and the university administration (2) perspectives on the benefits and drawbacks of unionization for workers employ-ers and society more generally and (3) general literature on the legal and ethical dilemmas raised by subcontracting in Iraq At the top of the packet I included a list of questions the first of which was ldquoWhat if any lsquobioethicalrsquo issues does the Sodexo controversy raiserdquo
For many bioethicists the answer to this question would be ldquononerdquo My students and I came to a different conclusion In class we discussed the case of one of the workers who though pregnant was denied break time and who along with the other workers demanding unionization was presumably struggling to pay her living expenses including health care ldquoWhat if she decided to get an abortionrdquo I asked ldquoWould her labor situation be relevant to her decision to abortrdquo The answer to this question was clear but the students went even further pointing out that labor status was relevant not only to abortion but also to practically all of the bioethical topics we had discussed including euthanasia organ donation and eugenics At the same time our examination of subcontract-ing in Iraq showed that while Emoryrsquos decision to abandon the employees was certainly a moral failure it was also part of a systemic shift toward subcontracting practices that had created ethical and legal conundrums throughout the world That bioethicists had written hundreds of thousands of pages on ldquoautonomyrdquo without writing one article about its relation to subcontracting seemed by the end of class an indication that the field had misunderstood its own premises
The goal of bioethics in the next forty years should be to guarantee that such fundamental misunderstandings do not occur This will happen by stopping the search for new top-ics and instead becoming more reflective about our methods and more proactive in building institutions that can produce thinkers with the sensitivity and analytical skills to realize the fieldrsquos founding ideals Doing so will require redefining the contours of not only the field but also our own identity as professionals It will not be easy but if we want to live up to our role as moral arbiters of some of our societyrsquos thorniest problems it is work that we will be glad to undertake
Harold Braswell is a student in the interdisciplinary PhD program at Emory Universityrsquos Graduate Institute of the Liberal Arts His research and teaching combine methods from cultural studies law philosophy and the social sciences to analyze pressing bioethical dilemmas He applies this interdisciplinary methodol-ogy in his dissertation which examines the relationship of hospice care to end-of-life autonomy
1 D Rothman Strangers at the Bedside A History of How Law and Bioethics Transformed Medical Decision Making (New Brunswick NJ Aldine Transaction 2008)
2 R Cooter ldquoThe Resistible Rise of Medical Ethicsrdquo Social History of Medicine 8 no 2 (1995) 257-70
3 SE Lederer ldquoChildren as Guinea Pigs Historical Perspectivesrdquo Accountability in Research 10 no 1 (2003) 1-16
4 See for example O Corrigan ldquoEmpty Ethics The Problem with Informed Consentrdquo Sociology of Health and Illness 25 no 7 (2003)
768-92 P Farmer and NG Campos ldquoRethinking Medical Ethics A View from Belowrdquo Developing World Bioethics 4 no 1 (2004) 17-41 and C Gill ldquoThe False Autonomy of Forced Choice Rationalizing Suicide for Persons with Disabilitiesrdquo in Contemporary Perspectives on Rational Suicide ed JL Werth (Philadelpia Penn Routledge 1998) 171-80
5 For more on the investigation of ldquoproblem constitutionrdquo in philo-sophically oriented social science research see SK White ldquoThe Very Idea of a Critical Social Science A Pragmatist Turnrdquo in The Cambridge Companion to Critical Theory ed F Rush (Cambridge UK Cam-bridge University Press 2008) 310-35
One winter morning the two of usmdashboth postdoc-toral fellows in medical humanities and bioethicsmdash gathered with a handful of reproductive science
graduate students in the lab to watch a demonstration on making alginate beads Due to their three-dimensional na-ture the beads are capable of holding ovarian folliclesmdashthe beads act as though they were a small ovary The scientists in the lab have managed to mature the follicles maintained in the beads into eggs fertilize these eggs and produce the birth of live mice This research was begun in an effort to develop a means of gathering ovarian follicles from young human can-cer patients before they commence cancer treatment that may result in their infertility thus preserving parts of their ovaries for later use in in vitro fertilization
But the point of this paper is what else happened that day in the lab The graduate students and the fellows began
Two Chicks in a Lab with Eggs
BY L ISA CAMPO -ENGELSTEIN AND SARAH B RODRIGUEZ
Lisa Campo-Engelstein and Sarah B Rodriguez ldquoTwo Chicks in a Lab with Eggsrdquo Hastings Center Report 41 no 3 (2011) 21-23
copy 2011 The Hastings Center Permission is required to reprint
22 HASTINGS CENTER REPORT May-June 2011
talking about the inability of the lab to extend the experiment to see if human ovarian follicles are similarly capable of ma-turing into eggs that would be fertilizable As the recipient of a grant from the National Institutes of Health the lab must abide by the Dickey-Wicker Amendment which bans federal funding for research involving human embryos and parthe-notes A parthenote is an egg that begins dividing as though it were fertilized even though fertilization has not occurred Eggs can be induced to develop into parthenotes (a process known as parthenogenesis) in the absence of sperm by sev-eral different chemical and mechanical stimuli that mimic fertilization The lab scientists understood the prohibition of federal funding for embryos but they were frustrated that parthenotes were lumped in with embryos especially giv-en their scientific differences because the ability to use human parthenotes would significantly improve their understanding of egg matura-tion in humans We were sur-prised to learn about the ban on parthenote research and somewhat chagrined to recog-nize how little we knew about the Dickey-Wicker Amend-ment Our discussion with the scientists of why a parthe-note was legally and ethically equated to an embryo in the Dickey-Wicker Amendment began the first of several joint research projects1
Many have noted the importance of multidisciplinary work and here we describe how such workmdashwell worked We also show how our postdoctoral fellowships could be used as a model for the postgraduate training of others in medi-cal humanities and bioethics But first a bit about our back-grounds because our multidisciplinary work is not just about being embedded with scientists but also about coming at medical humanities and bioethics from different disciplines Lisa approaches her work from a philosophical background with careful attention to power dynamics that can lead to health care inequities and injustices Sarah comes at her work from a historical perspective looking at how an issue devel-oped in order to contextualize ethical issues and frame ques-tions being asked today Yet given that we both work in the broader field of medical humanities and bioethics our work by its very nature is multidisciplinary Furthermore we are both interested in reproductive health and how the issues brought forward and the questions being asked are influenced by and influence the larger culture We learn from each other the importance of historic contextualization and philosophi-cal inquiry and we join our work with the work in the lab
By being embedded in the lab we can both learn more about reproductive science and enable scientists in the lab to think about their work away from the bench We discuss the differences between the scientific process and the histori-cal and ethical research processes as well as the similarities among the disciplines We learn about the science of ovaries ovarian follicles eggs embryos and parthenogenesis which furthers our ability to carefully analyze the intricacies of re-productive technologies The scientists learn about the legal historical and ethical parameters of the science providing them a useful context for understanding how and why their
work is seen as it is by those outside reproductive science It is this embedded nature of our fellowship that we suggest would make for a strong fel-lowship training in medical humanities and bioethics for it not only provides a greater understanding of science for us but also engenders multi-disciplinary research projects that few of us had contem-plated like the one on the Dickey-Wicker Amendment
Through these intellectual exchanges we encounter the difficulty of talking across disciplines To speak to each other we were forced to de-velop as one of our mentors has termed it a ldquocommon languagerdquo Without compro-mising complexity we had to
construct a way of expressing ourselves and our ideas in a way that made sense to the scientists and vice versa With-out this common language scientists sometimes do not see the value of perspectives from the medical humanities and bioethics at least in our experience Part of the reason for this (we learned from the reproductive scientists in our lab) is their sense that the medical humanities and bioethics voice is generally negative amounting to nothing more than finger wagging By working in the lab and providing suggestions of different ways to look at a topic or different questions to ask we were able to provide examples of a constructive voice from bioethics and medical humanities
But reproductive scientists also often hear critical voices from the public By interacting with each other in the lab we are able to begin to discuss perceptions and help contex-tualize why reproductive science is often met with such vis-ceral reactions by nonscientists In so doing we also explored reproductive scientistsrsquo own visceral reactions to critiques of their work For example for the summerrsquos brown bag dis-cussion group we selected and led the discussion on Emily Martinrsquos article ldquoThe Egg and the Sperm How Science Has Constructed a Romance Based on Stereotypical Male-Female
We believe the strength of our embedded fellowship is in large part due to our
ability to effectively communicate with each other through a common
language
May-June 2011 HASTINGS CENTER REPORT 23
Rolesrdquo As the title suggests Martin describes how gender roles are often projected onto reproductive biology resulting in the portrayal of eggs as passive and of sperm as active We were surprised by some of the scientistsrsquo negative reaction to this article Upon further discussion we realized that many of the scientists felt that Martin was chastising them and we were able to move past the tone of the article to elicit its more significant content Only by breaking down Martinrsquos argu-ment into a common language were some of the scientists able to understand and appreciate her claims In the end the discussion of Martinrsquos article was a success because the scientists grew more aware of the gendered language in re-productive biology and made a choice to avoid it Moreover the discussion led to multidisciplinary research projects on the topic such as an examination of how science textbooks from middle school through medical school employ gendered language
We believe the strength of our embedded fellowship is in large part due to our ability to effectively communicate with each other through a common language We learned to con-vey our work and its value in a way that makes sense to these scientists The credit is not just ours however the scientists also strove to construct a common language In fact the sci-ence contribution started long before we worked together It began when the principal investigator of the grant Teresa K Woodruff recognized the importance of incorporating hu-manities and social science projects into the overall project Part of doing this included embedding medical humanities and bioethics postdoctoral fellows in the lab per the sug-gestion of Laurie Zoloth Teresa understood that such an arrangement would encourage more interaction between sci-entists and humanists which would lead to multidisciplinary projects It also showed an appreciation for the value of think-ing about science and technology beyond the bench Putting scientists and humanists ldquoon the same teamrdquomdashhaving them work for the same organization to achieve similar or at least related goalsmdashestablished a level of camaraderie and trust from the get-go thereby creating an environment that would allow professional relationships and projects across disciplines to flourish
While the success of our fellowships relies in part on the personality of the scientists whose lab we are in our lab can still be seen as a model from which to copy future embed-ded fellowships in medical humanities and bioethics The
importance of this to the future of medical humanities and bioethics is clear As academic disciplines become increasingly technical we must be able to understand each other to have meaningful dialoguemdashsomething that is particularly helpful if ethical problems arise and only possible through a common language By establishing medical humanities and bioethics postdoctoral fellowships embedded in scientistsrsquo laboratories multidisciplinary workmdashand perhaps more importantly a common languagemdashwill hopefully emerge
Lisa Campo-Engelstein earned a PhD at Michigan State University in philosophy specializing in bioethics feminist theo-ry and socialpolitical justice When she cowrote this article she was a senior research fellow in medical humanities at the On-cofertility Consortium Northwestern University Feinberg School of Medicine where she examined ethical issues in the areas of reproductive technologies cancer and womenrsquos health She will continue analyzing these issues in her new position as an assistant professor at Alden March Bioethics Institute Albany Medical College She coedited Oncofertility Ethical Legal Social and Medical Perspectives (Springer 2010) and her work has ap-peared in Science the Journal of Clinical Oncology the Jour-nal of Medical Ethics and the American Journal of Bioethics
Sarah B Rodriguez earned her Master of Arts in the history of science and medicine from the University of Wisconsin-Madi-son and her PhD in societal and preventive medicine from the University of Nebraska Medical Center She was a senior research fellow in medical humanities at the Oncofertility Consortium when she cowrote this article she is now a postdoctoral fellow in medical humanities and bioethics at Northwestern University Feinberg School of Medicine She is interested in the history of womenrsquos sexual and reproductive health and especially in how this history frames current discussions She coedited Oncofertil-ity Ethical Legal Social and Medical Perspectives (Springer 2010) and her work has appeared in Science the American Journal of Bioethics and the Journal of the History of Medi-cine and Allied Sciences
1 S Rodriguez L Campo-Engelstein C Tingen and TK Wood-ruff ldquoAn Obscure Rider Obstructing Science The Conflation of Par-thenotes with Embryos in the Dickey-Wicker Amendmentrdquo American Journal of Bioethics 11 no 3 (2011) 20-28 C Tingen S Rodriguez L Campo-Engelstein and TK Woodruff ldquoPolitics and Parthenotesrdquo Science 330 (2010) 453
22 HASTINGS CENTER REPORT May-June 2011
talking about the inability of the lab to extend the experiment to see if human ovarian follicles are similarly capable of ma-turing into eggs that would be fertilizable As the recipient of a grant from the National Institutes of Health the lab must abide by the Dickey-Wicker Amendment which bans federal funding for research involving human embryos and parthe-notes A parthenote is an egg that begins dividing as though it were fertilized even though fertilization has not occurred Eggs can be induced to develop into parthenotes (a process known as parthenogenesis) in the absence of sperm by sev-eral different chemical and mechanical stimuli that mimic fertilization The lab scientists understood the prohibition of federal funding for embryos but they were frustrated that parthenotes were lumped in with embryos especially giv-en their scientific differences because the ability to use human parthenotes would significantly improve their understanding of egg matura-tion in humans We were sur-prised to learn about the ban on parthenote research and somewhat chagrined to recog-nize how little we knew about the Dickey-Wicker Amend-ment Our discussion with the scientists of why a parthe-note was legally and ethically equated to an embryo in the Dickey-Wicker Amendment began the first of several joint research projects1
Many have noted the importance of multidisciplinary work and here we describe how such workmdashwell worked We also show how our postdoctoral fellowships could be used as a model for the postgraduate training of others in medi-cal humanities and bioethics But first a bit about our back-grounds because our multidisciplinary work is not just about being embedded with scientists but also about coming at medical humanities and bioethics from different disciplines Lisa approaches her work from a philosophical background with careful attention to power dynamics that can lead to health care inequities and injustices Sarah comes at her work from a historical perspective looking at how an issue devel-oped in order to contextualize ethical issues and frame ques-tions being asked today Yet given that we both work in the broader field of medical humanities and bioethics our work by its very nature is multidisciplinary Furthermore we are both interested in reproductive health and how the issues brought forward and the questions being asked are influenced by and influence the larger culture We learn from each other the importance of historic contextualization and philosophi-cal inquiry and we join our work with the work in the lab
By being embedded in the lab we can both learn more about reproductive science and enable scientists in the lab to think about their work away from the bench We discuss the differences between the scientific process and the histori-cal and ethical research processes as well as the similarities among the disciplines We learn about the science of ovaries ovarian follicles eggs embryos and parthenogenesis which furthers our ability to carefully analyze the intricacies of re-productive technologies The scientists learn about the legal historical and ethical parameters of the science providing them a useful context for understanding how and why their
work is seen as it is by those outside reproductive science It is this embedded nature of our fellowship that we suggest would make for a strong fel-lowship training in medical humanities and bioethics for it not only provides a greater understanding of science for us but also engenders multi-disciplinary research projects that few of us had contem-plated like the one on the Dickey-Wicker Amendment
Through these intellectual exchanges we encounter the difficulty of talking across disciplines To speak to each other we were forced to de-velop as one of our mentors has termed it a ldquocommon languagerdquo Without compro-mising complexity we had to
construct a way of expressing ourselves and our ideas in a way that made sense to the scientists and vice versa With-out this common language scientists sometimes do not see the value of perspectives from the medical humanities and bioethics at least in our experience Part of the reason for this (we learned from the reproductive scientists in our lab) is their sense that the medical humanities and bioethics voice is generally negative amounting to nothing more than finger wagging By working in the lab and providing suggestions of different ways to look at a topic or different questions to ask we were able to provide examples of a constructive voice from bioethics and medical humanities
But reproductive scientists also often hear critical voices from the public By interacting with each other in the lab we are able to begin to discuss perceptions and help contex-tualize why reproductive science is often met with such vis-ceral reactions by nonscientists In so doing we also explored reproductive scientistsrsquo own visceral reactions to critiques of their work For example for the summerrsquos brown bag dis-cussion group we selected and led the discussion on Emily Martinrsquos article ldquoThe Egg and the Sperm How Science Has Constructed a Romance Based on Stereotypical Male-Female
We believe the strength of our embedded fellowship is in large part due to our
ability to effectively communicate with each other through a common
language
May-June 2011 HASTINGS CENTER REPORT 23
Rolesrdquo As the title suggests Martin describes how gender roles are often projected onto reproductive biology resulting in the portrayal of eggs as passive and of sperm as active We were surprised by some of the scientistsrsquo negative reaction to this article Upon further discussion we realized that many of the scientists felt that Martin was chastising them and we were able to move past the tone of the article to elicit its more significant content Only by breaking down Martinrsquos argu-ment into a common language were some of the scientists able to understand and appreciate her claims In the end the discussion of Martinrsquos article was a success because the scientists grew more aware of the gendered language in re-productive biology and made a choice to avoid it Moreover the discussion led to multidisciplinary research projects on the topic such as an examination of how science textbooks from middle school through medical school employ gendered language
We believe the strength of our embedded fellowship is in large part due to our ability to effectively communicate with each other through a common language We learned to con-vey our work and its value in a way that makes sense to these scientists The credit is not just ours however the scientists also strove to construct a common language In fact the sci-ence contribution started long before we worked together It began when the principal investigator of the grant Teresa K Woodruff recognized the importance of incorporating hu-manities and social science projects into the overall project Part of doing this included embedding medical humanities and bioethics postdoctoral fellows in the lab per the sug-gestion of Laurie Zoloth Teresa understood that such an arrangement would encourage more interaction between sci-entists and humanists which would lead to multidisciplinary projects It also showed an appreciation for the value of think-ing about science and technology beyond the bench Putting scientists and humanists ldquoon the same teamrdquomdashhaving them work for the same organization to achieve similar or at least related goalsmdashestablished a level of camaraderie and trust from the get-go thereby creating an environment that would allow professional relationships and projects across disciplines to flourish
While the success of our fellowships relies in part on the personality of the scientists whose lab we are in our lab can still be seen as a model from which to copy future embed-ded fellowships in medical humanities and bioethics The
importance of this to the future of medical humanities and bioethics is clear As academic disciplines become increasingly technical we must be able to understand each other to have meaningful dialoguemdashsomething that is particularly helpful if ethical problems arise and only possible through a common language By establishing medical humanities and bioethics postdoctoral fellowships embedded in scientistsrsquo laboratories multidisciplinary workmdashand perhaps more importantly a common languagemdashwill hopefully emerge
Lisa Campo-Engelstein earned a PhD at Michigan State University in philosophy specializing in bioethics feminist theo-ry and socialpolitical justice When she cowrote this article she was a senior research fellow in medical humanities at the On-cofertility Consortium Northwestern University Feinberg School of Medicine where she examined ethical issues in the areas of reproductive technologies cancer and womenrsquos health She will continue analyzing these issues in her new position as an assistant professor at Alden March Bioethics Institute Albany Medical College She coedited Oncofertility Ethical Legal Social and Medical Perspectives (Springer 2010) and her work has ap-peared in Science the Journal of Clinical Oncology the Jour-nal of Medical Ethics and the American Journal of Bioethics
Sarah B Rodriguez earned her Master of Arts in the history of science and medicine from the University of Wisconsin-Madi-son and her PhD in societal and preventive medicine from the University of Nebraska Medical Center She was a senior research fellow in medical humanities at the Oncofertility Consortium when she cowrote this article she is now a postdoctoral fellow in medical humanities and bioethics at Northwestern University Feinberg School of Medicine She is interested in the history of womenrsquos sexual and reproductive health and especially in how this history frames current discussions She coedited Oncofertil-ity Ethical Legal Social and Medical Perspectives (Springer 2010) and her work has appeared in Science the American Journal of Bioethics and the Journal of the History of Medi-cine and Allied Sciences
1 S Rodriguez L Campo-Engelstein C Tingen and TK Wood-ruff ldquoAn Obscure Rider Obstructing Science The Conflation of Par-thenotes with Embryos in the Dickey-Wicker Amendmentrdquo American Journal of Bioethics 11 no 3 (2011) 20-28 C Tingen S Rodriguez L Campo-Engelstein and TK Woodruff ldquoPolitics and Parthenotesrdquo Science 330 (2010) 453
May-June 2011 HASTINGS CENTER REPORT 23
Rolesrdquo As the title suggests Martin describes how gender roles are often projected onto reproductive biology resulting in the portrayal of eggs as passive and of sperm as active We were surprised by some of the scientistsrsquo negative reaction to this article Upon further discussion we realized that many of the scientists felt that Martin was chastising them and we were able to move past the tone of the article to elicit its more significant content Only by breaking down Martinrsquos argu-ment into a common language were some of the scientists able to understand and appreciate her claims In the end the discussion of Martinrsquos article was a success because the scientists grew more aware of the gendered language in re-productive biology and made a choice to avoid it Moreover the discussion led to multidisciplinary research projects on the topic such as an examination of how science textbooks from middle school through medical school employ gendered language
We believe the strength of our embedded fellowship is in large part due to our ability to effectively communicate with each other through a common language We learned to con-vey our work and its value in a way that makes sense to these scientists The credit is not just ours however the scientists also strove to construct a common language In fact the sci-ence contribution started long before we worked together It began when the principal investigator of the grant Teresa K Woodruff recognized the importance of incorporating hu-manities and social science projects into the overall project Part of doing this included embedding medical humanities and bioethics postdoctoral fellows in the lab per the sug-gestion of Laurie Zoloth Teresa understood that such an arrangement would encourage more interaction between sci-entists and humanists which would lead to multidisciplinary projects It also showed an appreciation for the value of think-ing about science and technology beyond the bench Putting scientists and humanists ldquoon the same teamrdquomdashhaving them work for the same organization to achieve similar or at least related goalsmdashestablished a level of camaraderie and trust from the get-go thereby creating an environment that would allow professional relationships and projects across disciplines to flourish
While the success of our fellowships relies in part on the personality of the scientists whose lab we are in our lab can still be seen as a model from which to copy future embed-ded fellowships in medical humanities and bioethics The
importance of this to the future of medical humanities and bioethics is clear As academic disciplines become increasingly technical we must be able to understand each other to have meaningful dialoguemdashsomething that is particularly helpful if ethical problems arise and only possible through a common language By establishing medical humanities and bioethics postdoctoral fellowships embedded in scientistsrsquo laboratories multidisciplinary workmdashand perhaps more importantly a common languagemdashwill hopefully emerge
Lisa Campo-Engelstein earned a PhD at Michigan State University in philosophy specializing in bioethics feminist theo-ry and socialpolitical justice When she cowrote this article she was a senior research fellow in medical humanities at the On-cofertility Consortium Northwestern University Feinberg School of Medicine where she examined ethical issues in the areas of reproductive technologies cancer and womenrsquos health She will continue analyzing these issues in her new position as an assistant professor at Alden March Bioethics Institute Albany Medical College She coedited Oncofertility Ethical Legal Social and Medical Perspectives (Springer 2010) and her work has ap-peared in Science the Journal of Clinical Oncology the Jour-nal of Medical Ethics and the American Journal of Bioethics
Sarah B Rodriguez earned her Master of Arts in the history of science and medicine from the University of Wisconsin-Madi-son and her PhD in societal and preventive medicine from the University of Nebraska Medical Center She was a senior research fellow in medical humanities at the Oncofertility Consortium when she cowrote this article she is now a postdoctoral fellow in medical humanities and bioethics at Northwestern University Feinberg School of Medicine She is interested in the history of womenrsquos sexual and reproductive health and especially in how this history frames current discussions She coedited Oncofertil-ity Ethical Legal Social and Medical Perspectives (Springer 2010) and her work has appeared in Science the American Journal of Bioethics and the Journal of the History of Medi-cine and Allied Sciences
1 S Rodriguez L Campo-Engelstein C Tingen and TK Wood-ruff ldquoAn Obscure Rider Obstructing Science The Conflation of Par-thenotes with Embryos in the Dickey-Wicker Amendmentrdquo American Journal of Bioethics 11 no 3 (2011) 20-28 C Tingen S Rodriguez L Campo-Engelstein and TK Woodruff ldquoPolitics and Parthenotesrdquo Science 330 (2010) 453
