To Clone or Not to Clone?

Throughout history, major breakthroughs in medicine and science have oftentimes been met with skepticism, blatant criticism and even fear. Take, for example, the advent of the autopsies or, closer to today, artificial insemination, stem cell research, and the right to choose how we die.

“Are these things playing with the proper order of nature or are they creating uncontrollable risks, frightening scenarios, or is all this being exaggerated?” asks Mark Hall, director of the Center for Bioethics, Health and Society at Wake Forest University. “Are we all just letting our science fiction fantasies run wild, and are we stalling productive advances in medicine and technology with Chicken Little fears of the sky falling in?”

How we address and discuss these issues as individuals, as a society or as an institution will be critical to the future of health science and technology. By offering a masters of arts in bioethics, Wake Forest University is providing students of the program with a “tool kit” to help guide us through these important deliberations. The only one of its kind in North Carolina, the bioethics program at Wake Forest is designed to equip graduates to practice, teach or conduct research related to ethics and public policy issues in medicine and biotechnology.

In the program, students learn to articulate the various issues, arguments and positions from different points of view and come to understand how to reconcile differences of opinion and how to question unexamined beliefs, says Hall, who is the Fred D. and Elizabeth L. Turnage professor of law, and a professor in the Department of Social Sciences and Health Policy.

In an age when genetic engineering of the human person is a distinct possibility, the challenges our society faces in bioethics have never been more pressing.

The goal of the program, he says, is to provide a tool kit for deeper understanding of – and successful ways of discussing — these or approaching issues, and to resolve them when they can be resolved, or otherwise find avenues to discuss and air them in productive ways.

“The skill set, or tool kit, is useful in a number of arenas,” Hall says. “Our goal is not simply to brand someone a bioethicist and give them a license to practice bioethics, to go spout off wisdom as some sort of seer or guru. It’s to bring a deepened understanding … to work in whatever occupation they’re going to pursue.”

“All of the developments in genetics, neuroscience, and stem cell therapies … have really pushed us forward into several new challenging frontiers. And those kinds of developments are only going to accelerate.”

The full-time MA in bioethics degree program, which began in fall 2009, is designed to be completed in as little as one academic year plus the summer. Part-time students can take up to six years to complete the program, and most bioethics courses are offered in the late afternoon or early evening to accommodate working professionals.

Planning for the MA in bioethics, part of the Center for Bioethics, Health and Society at Wake Forest, has been in the works for about 10 years. The study of bioethics, Hall said, dates to the 1960s, when the need for a better ability to address life-and-death cases came to the fore. Hall offered as examples the cases of Karen Ann Quinlan and Terry Schiavo, women who, because of accident and illness, catapulted the right-to-die debate into the headlines and public consciousness.

“These issues are still with us,” Hall says. “We’re still grappling with how to deal with them, and there are still major divisions in public attitudes about them, between religious beliefs and professional views and lay views. Those issues are never going to go away, and we’ve been focused on them for the past couple of decades.” But new issues now confront society.

Wake Forest President Nathan O. Hatch, who was instrumental in starting the bioethics program, has said, “In an age when genetic engineering of the human person is a distinct possibility, the challenges our society faces in bioethics have never been more pressing.”

Bioethics student Deborah Love is an executive coach and organizational development consultant who also holds an MBA in organizational behavior and industrial relations. She has a law degree from Wayne State University in Detroit.

The bioethics program, she says, has led her to challenge her beliefs, which many times have been “clobbered.” Love, for instance, has believed that rather than people having to choose to become organ donors, they should be presumed to consent, with the option of declining, which would ultimately increase the potential for eligible participants.

“The presumption is you’re a donor unless you say otherwise,” she says. “Then I read some research about it. There is a whole segment of our society that doesn’t trust the medical profession … We have this segment of society that feels their power differential is not equivalent with physicians, and they legitimately believe physicians might hasten their death to harvest organs on behalf of science for somebody who is in a more privileged position. I had not considered the world that way. That made me really stop and think that we can’t have that bias of presumption when we have a segment of the population that doesn’t trust the profession.”

When the Wake Forest community began discussing the possibility of implementing a program focusing on bioethics, no university in the state or any surronding state offered a master’s program in the discipline.

“When we first began to survey this field about 10 years ago we noticed right away that there was really a pressing need for more bioethics education and expertise. We felt like bioethics would be a good fit for Wake Forest, particularly to draw the different parts of campus together,” Hall says. “The slogan for Wake Forest is, ‘Small of scale, large in resources,’ and I think that exactly captures things. We bring a lot of resources to bear, but we’re going to keep the program well-sized to be able to deal with each person’s individual interests.”

What makes the Wake Forest program unique?

“First, it still is the only one in North Carolina. The key is that the scale and scope of it really reflects the advantages of Wake Forest as a whole. We can provide exposure to all the major areas of bioethics, which include clinical medicine, biotechnology, health care, finance and regulation … all of the key areas.”

In addition to its flexible scheduling options, the MA in bioethics at Wake Forest draws a diverse group of students — in regard both to age and professional background — who connect across various demographic and social boundaries.

“We’ve been able to draw students from so many different areas and walks of life, and they’ve all sort of melded together,” Hall says. “We have students in their 20s who have recently graduated from college, but they include people from the sciences, philosophy and religion, from business and economics — all together. But we also have a good number of students who are well along in their professional careers. Those are not just doctors but people in health care administration, insurance and other facets of professional life. They bring a lot of perspective and maturity alongside the youthful enthusiasm and the higher energy of the younger students.”

That bioethics was a multi-disciplinary field was the clincher for Gerardo Ramon Maradiaga, who holds a degree in philosophy from the University of North Carolina at Chapel Hill. He has experience at Halifax Regional Medical Center Emergency Department as a patient liaison and has shadowed a surgeon during multiple procedures. Maradiaga also is an Emergency Medical Technician and plans to become a paramedic or emergency physician.

“You have these great schools (within Wake Forest), and they’re going to all be involved in this program. And it’s not just some new program they came up with overnight. So, I knew they were really trying to make sure this would be a great program.”