Bystranowski, Piotr

Dranseika, Vilius

Żuradzki, Tomasz

English

Jagiellonian Univeristy Repository

1P. Bystranowski, V. Dranseika & T. Żuradzki | Bioethics and philosophy of medicine…INTERDISCIPLINARY CENTRE FOR ETHICS, JAGIELLONIAN UNIVERSITYA PRESENTATION OF NEW PROJECTPUBLISHED ONLINE: 24 AUGUST 2022DOI: 10.26106/F61V8S58PIOTR BYSTRANOWSKI1, VILIUS DRANSEIKA1 & TOMASZ ŻURADZKI21 Interdisciplinary Centre for Ethics (INCET), Jagiellonian University in Kraków, Poland2 Institute of Philosophy & Interdisciplinary Centre for Ethics (INCET), Jagiellonian University in Kraków, Poland BIOETHICS AND PHILOSOPHY OF MEDICINE A COMPUTATIONAL HISTORY OF THE FIELDTh e standard way practitioners of an academic discipline refl ect upon the history and impact of their fi eld is through „close reading” of selected texts, which is often mediated by their personal experience and academic interests. Th is approach is visible in the classical books about the history of bioethics (Jonsen 2003) or important articles that try to identify „the hottest topics” during the development of the fi eld. Here is a typical statement identifying trends in bioethics based on such an approach: „Over the course of the history of bioethics, certain topics have moved in and out of fashion: in the 1970s it was euthanasia and abortion, in the 1980s genetics, in the 1990s stem cells and reproductive technologies, and in the 2000s, enhancement and data/tissue storage” (Dawson 2010).Th e approach we adopt in our new project takes seriously the epistemological question of how one can justify the belief that, for example, the issue of „enhancement” dominated the debates of the 2000s. We employ a method characteristic for a distant reading: topic modeling – a computational text-mining technique aimed at discovering hidden thematic compositions in large collections of documents. An ‘unsupervised’ algorithm we used (latent Dirichlet allocation – LDA) identifi es ‘topics,’ that is, sets of words that tend to be used to-gether across documents in the corpus, and is able to provide the exact proportions in which diff erent topics discovered by the model contribute to each document in the corpus. In our paper forthcoming in Bioethics, we used this method to analyze over 19,000 texts published since 1971 in seven English-language leading journals in bioethics and philosophy of med-icine: American Journal of Bioethics; Bioethics; Hasting Center Reports; Journal of Medical Ethics; Journal of Medicine and Philosophy; Medicine, Health Care and Philosophy; Th eoretical Medicine and Bioethics (Bystranowski, Dranseika & Żuradzki 2022a).Our aim was not to replace close reading, so typical for the humanities, but rather to present an instrument useful for researchers that may support human interpretive work. As we observe, some topics are correlated, in the sense of being more frequently present together in the same texts. Th is simple observation allowed us to identify communities of related topics that tend to be expressed in the same texts. Th is way, we were able to draw2P. Bystranowski, V. Dranseika & T. Żuradzki | Bioethics and philosophy of medicine…a novel, fi ne-grained yet interesting map of bioethics and philosophy of medicine that readers should inspect in full on their own (Figure 1) together with other materials at our website. By providing extensive online supplements, we not only invite readers to engage in their own interpretations of the present topic model but also to utilize the model in a variety of ways, from more focused historical analyses to teaching.Figure 1. 91 content-based topics grouped into 8 clusters. Node size refl ects a topic’s prominence in the corpus, edge size refl ects Pearson’s correlation coeffi  cient for a given pair of topics (only correlation coeffi  cients above .05 are included in the graph). Th e method may be helpful in interpreting the thematic structure of the entire fi eld, the relations between diff erent themes, the patterns of researchers’ interests, and the evolution of such interests over time. Th us, for example, we are able to analyze the themes that „have moved in and out of fashion” in bioethics and philosophy of medicine more precisely and rigorously than with the help of standard „close reading” methods.3P. Bystranowski, V. Dranseika & T. Żuradzki | Bioethics and philosophy of medicine…Here are some examples of interpretations one can draw from our study. Our analyses show which topics in bioethics and philosophy of medicine were the most popular over the last 45 years in seven analyzed journals (the fi rst four content-based topics: Health insur-ance; Health law; Physician’s role; Research ethics committees). One may interpret that their popularity refl ects research interests relevant for the US healthcare system. For example, all of the top-10 papers characteristic for Insurance (see top-10 documents per topics) discuss Medicaid, US health reforms at diff erent levels (federal and state), the healthcare programs of American presidential candidates, rising healthcare costs in the US, etc.In turn, our diachronic analyses suggest changing patterns in research interests and reveal which themes have attracted or lost the attention of scholars over time. On the one hand, if we focus on the popularity of particular themes in the early days of the fi eld (1976-85) in comparison with the most recent ten years in our corpus (2011-20), the biggest winners in terms of relative growth are themes represented by the topics we called: (Moral) Enhancement, Public health emergencies, Circumcision and genital mutilation (whereas the most signifi cant losers are: Medical Confi dentiality, Historical topics in medicine and philosophy of medicine (History), Medicine and general philosophy of science (Science: philosophy)).Th e main winner (in terms of relative growth) can be easily interpreted. In particular, considering that (Moral) Enhancement correlates with Germline modifi cation and gene therapy, and Genetics: concepts and research, one can observe a broader trend of interest in diff erent ethical, regulatory, and theoretical questions about heritable genome editing. Th e topic Germline modifi cation and gene therapy is also among the recent top peaks. Still, it is also perfectly understandable if one considers the recent explosion of interest in the CRISPR/Cas9 method and the He Jiankui scandal. So, the above comment by Dawson (2010) about the popularity of enhancement topics did not describe the state of the art in the early 2000s, as much as it accurately predicted the main trend in 2010s.Th e diachronic analysis of topic prominence allowed us to identify the most pronounced topic peaks, understood as the highest sudden increases of topic prominence (in a given 5-year period, as compared to the previous two periods), as well as to speculate on the causes for such drastic shifts in the object of bioethicists’ attention. For example, the two peaks we observed for the topic Stem cells and embryo research (in periods 1991-95 and 2001-05, see Figure 2) may be straightforwardly interpreted as reactions to scientifi c discoveries and breakthroughs. Th e later, more visible peak represents an apparent reaction to the discovery in 1997 and 1998 of methods for deriving and culturing human embryonic stem cells indefi nitely and methods for the cloning of adult mammals using nuclear replacement techniques. Many papers most associated with the topic Stem cells and embryo research published in that period (see top-30 documents per peaks) cite the infl uential article by Th omson et al. (1998), while others also discuss the regulations or guidelines that followed these discoveries. Th e earlier peak of the same topic is a reaction to some advances in reproductive technology, particularly in vitro fertilization (1978), and then cryopreservation (1984) that have made early human embryo experimentation possible.Our topic model can be used for further analyses, for example, to investigate the impact of other fi elds on bioethics / philosophy of medicine or relations between bioethics / phi-losophy of medicine with other fi elds. Let us illustrate this briefl y with some examples. Th e beginning of institutionalized bioethics and philosophy of medicine corresponds with the rapid changes in moral and political philosophy between about 1968 and 1975, as docu-mented by other topic modeling studies (Weatherson, 2022). Th e works of key philosophers 4P. Bystranowski, V. Dranseika & T. Żuradzki | Bioethics and philosophy of medicine…relevant to these changes (Frankfurt, Th omson, Rawls, Singer, and Foot) are also critical for bioethics. In a recent commentary paper, Blumenthal-Barby and colleagues (2022) assumed that, compared to the early days of bioethics, the role of philosophy is now diminished across the fi eld. However, based on our topic-modeling study and drawing from citation analyses, in our new commentary paper (Bystranowski, Dranseika & Żuradzki 2022b), we argue that the picture is far more nuanced. First, the proportion of citations to philosophy in the lead-ing bioethics journals has remained very stable over the last decades. Second, there is no sign of decline in the relative prominence of ‘philosophical’ topics (identifi ed by measuring correlations between topics’ prominence in a text and the proportion of citations from such a text to philosophy journals) in the leading bioethics journals. While some par excellence philosophical topics popular at the dawn of bioethics (such as Doctrine of double eff ect and act/omission distinction (Omissions)) have indeed been waning in all corpus (but not in its bioethics subset), the presence of others has been surprisingly stable in the last 50 years:(e.g., Abortion: philosophical issues).Th us, a macro-level analysis based on citation data is a natural extension of our previous studies. In our ongoing study (with Mahdi Khelfaoui), we conduct a quantitative analysis of citation fl ows from and to bioethics and philosophy of medicine papers published in leading journals representing the discipline. In particular, by providing an analysis of the visibility of bioethics and philosophy of medicine in other disciplines (and other disciplines in bioethics and philosophy of medicine), we plan to contribute to the debate on the infl uence of bioeth-ics and philosophy of medicine on the biosciences, health studies, and social sciences and humanities (SSH). We believe that our quantitative studies will help us understand changes in science institutions and production as well as medical practice since establishing research ethics committees (RECs) in the 1970s with the institutional review boards (IRBs); through the development of ethics consultation in the 2000s; to the recent developments stemming from evidence-based medicine movement in the 2010s.Figure 2: Th e mean prevalence of topics in two clusters (BEGINNING OF LIFE and END OF LIFE) across 5-year periods from 1976 to 2020. Topics within each cluster are ordered by their overall prominence in the corpusBeginningof lifeEmbryos: research IVF and surrogacy Abortion: regulatory Abortion: philosophy Reproductive autonomyNeonatal Embryos: identityEndof lifeLaw: health Death: euthanasia Death: conceptDementia Death: life support Omissions War and prisons Sedation Hazards76- 8081- 8586- 9091- 9501- 0596- 0006- 1011- 1516- 2076- 8081- 8586- 9091- 9501- 0596- 0006- 1011- 1516- 2076- 8081- 8586- 9091- 9501- 0596- 0006- 1011- 1516- 2076- 8081- 8586- 9091- 9501- 0596- 0006- 1011- 1516- 2076- 8081- 8586- 9091- 9501- 0596- 0006- 1011- 1516- 2076- 8081- 8586- 9091- 9501- 0596- 0006- 1011- 1516- 200.0%1.0%2.0%3.0%4.0%5.0%0.0%1.0%2.0%3.0%4.0%5.0%5P. Bystranowski, V. Dranseika & T. Żuradzki | Bioethics and philosophy of medicine…AcknowledgmentsTh is summary is partially based on Bystranowski, Dranseika & Żuradzki 2022a. Th is research was supported by the European Research Council (ERC) under the European Union’s Horizon 2020 research and innovation program (grant agreement 805498).ReferencesBlumenthal-Barby, J., Aas, S., Brudney, D., Flanigan, J., Liao, M., London, A., Sumner, W. & Savulescu, J. (2022). Th e Place of Philosophy in Bioethics Today, American Journal of Bioethics. DOI: https://doi.org/10.1080/15265161.2021.1940355.Bystranowski, P., Dranseika, V. & Żuradzki, T. (2022a). Half a Century of Bioethics and Philosophy of Medicine. A Topic-Modeling Study, Bioethics 36(9), 902-925. DOI: https://doi.org/10.1111/bioe.13087.Bystranowski, P., Dranseika, V. & Żuradzki, T. (2022b). Th e Disconnection Th at Wasn’t: Philosophy in Modern Bioethics from a Quantitative Perspective, American Journal of Bioethics. DOI: DOI: https://doi.org/10.1080/15265161.2022.2134490 [preprint]Dawson, A. (2010). Th e future of bioethics: three dogmas and a cup of hemlock. Bioethics 24(5), 218–225. DOI: https://doi.org/10.1111/j.1467-8519.2010.01814.x.Jonsen, A.R. (2003). Th e Birth of Bioethics. New York: Oxford University Press.Th omson, J.A., Itskovitz-Eldor, J., Shapiro, S.S., Waknitz, M.A., Swiergiel, J.J., Marshall, V.S., & Jones, J.M. (1998). Embryonic Stem Cell Lines Derived from Human Blastocysts. Science 282(5391),1145–1147.Weatherson, B. (2022). A History of Philosophy Journals, Volume 1: Evidence from Topic Modeling, 1876–2013. Michigan Publishing Services.

Bioethics and philosophy of medicine : a computational history of the field

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Bioethics and philosophy of medicine : a computational history of the field

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