Abstract

Eric M. Meslin, Ph.D. was appointed Executive Director of the National Bioethics Advisory Commission (NBAC) in February 1998. NBAC was established in 1995 by President Bill Clinton to provide policy advice to the White House and other government departments and agencies regarding bioethical issues and research. Dr. Meslin came to NBAC from the National Institutes of Health where he was Program Director for the Ethical, Legal and Social Implications (ELSI) Research Program at the National Human Genome Research Institute. Prior to moving to the United States, he established the United Kingdom's first clinical ethics program while at the University of Oxford, and held academic, clinical and senior administrative appointments at the University of Toronto, where he remains a member of the Joint Centre for Bioethics. He is also a member of the editorial advisory board for HealthcarePapers. For more information about NBAC go to www.bioethics.gov

Eric M. Meslin, PhD
Executive Director
National Bioethics Advisory Commission for the President of the United States of America

What do you do all day?
A typical day at the National Bioethics Advisory Commission (NBAC) is hard to describe because of the different tasks undertaken, not all of which are under our (staff) control. The Commission meets approximately every six weeks, which means we're perpetually preparing for, or debriefing from a meeting. With 18 presidentially appointed commissioners and 16 staff, the things that must happen (and can go wrong) multiply exponentially. We produce materials that will become the Commission's reports to the President. This involves primary research and writing, inviting witnesses to testify (sometimes from around the world), and editing and publishing prior reports. We also track foreign and domestic literature, respond to media, Congressional, association and public inquires. It's hectic, but very rewarding.

What's so special about serving a President?
NBAC is a unique organization, precisely because it ultimately reports to President Clinton. Advisory bodies, commissions and ethics groups exist everywhere, but the NBAC has tremendous convening power. We're required by law to meet, deliberate and make our recommendations in public. This attracts attention. The Commission has received written requests from the President, asking that reports be prepared within a tight time frame. Coming from the most powerful person in the world, these assignments tend to focus one's attention fairly quickly.

Do people think it's ironic you're Canadian?
Colleagues often tease me about this. Although there are several important national committees in Canada, what may be ironic is that Canada has not established a national bioethics committee, while the NBAC Chairman, Dr. Harold T. Shapiro, President of Princeton University, is a Canadian from Montreal, and I'm from Toronto.

What's one difference between Canadian and U.S healthcare?
If you had asked several years ago I would've given a much longer list. There seems to have been some convergence between systems with Canada's healthcare financing difficulties presenting challenges to the basic principles of the Canada Health Act. Perhaps the most obvious difference is a practical one: the size and impersonality of the administrative bureaucracy in the US. My HMO is frustrating and dissatisfying; I receive more pieces of paper from more components of the non-health care system than one can imagine.

Can you summarize the controversy of the Human Genome Project and patent issues?
The Human Genome Project is going to be remembered as one of the greatest collaborative "big science projects" in history. Although current attention focuses on competition between publicly and privately funded researchers to complete the sequence, this will be less important an issue than the power of the information contained in the sequence itself. The U.S.-led project has been releasing sequence data every 24 hours for some time now so the patent issues - while relevant - are ultimately going to be resolved as a matter of law.

Weren't you the first Canadian to attend and graduate from Georgetown University's Kennedy Institute of Ethics?
Yes, there used to be a list in the hallway at the Kennedy Institute with everyone's name posted once he or she defended their dissertation. I was the 22nd student to get a PhD and the first Canadian. I had a full fellowship, which made my parents quite happy since tuition ran approximately US$8,000 a year then. I often wondered if I received the fellowship to fill out the "foreign" quota. When I was accepted, applications provided two options for citizenship: "United States" and "Other." Checking "Other" presumed applicants didn't speak English and I was informed I was to complete the English as a Second Language entry exam. I did get it waived.

What do you love about teaching? Should ethics be lively?
There are many things I love about teaching, and it differs depending on the group and relates directly to what makes ethics lively. I once taught an undergraduate class on ethical issues in human subjects research and suggested students role-play a university research ethics board meeting. Not only had they thoroughly prepared assignments, they came dressed as various health care professionals. There is nothing to compare to a highly motivated and energized class to make a professor's day (or month). Graduate students - and I've worked with a lot of excellent people in Toronto - challenge you in different ways, not the least of which is that they know so much. Moreover, in a field like bioethics, the current generation will be among the most active and influential in clinical, research and policy arenas.

What do you wish you knew 20 years ago?
Doing bioethics in the real world involves political skills as well as content knowledge. Knowing about bioethics theory or having encyclopedic knowledge about cases or principles is necessary, but not sufficient to make progress. Inevitably, the bioethicist will interact with and need to understand the views and perspectives of people with different methodological training, different goals and different dispositions.

Are you a moral relativist?
No, I don't think so. Working in bioethics will always present situations where compromise and consensus are required; particularly in clinical and policy settings where different values are sometimes in conflict. However, there are some moral positions that are fundamentally defensible and ought not to be compromised.

Are you an ethical man?
Despite what Aristotle said, one shouldn't assume that there is a direct relationship between academic training in ethics and ethical behavior. You'd be surprised how many people make this assumption.

What books are you reading?
I usually read two or three books at a time. I've just finished reading Simon Winchester's The Professor and the Madman, and Bernhard Schlink's The Reader. I'm now reading Cracking Codes: the Rosetta Stone and Decipherment by R. B. Parkinson and The Perfect Storm by Sebastian Junger.

What's the best advice your mother gave you?
Drink a lot of orange juice.

In being surrounded by females at home, what ethical balance do your wife and two daughters bring?
My daughters always remind me that I am in the minority in the house (there's also our cat Roxanne and dog Sadie). This is a good lesson in civics and gender relations.

Acknowledgment

This profile made possible through an educational grant from Aramark Canada