What Is Bioethics?
Jacob M. Appel is a bioethicist and fiction writer. He holds a B.A. and an M.A. from Brown University, an M.A. and an M.Phil. from Columbia University, an M.D. from Columbia University's College of Physicians and Surgeons, an M.F.A. in creative writing from New York University, and a J.D. from Harvard Law School. He has most recently taught at Brown University in Providence, Rhode Island, and at the Gotham Writers Workshop in New York City. He publishes in the field of bioethics and contributes to such publications as the Journal of Clinical Ethics, the Journal of Law, Medicine & Ethics, and the Bulletin of the History of Medicine. His essays have appeared in The New York Times, The New York Daily News, The Chicago Tribune, and other publications.
Appel has also published short fiction in more than one hundred literary journals. His short story, Shell Game With Organs, won the Boston Review Short Fiction Contest in 1998. His story about two census takers, "Counting," was shortlisted for the O. Henry Award in 2001. Other stories received "special mention" for the Pushcart Prize in 2006 and 2007.
He is admitted to the practice of law in New York State and Rhode Island, and is a licensed New York City sightseeing guide.
Appel contributed a Dangerous Idea to Big Think's "Month of Thinking Dangerously," advocating that we add trace amounts of lithium to our drinking water to help reduce the suicide rate.
Appel is a Big Think Delphi Fellow.
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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