Peter Singer, MD, MPH, was awarded the second annual $50,000 MacLean Center Prize in Clinical Ethics on Saturday, and challenged this weekend’s Dorothy J. MacLean Fellows Conference to think bigger about medical and clinical ethics. And to think globally.
“Bioethics is actually, on reflection and especially clinical ethics the way it’s practiced here [at the MacLeanCenter], a form of social innovation or a form of social entrepreneurship that leads to sustainable impact and scale,” said the University of Toronto professor and CEO of Global Challenges Canada.
Singer and others are focusing the Grand Challenges motif, which was issued at the turn of the 20th century by mathematician David Hilbert as a clarion call to solve the big math problems of the day, on tackling the developing world’s health problems through scientific and technology innovation.
Singer, who was recruited to the MacLean Center as a fellow in 1987 by center director Mark Siegler, MD, used a few examples at his keynote address to draw the connection between clinical ethics and social entrepreneurship.
He cited the first successful live donor liver transplant in 1989 at the University of Chicago Medicine. Before doctors performed the surgery on Alyssa Smith, they sought out ethical guidance from Siegler and others.
“The goal was to put out the issues openly and transparently rather than have a backlash after a technological leap,” said Singer. The idea of a waiting period for donors to ponder their decision, for example, was one of the guidelines that came out of that process and is now adopted around the world.
Singer says this was a form of social innovation. The ethical reflection on transplants laid the groundwork that enabled such procedures to be more broadly accepted, leading to improvements in the lives of patients and their families – one of the goals of clinical ethics.
Turning to the developing world, Singer said while there’s been much study on end-of-life care in the developed world, for instance, there is very little of it in the developing world where most deaths occur.
He noted there is much the developed world could teach about pain management techniques, for example, developed in part through clinical ethical examination, that would improve the lives of so many people suffering in the later stages of life.
The latest iteration of Grand Challenges was kicked off in early 2003 by a $200 million pledge by the Bill & Melinda Gates Foundation, and then pushed forward by a paper by Singer and other health care heavyweights in the journal Science.
That was followed up by the creation in 2010 of Grand Challenges Canada, which received $225 million from the Canadian government to stimulate and fund medical breakthroughs in global health. Singer is finding success in getting other countries to adopt this model.
“There’s no question in my mind that talent is global; the only thing that’s not global is opportunity,” Singer said.