Written by: Jenna Jacobs | jjacobs@cshl.edu
During the Banbury Center’s December 2022 meeting, “Developing an Ethical Framework for Human Research in Private Spaceflight,” I had the opportunity to meet with Vardit Ravitsky, Ph.D. Dr. Ravitsky is full professor of Bioethics at the University of Montreal’s School of Public Health, and senior lecturer on Global Health and Social Medicine at Harvard Medical School. She received her Ph.D. from Bar-Ilan University in Israel, her M.A. from the University of New Mexico, and her B.A. from the Sorbonne University in Paris, France. Dr. Ravitsky spoke to me about her experience running an active research program in bioethics.
Can you tell me about what you do in, more or less, two sentences?
I do research on the ethical, legal, and social implications of emerging biotechnologies. My research has two types of focus: First, the impact of these emerging technologies on the well-being of patients and users, and on policy; how do we make policy to govern these technologies? The second focus is on justice concerns. Often these technologies are very expensive at first and they mostly benefit privileged populations. Therefore, they tend to exacerbate health disparities. My research tries to see how we can implement these new technologies so that they can benefit everyone and promote equity.
What is your favorite part of what you do? What gets you excited to go to work?
I have two answers to this question; the first one is impact. I was trained as a philosopher initially, and in philosophy we ask very abstract questions. Sometimes it’s difficult to see how these questions – as important as they are – will actually changes the lives of real people. In bioethics, even when we ask a conceptual question, it’s very easy to see the impact that it will have on society. There are three types of impact; the first is on users and patients. For example, a lot of my research is about a new technology that allows genetic testing of the fetus during pregnancy. It is very exciting for me to facilitate access for families to such a new technology in a socially responsible way. The second type of impact is impact on clinicians. For example, we have a new study funded by the National Institutes of Health on how to use artificial intelligence in diagnosis of disease. So, how do you educate clinicians regarding how to offer artificial intelligence-based diagnosis to their patients? It’s difficult to do! The third type of impact is on policy makers. If there’s a new technology, does the government fund it? Is it allowed? Is it banned? So, what excites me is the three types of impact that I am able to make: impact on users and patients, impact on clinicians, and impact on policy makers.
My second answer to this question – what gets me excited and gets my creative juices flowing – is the meeting point between novel science and challenges to fundamental concepts: our humanity, our cultural assumptions, or our social norms. For example, 44 years ago we discovered in vitro fertilization. This discovery separated genetic motherhood from gestational motherhood because one woman could be the genetic mother of that fetus while another could carry the pregnancy. In a way, this technology deconstructed thousands of years of human understanding of motherhood. That’s what really gets me excited – the conceptual challenges of new discoveries.
Your work often involves controversial issues, which can come with people with especially passionate perspectives. How do you navigate these difficult topics?
I think that to do bioethics in these very socially controversial areas – especially end-of-life, reproduction, abortion, manipulation of DNA – the first thing that you have to do is listen. Keep an open mind and be inclusive of all the stakeholders; do not exclude anyone from the debate. I think it’s critical to allow for multiple perspectives and nuance. Sometimes the correct answer is, “It depends.” But it is also important to not be afraid of a clear, normative recommendation or an ethical bottom line. Sometimes there is a better answer and a worse answer, and you need to have the moral courage to convince policymakers and clinicians with your arguments.
What is a common misconception about bioethics or your work?
I think the most prevalent misconception is that bioethics exists to slow down or create barriers to scientific progress. I call this perception “The Ethics Police.” This perception is sometimes created when scientists have to get approvals for their studies from the ethics board, and the ethics board responds with criticism, conditions, or limitations. So, for many scientists, their meeting point with ethics is when they are told not to do something or to fix something. But bioethics as a field, in my view, does not exist to slow down or impede science. It is a facilitator. If we want scientific progress to occur, we have to do things responsibly. We don’t want to cause societal backlash or social harm. Bioethics ensures that things are done responsibly in order to facilitate, allow, and promote scientific progress.
What are the areas in biosciences that you believe deserve more ethical considerations?
Right now, I think the ethical considerations surrounding the environment are critical. We’re in the midst of a climate crisis that will have implications for everything from human health to the global economy. I think the field of biosciences and the field of bioethics should work together to mitigate the dangers of this crisis. Also, artificial intelligence is a rising force and every aspect of science will be using it in the coming years. Precision medicine is another area. Genomics and other technologies will allow us to better tailor medicine and research to individual patients and specific populations. These are some of the areas that are hottest right now.
This is your first time at the Banbury Center. What do you think of the meeting so far?
The meeting is mind-blowing! It’s not just interesting and productive and rich; it’s on a topic that no one’s ever written about, so we feel like we’re building a new field of study here. The people at the table were selected very carefully to really complement each other’s views. We come from not just different disciplines, but from different sectors: industry, academia, government, media. The way we all are able to communicate across our backgrounds and the institutions that we represent is just fascinating, and it’s the best meeting I’ve attended this year.
Is there a general topic or discussion that you have particularly enjoyed?
Yes. We’re talking about research ethics in private spaceflight, and a big part of the discussion is, “Is this unique? Is this exceptional as a research context?” Or, can we use well-established principles in research ethics from other fields and apply them to this futuristic context? It’s not like we have been doing research on human beings in space in a commercial context for years; it’s brand new, and we think it’s going to increase in volume. So, this whole discussion of, “Do we have to reinvent the wheel for this? What is considered new?” versus all the analogies to older contexts is fascinating.