Conferences as a Tool for Interdisciplinary ( Postgraduate ) Learning in Bioethics

In recent years, alongside the general advancement of bioethics in a range of professions, bioethics conferences, both at a national and international level, have developed and become increasingly popular. One challenge for those learning bioethics is often to engage with disciplines outside their own, for instance by exploring new methodological approaches or theoretical frameworks. The interdisciplinary nature of bioethics motivates the development of different forms of interdisciplinary learning. In this paper, the authors discuss the role of bioethics conferences that, it is argued, serve as an important tool for interdisciplinary learning and interaction in bioethics. Special reference is given to the Postgraduate Bioethics Conference, which the authors convened in 2014 and have since overseen, to demonstrate how such a conference can assist learning in bioethics.


Introduction: Rising prominence of bioethics
Since the 1980s, the demand for better professional and academic bioethical expertise has increased following the ethical challenges arising from advances in technology and science.In responding to this demand, universities have, over the last few decades, set-up dedicated research centers in bioethics (Wilson, 2014).As these centers have become established, postgraduate programs have been developed in order to provide bioethical education, and research has attempted to contextualize bioethics as an academic discipline (Turner, 2014;Ives, Dunn & Cribb, 2016).Montgomery (2016, p. 23) states that " [b]ioethics can be considered as a topic, an academic discipline (or combination of disciplines), a field of study, an enterprise in persuasion"; and acknowledges that it is a unique field of study, standing at the intersection of a variety of disciplines (p.23).This paper seeks to respond to the particular demands of interdisciplinarity in bioethics by reference to conferences as a tool for learning.It focuses on (postgraduate) bioethical learning, which the authors believe to be concerned with the development of new skills and knowledge, rather than bioethical education, which is considered to refer to academic programs in bioethics.

The challenge of the interdisciplinary nature of bioethical learning
Interdisciplinary learning emphasizes "collaboration and interactions between disciplines" (Park & Son, 2010, p. 23).An interdisciplinary research capacity is recognized as a central aim of graduate-level learning outcomes, but with sparse literature available identifying substantive methodologies to achieve this aim (Borrego & Newswander, 2010), with a few exceptions existing in relation to Sustainability Science (Sprain & Timpson, 2012; Blake, Sterling, & Kagawa, 2013).Postgraduates studying or researching bioethics might need to learn theories and methods from disciplines with which they are unfamiliar.Therefore, bioethics, as Schaefer-Rolffs (2012, p. 111) states "has to include multiple perspectives because only on the basis of a discourse with different points of view it is possible to decide what the right way to deal with a certain situation is."A primary challenge in bioethics is therefore not in becoming a polymath, but in developing skills and strategies needed for a reasonable integration of relevant perspectives.Chadwick (2015, p. 32) stresses that "the future of bioethics rests on possibilities of harmony between different voices...".And there are many voices.Bioethics can require understanding of the moral, social, and regulatory frameworks and environments in which biological innovations emerge.The new technologies that bioethics addresses often stretch the boundaries of the various disciplines it involves.Norms 1 or values can develop rapidly in bioethics through evolutions in practice, which cannot be readily explained or understood through the lens(es) of traditional, normative frameworks 2 and principles of individual disciplines.These nebulous evolutions can lead to uncertainty regarding the scope of bioethics.Ives et al., have noted their frustration at the "multifarious and vague" nature of bioethics, such that even "the most seasoned researcher" would be challenged (Ives, Dunn & Cribb, 2016, p. 1).As such, bioethical issues can spark numerous complex questions which engage a variety and sometimes unknown quantity of disciplines.
Contemporary debates in bioethics have required a move beyond the theoretical to the empirical, to take account of "real life" implications, where different disciplines involved in a bioethical debate work together cohesively to encourage engagement with different research methods, which researchers might not be familiar within their own discipline.For example, in the bioethical context, a sociologist may see facts about the external world as constructed, whereas a philosopher views them as an objective reality (Adler & Shaul, 2012, p. 197).Bioethics also necessitates knowledge of other disciplines due to its applied and problem-centered approach which, in the words of Nikitina (2006), involves "enlisting the knowledge and modes of thinking in several disciplines" (p.253) to improve the human condition and generate "tangible outcomes and change" (p.263).She provides an example of a bioethics course at the University of Pennsylvania which allowed students to bring together disciplinary tools to formulate calls for legislative change.One student of the class reflected that this project left her feeling "more action-oriented in her spirit than her biochemistry background or an ethics course would have prepared her for" (p.264).The proposal she wrote, concerning the determination of death for humans born with anencephaly, involved not only a scientific perspective, but also "converging the lenses of 'the Catholic Church's point of view', 'the organ-donors' point of view', 'the parents of the child's point of view', and 'the [encephalic] child's point of view'", which informed her personal opinion as well her recommendation for legal action (p.264).
The need for an interdisciplinary approach is not limited to bioethics.As Klein (1996), a prominent interdisciplinary theorist, points out, "interdisciplinarity is on everyone's agenda; actually implementing it in institutional settings is a more difficult proposition" (p.209).Romm (1998) considers its significance in terms of how it provides scope for communities to enhance "democratization of knowledge construction processes in society" (p.65).For Romm this fosters inquiry leading to reflexivity, which is ideally a process "whereby people learn to transform themselves" (p.65).Researchers whose work is of a bioethical nature, in particular, require an approach that is inclusive of other disciplines so that their research can be regarded 2 For example, Hunt and Carnevale (2011) discuss how anthropological and phenomenological sources can develop an alternative framework for bioethical enquiry for investigation of how moral experience affects the everyday lives of individuals and groups.
as subject to a democratic knowledge process.The constituency of this bioethical democracy is, however, open to debate, not least because bioethics seeks not only to describe but also to prescribe policy recommendations which implicate the values and beliefs of various stakeholders (Takala, 2017).Teachers should be wary of a prescriptive account of bioethics, which only accounts for a suppression of what he or she considers to be facts unsuitable for the students' palate.Alive to this potential methodological minefield, Gosić's (2011) analysis of the educational principles of Jahr (1930) is poignant.The concept of teaching, she argues, "can be approached in different ways", and students should be free to choose approaches to solve a certain problem" (p.411).Further, she maintains that, according to Jahr's principles, bioethics courses should improve the character of students, encouraging them to be open and tolerant of different disciplinary climates as well as motivating them to articulate and present their viewpoints.(p.414).
Though bioethics is commonly understood as involving ethical issues arising from the biological and medical sciences (Kuhse & Singer, 2006), according to Bracanović (2012, p. 148) an "integrative" account of bioethics "should cover all ethical questions that are in any way related to the phenomenon of life".Sodeke and Wilson (2017) comment positively on integrative bioethics as being a bioethics that integrates all disciplines and knowledge together.Schaefer-Rolffs (2012) argues that a 'core idea of Integrative Bioethics is pluriperspectivism -the inclusion of all relevant and important points of view that can add a new position to the discourse and broaden the view on the topic that is talked about" (p.114).For Schaefer-Rolffs, the combination of integrative and pluriperspective approaches does not mean integrating other points of view into only one which is considered right, but rather "it means that there has to be an equal discussion between different positions" (p.114).
The ramifications of an "equal discussion" in bioethics are significant.Chadwick (2015) notes that "[t]he ethical expert, in so far as he or she has a relevant body of knowledge, is precisely one who is aware of different approaches to the matter" (p.38).Yet bioethics must go beyond a mere mutuality of awareness.An early and highly significant commentary on the field postulated how bioethics should act as a "bridge" between disciplines so as to be truly global in the solutions offered, even acting as a new scientific discipline in itself (Potter, 1971).More recently, it has been argued that bioethics "should not content itself with a mere mechanical gathering of diverse perspectives… but should aim at true integration the development of a unified platform for discussion of the ethical problems concerning life" Jurić (2012, p. 88).Stember (1991) considers that multidisciplinarity involves the presence of various perspectives, but interdisciplinarity transcends this by indeed seeking to integrate these perspectives (pp.[4][5].For bioethics this is particularly important, representing its evolution from a multidisciplinary area to an interdisciplinary field (Magnus, 2001, pp. 991-92).These points implicate bioethics and signify that in many cases a bioethicist with an interdisciplinary grounding should be able to speak with more authority and expertise to those whose their research engages which herald from distinct disciplines.An inference which follows is that such a bioethicist may be able to make his or her argument from just one perspective, but writes accessibly for generalist readerships and is open to the possibility of interrogation outside their own discipline.His argument should be couched in terms, which appeal to the wider bioethical electorate.

Bioethics conferences
It is our belief that bioethics conferences provide an essential route to bridging gaps between disciplines to help achieve the integration of perspectives that bioethics necessitates.A bioethics conference provides a unique opportunity to actively facilitate the exchange of ideas and assist understandings of the types of emerging framework and environment mentioned above.

Survey of learning at bioethics conferences
To supplement the above consideration, we conducted a survey 3 to find out the experiences of delegates of bioethics conferences in acquiring knowledge from someone from a different discipline to their own.The survey was sent by email to approximately fifty bioethics academics, of which six responded.The academics were asked to consider the following questions: • What is your discipline?
• What is the discipline of the person you acquired knowledge from?
• What knowledge did you acquire from that person that allowed you to learn something about a bioethical scenario that would not have been possible merely through the lenses of your own discipline?
• How did this knowledge exchange occur (i.e.keynote/at dinner/etc.)?Provide as much context as possible.
• Has this impacted the way you think about a bioethical situation?If so, how?
3 Research ethics approval granted by the University of Southampton.

Summary of responses
Tom Beauchamp responded with respect to bioethics conferences that "[f ]or more than forty years I have learned a great deal in bioethics from people in other disciplines, most notably law, history, psychology, medicine, public health, and veterinary sciences --but far beyond as well".A postgraduate student (who preferred to remain anonymous) responded: I remember speaking to Professor John Bryant at the bar at the Postgraduate Bioethics Conference 2014 and we started discussing the subject of GMO crops.I expressed some apprehension about their proliferation.He then explained to me how the genetic modifications that occur in these crops are really significantly less drastic than that which occurs "naturally" through cross-breeding.This scientific knowledge informed how I think about the ethics of GMO crops.
Anne Barnhill, a philosopher, acquired knowledge from a public health practitioner about ethical concerns over her talk on behavior change.This exchange occurred in the same room after the presentation occurred, and this illustrates the importance of providing the time for such interactions to occur, i.e. not having back-to-back sessions and providing the opportunity for delegates to mingle in the same room of a session after its formal conclusion.A postgraduate student in law, Louise Austin responded in the following way: One of the keynote speakers [at PGBC 2016] discussed a recent significant case on informed consent.He took a different approach as to the interpretation of the interaction between law and ethical guidance.I discussed this with him in one of the breaks and I reconsidered my interpretation following that.My background to date has been purely law, whilst the person I spoke with has a background in medical law and ethics, and the ethical perspective gave me a different interpretation of the case.
Austin's response is interesting in how it led to her reinterpretation of a legal decision in light of an ethical perspective.It indicates how a conference such as the Postgraduate Bioethics Conference (PGBC), which is convened in the United Kingdom, can operate as a forum for especially postgraduate students and teachers, encouraging a transition beyond classroom teaching and the didactic; a feature ideally suited for the ethical discussions.Postgraduate students can also learn from one another.Daniel Tigard, a postgraduate from Tulane University and a delegate of PGBC 2014 and 2016, responded that: [T]he clearest example I recall from the PGBC 2016 was my productive interaction with Georgina.She is [a postgraduate student] in the Institute of Applied Health Research at Birmingham; whereas I am in philosophy, specializing in applied ethics (from a more theoretical perspective).Georgina and I are both working on the issue of moral distress in medical practice and, so, we were aptly paired together for our presentations.I remember we had an interesting exchange during the session concerning how to define moral distress.Later that evening, in the bar, we continued chatting.I was intrigued by her firm empirical approach, investigating the nature of moral distress prior to developing a conceptual notion of her own; this process, I believe, is meant to define the phenomenon from the ground up.I, on the other hand, have started my project with a robust conceptual analysis.I like to think she and I have helped each other to see the merits of diverse methodologies.While I was already keen on verifying philosophical analyzes with empirical data, I think I am now more inclined to utilize a multitude of approaches, especially when studying morally significant experiences in such important realms as medical practice.
Tigard's emphasis on the acquisition of knowledge about a methodology from another discipline is indicative of the benefits of interdisciplinary learning previously discussed at a bioethics conference.Moreover, that the interaction occurred at a bar demonstrates how some interdisciplinary discussions, leading to an enhancement of understanding, may be best broached as informally as possible.Tigard's experience points to the type of cross-fertilization of disciplines within bioethics which Ives et al. (2016) identified can lead to a wide variety of research methodologies, and might include the combination of traditional theoretical discussions which could be combined with empirical studies.
The authors consider that the above testimonies highlight that postgraduate bioethics conferences provide a crucial opportunity (which may be their first) for interdisciplinary learning.The statements from the participants point to the conclusion that such an approach is suitable for exchanging knowledge and learning about different standpoints.For example, lawyers can hear (and challenge) medics' views on the ethical dimensions of healthcare, and vice versa.Thus bioethics conferences become conduits to not only learn novel perspectives, but to become more "inclined to utilize a multitude of approaches" and discover a perspective that was previously unknown to participants.This utilization represents not only the mere presence of different academic voices (multidisciplinarianism), but the integration between the disciplines (interdisciplinarianism).The opportunities which exist for such interactions will be influenced by the university and research center at which a bioethicist is based, and as such our recommendations may be of greater relevance to those bioethicists whose university does not present (relatively speaking) such possibilities.
Further work might be required to indicate the ease of transfers of knowledge between disciplines, and whether certain disciplines within bioethics communicate more effectively than others.Despite the possibility of such variations, the authors support Solomon's (2012) general viewpoint with respect to bioethics that the "more open the field becomes, the richer the discourse" (p. 1).To foster bioethics conferences which lead to more of an open field, incorporating the type of discussions and learning mentioned above, we present recommendations.

Recommendations on bioethics conferences as a tool for understanding bioethical interdisciplinarianism
This article has provided empirical evidence of the impetus of and for interdisciplinary learning in (postgraduate) bioethics conferences.To achieve this goal, conferences should be suitably structured to promote interdisciplinarianism within bioethics.An obvious way to ensure this happens is to arrange for the participation of keynote speakers and other presenters from as wide a range of disciplinary backgrounds as possible.To progress from mere multisciplinarianism, however, and embody interdisciplinarinism, organizers of bioethics conferences should also seek to specifically arrange the program to actively facilitate an exchange of ideas between the different disciplines.Sessions could be arranged around themes not confined to one academic discipline, with presenters from various disciplines.Presenters should be particularly encouraged to allow significant time for interactive sessions with audiences after their talks.It may be daunting for presenters, especially postgraduates, to know that the audience contains specializations and expertise quite distinct to their own.The end of a session should not therefore be designated as a "question and answer" time, but rather an extended opportunity for feedback and round table discussion.This should provide scope for presenters to receive helpful commentary (rather than simply interrogation) with respect to their work, and thus be more enriching.An atmosphere should be cultivated whereby bioethics conferences allow for horizontal exchanges of information between disciplines, rather than impressing upon delegates that the speakers will be performing top-down all-encompassing specialist training.The approach, which should be fomented in bioethics conferences, is one in which, as far as possible, all delegates have an opportunity to contribute by sharing from their own particular expertise.Following the insight from the respondents to the survey, plenty of opportunity should be provided to discuss talks, in feedback either after presentations, or more informally, during intervals between sessions in a sociable environment.The talk-feedback time ratio could be limited to 2:1, for example a keynote talk lasting 40 minutes with 20 minutes of feedback; or for a more radical solution, 1:1, with 30 minutes of a talk followed by 30 minutes round table discussion feedback.To minimize the possibility of limited feedback following a talk, delegates could submit their questions or responses electronically during the talk.A moderator could then gather these and ask them on behalf of the audience.
A confident presenter could also answer multiple questions consecutively, perhaps to emphasize the connection between different disciplines.For round table discussions, it would be especially important to brief delegates of the talks well in advance of a conference to allow for preparation.
Informality in a bioethics conference can be introduced by utilizing novel approaches to presentation, such as PechaKucha (a presentation style in which 20 slides are shown for 20 seconds each) or breakfast discussions/talks as planned by the organizers of PGBC 2017.A three-minute thesis challenge was part of the program of PGBC 2016, and involved delegates summing up their research in a way that was intelligible in a very short period of time.This was a useful tool in broadening delegate participation and, being conducted in a lounge with access to refreshments after the main event, allowed for varied discussion and feedback.Over at least the last five years, the annual PGBC conferences have included a range of workshops, which have also provided a platform for communication and dialogue.Interactions outside of the scheduled sessions have also proven to be fruitful.Conference organizers should enable time for informal talks and opportunities for delegates to mingle after the conclusion of the scheduled sessions.
Organizers should give particular thought to the layout of the conference to promote interactivity between delegates as far as possible.In conference planning, the present authors utilized a cabaret style of seating, as opposed to theatre or classroom seating plans, to promote social interactivity between delegates.The format of bioethical learning conferences proffer can, in certain respects, resemble that of hospital or governmental ethics committees, which may themselves necessitate an interdisciplinary approach (McGrath, 2006, p. 59).

The postgraduate imperative
Although the aforementioned points are relevant to bioethics conferences in general, it is submitted that they are of particular interest to postgraduate bioethics researchers, who may not have the experience of working with and learning from academics from other disciplines.The annual PGBC in the United Kingdom is unique in terms of its provision as a national postgraduate bioethics conference.The authors, alongside Dr David Lawrence and Dr Sacha Waxman (who convened the conference in 2015), formed a postgraduate bioethics community in conjunction with the Institute of Medical Ethics to oversee PGBC and develop other events for postgraduate bioethics students.At the time of writing, the authors could not find evidence of any other equivalent national organization in the world.It is recommended that national postgraduate bioethics communities are developed to assist in learning, especially from an interdisciplinary perspective for postgraduate bioethics students, with the centerpiece of the community's work being an inclusive and accessible national postgraduate bioethics conference.It has been our experience that postgraduates are not entrenched in their own discipline, and can enjoy learning and interacting with other disciplines.Thus, whether or not such a bioethics community is postgraduate led, it should at least seek to incorporate postgraduate researchers.The aspects of promoting learning through conferences may be applied to areas other than bioethics necessitating an interdisciplinary approach.