Ethicists unite: you have nothing to lose but your non-citation

Yesterday Richard Ashcroft, Professor of Bioethics at Queen Mary College, London, wrote in a Facebook update: ‘I am fed up with being asked to come into science/medicine projects, add a bit of ethics fairy dust, usually without getting any share of the pie, just to shut reviewers up. I am not doing it any more. If they think we are important, treat us with respect. Otherwise, get lost.’

Lots of people liked this. So do I. Ethicists have for too long been the invisible but essential backroom boys and girls of biomedicine; patronised by the practitioners of ‘hard’ science; seen as unimaginative but powerful bureaucrats who have to be kept sweet; as despised social scientists who wield rubber stamps made essential by other zeitgeist-dictating social scientists who want to keep their woolly-headed chums in a job; as factotums who don’t deserve to have their names on the papers any more than the temp who does the photocopying. Why is this? 

Partly it is because biomedical researchers tend (it’s just a tendency, if you’re thinking of responding violently to this blog – there are loads of honourable exceptions) to be clever, confident, narrow and single-minded scientific nerds. They are the people who thought that the time spent discussing the feelings of a dying patient would have been better spent on a more in-depth look at the cytokines. They probably did better at school than the social scientists, and therefore, illogically, think that social science itself is less worthy of regard. Having spent too long on the cytokines, they don’t understand the language of ethical discourse, and that scares them. Fear often expresses itself as contempt.

Partly it is because they are temperamental utilitarians, with a fundamentalist conviction that their research will save the world. Sometimes rats, patients or principles may have to be sacrificed to appropriate that salvation. They are prosaic people, but allow themselves a few self-glorifying metaphors, often culled from life-endangering expeditions. Just think where we’d be if Edmund Hillary had lost his nerve on the Khumbu icefall. Well, ethical objections are like that icefall. They’re not usually bad people; just good people who believe too passionately in one thing. And that can be a very bad thing indeed.

Partly it is because of a popularly held association between ethical concerns and general regulatory fussiness. Ethicists are seen as representatives of the meddling nanny state. They are lumped together with the often ludicrous health and safety police. Researchers think of ethicists as list-tickers and clipboard carriers rather than sages. This association is unfair. The typical ethicist might be low on sagacity, but loathes checklists with a pure, holy hatred. And can give some very sophisticated reasons for that hatred. With footnotes.

But some of the disdain is just. Ethicists often don’t write their papers in any known language. And when it is possible to follow their arguments, the only possible response is often ‘so what?’ There is a lot of tedious reinvention of the wheel. A high proportion of published ethical discourse is a sort of philosophical masturbation, and there’s a negative association between masturbation and fecundity.

In print and on committees we are often pathetically equivocal, as if there is something intellectually disreputable about a conclusion. That conclusion-aversion feeds the cynicism of the biomedical researchers. If ethics is merely discursive, how can ethicists maintain seriously that they are the guardians of the notional public conscience? And if they can’t do that, are they not merely irritants – polysyllabic jobsworths with PhDs and a genius for job-creation?

But ethicists are essential. Their main contribution is to give perspective; to raise the eyes of the researchers from the furrow they are ploughing so that they can see the place of the research in the human and societal contexts in which it must be evaluated. It’s a scary research ethos that sees that function as peripheral.

I hope that Richard has started a revolution – a revolution concerned not with the individual academic status of professional ethicists, but with the place of ethics in the biomedical world.