Part way through my doctoral studies in philosophy, in the early 1990s, I took a gap year. I returned to Toronto, my home town, and worked at a housing program for people with HIV and special needs: homelessness, psychiatric illness, recovery from drug addiction, and the like. This turns out to have been one of the worst years of the AIDS epidemic and I did my best to help the residents of the program struggle with ill health and stigma on top of their other challenges.
I usually worked the night shift, from 11:00 p.m. to 7:00 a.m., and that meant that, on the quiet nights, I could read. I became interested in what philosophers were saying about the AIDS crisis.
Philosophers had first addressed the moral issues arising from disease and illness in the 1960s as part of the new interdisciplinary field of bioethics. As medicine developed techniques that prolonged life—whether that of a newborn with severe disabilities or an octogenarian in an intensive care unit—more and more people came to realize that doctors’ medical expertise did not guarantee that they knew what was morally right for their patients.
When I started reading what bioethicists had written about the AIDS epidemic, I was struck by how the questions they explored were primarily addressed to health care and public health professionals—whether testing for HIV should be mandatory for certain groups, whether physicians treating an HIV-positive patient have a duty to warn third parties of her or his infection, whether health care professionals with HIV should be restricted in their practices.
But these were not the moral questions that the residents I was working with were facing. They wrestled with when to disclose their condition to others; what sexual responsibility entailed; and how to have a meaningful life when it seemed likely to be massively abbreviated.
I started to realize that these questions in what I now call the bioethics of everyday life are pervasive and indeed have a kind of logical priority to the dominant questions in bioethics that focus on medical practice and public health. If we want patients to have autonomy over their health care decisions, we presuppose that each of us has something at stake morally in our own personal struggles with health and disease.
My work that year inspired me to take a second master’s degree in bioethics when I returned to grad school, and it remains a research and teaching interest.
More often than not during my term as UC Principal, I have taught a large, introductory bioethics class, a particularly interesting pedagogical task in that most of the students are specializing in the sciences and thus rarely get the chance to reflect critically on their main areas of study.
This issue of UC Magazine explores how others in our community engage with the challenge of health and disease. University College alumni include such giants as Charles Best (BA 1921 UC), co-discoverer of insulin; John McCrae (BA 1894 UC), World War One field doctor and poet; Erving Goffman (BA 1945 UC), the sociologist of stigma; and Reva Gerstein (BA 1938 UC), psychologist and mental health pioneer. This issue demonstrates that the College—its staff, students, faculty, and alumni—continue to work to better our response to what Susan Sontag called the “night-side of life.”