by Gordon Nary
Gordon: When did you attend University of Manchester , what degrees did you earn, what was your favorite course, and why was it your favorite?
Simon: I was an undergraduate at Manchester University and graduated in 1987 with a Bachelor of Arts in Philosophy. I joined the course as a mature adult, I had previously trained as a nurse and had been working in a major cancer centre in Manchester UK. I had always had an interest in philosophy and I eventually plucked up courage to try for University.
By the time I was accepted on the programme I was hungry for knowledge and devoured whatever was on the table, ancient philosophy especially Plato, epistemology (theory of knowledge) and of course ethics. What was particularly interesting about the programme was that you could take courses in analytic philosophy (the Anglo-American approach to philosophy that developed in the 20th century) and courses in 'European' philosophy (inspired by phenomenonology).
The link between these two contrasting and potentially conflicting approaches to philosophy was for me Ludwig Wittgenstein, the enigmatic Austrian philosopher who moved from aeronautic engineering to philosophy. Wittgenstein was initially the champion of analytic philosophy only to spend the remainder of his career systematically pointing to the flaws of that approach.
Wittgenstein's work was highly influential and he turned up in virtually everything I studied. I also enjoyed studying aesthetics with John Harris who later became my PhD supervisor. At that time he was one of the early and leading forces in Bioethics as it was developing in the UK and with a major focus on medical ethics. I also studied ethics and though I could not get on with the analytic approach to ethics, which made moral problems into linguistic quibbles I still enjoyed it.
One teacher David Lamb taught 'applied' ethics and this I could live with, it was real and made a direct link to the ethical issues I had encountered as a nurse. David Lamb made a major contribution to the debates about the diagnosis of death which were being revisited at the time because of advances in organ retrieval for transplantation. As David pointed out, there is something deeply counterintuitive about looking at a pink, warm, breathing body and thinking of it as a 'corpse' for the purposes of transplantation.
After I graduated I returned to nursing and eventually became the manager of a bone marrow transplant unit, treating adults with leukemia and similar cancers. It was an experimental unit at the cutting edge of cancer treatment but wracked with ethical problems. The philosopher in me needed to spend some time thinking about these issues and so I began my PhD studies with John Harris in which I explored the concept of 'quality of life' as used in the health context.
Gordon: Please explain what Bioethics is.
Simon: Bioethics doesn't have a single agreed definition - it is contested! But you could say that a working definition is the exploration of the ethical issues arising out of biotechnology innovation, a big 'branch' of which focuses on the context of medicine and health care. Some might argue that bioethics is synonymous with medical ethics but that would be too narrow. Also there are various parties who have a stake in bioethics, philosophers of course, lawyers, practitioners of various kinds but also social scientists who have brought an important critical lens to bioethics. My own career began very much focused on medical ethics and the everyday ethical challenges of healthcare practice. In later years I began to look at the wider field of the 'bio' and have most recently been working on innovations within synthetic biology.
Gordon: when did serve as Lecturer in Bioethics at University of Manchester and what were topics that you addressed?
Simon: My first post as a Lecturer in bioethics was at the Centre for Social Ethics and Policy at Manchester University in 1999. Most of my work was delivering ethics and law 'training' to doctors, nurses and other health professionals, going to their place of work and listening to the issues that they were facing in everyday working life. I say 'training' but really we listened and facilitated discussion, it was not my role to deliver truths from on high but to help professionals by providing tools for thinking through the issues and dilemmas they faced.
There were so many issues brought to the table but prominent at that time were questions related to 'do not resuscitate decisions' and the fall-out from the organ tissue retention scandal in the UK that emerged after a series of enquiries into Bristol and Alder Hey hospitals. Alder He was also on my 'patch' and the feelings of professionals were very raw. The ethical problem of organ retention led me to develop a more than twenty-years interest in research ethics. The ethical use of human tissues for research is something I am still working on today.
Gordon: when did serve as Reader in Bioethics Newcastle University and what is one of your favorite memories at that time?
Simon: I was tempted away from Manchester in 2003 to Newcastle University and a post in the Policy Ethics and Life Sciences Research Centre (PEALS). I realised that something very exciting was happening in the North East of England. There was a buzz to PEALS that I had not experienced before in my work in bioethics. Erica Haimes was pioneering a novel sociological approach to bioethical questions, to the fore of what became the ‘empirical turn’ in bioethics. Tom Shakespeare, with a seeming bottomless well of creative energy nurtured and responded to a growing public interest in the innovations of the Biosciences. Tom’s many connections with the creative world invited artists and writers to weave a colourful thread into the interdisciplinary tapestry of PEALS. There was also a network of clinicians and scientists, encouraged and supported by John Burn, Professor of Genetics, who were actively inviting ethical scrutiny of their research.
As a research centre, PEALS was unusual in many ways. It was, initially, a collaboration between unlikely bedfellows, the rival institutions of Newcastle and Durham Universities plus the International Centre for Life, a millenniumal project devoted to science education. They say that it takes a village to raise a child and PEALS was a precocious child that grew to maturity in the unique science village that developed on the campus of the Centre for Life in Times Square, Newcastle upon Tyne. You could literally walk out of the PEALS office and (by invitation) into the regional fertility centre, the genetics clinic, a stem-cell laboratory, across the public square and into a science learning centre;, it was a unique crucible of opportunity.
The first decade of the 21st century witnessed the birth of genomics and the race to routinise genetic technologies into everyday life. The creation of human clones for research by cell nuclear transfer, the cultivation of human embryonic stem cells, and the use of human eggs and embryos in research were some of the many important issues that came to the table in quick succession. Subsequent PEALS directors have widened the horizon of interest, Janice Mclaughlin with work on disability, and Jackie Leach Scully with feminist bioethics. In addition to contributing to these areas of research I have maintained an interest in clinical ethics, research ethics and end of life decisions.
Gordon: When were you appointed Professor of Bioethics, Director of Policy Ethics and Life Sciences (PEALS) at Newcastle University and what are courses you teach?
Simon: I was initially appointed as senior lecturer and Co-Director of PEALS, and I moved through Reader to full Professor and Director in 2019. Over my time in PEALS I have continued to teach courses for professional development including on medical ethics, research ethics and the ethics of human genetics, on palliative care and end of life decisions. I also ran courses on the sociology of health and illness.
Gordon: What are some of the Bioethical challenges in Healthcare in the United Kingdom and what are your recommendations on how they should be addressed?
Simon: This is a difficult one to answer, for example in any publicly funded health care system like the NHS there are the perennial problems of resources now made worse by an ageing population and the acute impact of the COVID pandemic. The 'solution' to these problems, if there is one, lies as much with politics and economics as it does with ethics.
However, the value of having a publicly funded health system that allows treatment for all free at the point of care, massively outweighs any of the inherent problems in such a system. Of the many issues that have continued to engage me in my work then it is probably the challenge of innovation and the processes leading up to innovation that are still relevant. These include the ethical problems associated with complex research e.g. the challenge of including 'vulnerable' participants such as children or people with impaired capacity as reserach participants, the problems of managing public dialogue about the virtues and vices of new technologies like gene-therapy and gene-editing, the question of what they promise and what they can deliver.
Medicine is always pushing at the boundaries of life, even at the very essence of what it is to be human. I don't have the hubris of some in the field to proffer neat solutions, I see my role as enabling society to develop the resources to navigate such thorny moral problems, through policies, protocols and laws that support progress but with maximum safeguards.
The PEALS approach (and therefore my approach) is to enable as many voices to come to these debates as possible, to contribute to the development of a reflexive workforce (scientists, doctors, policy makers) so that the strategies we do adopt to enable innovation are the best we can achieve given the fallibility of human judgment. I think that I have done this in a few modest ways through my research, my teaching and my engagement work with civic society.
Gordon: Thank you for an informative and exceptional interview.