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  • BIOETHICS FORUM ESSAY

Science as Civic Education

This primary season was a vindication of democracy, especially among the young. Not since the primaries of 1968, when Gene McCarthy and Bobby Kennedy battled for the Democratic nomination, have university-age voters come out in such force. A new class of voters is coming of age and doing so in a hurry. Motivated by heady idealism and powerful oratory, young voters have forced both parties to reassess their electoral strategies.

As educators we should also take this opportunity to evaluate how well the academy is preparing this young cohort of voters for their embrace of the political process. What should the liberally educated student know in order to make wise decisions at the ballot box? Polemics aside, what tools will they need, in either party, to participate in constructive deliberative democracy? How will our faculties meet this need as knowledge has become sequestered in increasingly specialized domains of inquiry? More specifically, what role should science education play in preparing the next generation for civic engagement?

Over the past 10 years I have thought about these questions during weeklong visits to small liberal arts colleges as a Woodrow Wilson Foundation Visiting Fellow. Leaving behind my day-job as a physician-ethicist teaching at Weill Cornell Medical College, I have ventured to campuses across the country pitching liberal learning. Typically, I have been invited to teach in classes, meet with students and give a public lecture. Like other Visiting Fellows, I tried to show how a humanistic education enriches one’s personal and professional life, no matter the career choice.

I have been to six schools under the auspices of the Woodrow Wilson Foundation and was welcomed at each with great enthusiasm and gracious hospitality. What was different from school to school was how I was typecast. Although bioethics is an interdisciplinary field – one that borrows heavily from the sciences, humanities, and social sciences – I was often viewed as either a humanist or a scientist depending on my host’s own discipline.

At some schools, my academic itinerary tilted in favor of the science center. At others I found myself in English and government classes. On each campus, I saw many of the same students from one class to the next over the course of the week. Sometimes they were the pre-meds and the science students. In other years, they were the ones interested in public policy. It was not as much of a mixed crowd as I would have hoped.

What was especially strange about this variable reception from campus to campus was that each school had received virtually identical background material about my interests and research. The variance, I suspect, reflected how subject categories and individuals are increasingly categorized. We can’t straddle the chasm that divides the sciences from the humanities. We have to choose sides.

Despite my own proclivity for interdisciplinary work, I was trapped by expectations about what I might know or wish to share. Although the sample size of my travels is small, the stereotypic nature of my experience made me wonder if I was perceiving the same silo effect that students experience as their curricular choices segregate the sciences from the humanities.

If we want to meet the needs of students and prepare them for civic engagement, we need to overcome the divide. Although students majoring in the sciences have the opportunity for in-depth training and sometimes research experience, most non-majors have but a cursory sense of what their classmates are up to in a science center they seldom enter. Many students end up with no meaningful exposure to science.

It is ironic that this curricular divide persists in today’s policy climate, when the world needs both scientific progress and an electorate that can both endorse and modulate its reach. Students need a requisite dose of science literacy, much as they would benefit from a second language to understand and respond to threats like global warming and pandemic flu or the ethical challenges posed by embryonic stem cell research or contentious cases like Terri Schiavo. Fluency in science is not the objective for the non-major. Rather, it is the ability to appreciate the scientific method, critically assess data, and weigh this information within the context of studies in the humanities and the social sciences.

To achieve these objectives, universities need to foster cross-talk among the disciplines. Only then can the tools of science be instrumentally employed in public discourse in tandem with the rich humanistic traditions that need to inspire debate. While scientific facts should never dictate a course of action, they must be part of the deliberative process.

Although we cannot rid ourselves of the academy’s scholarly silos, as faculty we need to make them more porous. We need to help students make connections between disciplines through interdisciplinary study and by providing guidance consistently over the undergraduate experience to encourage the sort of intellectual synergy that can only emerge by exposure to many fields. This is good for the humanities as well as the sciences. (The Nobel Laureate Thomas Cech has observed that many of our best and most creative scientists were products of undergraduate educations that prized liberal learning.)

We should not expect that token course distribution requirements will lead to a coherent academic experience. Instead we need to create new ways of facilitating academic collaboration across divisions and learn from universities and scholars who are doing just that. (At my alma mater, Wesleyan University, a popular offering has a philosopher and molecular biologist jointly teaching a course on the biology and ethics of stem cell research. The basis of their success as educators stems from joint scholarly efforts.)

But beyond looking for good examples of interdisciplinary exchange, we need to understand the perceptual barriers that make productive exchange so difficult. Nearly fifty years after C.P. Snow famously talked about the “two cultures” divide between the sciences and humanities and the need for a “third culture” that bridged these disciplines, it is time to debunk the perception that the sciences and the humanities study different things, that one is hard and the other soft, and that these areas of inquiry are antithetical.

In one of bioethics’ seminal texts, The Silent World of Doctor and Patient, Jay Katz makes the brilliant – and contrarian – observation that the rise of Baconian science ultimately made humanistic discourse with patients possible. Katz, a psychoanalyst who taught at the Yale Law School, argued that it was impossible to imagine a construct like informed consent before there was empirical science. Before information exchange could take place, a physician needed to know something about foreseeable outcomes, risks, and benefits.

In Katz’s analysis, science ended the physician’s relative ignorance and made conversations between doctors and patient possible. The growth of science did not remove uncertainty, but with its rise “the uncertainty could be specified.” Science and humanism were not antithetical. They were synergistic in ending physician paternalism and investing patients with choice.

This enfranchisement of patients reminds us that if students are to make informed choices as voters and citizens, the academy will need to foster a more robust intersection between the sciences and the humanities. Only then will students possess the requisite technical and humanistic knowledge to appreciate the strengths and limitations of each way of knowing. That humility will serve them – and the rest of us – well in the voting booth.

If the greatest generation’s preparation for the age of majority was a civics lesson, this generation’s may well be in a laboratory session. Given the surge of political interest on campus, now is the time to integrate science education into general education. Let’s make scientific inquiry as hip as voting and, like the ballot, make science education accessible to all. Civic engagement and deliberative democracy requires at a minimum a scientifically literate electorate.

Joseph J. Fins is chief of the Division of Medical Ethics at Weill Cornell Medical College.

 

Readers respond

Joseph Fins offers valuable observations about what a modern version of a liberal education should embody – where students concerned about (and, today, increasingly involved with) politics and public policy need to see their faculty mentors engaging in work that combines the arts and humanities with science. Kudos to the Woodrow Wilson Foundation for sending this bioethics Johnny Appleseed out to plant interdisciplinary trees and a cry of disappointment that his college hosts apparently want to place him in mono-crop orchards!

Joseph is absolutely right that Jay Katz’s description of the way in which science and humanism can combine in an informed consent dialogue is yet another illustration of why students will need both to “make informed choices as voters and citizens.” The same, however, is that more than 25 years after The Silent World of Doctor and Patient, I for one see medical students and young doctors as ill-equipped to engage in the conversation that Jay imagined as their forebears. Many in medicine have moved away from the old paternalism of doctor-knows-best (which one could term a “science” model to the extent that means that the physician, facing the limits of his or her own knowledge and of the field’s itself, does not share those limits and the resulting uncertainty with the patient). Yet too many have not moved to a humanistic model, much less to the mixed pattern prescribed by Jay; instead, they profess to adopt “autonomy” as a value but end in a dichotomous fashion either saying “it’s your choice” (even if the patient would rather have it be “our choice,” following a dialogue) or, when the physician feels too much is at stake, sliding back into a paternalistic mode, to manipulate the decision in the way the physician thinks best. There are, of course, many outstanding exceptions to this pattern – Joseph Fins and numerous other Fellows of the Hastings Center, as well as physicians who work on “narrative medicine” and bring humanities into their science that way – but it would be good if Joseph’s prescription for young people becoming informed and multi-disciplinary-competent citizens were also applied to the country’s pre-med students, because they and their future patients also need the blending of science and humanities envisioned three decades ago by Jay Katz but not as yet commonly understood in pre-med programs much less medical schools and post-graduate training.

– Alexander M. Capron,
University of Southern California Gould School of Law

Published on: June 20, 2008
Published in: Bioethics

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