In the history of bioethics broadly, I think what's interesting in Australia is that that was, like a lot of things in Australia, there's a sense that these bad things happen somewhere else, they don't happen here. And so looking at, say, the archives of the Medical Journal of Australia and any kind of sort of letters and any kind of discussion of the Nazi experiments, or the Nuremberg trials... in Australia, that was always seen as stuff that happens elsewhere. So it was it was... wasn't seen as something that really caused much reflection, or action in the Australian medical community. I think more broadly, it certainly was one of the contributing factors to the development of medical ethics and then bioethics, and then after that, the Helsinki declaration in the Bennett, but never start sort of trying to pretend that was (laughs) that was in the 60s... 60... 1960 something or other, but yeah, that that also sort of shaped the emergence of bioethics in the US.

So in this particular paper, what are the kind of main argumentative points?

Yeah, I suppose one of the the contributions aside from just you know, yeah I'm certainly not just wanting to do you know, repeat... here's the American history here's the Australian history. I think there are distinctive and interesting things. And similarities as well between, say the Anglosphere approaches, I mean, there's a whole other question around European and different Asian approaches to bioethics. But in Australia, I think the main the main takeaway, I guess, was that, you know, I myself was attracted to some of these sociology critiques of bioethics. As, you know, bioethics has been, you know, the handmaiden to medicine and just rubber stamping these, you know, medical experiments and just trying to make novel biotechnologies palatable to populations, that sort of stuff, you know, people, like I guess, in some ways, Nicholas Rose, and then the historian Roger Kuta, have made some of those accusations against bioethics in Australia. And I think what was interesting and looking at the archives of how, and by the archives, I mean, a lot of internal letters around the establishment of the Monash bioethics centre, and that it was generated by scientists, you know, a guy, John Swan, who was the Dean of Science at Monash University, and then Professor William Walters, who was in medicine and in obstetrics, they came together and saw the need for an ethics centre. And so then they approached Peter Singer who had just come to Monash from Latrobe University and asked him would he be interested in sort of helping establish this bioethics centre? So I think one of the interesting things of looking at this, this was 1979, and then into 1980, was that, firstly, it was driven by the scientists and medicine and the medical side of things, initially at least, and that it was out of a genuine concern of not knowing how, you know, that William Walters was involved in, in the IVF programme at Monash University and there was and he had a lot of questions and had himself given some papers at various seminars, sort of raising these ethical questions around IVF and the development of it before even the birth of the first child through IVF. And so I think that was interesting in that it did... and this is I guess, when I talked about Co-production and using that science and technology studies concept to see that bioethics was sort of Co-produced through applied philosophers like Peter Singer, philosophers who are wanting to get out of the office, so to speak and into, quote, unquote, the real world. And that together, they sort of established this the centre that was not, I guess, as linear, as some of the critiques that people make: 'oh' bioethics just rides on the coattails of medical science progress and those sorts of things'.

Hmm. Yeah, it was interesting to read that it seemed like there was a real desire from the medical researchers and scientists to engage in that.

Yeah, yeah, I found that, that to be quite interesting. And William Walters, and he is an interesting figure as well, because he then after Monash... I don't talk about this in the paper, but then he went to the University of Newcastle and established or helped establish they had quite a cutting edge for the one of a better word, bioethics component to their medical education in the early 90s. And he was instrumental in getting that through.

So I'm curious about the sort of broader project. Are you, are you presenting this project in order to understand bioethics in Australia better to help it develop itself in some particular way? Or is it kind of like purely historical to find out where it came from? And to to establish how it's different than away from bioethics elsewhere? Or is there a sort of forward looking component that you hope to influence?

There's certainly a forward or present focus to it, I think, in sort of my approach to history, seeing that these understanding sort of how an institution or set of practices or ideas, rose in prominence, I think, helps us to understand how they're used and practiced today. So yeah, there's certainly a present day purpose for this. I wouldn't say I'm entirely clear what that is at the moment. But I think one thing, one thing that I do think about is, you know, that things could have been otherwise. So that that's not necessarily to say that everything's, you know, bad as it is now, but more to sort of just think about the contingencies along the way. That things that the way bioethics developed itself could have been different, and things in the present are also contingent on those differences, and also to understand some of those current debates. So yeah, why not? I'll just jump straight into sort of, like this fascination with eugenics among primarily, Monash slash Victorian based bioethicists, and that there is a long history to the eugenics movement in Victoria, and as a state, and but then that's something else that I'm interested in is state differences. And I think we've seen that play out in the way different states have responded to the pandemic. And I think that's based on different sort of cultures of public health, but also, I think, different ethical cultures about what state desires and what citizens expect. So in some ways, I don't... you know, for your listeners, who are beyond Australia, I think, you know, constitutional politics, I don't get into that, or won't be getting into that so much. But I think just the way different states are set up in the way that the state does have control over the health system has meant that there are different state difference. There are states differences in I think, the way bioethics developed as well. And then you also see that in, I've seen that in different diocese, in terms of Anglicans and Catholics, so it's not something I only allude to in the paper, but you know, in terms of futures, the book that I'll publish will have a lot more of the emphasis on religious and feminist perspectives on that early period. And with, say, the Catholic Church for instance, there was a very aggressive depending on your perspective, or very vocal and well organised Catholic bioethics representation in Victoria. And in Brisbane, there was also a very strong bioethics Catholic community, but they have a very different approach and and style if you'd like to bioethics, much less hostile in the Brisbane group whereas a lot more polemic down in Victoria between Peter Singer primarily and the Monash bioethics centre and then the St. Vincent's bioethics centre with Nick Tonti-Filippini and Kevin Andrews and others.

Very interesting, I think, it seems from the paper like Peter Singers' presence in Australia was like a major contributor to the development of bioethics by specifically that bioethics centre that you're talking about at Monash, but maybe bioethics as a field here as well.

Yeah, I mean, I think that's another one of those sort of like, alternate histories to consider. I mean, bioethics would have developed in some way if he had never returned to Australia. So he did his studies at Oxford, then he had a brief position at CUNY in New York. And then he got a position at Latrobe and then moved to Monash and, and it was really only in his move to Monash. So Latrobe didn't have a medical research programme... doesn't didn't have a medical school. I don't think it's going to medical school now. So he wasn't really apart from some stuff that he had written with Helga, I think he had written with Helga, maybe he hadn't even written with Hel- No, he wouldn't have written with Helga at this stage, but he didn't really have much in the way of medical ethics until he came to Monash. And then yes, he was quite a prominent figure. But there were others as well. So Max Charlesworth was also getting involved in this area, independently of Peter Singers influence and then the Queensland Bioethics Centre, which was the Catholic bioethics centre, was also in development, independent of the influence of Monash. So I think that bioethics would have developed, but probably not to the same prominence. And then I think in Melbourne, it was interesting, because there were these sort of two very strong forces in the Catholic bioethics centre at St. Vincent's, and then the Monash bioethics centre, and they would often have quite public debates. So there were those types of quite hostile forces in Melbourne, or polemic forces between the Catholics at the St. Vincent's bioethics centre, and Monash, which I think, again, sort of gave this sense of urgency and importance of these debates. And when I say hostile, I mean, there certainly was hostilities, and some, you know, not nice activity, I guess. But it's another interesting thing in the study is the way that Nick Tonti-Filippini was Peter Singer's student. So there was they had cordial relationships. And and it's it's been interesting, the way I guess, coming into this project, I kind of was aware of these sort of polemics between Nick and these other groups. But it's been interesting in interviewing some of the people who were involved in those debates, how highly they kind of regarded Nick Tonti-Filipini as a person who has since passed away, so I wasn't able to interview him. But yeah, it's, again, a different kind of culture, I think, to what we have today. In there aren't those, at least now in Australia, those same kinds of debates, or even the prominence given to them. There's occasional flare ups, I would say, but not in the same sort of sustained way.

Yeah, yeah. That seems interesting. And it seemed like a very fertile time. Fertile discussions and rich, yeah, rich conversations that were happening. And I think, you know, this kind of, I think goes to the, your initial question or your point about teaching people and about Roe v. Wade, and the kind of American story and stuff like that. I confess that I didn't know until moving to Australia in 2019, that Peter Singer was Australian. I always thought he was American.

That's interesting. And yeah, I mean, that's I'm not I'm not a very nationalistic person. So I find it funny being in this position of sort of working on this research area, and getting, I guess, irritated when Peter Singer or others are referred, or these developments are not referred to in their Australian context, they're just sort of assumed to be American or something so prominently for me an example of that is in Renee Fox and Judith Swayze's 'Observing Bioethics' which is a quite a sort of prominent book in this area. They talk about the founding of the International Association of Bioethics and basically say Dan Winkler did it. And then and then I think they said Peter Singer was involved a little bit, which is just completely washing away any kind of international involvement in the establishment of the International Association of Bioethics. They sort of presented as this primarily American initiative, whereas, you know, it was housed at the Monash Bioethics Centre. But anyway, yeah, I'm not interested in this for nationalistic reasons, its more just for accuracy of the story, I guess.

Fair enough. I think that's actually important, because otherwise, we do lose the meaning of the International that word International. And yeah, it starts to be like the World Series of Baseball.

That's right (laughs).

So I guess we're kind of actually coming to our time here. It's been so interesting to talk with you about this. And I have a I have a sense of what maybe some of the primary takeaway messages are that you'd hoped people would glean from the paper. But do you have any in particular that you'd like to sort of mention that you hope people will come away with?

Yeah I think that's an interesting question. I guess that they would come away from reading the paper that a number of the narratives that we have about bioethics, and especially among biothicists, I guess, the stories that we tell ourselves are more complicated and more complex. So I guess one prominent story being that it originated in the US and then just spread out and was replicated in other locations. Alastair Campbell talked about sort of, you know, it's just like Coca Cola being exported. But instead, I guess one takeaway message would be to see the way that a culture shapes the ethical responses to medicine, as culture shapes, medicine, as well. And I guess the other takeaway would be around, I guess, some of the criticals stories around bioethics of what I talked in that paper about being a sort of reductive thesis that, you know, we can just reduce bioethics to some kind of commercial exchange or some kind of prestige exchange with medicine. And it's this relationship of convenience. And that while there may be some evidence for that at different times, in the late 70s, and early 80s, it was not so straightforward.

Very interesting.

No worries.

Thanks so much for talking with me, Chris.

Oh, thanks for the opportunity.

No problem. And anyone who's interested will be able to find Chris's paper linked in this episode's show notes along with the transcript of our discussion.

Great. And send me an email if you want access to the paper and you don't have it.

Yeah, there you go. I'll provide your email address in the show notes as well, Chris.

Excellent.

All right. Cool. And listeners if they'd like to can check out Chris's podcast which is called Undisciplinary and it's available on Apple podcasts and elsewhere.

Yeah, I think it's sort of through most good podcasting outlets (laughs).

Awesome, she pod is hosted by me Kathryn McKay and produced by Madeline Goldberger. You can find the other episodes of SHE Pod on Spotify, Radio Public, Anchor or wherever you get your podcasts of quality. Thanks so much for listening. Bye.