T H E   N I H   C A T A L Y S T     N O V E M B E R  –  D E C E M B E R  2002


New Face in Town: Dan Brock has joined the CC Department of Clinical Bioethics

Dan Brock was an economics major who became an investment banker and then decided to try his hand at something he thought would be more "worthwhile."

So he returned to school, got a doctorate in philosophy, and emerged with an interest in a field whose name had yet to be coined: bioethics.

Since that time, more than 30 years ago, he has contributed to some of the major doctrines shaping the ethical practice of modern medicine, including the landmark Deciding to Forgo Life-Sustaining Treatment. This work was performed in his capacity as staff philosopher on the President’s Commission for the Study of Ethical Problems in Medicine in the early 1980s.

On June 30, Brock began a five-year appointment as an NIH senior scientist in the Department of Clinical Bioethics, where his new unit on ethics and public health will center the department’s explorations into health policy and priorities.

Brock intends to continue his already extensive research on the prioritization of health-care resources and the implications of advances in genetics knowledge and technology. Much of his work has involved developing alternatives to the "ethically inadequate" cost-effectiveness standard for resource allocation. "Cost effectiveness is a useful piece of information," he says, "but it ignores equity and justice"—not to mention common sense, such as when capping teeth was ranked above appendectomy in Oregon’s attempt to prioritize Medicaid expenditures using a cost-effectiveness standard.

As the recipient of an ELSI (Ethical, Legal, and Social Issues) grant from NHGRI, he and three other philosopher–co-authors produced the book From Chance to Choice: Genetics and Justice (Cambridge University Press, 2000). "New capacities to shape our children can raise new issues of social justice," Brock observes, noting that his writings on responding to moral obligations to prevent genetically transmitted disease have been viewed as sending a "threatening and offensive message" by some groups representing disabled people. "It’s an emotionally charged issue."

On the horizon, Brock adds, is the related issue of effecting genetic modifications not to prevent disease but to enhance normal human abilities, much as is already happening in the psychopharmacology arena. He cites the use of prescription medications to boost everyday function, such as antidepressants to counteract shyness. Gene manipulation for similar ends "should be a public worry before we actually need to confront it," he says.

Brock comes to NIH from Brown University, in Providence, R.I., where he had a joint appointment in the Philosophy Department and the medical school. He was Charles C. Tillinghast, Jr. University Professor, professor of philosophy and biomedical ethics, and director of the Center for Biomedical Ethics.

Brock has been philosopher-in-residence at Rhode Island Hospital, a member of the Ethics Working Group of the Clinton Task Force on National Health Reform (along with Ezekiel Emanuel, now director of the NIH Clinical Bioethics Department), and a consultant to the World Health Organization on genetic testing and reproductive control. http://www.bioethics.nih.gov/emanuel.html

He was a senior visiting scholar at NIH from September 2001 to May 2002—and he turned down an offer of first chair in bioethics at England’s Oxford University before accepting his NIH appointment.

—Fran Pollner

On the Principles and Practice
Of Clinical Research

Registration for the 2003 "Introduction to the Principles and Practice of Clinical Research" begins November 15. The course will run February 18, 2003–May 21, 2003.

Classes will be held on the NIH campus on Tuesday and Wednesday evenings from 6:00 p.m. to approximately 7:30 p.m. There will be optional breakout sessions Monday evenings to explore specific topics in greater detail.

Registration deadline is February 1, 2003. There is no charge for the course, but the purchase of a textbook is required. A certificate will be awarded upon successful completion of the course, including a final exam.

For additional information or to register, visit the course website.

Seems Like Yesterday . . .

Wendy Baldwin

Thirty years ago, Wendy Baldwin came to NIH for a two-year appointment with NICHD. She didn’t expect to stay, she says, but one thing led to another as she took on expanding roles within NICHD.

In 1993, Baldwin became the NIH deputy director for extramural research, a post she will be leaving at year’s end to become vice president for research at her doctoral alma mater, the University of Kentucky in Lexington.

Once Again Demystifying Clinical Medicine

Following last year's success, NIH will again be offering the course on "Demystifying Clinical Medicine for PhD Students, Fellows, and Staff."

Starting Tuesday, January 7, the course will be offered weekly through mid-May from 4:00–6:00 p.m. in the ground floor auditorium of Building 60.

The goal is to "demystify medicine" through clinical presentation of patients and their pathology and diagnostic and therapeutic advances that have emerged from advances in basic biology. Each session will be conducted by a clinical and a basic scientist who will subsequently engage in discussion with the audience. The course will again be directed by Win Arias, professor of physiology and medicine at Tufts School of Medicine in Boston and NIH adjunct investigator and special assistant in the office of the NIH deputy director for intramural research.

The curriculum includes approximately 25 major diseases and related basic biologic advances and is designed to bridge the ever-increasing gap between advances in basic biology and their application to human disease. Typically, PhD scientists do not receive training in pathobiology and have little exposure to clinical disease, advances in diagnosis and therapy, and the major unsolved clinical problems that challenge basic research. A class schedule will be printed in the January-February issue of The NIH Catalyst.

There is no tuition. E-mail your registration, including name, address, e-mail address, and position at NIH, to the course director. Enrollment is limited to 180 students who should have an advanced degree or be in a PhD program. This is a noncredit course, but students who complete a take-home essay-type final examination will receive certification of course completion.



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