SHE Pod Season 3 Episode 9: Prof Ainsley Newson on Academic Bioethics and Research

7:11AM Oct 17, 2022

Speakers:

Kathryn MacKay

Ainsley Newson

Keywords:

bioethics

field

ethics

research

thinking

argument

normative statement

questions

position

draw

broadly

ethical issue

view

autonomy

ainsley

reasoning

concepts

called

normative

academic

Hello, and welcome to the xi research podcast. I'm your host Kathryn MacKay. And today we have another special episode for you. This time featuring Professor Ainsley Newson, giving a recent talk entitled academic bioethics and research, which she presented at a woronora network event focused on academic and clinical bioethics finding a way forward together. Without further ado, here's Professor Ainsley Newson and her talk academic bioethics and research.

Thank you so much for the invitation to present and to start this really interesting and important discussion. So my brief was to talk to you about academic bioethics and research, which sounds easy, but actually, it's incredibly difficult to do in a short timeframe. So what I'm presenting here is unnecessarily high level, but I'm very happy to expand on aspects of it in our discussion time. So there's two things I'm going to do in this presentation. The first is attempt at a very high level to describe what the type of work that we do as bioethics scholars at Sydney health ethics, acknowledging that Sydney health ethics comprises people who do academic bioethics, but also other things too, such as qualitative health research and critical public health. And I'm going to talk to you a little bit about some of the methodologies that we use when we undertake bioethics research at Sydney health ethics. So to start with by talking about academic bioethics. So ethics more broadly, is a field of inquiry where we look at moral values underlying human behaviour and conduct. And within this bioethics is a field of inquiry. And I use that term very deliberately there is, if you believe a whole literature in bioethics about whether it is a subject, a collection of methods, or discipline or a field. And I'm one who tends to think that bioethics is a field, where we examine ethical issues in healthcare, research and population health. But we do that critically, we do that with an idea of forming ideas, as I'll go on to say about what should happen and why or how we should behave and why. And so when we're thinking about ethics, it's something distinct from etiquette, or custom, or our gut reaction, opinion, etc, the things that are on the slide here, these things are, of course, irrelevant. But the point of ethics is to critically engage with those intuitions, those emotions, those feelings, to try and look at what is driving them, and to look at how that should inform what we do and how we think and who we are going forward. So when we think about ethics, it is a way of thinking through in a fairly specific way, using methods such as those from philosophy and applied ethics, when we have a difficult issue, where conflict or concern is likely to arise. And so a good way of identifying when an ethical issue might be happening, or a good way of framing what an ethical issue might be, is to start with questions that that look at terms such as should or ought or must. And so if you're asking a short question, and if it's not just about effect, then that's an indication that there is an ethical aspect to what you're thinking about. And when we undertake ethical reasoning, it helps us in a couple of different ways. Depending on which ethical theory we might be following or attempting to use when we're tackling a particular problem, we might ask questions about the action that we're going to perform. Or we might ask questions about who we are as a person, and how that value how those values and actions should inform the outcome of what we're doing. And so if we're thinking about an action, we're trying to think about what is it that makes this right or wrong? And a key aspect in ethics more broadly, but also bioethics is that we're trying to come to a conclusion or take a position. Our job is to try and persuade others to think that the argument that we're making is the correct one. And when we're making these arguments, we're doing so in a way that is supported by reasons.

And there is a key distinction when we're talking here about so called normative bioethics, or when we're coming to a position making an argument. There is a distinction here between descriptive and normative statements, and I'd like to acknowledge Lee Sidibe who I believe is in attendance today for developing this slide. So, descriptive statements are tested using facts or evidence, we can objectively measure them and we can see the information in front of us. And these can be either true or untrue. Although of course, sometimes there is contention over the type of method that we use to measure something or the actual kind of epistemic or knowledge base. There's limits to the evidence that we can see. But generally, a descriptive statement is a sort of a what statement or a house statement, and we can see the information in front of us. A normative statement, on the other hand is evaluative, that is, it is a value laden statement, and we are trying to make a statement about what should happen or what should not happen. So, we are being either prescriptive or prescriptive. And we can only test a normative statement by looking at how the statement is constructed, whether it is logical whether the premises that it is based on are correct, and you know, whether we actually agree or not, and on what grounds. And so, the same facts can lead to different normative statements. So, just to take a very high level example of something like voluntary assisted dying, here, you might have a factual statement around suffering occurs at the end of life or can occur at the end of life. But the value that occurs from that suffering occurring, might lead you to take a different position on the moral acceptability or the ethical acceptability of voluntary assisted dying. So you could make an argument on a certain basis, and then you invite people to interrogate your argument, and to see whether they agree with you or not, and on what grounds. So what we're trying to do, as I've said, is to make and defend a position, and we come up with a set of reasons to support a key idea. And what we are attempting to do here is to persuade others to take our position to, and we do this in our academic publications, we do this in our submissions to policy consultations. And when we do this, we can draw on certain ethical theories, although we don't always do so explicitly. We can do this through what we call conceptual analysis. So you would hear terms in bioethics debates such as autonomy, that's a very popular one. And when we invoking a certain analysis of a concept, we would say, Well, what idea of autonomy are we relying on here? How are we defining it? Do we agree with the theory of autonomy that is being put forward here and on what grounds and so something that on the face of it could look quite simple, you will start to see that it actually is much more complex. And there's a lot of debate in our fields about what these terms mean, and how they apply in certain situations, as well as their relationship to other concepts in the fields such as empowerment, freedom, and so on. And also, very importantly, tools of argumentation and reasoning. So I've mentioned this a little bit so far. But there are formal ways of making and defending arguments involving making premises that should logically lead to a conclusion. And our goal is to come up with a valid argument. Now, if any of you have read bioethics literature, or literature that draws on bioethics, you'll be thinking, hang on, I don't see that in the literature as plainly as Ainsley has just described it. But this is because actually, we're, we're probably not as great at this in the field as perhaps we should be. And we don't always set our papers out with a formal argument in this way. But also, perhaps it's arguable that we don't always need to, as long as we're clear about where we're coming from and clear about how we're using concepts. So generally, what you're looking for when you're engaging with normative bioethics scholarship, is, are the authors of this work, making it clear what their position is? Are they showing the grounds on which they're making their argument? And are they drawing on all the relevant background information, which can include other theory that has gone before or perhaps some empirical evidence to, but ultimately, good bioethics research involves making and defending a position and being clear about how you're getting to your conclusion, to invite others to then critically engage with your views.

So what you'll see from that is that I so far, I haven't at all mentioned what is a very common way of thinking about ethical issues in clinical care or medicine more broadly. And that is the so called four principles of Biomedical Ethics. So these are somewhat unavoidable in a in a medical school environment or a health professional education environment. They're also commonly invoked in clinical ethics practice on our healthcare practice more broadly. So I would say these, of course, are highly influential, and, you know, very highly regarded in the field. But in our day to day work as academics working in the bioethics sphere, I would say we draw on these relatively infrequently in the sense that what we do is kind of in parallel to this type of analysis. So that this is just one mechanism that we can use when coming up with arguments for positions that we wish to defend. And so We take on broader approaches or the theories, we look at different conceptualizations of the of the principles that Beecham and Childress have articulated. So just to kind of illustrate that, when you think of bioethics, it's a lot more than just the four principles, important as they are. So I'll just move on now to briefly consider what we actually do when we do bioethics research. So it's really complex to explain and very challenging, and I probably won't do a particularly great job. But I think one thing to explain is that as a field, bioethics remains relatively young, and it is also a field that has come from lots of different places, and there are bioethics groups, in lots of different faculties in universities globally, they can be in medical schools, in law faculties, in social science areas in philosophy. And there's also people doing bioethics work within non government organisations, government departments, for example. And so we are coming at this idea of what we should do, and why in health from lots of different backgrounds. We come from philosophy, social science, law, medicine, history, etc. And so when we do this, we bring with us our baggage from our training. And we bring with us our disciplinary norms and our expectations. And sometimes there's quite a bit of negotiation to be done, to work out how we all rub along together, the way that we ask questions can differ and the concepts that we tend to draw Ron can also be different for these reasons, as are the theories and approaches that we do. So there's a lot of concentric circles in bioethics research. And this can come to the surface when we are evaluating each other's research proposals for funding when we're collaborating with experts from outside our fields as well. But so what do we actually use? What methods do we use? I've touched on this a little bit already. But we use all of these things that are coming up on the slides here. Now, qualitative health research, normative bioethics reasoning, which I've picked up on and described in the most detail, so far, deliberative, public engagement, that is a form of engagement, using qualitative methodology, but in a way to have your participants as experts alongside you by the end of the process, historical reflection, survey based or quantitative research, policy analysis, and of course, philosophy. So Oh, and of course, legal reasoning as well. So you can see here that there's a lot of different methods involved in the way that we ask and answer our questions. And one valid question in our field is, well, which of these is primary? And there isn't necessarily an answer to that question. All of you attending today will probably have different views about that. But ultimately, we are an inherently disciplinary field, interdisciplinary field rather. And so actually bringing these norms and expectations and being clear about where we're coming from, is part of how we successfully collaborate with each other. So when it comes to your practice, whether you are an academic who identifies as someone in bioethics already, someone who's interested in bioethics, or someone who really hasn't had much to do with it until this point in time, your practice whatever it is, what would you defend about it on an ethical perspective? And what makes your view about this a reasonable view to hold? And on the other side? What worries you if anything about your practice and why and again, what makes your view reasonable? And most importantly, how would you seek to convince someone else that your view is the correct one. So that's just a way of trying to kind of so called wiggle your ethics and 10 a, when you're thinking about and reflecting on your own work. Thank you so much for listening.

Thanks for listening to this special episode of The she research podcast. You can find a transcript of Ainsley talk Linked in this episode's notes. She pod is produced by she network and edited by Madeline Goldberger. You can find our other episodes on Spotify, radio, public anchor or wherever you get your podcasts of quality. Thanks again for listening. Bye