View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by ASU Digital Repository Assessing Corporate Bioethics A Qualitative Exploration of How Bioethics is Enacted in Biomedicine Companies by Jennifer Brian A Dissertation Presented in Partial Fulfillment of the Requirements for the Degree Doctor of Philosophy Approved October 2011 by the Graduate Supervisory Committee: Jason Robert, Chair Daniel Sarewitz James Hurlbut Jonathan Moreno Mark Brown Jane Maienschein ARIZONA STATE UNIVERSITY May 2012 ©2012 Jennifer Elizabeth Dyck Brian All Rights Reserved ABSTRACT Corporations in biomedicine hold significant power and influence, in both political and personal spheres. The decisions these companies make about ethics are critically important, as they help determine what products are developed, how they are developed, how they are promoted, and potentially even how they are regulated. In the last fifteen years, for-profit private companies have been assembling bioethics committees to help resolve dilemmas that require informed deliberation about ethical, legal, scientific, and economic considerations. Private sector bioethics committees represent an important innovation in the governance of emerging technologies, with corporations taking a lead role in deciding what is ethically appropriate or problematic. And yet, we know very little about these committees, including their structures, memberships, mandates, authority, and impact. Drawing on an extensive literature review and qualitative analysis of semi-structured interviews with executives, scientists and board members, this dissertation provides an in-depth analysis of the Ethics and Public Policy Board at SmithKline Beecham, the Ethics Advisory Board at Advanced Cell Technology, and the Bioethics Committee at Eli Lilly and offers insights about how ideas of bioethics and governance are currently imagined and enacted within corporations. The SmithKline Beecham board was the first private sector bioethics committee; its mandate was to explore, in a comprehensive and balanced analysis, the ethics of macro trends in science and technology. The Advanced Cell Technology board was created to be like a watchdog for the company, to prevent them from making major errors. The Eli Lilly board is ii different than the others in that it is made up mostly of internal employees and does research ethics consultations within the company. These private sector bioethics committees evaluate and construct new boundaries between their private interests and the public values they claim to promote. Findings from this dissertation show that criticisms of private sector bioethics that focus narrowly on financial conflicts of interest and a lack of transparency obscure analysis of the ideas about governance (about expertise, credibility and authority) that emerge from these structures and hamper serious debate about the possible impacts of moving ethical deliberation from the public to the private sector. iii DEDICATION To Nan. Thank you for all the love and inspiration, and the best e-mail I’ve ever received: hi Jen -congrats!!!!!!!!!!! I have been thinking of you for days. Must have been some vibes coming thru. The space bar is sticking and I cant type anyway soo please the sloppy mess. Peg and phil were in california all week and I just looked at email. will your job change, do you need any tuition money?or anything. I'm so proud of you I could burst. I love you so much, Nan, iv ACKNOWLEDGMENTS I am deeply indebted to my (large, but never unruly) dissertation committee for their energy, feedback and support. I wish there was more time to spend brainstorming, debating, building ideas with each of you. Thank for your encouragement and guidance. My interviewees were gracious with their time, and I am thankful for both their candid and opaque responses to my questions. Many people made significant contributions to this project. I am particularly thankful to Amy Hillman, Erik Parens, Eric Meslin, John Evans, Nathan Johnson, Elihu Gerson, Françoise Baylis, Adrienne Asch, and Leon Kass for long conversations that clarified messy and incomplete ideas, pushed me to think harder, and made my work much more interesting. Their generosity and talent are inspiring. The wonderful people at the Center for Biology and Society and the Consortium for Science, Policy and Outcomes at ASU make it particularly hard to move on. I am deeply grateful for opportunity to spend a few years in such challenging, fun and truly unique intellectual environments. Finally, thank you to my very patient, very funny and very supportive friends and family. You all make my heart smile. A special thanks to Ills for all the little laughs and that one big move. v TABLE OF CONTENTS Page LIST OF TABLES .................................................................................................................. vi PREFACE .............................................................................................................................. vii CHAPTER 1 INTRODUCTION ............................................................................................. 1 Voices of Bioethics ......................................................................................4 History of Bioethics Committees.............................................................. 7 Case Studies................................................................................................16 Methodology..............................................................................................20 Theoretical Framework and Relevant Literature ................................25 2 BIOETHICS AND BUSINESS ..................................................................... 32 Can Corporate Ethics Be Valued? ..........................................................35 What Value Might Corporate Bioethics Add? ......................................45 What Forms of Value does Corporate Bioethics Produce?.................49 3 THE CORPORATE CONSCIENCE: THE ETHICS AND PUBLIC POLICY BOARD AT SMITHKLINE BEECHAM .............................. 57 Background................................................................................................58 Relationships.............................................................................................60 Problem Space........................................................................................... 67 Purposes and Benefits.............................................................................. 75 Conclusion .................................................................................................85 4 THE WATCHDOG: THE ETHICS ADVISORY BOARD AT ADVANCED CELL TECHNOLOGY.................................................... 86 Background................................................................................................86 vi CHAPTER Page Relationships.............................................................................................88 Problem Space...........................................................................................98 Purposes and Benefits............................................................................106 Conclusion ................................................................................................118 5 BUREAUCRATIC BIOETHICS: THE BIOETHICS COMMITTEE AND BIOETHICS NETWORK AT ELI LILLY ........................................... 119 Background..............................................................................................120 Relationships........................................................................................... 124 Problem Space..........................................................................................131 Purposes and Benefits............................................................................ 137 Conclusion ............................................................................................... 146 6 DISCUSSION ............................................................................................... 148 Key Findings............................................................................................ 153 Summary .................................................................................................. 159 7 CONCLUSION .............................................................................................. 161 Future Directions.................................................................................... 163 REFERENCES .................................................................................................................. 166 vii LIST OF TABLES Table Page 1. Comparison of Committees ....................................................................... 160 viii PREFACE The practices and outputs of scientific and technological research and development influence our lives in profound and complex ways, and with new advances come new and complicated questions about risk, oversight and regulation, equity and access, costs and benefits, human nature, and human dignity. The research is carried out in a variety of contexts, including public and private institutions both locally and more globally, under varying regulatory frameworks and levels of oversight. Conversations about the ethical and social implications of science, medicine, and technology are equally fractured and fragmented. The field of bioethics emerged, in part, from “the need to bring the perceived chaos of biology and medicine into the