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Published: April 10, 2019 Author: Joe Higgins

A woman is suffering from end-stage pancreatic cancer while concurrently selling her prescribed opiates to support an addiction to methamphetamine. She then returns to her physician for more prescribed medication as her pain worsens.

What should the treatment team do? What would you do?

The above scenario was just one of the many thoughtful topics and shared discussions that took place during the inaugural Jennifer Horner Lecture in Bioethics Series hosted by the College of Health Sciences and Professions (CHSP) on March 28.

The event was created to honor Dr. Jennifer Horner, associate dean emerita, who retired from CHSP in May 2018 after more than 10 years with the college as both a professor and the associate dean for research and graduate studies.

“Jen did a lot to transform this college through a great period of growth,” said CHSP Dean Randy Leite. “She has an absolute passion around bioethics, and she has spent a lot of time reading, studying, thinking about and teaching bioethics. There was no better way to honor her legacy in the college than to initiate this lecture series.”

The inaugural series featured a diverse events lineup, including a scene from the play “Confessions of a Reluctant Caregiver” by Merri Biechler, a group panel discussion and a keynote lecture delivered by Bruce Jennings, an adjunct professor in the Center for Biomedical Ethics and Society and the Department of Health Policy at Vanderbilt University School of Medicine.

Dr. Horner said she recommended Jennings as the first speaker of the series because of his contributions to bioethics literature and the relevance of his work.

Jennings’ lecture, entitled “Bioethics as Civic Learning: Rethinking One Another in a Time of Interdependence,” explored the past practices of bioethics and future direction of the field. He explained the former view of considering a person as an isolated individual has given way to exploring the individual in the context of his/her relationships with the world.

“You’re living your life in and through everything around you. You’re not necessarily a product of that because you’re also a unique individual,” Jennings said. “You’re a product of your own thoughts, your own goals and your own life plan. It’s not undercutting the moral importance of the individual human person. It’s thinking about the person in a new way.”

Jennings noted that he was proud to be selected to deliver the event’s first keynote lecture.

“I was very glad to have an opportunity to lay out some of my ideas for how we can take relationships, family and culture more seriously in bioethics so that we don’t pretend that individuals are just sort of these single entities that are just floating around in empty space,” Jennings said.

Following Jennings’ keynote lecture, Biechler’s play explored the experiences of a woman in charge of the care of her parents, both of whom were dying of cancer.

The play, combined with Jennings’ thoughtful lecture, set the perfect state for a case study and panel discussion with Jennings, Dr. Horner and Susan Erlewine, MSN, RN-BC. In the case of the woman suffering from pancreatic cancer who was selling her medication to support another drug addiction, the notion of “do no harm” to the patient was countered with a debate as to the harm caused to society in contributing to the sale of drugs in the community. The fact that addiction is classified as a mental disorder contributed another wrinkle to the case study and group discussion.  

“We have to cope on a day-to-day basis with flawed human beings and flawed systems. In any given case, the outcome is rarely perfect or ideal,” Jennings said about the ethical dilemmas presented. “Our job on any given day is to make it better rather than worse. Our job on a long-term basis is to correct our systems and our institutions so we come closer to the ideal of a perfect outcome.”

Following the day’s events, Dr. Horner took a moment to reflect on the inaugural series that was created to honor her CHSP legacy.

“Mr. Jennings’ emphasis on ethical thinking and ethical action in the context of interdependent relationships and intergenerational responsibilities represents bioethics as a civic enterprise; these cutting-edge concepts are very important to our teaching and learning of bioethics,” she said. “I thought Merri Biechler’s play was very powerful and hope that this dramatic method will continue to be used to illustrate realistic ethical quandaries in the future. I also liked the panel discussion because it allowed spontaneous reaction from the audience and greater depth of conversation.”