AMA Journal of Ethics®

Illuminating the art of medicine

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AMA Journal of Ethics®

Illuminating the art of medicine

Virtual Mentor. April 2001, Volume 3, Number 4.

From the Editor

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Lighten Up

The journal editor writes about his work as a bioethicist and the importance of balancing the influence of various forces that impact those working to solve real-world problems in the field of medicine.

Audiey Kao, MD, PhD

As we enter the month when April foolery and the bloom of spring are celebrated, it seems like an appropriate time to poke fun and laugh at ourselves with individual renewal and growth as our goals. More specifically, the bioethics enterprise that has been intently nurtured and firmly established over the past three-plus decades demands periodic examination of its roots and branches so as to promote its continued flourishing.

First, bioethics deserves worthy credit for tackling the issues and challenges brought about, in large part, by advances in science, technology, and medicine. This focus is reflected, for example, in the recognition among leaders of the human genome mapping project to dedicate public funds for examining and addressing the ethical consequences of decoding our genetic biology. Bioethicists have also played a key role in protecting respect for autonomy as it applies to clinical care and human subjects research. In an increasingly interconnected world, the social and economic implications of our decisions in these matters are so far-reaching that attention to the ethical dimensions of individual or collective choices is critical.

Given these important contributions, the bioethics enterprise is nevertheless caught, in some respects, under the weight of its success. Today, the field of bioethics and its practitioners enjoy much exposure in the mainstream discourse. Rarely does a day go by that ethical dilemmas raised by one story or another are not reported on and disseminated in print, TV, radio, and over the Internet. But like all stories that compete in the marketplace of information, the bioethics stories considered "newsworthy" are oftentimes the most dramatic, exotic, or entertaining. A scan of the morning headlines can reveal stories that feature commentary about and analysis of the fertility tourists, fashion models (or ivy league co-eds) selling their eggs, and organ snatching.

Of course, there is media coverage, like the recent Time cover story (February 12, 2001) that focused graphic, and much needed attention on the human suffering and devastation of the AIDS plague in Africa. With more than 17 million Africans dead from AIDS and many millions more infected with HIV, our collective response to this human suffering will define our humanity in significant ways in the new century. Therefore, the media would do better to lighten up on the load of stories that directly or indirectly affect few individuals and communities, and focus on more pressing and prevalent challenges that confront us as a global society.

While the media plays a key role in driving the public discourse, it is simply too easy and convenient to blame an insatiable appetite for sensationalistic journalism for the quality of discourse concerning matters of ethical import. As members of the bioethics enterprise, we also contribute to this trend through our over-intellectualization of issues and by focusing on one branch of a tree -- often the most remote one, at that -- rather than the forest. Moreover, philosophical critiques that border on self-righteousness can be less than helpful to those doing the work of bioethics, dealing with issues that are never black and white. As an applied field of study, the bioethics enterprise continues to contribute to positive changes in society, but bioethicists, as public intellectuals, must balance their energy and expertise carefully so that issues of greatest import and relevance get their proper due. As members of the bioethics enterprise, we can often advance our ideas and passions more effectively if we don't take ourselves too seriously, but rather lighten up on academic intensity, roll up our sleeves, and simply get to work crafting practical solutions for real-world problems.

As the Virtual Mentor nears its two-year anniversary, it is necessary that we constantly reexamine and turn a self-critical eye on our work, but at the same time, know when not to take ourselves so seriously; this advice will come as no surprise to the hardworking and dedicated editorial staff. To our readers and contributors, your comments and critiques about how the Virtual Mentor can better achieve its goal of strengthening the ethics and professionalism of tomorrow's physicians are always welcome, even if it is to tell us to lighten up now and then.

The viewpoints expressed on this site are those of the authors and do not necessarily reflect the views and policies of the AMA.