InFocus MacDonald, C. 2003. Will the “Secular Priests” of Bioethics Work among the Sinners? The American Journal of Bioethics 3(2):InFocus http://bioethics.net AJOB 1 Will the ‘Secular Priests’ of Bioethics Work Among the Sinners? Chris MacDonald, Ph.D. Saint Mary’s University, Halifax, Nova Scotia, Canada Abstract In this paper, I explore briefly the “secular priesthood” metaphor often applied to bioethicists. I next ask: if, despite our discomfort with the metaphor, we were to embrace the best aspects of the priesthood(s) – which I identify as the missionaries' willingness to work among sinners and lepers, at their own peril – would we be able to live up to that standard of bravery? I then draw a parallel with the fears of contagion currently be voiced (by Carl Elliott and others), with regard to bioethicists working in or near corporate settings. I argue that such fears may themselves have a number of deleterious effects, and I suggest several possible positive steps in response to that fear. One of the metaphors that makes those of us within the bioethics community most uncomfortable is that of ‘bioethicist as secular priest.’ The comparison is not without basis, of course. Ethicists commonly act as confidants, as advisors, and as interpreters of the ‘holy texts’ of bioethics. But our discomfort with the comparison is also understandable. We hope that, unlike priests, we do not preach (or at least that we keep the preaching to a minimum), and we also hope to be modest in our claims to know the truth. Where the priest can hope to call upon revealed truth, all that the bioethicist can call upon is considered judgment. Secular bioethicists don’t want to be compared to Christian, Jewish, or Muslim clerics. No offense is intended here; likely those same clerics would likewise want to make a clear distinction between what we, and they, do. But the characteristic shared by a number of religious orders that most amazes me, and the one that I think most warrants careful thought as far as comparisons with bioethics are concerned, is the willingness of some orders of the priesthood to undertake work in difficult settings, in places that are dangerous both physically and spiritually. Priests (and I use the term loosely, here, to include holy men and women of many faiths) have been willing to work among the sinners, the lepers, the ‘savages.’ History shows us, of course, that such work too often reflected an unfortunate ethnocentrism. But the fact remains that such work requires bravery and dedication. If (or to the extent that) bioethicists are to be compared to priests, who are the modern-day pariahs to whom we will minister? Some will be quick to point, here, to the ‘untamed wilds’ of the clinical setting, or to the jungles of the Research Ethics Board. But by missionary standards, those settings are tame. The people in those settings are people too much like us (fellow professionals, fellow academics, people with university degrees) for working among them to be considered brave, on a day-to-day basis. Surely, such work presents the opportunity for bravery (see Freedman 1996). Standing up to a powerful clinician or researcher is, as the largely unwritten history of our discipline makes painfully clear, a difficult and sometimes dangerous thing. Ethicists’ jobs have been threatened, and even lost, over such things. But those crises are not the bread and butter of our work in these relatively tame lands. I think an argument can be made that, to the extent to which a comparison is to be made, the real pariahs of modern bioethics – the ones among whom our work involves the most moral and professional peril – are the biotechnology and pharmaceutical companies. Worries about the risks of contagion involved in working with biotech/pharma were front and center, for example, at the 2001 annual meeting of the Canadian Bioethics Society, held in Winnipeg. Plenary speaker, Carl Elliott, 1 worried aloud about the academic freedom of ethicists in the employ of large corporations, and warned, quite appropriately, against letting such corporations use bioethicists as a way of absolving themselves of responsibility for moral choice. Françoise Baylis, also speaking in a plenary session, reminded us that working in, or even near, such settings may put us in situations that require us to make personal and professional sacrifices in order to do the right thing. 2 Charles Weijer, in the post- conference session on bioethics and the media, told how the invited editorial he had written at the request of an academic journal had been deemed unsuitable for publication, apparently because his views (by no means idiosyncratic) conflicted with drug company interests. 3 And Arthur Schafer told the audience at the post-conference workshop that he thought that the domination of the health research agenda by pharmaceutical company funding was the most urgent