Bioethics Moves into a New Era
In late April 2014, Wake Forest University’s Bioethics program traded its high-rise views but isolated floors in a downtown tower for space in the newly renovated, historic 525@vine building near Biotech Place in Wake Forest Innovation Quarter. The new location and layout, with classrooms and common areas, will support the program’s multidisciplinary nature and cross-campus reach.
“This new space is an ideal setting to fulfill our educational mission and public engagement goals,” said Mark Hall, JD, professor of Law and Public Health. “It’s more accessible and will foster more interaction. The human factor is vital in every area of life, but especially so in the arena of bioethics.”
Becoming a Leader in Bioethics
Hall has worked with the bioethics program since 2001, when a cross-campus initiative led by Sally Shumaker, PhD, identified bioethics as a perfect fit for the university’s Pro Humanitate mission and Wake Forest Baptist Medical Center’s stature in leading-edge clinical care and research. However, the institution needed to commit resources and recruit expertise before it could join the national dialogue on issues such as end-of-life care or emerging medical technologies.
Nine prominent scholars were invited in 2004 to advise program organizers. Over the next four years, the cross-campus organizers recruited a faculty member to focus on research ethics and lead program development, helped Internal Medicine establish an endowed chair on clinical ethics, started a master’s program in bioethics, and secured institutional funding for the Center for Bioethics, Health and Society.
Since 2009, the Center has sponsored national conferences on patient-centered care, research ethics, genetic enhancement and access for the uninsured. In 2013, the Center celebrated its fifth year with a “Bioethics All-Star Speaker Series.” Support for the Center was recently renewed for five additional years.
“Now, through the resources and capacity that the Center provides, we are able to step to the forefront and engage in the national conversation on bioethics,” Hall said. “Furthermore, we are prepared to lead as new bioethical issues emerge.”
The Center for Bioethics, Health and Society focuses on three key areas: biotechnology, health care justice, and clinical ethics. It approaches these priorities through research and scholarship, education, and public engagement. The Center has provided seed money for pilot studies, funded continuing education and workshops on clinical ethics, and sponsored symposia on topics such as food laws and their impact on public health and safety.
“You can’t have conversations about many of the important questions in health care ethics without input from medical professionals and those working in public health, law and policy,” said Ana Iltis, PhD, associate professor of Philosophy, who was recruited in 2009 to direct the Center. “We are a nexus for bringing those people together. Often there’s no natural connection between those entities, but our Center makes fruitful collaborations possible.”
Bioethics faculty consult with researchers when questions arise about research studies. For example, an investigator may collect genomic data from a subject for one purpose but later would like to include the data in a national database. How should the investigator inform the subject about this change?
On the Reynolda Campus, Iltis leads research consultations on questions like this. Her counterpart and co-director, Nancy M.P. King, JD, professor of Social Sciences and Health Policy, is the key contact at the Medical Center.
“We don’t set ourselves up as the authorities who must vet everything,” said King. “We help clarify issues and identify important questions. For example, how do we think about the role of research subjects when we have all these new biotechnologies? We enroll people who are already patients as research subjects, but do they understand the difference between research and treatment?”
The Medical Center’s Clinical Ethics Committee meets six times each year and provides support for bioethical policies, clinical consultations and continuing education. John Moskop, PhD, Wallace and Mona Wu Chair in Biomedical Ethics and professor of Internal Medicine, chairs the Committee and teaches a master’s level survey course on clinical ethics.
“Roughly three quarters of our clinical ethics consultations have to do with treatment decisions near the end of life,” Moskop said. “Family members often cannot agree on care decisions when patients cannot speak for themselves. That is why we emphasize the importance of advance care planning and advance directives to prevent these situations at an already difficult time.”
Hall and King lead the Master of Arts in Bioethics program, which draws faculty from the schools of Medicine, Law, Divinity and College of Arts & Sciences. The MA degree requires 24 hours of course work and a six-hour thesis.
To serve the varied needs of students pursuing clinical practice, research, administration, health law or ministry, several joint or dual degrees are offered. These include the MD/MA, JD/MA, MDiv/MA and BA/BS & MA, as well as a 12-hour graduate certificate.
As of April 2014, 30 students have completed a Master of Arts degree, and four students have completed a graduate certificate. Enrollment each year averages about 30 students, with approximately half of the students having completed their coursework who are focusing on writing their thesis.
“We have a broad mix of students who are incorporating bioethics into their careers,” King noted. “We try to be accommodating and responsive to each student’s needs and interests and will continue to shape our program to fit their needs as medicine, law, society and bioethical issues evolve.”
Credit: Internal Communications