Thirty years ago, bioethicists had many concerns about our future. Two of the greatest were psychosurgery and subliminal behavioral conditioning.

 
Students Riley Carpenter, left, and Shruti Puri, right, talk with Greg Pence about bioethics issues. Pence will be speaking on the past and future of bioethics at the prestigious Federal University of Minas Gerais in Brazil on June 13.

What was that last one?

“That’s when you walk into Parisian and you hear a voice telling you to go ahead and buy that Polo shirt or that dress and you can’t resist it,” says Gregory Pence, Ph.D., bioethicist. “We see how important both of those concerns turned out to be. It shows you just can’t imagine what’s coming.”

Pence will be speaking on this topic at the prestigious Federal University of Minas Gerais in Brazil on June 13, examining “Thirty Years of Bioethics: What Have We Learned, Where Do We Go From Here?” as part of the university’s Great Lecture Series.

A philosophy professor, Pence describes bioethics as ethical issues raised by biology in medicine. Pence, who also teaches medical ethics to first-year students in the UAB School of Medicine and directs the Early Medical School Acceptance Program, is looking forward to discussing some of the concerns he believes all will consider in the coming years.

Pence identifies nine areas that may cause future unease: global medical injustice, stopping the spread of AIDS and HIV, the bioethical implications of global warming, global research ethics, religion and bioethics, implications of allowing couples to choose against having children with genetic diseases, dying with dignity and drug companies’ coziness with doctors.

Interestingly, another area of concern for Pence has recently received extensive news coverage — the ethics of emerging infectious diseases and the manner in which societies deal with them. Andrew Speaker, a 31-year-old personal injury lawyer from Atlanta, recently traveled through Italy, the Greek Isles and other spots in Europe for his wedding and honeymoon and then back to the United States after being diagnosed with multi-drug-resistant tuberculosis.

Many ethical questions have been raised by Speaker’s trip. Why was he allowed back into the United States by a border inspector who disregarded a computer warning to stop him and don protective gear?

Did his new father-in-law Robert C. Cooksey, a CDC microbiologist whose specialty is TB and other bacteria, report him to federal health authorities? If not, why? If so, when? Did the CDC abandon Speaker by asking him to check into a health facility in Rome instead of returning to the United States for treatment, as he claims?

At the very least, says Pence, the incident is revealing the holes in global disease control.

“This certainly shows the shifting nature of bioethics,” Pence says. “Most of our discussions have been inside nation states, but things are global now. We live in a world that’s so much more connected, and things can move so quickly. And denial and secrecy don’t work, although those have been the policies of many places in the past, such as China with SARS.

“Can you imagine if Ebola came here? We don’t have the concept to deal with it right now.”

That’s why bioterrorism is also a key concern, Pence says. There are ethical choices to be considered that would be immediate in impact and very, very difficult to make.

“Let’s say there’s a lethal outbreak of some agent or disease, and the decision has to be made to kill 100 people to save 10 million. Someone will have to make that decision,” Pence says. “Even more scary is that someone would not be able to make that decision and 10 million would die. But we have not had a national discussion on it. And who wants to take the heat for making that decision?”

However, Pence says, not everything is doom and gloom. In fact, he says, hope lies in the expansion of bioethics beyond America’s borders during the past 30 years. Bioethics centers exist in Japan, Brazil, Nairobi, Holland and other points around the globe. And, in 30 years the global community could look back on some of these issues and compare them to subliminal behavioral conditioning.

“Life will throw you some things that are just going to be different,” Pence says. “The one thing we know is that bioethics will be interesting. That’s a guarantee.”