Philosophy professor discusses draw of subject, lecturing on bioethics

Philosophy is for those who are not afraid to think and question how the mind works, and consider what is ethically right and wrong.

Professor Hilary Bok, the Henry R. Luce Professor of Bioethics and Moral Theory, is not afraid to do either.  Bok, originally from outside of Boston, received her undergraduate degree in philosophy from Princeton, and her Ph.D from Harvard.

She has taught many classes relating to ethics, such as Intro to Moral Philosophy, Intro to Bioethics, Addiction, Depression, and the Self, a class about the moral status of animals, and a graduate seminar on Kant’s Moral Theory.

Bok is the author of Freedom and Responsibility, and has written papers about stem cell research. She is currently working on a project about the implications of neuroscience on moral responsibility.  She sat down recently to talk with The News-Letter about her passion with philosophy, especially bioethics.

The News-Letter (N-L): When did you first get interested in philosophy?

Hilary Bok (HB): Well, my mother’s a philosopher. But oddly, that didn’t make me interested in philosophy. That made me think that philosophy was taken, that it was sort of hers.  It never occurred to me that I would actually do it, until I took a philosophy class my sophomore year.

I took it in part because it was the most interesting sounding class that filled a hole in my schedule and allowed me to sleep late. So then, about the second week into the class, I was just in love. I had never thought it was a subject I might do.  It was always something she did. But once I was in the class I decided that this was what I love, and that was that.

N-L: When did you get interested in bioethics?

HB: I’ve always been interested in bioethics, I didn’t start working on it until I came here, in part because, before I was here, I was at Pomona, a liberal arts college in California.  And if you’re at a liberal arts college, that means it doesn’t have a medical school in the same town or community.

That means that if you do bioethics, you are mostly sort of imagining what kinds of conflicts you think doctors might face, and imagining what they might do as a result. And I always thought, that’s a recipe for doing very bad work if you don’t really know what you’re talking about.

While I was interested in bioethics, as long as I was at Pomona, I thought that that’s not the sort of thing I would be likely to be any good at doing, just because I didn’t have actual doctors there. I didn’t have a hospital that was part of my university.

I could, of course, have walked into the local hospital, just grabbed a doctor, and said “Hello, doctor, why don’t you talk to me about all your moral problems”, but that seemed rude. There weren’t any doctors who were a part of our community back at Pomona which is why I didn’t really try to do bioethics. It’s kind of like studying rhinoceroses when you live in America. You could, but you’d be so likely to do it badly because there aren’t any here.

N-L: So is that what brought you to Hopkins?

HB: What brought me to Hopkins was that they acquired funding for a professor to teach bioethics. So they approached me asking would you be interested in teaching bioethics despite the fact that you’ve never done it before, and I said yes.

N-L: What would you say you love most about bioethics?

HB: So what I love most about ethics in general, is the way that it allows me to be both completely abstract and practical.  I have this sort of “mathy” part of my head, which loves abstract problems, but I also love being incredibly practical. So doing chess problems would engage the same part of my mind, but it would have no practical use of any kind and would therefore get boring to me at a certain point.

What I love about ethics is that I get to do problems that are much more interesting but in the same vein as chess problems, that also have immense practical import. What I love about bioethics is that on the one hand it’s, if anything, even more practical.

In the 2004 presidential campaign, I wrote large parts of one candidate’s stem cell position paper. As a Philosophy Ph.D it never occurred to me that I’d write a position paper for anybody, because why would anybody want a philosopher to write their position paper?  There’s also the fact that you find out about all these fascinating things that doctors are doing, these strange new technologies, that, at least to me, not being myself a physician, seem to me like science fiction all the time.  Except that instead of science fiction, with which you have to sort of go, “why am I reading this science fiction when I could be reading something true,” this is true. And you learn about this stuff and it raises moral conundrums.  You get to think about how to answer them, and it’s just endlessly fascinating.

N-L: Bioethics seems to be one of those not-philosophy course philosophy courses, meaning that there are a variety of grade levels and majors that take it. Why do you think that is?

HB: I think that there are people who end up majoring in philosophy who got into it through bioethics. But it’s an introductory class in the same way that Philosophical Classics or Introduction to Moral Philosophy are all introductory classes. Bioethics probably draws a larger group of people, I assume, because it draws a lot of pre-meds.  There are just a whole lot of undergraduates at Hopkins who are pre-med.

When I was an undergraduate, we also had distribution requirements, and for me, the problem one was science. And I took two geology courses, in which I had very little independent interest.  There were some fun things we did in those classes, but mostly it was just for the requirement.

So one of the things I hope for in teaching this class is that, if there are pre-meds or people that are majoring in the sciences for whom the humanities is the problem one that they can take this class and it will not be for them the way geology was for me, like “Oh god, I’ve got to take some class, why not this.”

While with bioethics there’s something that actually ties into what you’re doing, and does what a distribution requirement is supposed to do, which is teach you that there are ways of making arguments that are not the same as the ones that you’re most familiar with in your major, and to appreciate what those arguments can do.

So sometimes I find that, especially with people who have had really no exposure to philosophy, they will just be puzzled in that class by the idea that there are right and wrong answers to questions, or might be even though there are no lab notebooks.

I want them to see why that’s not an insuperable objection, why it doesn’t follow from the absence of carefully controlled experiments that all philosophers do is just hand-waving. Because that’s what I think a distribution requirement ought to be about.

I assume that one reason a lot of people take it is partly because it looks good on a medical school application and partly because they have humanities distribution requirements, and because this, unlike many courses, has some actual relevance to their major.

N-L: What do you think is one of the most controversial issues in bioethics, or, which do you find to be the most interesting to meditate on? Why?

HB: There are a lot of controversial issues associated with, for instance, health care reform. Should the government have any role at all in denying care?  Presumably, it has to, because I would not want the government to be on the hook for, for instance, a therapy that one doctor on Earth thought was effective.  Suppose that I decided for some wacko reason that, I’m a doctor, and that waving a daisy in your general direction will cure your cancer.

I don’t want for me to be able to charge the government for this. That is, of course, an extreme case. But there are a lot of cases where the evidence that something is effective is equivocal, or some people want the treatment but it’s not quite clear that it works.

From there you turn into, well, it works, but this particular medicine gives you on average an extra hour of life but it costs 5 million dollars a dose, is it worth it?  You can see that there’s a spectrum that moves from something like “appendectomy saves your life for cheap” to “5 million of dollars a dose for an extra hour of life” and from there to “well it’s not quite clear if it gives you anything, the data is mixed,” to me waving a daisy in your general direction. If the government is going to be reimbursing anything, it has to decide where on that spectrum it’s going to cut things off.

I want it to cut things off somewhere because I don’t want the daisy.  On the other hand, trying to do that at all gets you into the territory where people will accuse you of favoring death panels, regardless of whether or not that’s true.   And that makes things very controversial. There are a number of incredibly controversial areas of health care reform, including the treatment of animals, physician-assisted suicide, stem cells, abortion, cloning.  I also think the implications of neuroscience for morality and moral responsibility is very interesting.

N-L: Is there anything you’re interested in working on right now, in terms of publishing or course development?

HB: Well, I’m working on a project with a couple of other people about the implications of neuroscience for moral responsibility and self-governance.

N-L: Do you have a class that’s a standout favorite?

HB: No, because I actually don’t teach classes that I don’t really want to teach.  I love teaching bioethics (the introductory class) just because I love when people sort of see what philosophy is all about, especially with people in that class who maybe haven’t taken philosophy in the past.

I love some of the upper-level courses just because I love the topics. I love Kant’s moral theory.  I think the status of animals is cool; how you try to figure out how you treat a being who has no autonomy and has no ability to sort of enter into understandings with you about know exactly what they’re supposed to do, and how you’re supposed to do things as a result.

But it’s obviously somebody that you ought to treat morally. It isn’t like a child, who will at some point grow up to be an adult, and you have to prepare it for that.

N-L: Is there any specific advice you’d give students?

HB: I think, especially, in today’s job market, there’s a tendency to major in something because it’s useful.

As I look back, I majored in something I loved. And that was the right choice. Not just because you love it and you’ll have fun, but also because you learn much, much more from doing something that you love.

If you love something, then you will plunge into it in a way you’re unlikely to plunge into anything that you don’t love. And if you plunge in it that way you will learn how to think clearly and deeply and well in a way that you won’t if you don’t. So not just because things are fun, but because you learn more. If you love something apparently impractical, do not dismiss the practical implications of just doing something you love.

I think that I would think that even if I hadn’t ended up actually being gainfully employed in this discipline. But anyone to whom I might give this advice I would point out that I might be biased by the fact that it worked out for me.