What Is Bioethics?

Question: How do you balance bioethics, psychiatry, and writing?

Jacob Appel: Sure.  I try to wake up every morning and get several hours of writing done before I go to the hospital, which can range between 5:00 in the morning and 7:00 in the morning.  So, I could, in theory, be writing as early as 3:00.  Do a few hours of writing; see my patients during the day.  Intermittently during the day I do some phone interviews.  If I'm on call at the hospital I can write a bioethics column and then I come home and do probably a couple of hours of bioethics work in the evening.

Question: What does your work as a psychiatrist and bioethicist entail?

Jacob Appel: Sure.  Well, until recently, I was teaching bioethics at Brown University and NYU.  So, there I would have my full class of either undergraduate or graduate students and I would do some consulting work on the hospital floors as well.  Now, since I'm practicing medicine nearly full time at Mt. Sinai in psychiatry, I do occasional bioethics consultancy inside the hospital at Mt Sinai, but far more often, I'm consulting people outside, giving them advice on issues relating to the beginning of life, end of life.

Question: What is bioethics, and what is the role of a bioethicist within a hospital?

Jacob Appel: Absolutely.  I think 30 years ago, there were no bioethicists.  It is one of the new occupations of the technological age that we live in.  And it takes traditional moral questions about when life begins when life ends, and sees them through the prism of modern technologies.  And as we've developed, for example, ways of keeping life going beyond its natural parameters, the question arises; how far should we keep life going?  And a bioethicist inside the consultant setting of the hospital doesn't offer people answers, it sets out parameters for people to think about answers.  So that a family on their own can make decisions based upon different ways other people have handled these situations in the past. 

Question: Should bioethicists perceive themselves as arbiters of right and wrong?

Jacob Appel: I think it's far better to think of bioethicists as guides.  I think there is a cottage industry now of people who have made a living or a career out of criticizing bioethicists because they view bioethicists as these plutonic guardians on high who step into the fray and say, "this is how we will do things."  I know no professional bioethicists who actually operate that way.  Far more bioethicists show people the signposts, show people different alternatives and let them make their own decisions.  And I think that's important.  I think that in the same way you wouldn't want your medical or legal decisions made by someone else; you will want to be consulted on an expert and then make the decision on your own.  A bioethicist is an expert who shows you different parameters and then let you make your own decision. 

I should add, before the 1970's, philosophy as a field had branched far away from moral thought.  It delved into questions of epistemology, the five-year olds age old question, when my parents leave the room do they still exist?  And it's bioethics that in addition to working inside the hospital with families has also brought back morality back into the field of philosophy.

Recorded on March 1, 2010
Interviewed by Austin Allen

The discipline is less than 30 years old, but its practitioners have become a fixture in hospitals, and its inquiries have "brought morality back into the field of philosophy."

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Originally Poe envisioned a parrot, not a raven

Quoth the parrot — "Nevermore."

The Green Parrot by Vincent van Gogh, 1886
Culture & Religion

By his mid-30s, Edgar Allan Poe was not only weary by the hardships of poverty, but also regularly intoxicated — by more than just macabre visions. Despite this, the Gothic writer lucidly insisted that there was still a method to his madness when it came to devising poems.

In an essay titled "The Philosophy of Composition," published in 1846 in Graham's Magazine, Poe divulged how his creative process worked, particularly in regard to his most famous poem: "No one point in [The Raven's] composition is rerferrible either to accident or intuition… the work proceeded step by step, to its completion with the precision and rigid consequence of a mathematical problem."

That said, contrary to the popular idea that Edgar Allan Poe penned his poems in single bursts of inspiration, The Raven did not pour out from his quivering quill in one fell swoop. Rather it came about through a calculative process — one that included making some pretty notable changes, even to its avian subject.

As an example of how his mind worked, Poe describes in his essay that originally the bird that flew across the dreary scene immortalized in the poem was actually… a parrot.

Poe had pondered ways he could have his one word refrain, "nevermore," continuously repeated throughout the poem. With that aim, he instantly thought of a parrot because it was a creature capable of uttering words. However, as quickly as Poe had found his feathered literary device, he became concerned with the bird's form on top of its important function.

And as it turns out, the parrot, a pretty resplendent bird, did not perch so well in Poe's mind because it didn't fit the mood he was going for—melancholy, "the most legitimate of all the poetical tones." In solving this dilemma in terms of imagery, he made adjustments to its plumage, altogether transforming the parrot — bestowing it with a black raiment.

"Very naturally, a parrot, in the first instance, suggested itself, but was superseded forthwith by a Raven, as equally capable of speech, and infinitely more in keeping with the intended tone," Poe explained in his piece in Graham's. "I had now gone so far as the conception of a Raven — the bird of ill omen — monotonously repeating the one word, 'Nevermore,' at the conclusion of each stanza, in a poem of melancholy tone…"

It was with these aesthetic calculations that Poe ousted the colorful bird that first flew into his mind, and welcomed the darker one that fluttered in:

In there stepped a stately Raven of the saintly days of yore;
Not the least obeisance made he; not a minute stopped or stayed he;
But, with mien of lord or lady, perched above my chamber door—
Perched upon a bust of Pallas just above my chamber door—
Perched, and sat, and nothing more.
Then this ebony bird beguiling my sad fancy into smiling,
By the grave and stern decorum of the countenance it wore…

The details of the poem — including the bird's appearance — needed to all blend together, like a recipe, to bring out the somber concept he was trying to convey: the descent into madness of a bereaved lover, a man lamenting the loss of a beautiful woman named Lenore. With that in mind, quoth the parrot — "nevermore" just doesn't have the same grave effect.

* * *

If you'd like to read more about Edgar Allan Poe, click here to review how his contemporaries tried to defame him in an attempt to thwart his success.

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