Understanding Bioethics

A recent guest speaker at Upper School News explained that he owed much of his career path to a decision to take a 4:00 p.m. class rather than an 8:00 a.m. class in college. As a pre-med student, Dr. Arthur Caplan was required to take outside course offerings. His selection of an afternoon Philosophy class sparked a deep interest, which ultimately led to his receiving a PhD in the history and philosophy of science at Columbia. Dr. Caplan—the Drs. William F and Virginia Connolly Mitty Professor and founding head of the Division of Bioethics at New York University Langone Medical Center in New York City—is now one of the leading bioethicists in the world.

Dr. Caplan joined the girls to discuss bioethics, or the ethical implications of biological research, at the request of one of his former college students, Kim Karetsky Krinsky ’95. The field, he explained, was born out of concern over concentration camp studies; research done on prisoners for military purposes; and later, the withholding of a treatment during the Tuskegee Study, which examined the effects of untreated syphilis on the human body. Bioethics, Dr. Caplan also noted, interests individuals from many different roots—lawyers, doctors, journalists, psychiatrists, anthropologists, and researchers—who study it and consider it to be critical in their fields.

To illustrate some of the bioethical issues and discussions that can arise, Dr. Caplan used the example of HPV vaccinations. HPV, he explained, causes 100% of cervical cancer cases. There are 100 strains of HPV, seven of which cause cancer and two that cause genital warts. In the United States, there are 10,000 cases each year that result in 4,000 deaths (mostly because those women didn’t have pap smears). In poorer countries, the death rate from cervical cancer is 300,000. Treatment is very difficult, Dr. Caplan explained, so prevention is key.

There are currently two vaccinations being marketed for HPV. Merck’s protects against four strains, while Glaxo’s protects against only two strains but is cheaper. Dr. Caplan asked, “Ethically is it okay not to worry about genital warts in a developing country because a vaccine is cheaper and still prevents the other two strains?”

Dr. Caplan discussed other key ethical issues, which are: Why and when should we vaccinate? Are we encouraging sex and discouraging abstinence? What about the safety? Should the government mandate these vaccines? Who gets access? What about boys, who are also carriers?

While News ended with a Q & A, at least 20 girls lined up after the program to continue their discussions with Dr. Caplan. Their interest in bioethics piqued, recess was quickly forgotten.