Bioethics Field Is Less Diverse, with Different Views, than the General Public

By Stacey Kusterbeck

Bioethics is a growing and influential field, yet little is known about bioethicists themselves. “It is important to understand bioethicists’ backgrounds and views because these may shape policies and practices,” says Leah Pierson, PhD, an MD-PhD student at Harvard Medical School and the Harvard T.H. Chan School of Public Health. Pierson and colleagues surveyed 824 bioethicists on a wide variety of topics, including abortion, medical aid in dying, and resource allocation.¹ If comparable data were available, the researchers compared how bioethicists’ views aligned with broader public opinion. “The findings reveal significant differences between bioethicists’ views and those of the general public on certain issues,” notes Pierson. Some key findings:

• Bioethicists appeared to be less supportive of compensating organ donors than members of the public.

• Bioethicists tended to favor giving equal consideration to saving lives regardless of age. In contrast, members of the public tend to favor prioritizing younger patients.

• The majority (87%) of bioethicists said that abortion is ethically permissible, while support is lower among the U.S. public.

• Bioethicists’ views on medical aid in dying aligned fairly closely with those of physicians and the public.

• Bioethicists were more supportive of permitting confidential healthcare for adolescents, compared to adolescents or their parents.

“The divergences between bioethicists’ views and those of the public are significant given that bioethicists play an influential role in shaping practices and policies in medicine, science, and public health,” says Pierson. If bioethicists’ perspectives are out of step with societal values, it raises concerns about whether ethics recommendations will be acceptable to patients.

The findings also raise questions about why bioethicists’ views diverge from those of the general public. There are several possible explanations, according to Pierson. It is possible that, since bioethicists have devoted their careers to reading and thinking about certain issues, it leads them to reach different conclusions than the general public. Another possibility is that bioethicists had different views than the U.S. public from the outset of their careers, and that the field of bioethicists is appealing to people with certain backgrounds or opinions.

Bioethicists also were asked about their demographic, academic, professional, and religious backgrounds. The field is markedly less diverse than the U.S. population, and less diverse than academics overall, the study found. Bioethicists in the sample were mostly (81%) white and more liberal, more educated, and less religious than the U.S. public. Most (61%) reported that a degree beyond college was the highest level of education attained by either of their parents. The vast majority (87%) of bioethicists identified as slightly liberal, liberal, or very liberal; 9% identified as moderate, and only 4.5% identified as slightly conservative, conservative, or very conservative. Less than half said they were a member of an organized religion, and about the same percentage described themselves as agnostic, atheist, or “nothing in particular.”

“While we did not explicitly ask about bioethicists’ life experiences, it is easy to imagine that bioethicists’ demographic backgrounds have left them with different perspectives on certain issues than members of the U.S. public,” says Pierson.

Lack of diversity in bioethics is a concern for several reasons. One issue is that it risks perpetuating systems, policies, and practices that are unfavorable or insensitive to underrepresented groups. “The field may prioritize perspectives and problems facing the privileged, while neglecting issues impacting marginalized communities,” says Pierson. To promote diversity in the bioethics field, Pierson says these changes are needed:

• removing barriers to entering bioethics (such as requiring expensive credentials like a Master of Bioethics degree, or programs offering limited or no financial aid);

• actively recruiting and supporting students from underrepresented backgrounds;

• examining and reforming policies and cultures that make the field unwelcoming;

• fostering an environment that values and amplifies diverse voices and perspectives.

“A homogeneous field lacks the range of lived experiences and viewpoints needed to fully grapple with complex ethical issues. It undermines the legitimacy of a field that aims to shape practices impacting all of society,” emphasizes Pierson.

REFERENCE

1. Pierson L, Gibert S, Orszag L, et al. Bioethicists today: Results of the views in bioethics survey. Am J Bioeth 2024; May 6:1-16. doi: 10.1080/15265161.2024.2337425. [Online ahead of print].