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introduction

I am a Canadian graduate student who studied bioethics at Harvard, an institution that is renowned for the worldwide talent it attracts and, at the time of writing, is at risk of losing the ability to host an entire population of international students like me. I am a person of colour. I am a woman. I am an academic. All of these are layers of identities that are affected in various ways by the policies of the current administration. As Harvard v. USA battles it out in the courtroom, international students are caught in limbo, living in fear that they will have to pack up and leave tomorrow.

Many have spoken about the state of science and research funding and its ripple effects on local and global health. Instead, what I want to share here is my perspective as an early-career bioethicist figuring out my limits in a field that is still negotiating its role in the world. I hope this perspective can illuminate a few reasons why the advocacy efforts, or lack thereof, that bioethicists undertake today will influence who chooses to join this field in the years to come.

My observation, just a few months into the declining support for science, medicine, and academia at large, is that advocacy is not field-specific. The loudest voices have come from individuals, from political scientists to health practitioners, who dared to publicly question policy decisions. Others have taken a different route — scrubbing research grants of specific words, changing the names of whole departments, and switching gears to focus on ‘safe’ research as they ride out the current climate of uncertainty. When academies do, on occasion, take a public stance, it sometimes feels performative rather than substantive. Take, for instance, public statements defending university ideals, in contrast with actions taken to shut down or rebrand programs and research agendas (1).

Both approaches to dealing with the political challenges of today have their risks and benefits. Applied ethics is a practice that blends moral philosophy with risk analysis. We are taught to weigh the risks and benefits and look for the unintended consequences. If putting one’s research at risk hurts more people than it helps, then advocacy may seem a liability. It is certainly easier to be an advocate when one does not have a department to run and grants to secure. That is why the youth, with less to lose, have historically been the loudest voices in movements for change. A study by Pacia et al. shows that the trend continues today, with early-career ethicists across Canada and the US being more likely than their senior colleagues to support social justice work in bioethics (2).

Bringing advocacy into higher stake scenarios, however, makes it all the more meaningful and effective. It signals to students and staff that each of us matter, regardless of the identities we cannot hide and the thoughts and ideas that we are now encouraged to bury inside. Yet in spite of bioethicists’ perceived commitment to justice, they have not been the most active group speaking truth to power. An earlier CJB perspective tackled a similar conundrum by attempting to explain “why philosophers aren’t better people” (3). Dwyer describes his experience in bioethics in the following reflection:

I was surprised to find that they were not better people. It’s not that these philosophers were bad people; it’s just that they were not any better (or worse) than the biologists and sociologists that I met. [...] We all need to respond to misfortunes and difficulties: illness, death, insults, criticisms, splashes of water, and whatever happens in daily and political life. Philosophy should train us to respond in better ways

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Protecting bioethics and the bioethicist

It is my personal conviction that bioethics, in an applied or practical sense, is uniquely positioned for advocacy — its practitioners are experts on how to navigate the moral challenges affecting the healthcare community. Other bioethicists may choose not to partake in social justice movements in order to maintain a certain perception of objectivity, neutrality, and non-partisanship. However, some have rejected this choice between advocacy and objectivity as a false dichotomy, arguing that knowledge cannot be separated from the sociopolitical context in which it is produced and that it inevitably reflects the values and interests of its makers (4). Embracing “strong objectivity,” as coined by feminist epistemologist Sandra Harding, allows us to bring the many influences behind knowledge production to the surface, and acknowledges the power structures that elevate some viewpoints above others (5).

There are many ways that the current climate of academic suppression weakens discourse in bioethics. Bioethics, as a field, prides itself on pluralistic problem-solving. When we stand by and make it okay to exclude different ideas from our spaces, we normalize an environment that undermines the field’s capacity for moral pluralism. We send a message that only specific viewpoints and specific people are welcome; and so naturally, some people will stay away from these spaces. For those who see bioethics as a purely academic endeavour, advocacy and civic engagement in these times is still necessary to protect the academic freedom needed for strong objectivity and to protect the voices and viewpoints at risk of being silenced by intensifying power structures.

Without the capacity to explore different ideas and ask difficult questions, we may begin to undermine the core mission of bioethics and its ability to be a convening space for conflicting ideas. By disengaging from advocacy, bioethicists send the message that we will not stand up for each other, in our bioethics community, with the same resolve we bring to our ethical commitments towards those we serve in clinical care, public health, and beyond. Further still, the lesson young bioethicists are learning is loud and clear: When it comes to injustice, our role is to observe it, occasionally call it out, but almost never to act on righting the wrongs.

And yet, who else is better positioned than bioethicists and moral philosophers to speak up about a moral crisis?

The COVID-19 pandemic called on health professionals to work on the frontlines at the risk of their own health and well-being. This was the job and the mission they signed up for. Maybe today’s fight against injustice should be our version of this calling. When human dignity is under attack, and the ethical principles we hold near and dear are violated, it is our turn to rise up to address the challenges that we signed up for.

Where to begin again as history repeats itself

Canadians should remember that these are not issues constrained to the US. Canada faced its own anti-science era over a decade ago under a federal government that was systematically sidelining science, slashing grants, and suppressing researchers. The moment called upon Canadian researchers to adopt a spirit of activism and work together to protect public science from political interference, leading to tangible outcomes that formalized scientific integrity in federal policies and mandates (6). As we watch some of this history repeat itself south of the border, we can learn from the lessons of Canadian scientist-activists who came before us on how to react in the face of an anti-science agenda and safeguard our ability to pursue scientific objectives free of undue influence.

Protecting the field of bioethics requires that we embrace the moral courage to translate abstract inquiry about moral conduct into action. This work can start small, by supporting and amplifying the efforts of advocacy groups, like the ongoing campaigns by the Union of Concerned Scientists (7) and Stand Up for Science (8), and by lending our voices and expertise to the many scientists and physicians pushing to safeguard our collective academic freedom. It can also start in the classroom, by affirming to students from all walks of life that they still belong in these spaces even when the news and the leadership tell them otherwise.

What I remember most from graduation was not the thousands of grinning faces under a sea of black caps, nor the moment that I finally received my degree. It was the few professors who joined the ceremonial procession wearing circular badges that read, “Without our international students, Harvard is not Harvard”. Years later, when I look back on my graduate education, the mentors who stood up for me are the ones I will always remember.

Bioethicists, look around you — at patients whose health is on the line, at students who you lecture on virtues of moral courage, at the integrity of a field that is inseparable from a history rooted in social justice. Students like me are looking at mentors like you for guidance on how to act in these trying times in order to uphold the principles that we have learned are so integral to the work of bioethics. Many of us are still waiting for you to lead by example.