Shows
Bio(un)ethical#21 Bryan Carmody: Are doctor shortages real?In this episode we speak with Dr. Bryan Carmody, pediatric nephrologist and associate professor of pediatrics at Eastern Virginia Medical School. We talk about whether America really faces a doctor shortage, why people in areas with plenty of doctors still struggle to access care, whether proposed solutions can address the access problems many patients face, and how AI may affect these problems in the near future.(00:00) Our introduction(04:03) Rethinking the doctor shortage narrative(09:00) The AMA and the AAMC(16:11) Shortage of 187,000 physicians by 2037(25:20) Physician misallocation(38:19...2025-07-141h 41Bio(un)ethical#20 Rachel Fraser: How your social world shapes what you knowIn this episode we speak with Dr. Rachel Fraser, Associate Professor of Philosophy at MIT, about whether experiences of oppression can yield special insights, whether these insights can be shared with members of dominant groups, and what implications this has for policymaking.(00:00) Our introduction(03:39) Interview begins(03:43) Historical roots of standpoint epistemology(27:38) Situated knowledge: What kind of knowledge depends on social position?(41:03) What kind of knowledge depends on social position?(46:04) Does standpoint theory stereotype or essentialize people?(53:19) Epistemic advantage: Does oppression give you special insight?2025-03-181h 48Bio(un)ethical#19 Emily Largent and Govind Persad: Is bioethics ok?In this episode, we speak with two leading bioethics scholars about the state of bioethics today. Dr. Emily Largent is the Emanuel and Robert Hart Associate Professor of Medical Ethics and Health Policy and the Chief of the Division of Medical Ethics at the University of Pennsylvania Perelman School of Medicine. Dr. Govind Persad is an Associate Professor at the University of Denver Sturm College of Law and our first returning guest on Bio(un)ethical.With Emily and Govind, we consider critiques of bioethics coming from inside and outside of the field. In light of our...2025-02-271h 21Bio(un)ethical#18 David Thorstad: Evidence, uncertainty, and existential riskIn this episode, we speak with Dr. David Thorstad: Assistant Professor of Philosophy at Vanderbilt University, Senior Research Affiliate at the Global Priorities Institute, and author of the blog, Reflective Altruism. We discuss existential risks–threats that could permanently destroy or drastically curtail humanity’s future–and how we should reason about these risks under significant uncertainty.(00:00) Our introduction(09:32) Interview begins(14:32) The longtermism shift(23:17) Framework for objections to longtermism(29:47) Overestimating existential risk: population dynamics(36:06) Overestimating existential risk: cumulative vs. period risk(39:44) Overestimating existential risk: ignoring backgr...2025-02-111h 38Bio(un)ethical#17 Rochelle Walensky: How can we fix American public health infrastructure?In this episode, we speak with Dr. Rochelle Walensky, former director of the Centers for Disease Control and Prevention (CDC). We discuss the state of American public health infrastructure, the challenges it faces, and what we can do to improve it.(00:00) Our introduction(03:45) Interview begins(09:32) Core challenges: Maintaining and growing the workforce(18:41) Core challenges: Standardizing and modernizing data systems(28:01) Core challenges: Reorganizing laboratory systems(30:32) The problem of fragmentation(44:55) Tradeoffs in communication; “following the science”(52:57) Biggest lessons learned(1:00:37) Public health infrastructure in the US vs. elsewhere(1:07:34) Paths forward: public inve...2025-01-281h 18Bio(un)ethical#16 Quayshawn Spencer: What is race?In this episode, we speak with Dr. Quayshawn Spencer, Robert S. Blank Presidential Associate Professor of Philosophy at the University of Pennsylvania, about what race is, why he’s a radical racial pluralist, and what this could imply in science and medicine.(00:00) Our introduction(11:23) Interview begins(20:21) Methodology: What are philosophers of race trying to do?(32:05) From aspiring physician-scientist to philosopher of race(41:08) Becoming a realist about race(44:44) Human continental populations and the OMB racial classification scheme(1:00:43) The national meaning of “race” in US racial discourse(1:12:35) Why not be a pure social...2025-01-141h 42Bio(un)ethical#15 Jeff McMahan: On the ethics of choosing our children's genesIn this episode, we speak with Dr. Jeff McMahan, Emeritus Sekyra and White’s Professor of Moral Philosophy at Oxford University, about whether germline gene editing is ever morally preferable to embryo selection and whether and when we should control the genetic outcomes of our children.(00:00) Our introduction(06:48) Interview begins(10:06) Same-child choices and different-child choices(27:24) Against the comparative view(31:25) Against the impersonal view(38:33) In favor of the two-tier view(45:47) Implications for genetic counseling(50:08) Other objections to gene editing(51:36) Treatment versus enhancement(56:55) Is it morally permissible to control our ch...2024-12-171h 27Bio(un)ethical#14 James Diao: When should race be used in medical algorithms?In this episode, we speak with researcher and physician Dr. James Diao about when and why race should be included or excluded from clinical algorithms. We focus on his work evaluating the implications of including race as a variable in two clinical algorithms: one used to assess lung function, and another used to assess cardiovascular disease risk.(00:00) Our introduction(05:10) Interview begins(09:47) Criteria for the inclusion/exclusion of race of clinical algorithms(16:23) Inclusion of race in lung function equations(27:04) Estimated racial disparities in lung disease classification(31:37) Estimated racial disparities in access to social...2024-12-101h 27Bio(un)ethical#13 Sarah McGrath: Are there moral experts?In this episode, we speak with Dr. Sarah McGrath, professor of philosophy at Princeton University. We discuss whether and when it makes sense to defer to others about the answers to moral questions, whether moral deference is any less appropriate than deference in other domains, like math or science, and whether we have reason to think bioethicists are moral experts.(00:00) Our introduction(04:28) Interview begins(08:02) Varieties of moral deference: pure versus impure(12:39) Outline of Sarah’s view and argument(20:58) The (ir)relevance of meta-ethics (what ethics is and where it comes from)(41:13) How to...2024-11-271h 18Bio(un)ethical#12 David Wendler: Are we overprotecting kids in research?In this episode, we speak with Dr. David Wendler, Head of the Section on Research Ethics in the Department of Bioethics at the National Institutes of Health Clinical Center and philosopher by training. We discuss the ethics of pediatric research: how much risk we should expose kids to in research; what we should do when the federal research regulations don’t make sense; and what was and wasn’t wrong with the Kennedy Krieger Lead Abatement Study.(00:00) Our introduction(05:25) Interview begins(13:56) How risky can pediatric research be?(32:38) What counts as “minimal risk”? Risks of daily li...2024-11-121h 45Bio(un)ethical#11 Richard Leiter: Is a better death possible?In this episode, we speak with Dr. Richard Leiter, senior palliative care physician at Dana-Farber Cancer Institute and Brigham and Women’s Hospital and assistant professor of medicine at Harvard Medical School. We discuss the state of end-of-life care in the US today, why patients often receive care that doesn’t align with their values, whether some of the care that doesn’t seem to promote the things patients’ care about actually is aligned with their values, and whether doctors put too much pressure on patients to make end-of-life decisions autonomously.(00:00) Our introduction(08:46) Interview begins(13:47) Do early...2024-10-291h 28Bio(un)ethical#10 Danielle Allen: Should laypeople make health policy decisions?In this episode, we speak with Dr. Danielle Allen, professor of political philosophy, ethics, and public policy at Harvard and Director of the Allen Lab for Democracy Renovation, about the extent to which we should involve laypeople in decisions about health and science policy through democratic, participatory processes.(00:00) Our introduction(08:47) Interview begins(12:23) Power-sharing in the domains of health and science policy(16:23) Is representative democracy enough?(21:03) Does power-sharing always require democratic mechanisms?(24:13) What role should professional ethicists play in shaping policy?(31:03) Does power-sharing produce other substantive benefits?(32:56) Trade-offs between power-sharing processes...2024-01-1658 minBio(un)ethical#9 Marc Lipsitch: How to ethically prevent the next pandemicIn this episode, we speak with Marc Lipsitch, epidemiologist and professor at the Harvard T.H. Chan School of Public Health and Director of the Center for Communicable Disease Dynamics, about what lessons we should take from the COVID-19 pandemic, what role research should play in mitigating and preventing future pandemics, and how we should regulate research on potential pandemic pathogens.(00:00) Our introduction(11:26) Interview begins(12:35) The role of surveillance in preventing pandemics(23:05) What policymakers got wrong during the COVID-19 pandemic and why(26:23) Could we have prevented backlash to COVID-19 mitigation policies?(30:34) How...2024-01-021h 01Bio(un)ethical#8 Sally Haslanger: How social contexts shape our moral normsIn this episode, we speak with Dr. Sally Haslanger, Ford Professor of Philosophy and Women’s and Gender Studies at MIT, about what norms are, how we can know when they need to be changed, and how we should change them.(00:00) Our introduction(5:12) Interview begins(16:07) What grounds social norms(18:56) How we can know a moral norm is problematic(23:11) How social and moral norms relate(29:49) What is social critique?(35:54) Social critique without situated knowledge of a social practice(50:06) Are structural solutions always better?(52:21) The role of philanthropy and expertise(1:05:18) Wh...2023-12-121h 25Bio(un)ethical#7 Jennifer Blumenthal-Barby: Is nudging ethically required?In this episode, we speak with Dr. Jennifer Blumenthal-Barby, a philosopher and bioethicist at Baylor College of Medicine, about why she thinks clinicians are often permitted, and even required, to use insights from behavioral economics and decision psychology to shape patients’ medical decisions.(00:00) Our introduction(05:50) Interview begins(07:57) What is a nudge?(15:15) Is there any such thing as pure rational persuasion?(18:12) What makes a decision good or bad?(23:15) Can nudges make patients’ medical decisions better?(42:40) How credible are the findings of decision science?(45:21) Do nudges disrespect autonomy?(56:16) Justifying nudges as inst...2023-11-141h 09Bio(un)ethical#6 Jeff Sebo: Why we’re wrong about who mattersIn this episode, we speak with Dr. Jeff Sebo, a philosopher and bioethicist at New York University, about what it would mean to take seriously the possibility that non-human animals (including insects) and future AI systems might matter morally.(00:00) Our introduction(05:56) Interview begins(07:21) The moral circle vs. the legal and political circles(13:18) Why has the moral circle expanded over time?(20:53) How should we trade off human and non-human welfare in practice?(33:40) How should we treat non-human animals in research?(37:25) How should we treat current AI systems, given that we’re not ce...2023-10-311h 25Bio(un)ethical#5 Chris Robichaud: Can we teach people to be more ethical?In this episode, we speak with Dr. Christopher Robichaud, Director of Pedagogical Innovation at Harvard’s Edmond and Lily Safra Center for Ethics, about whether and how we can teach scientists, doctors, and other professionals to be more ethical, what the goals of ethics education ought to be, and how we can know we’re achieving them.(00:00) Our introduction(13:18) Interview begins(17:39) Does ethics education miss the point?(22:05) Four goals of ethics education(30:05) Goals: Improving moral reasoning(32:39) What drives the focus on moral reasoning?(36:05) Does focusing on moral reasoning promote moral relativism or n...2023-10-171h 11Bio(un)ethical#4 Holly Fernandez Lynch: Do IRBs do more good than harm?In this episode, we speak with Professor Holly Fernandez Lynch, a lawyer and bioethicist in the Department of Medical Ethics and Health Policy at the University of Pennsylvania and founder and co-chair of AEREO, an organization that aims to understand and measure the benefits and drawbacks of the IRB system. With Holly, we discuss what we currently know about the benefits and costs of IRBs, why it’s so hard to measure them, and whether justifying the IRB system requires establishing that it produces good outcomes, or just that it follows good procedures.(00:00) Our introduction(04:58) Interview be...2023-10-031h 21Bio(un)ethical#3 Marie Nicolini: Should people with mental illness have access to medical aid in dying?Content warning: This episode contains discussions of suicide, suicidal ideation, and symptoms of mental illness. If you or someone you know or love is struggling, please seek help. You can call or text 988 to reach the suicide and crisis lifeline.In this episode, we interview Dr. Marie Nicolini, a psychiatrist and bioethicist who testified to the Canadian Parliament as an expert witness on the issue of medical aid in dying (MAID) for mental disorders. With Marie, we discuss whether we should legalize MAID for mental illness, what practical and conceptual challenges we face in constructing appropriate safeguards...2023-09-191h 18Bio(un)ethical#2 Govind Persad: How (not) to allocate resources during a pandemicIn this episode, we interview Dr. Govind Persad, an expert on resource allocation whose work influenced COVID-19 allocation policies, about how we should allocate scarce medical resources, what stood in the way of optimal allocation during the covid pandemic, and how we can improve resource allocation within the US healthcare system. (00:00) Our Introduction(04:05) Interview begins(12:06) What is a “framework” for allocating health resources?(14:20) What normative assumptions are baked into allocation frameworks?(19:36) What principles are included in allocation frameworks?(20:24) Overview of first two principles: Maximizing benefits and favoring the worst off(26:11) Overview of se...2023-09-051h 19Bio(un)ethical#1 Robert Steel: Can research be too risky?In this episode, we interview Dr. Robert Steel about how we should assess the risks and benefits of research, what justifies research oversight, and whether there should be upper limits on the amount of risk research participants are exposed to.(00:00) Our introduction(05:06) Start of interview; IRB background(13:34) The notion of minimal risk(24:49) Justifying IRB risk evaluation: Initial discussion(37:07) Justifying IRB risk evaluation: Group soft paternalism(45:57) Justifying IRB risk evaluation: Maintaining social trust(54:13) IRB assessment of social value(56:25) Alternative justifications (beneficence, non-maleficence, non-exploitation)(01:02:36) Implications: Benefits to society count...2023-08-211h 18Bio(un)ethical#0 Welcome to Bio(un)ethicalWelcome to Bio(un)ethical, the podcast where we question existing norms in medicine, science, and public health.In this episode, we (Leah Pierson and Sophie Gibert) introduce the podcast and talk about why we started it and what we hope to achieve.If you want to support us, the best way is to subscribe, rate, and review our show wherever you get your podcasts, and recommend it to a friend. You can find more episodes at our website, biounethical.com, and can also join our email list to receive episode alerts and submit questions...2023-08-1721 min