The two following editorials appear in the April 2024 issue of the American Journal of Bioethics.
Qatar’s Bioethics Meeting
David Magnus
What is the purpose of a large academic meeting attended by hundreds or thousands of participants? What are the reasons, given current virtual conferencing technology, to hold such meetings in person? Although there are often high-minded justifications for both, I suspect that the real motivations for many attendees are complex and multifaceted. Exploration of these reasons is worth considering before tackling the ethical dimensions of choice of venue.
First, in person meetings are often opportunities for revenue generation by professional societies. Indeed, the ability to make money from conferences has led to an explosion of predatory conferences. Even legitimate professional societies often depend on the revenue generated from meetings.
Second, as attendees, we want to travel to new, interesting, or nice places. If we are honest with ourselves, conferences are too often boondoggles that allow (mostly highly resourced) academics and medical professionals to have free vacations and hang out with friends from other institutions. For some of us, they are a chance to enjoy nice restaurants in different locations. David Lodge’s academic novel “Small Worlds” is about elite academics in Comparative Literature and English traveling around the world and enjoying themselves. Bioethics summer camp was a clear expression of this idea as it rotated for many years between sea and mountain resorts with very light programs.
A related, but important reason for attending meetings is to catch up with friends and former students and colleagues (or former mentors). They are also occasions to meet new people, often through introductions from our friends. Thus, these meetings are important social spaces for creating and maintaining professional social networks and for introducing the next generation into these networks. There is also the “exchange of ideas,” typically touted as the reason for meetings, but that aspect of conferences can be accomplished just as easily virtually as through in person meetings. And while there may be informal exchanges of ideas occurring outside of sessions, I am skeptical that the social aspects of networking are closely linked to the exchange of ideas rather than other aspects of socialization (and this view is supported by at least some social science research that studies student attendance at professional meetings).
To the extent that the primary purpose of in person meetings is to build and maintain professional social networks, then critical questions can be raised about the extent to which this really meets any high-minded ideals of openness or access. Trainees and younger scholars who are already placed at prestigious academic institutions will disproportionately benefit from continuing to expand their networks, while those who are less resourced may struggle to benefit from the many informal networking benefits of in person meetings. When added to the differential in resources to attend, it is difficult to avoid the conclusion that one of the important functions of in person meetings is to continue the social hierarchies that constitute current academic life so that those of us at highly regarded and highly resourced institutions can ensure the maintenance of the status quo and to pass that on to our intellectual heirs (trainees). In short, conferences are ways to have fun while reinforcing the academic caste system.
From this perspective, many of the justifications for holding the IAB meeting in Qatar provided by Jecker and colleagues (2024) ring hollow. While I respect and appreciate efforts that leaders of organizations like ASBH and IAB to try to mitigate the inequity inherent in these meetings, through travel funds and formal, structured events that allow junior scholars at less resourced institutions to interact with prominent faculty, it is difficult to see how these meetings are going to lead to the sort of improvements in epistemic injustice touted by the authors compared to hosting virtual meetings.
If we take for granted that there will be an in-person meeting, other questions are raised that the Target Article addresses. What values should govern the choice of venue for meetings, particularly international meetings? Was Qatar an appropriate choice?
The Dobbs decision resulted in the loss of reproductive rights for women in many states and comes as state laws are passed that have placed restrictions on transgender care. When PRIM&R was scheduled to have an in-person meeting in Salt Lake City, a location that had a law forbidding abortion already on the books, and anti-LGBTQ policies, they decided to cancel the in-person meeting in favor of a zoom meeting. There are two distinct lines of reasoning that were offered to support this view. First, as Eliza Hurley, then the Executive Director of PRIM&R argued in a letter she sent to members, is that these policies and laws “are discriminatory and antithetical to PRIM&R’s values as an ethics organization.” Second, there is concern about the potential impact on the health and well-being of members who attend. It is possible that PRIM&R members in attendance might need healthcare that they would not be able to receive because of these policies and laws while in attendance.
Each of these points are made in the OPC’s that are critical of the choice of Qatar as a location for the meeting. Ozisik, Dellgren, and Emanuel are particularly on point for the second concern. Any location that raises significant safety concerns for its members should not be chosen as a venue. The first point highlights that the values reflected in the choice of venue can be hurtful and discriminatory. Homosexuality and transgender identity are unlawful in the venue that was chosen. It is difficult to get past this basic fact. The FAQ’s from the IAB state that “Participants who choose to use the opportunity of attending a Congress to tour Qatar or the Gulf region are solely responsible for their own health and safety. The IAB recommends heeding local cultural norms related to dress code, food, interpersonal relationships, etc., as they would as visitors in any other country.” This means that individuals who are LGBTQ are at risk if they leave the immediate location of conference or act as themselves. They are setting up the meeting as a hybrid meeting so that LGBTQ individuals can attend virtually. But this means that the primary benefits of an in-person meeting described above, are functionally not available to LGBTQ members.
A colleague pointed out to me that in addition, the conflicting values between Qatar and any bioethics group, include the lack of basic rights to women, over and above reproductive rights that are denied in some U.S. states. The Human Rights Watch (2023) Report on Qatar describes the discriminatory rules that require guardianships for women, restrict their ability to travel, and make reporting of rape a crime for the victim (for non-marital sex).
The defenders of the choice of venue argue that an important distinction should be made between the government of Qatar and the local institution that is playing host. But is there as sharp a line between the government of Qatar and the local sponsor as this suggests?
Qatar is well-known for its efforts at influence-peddling in the EU and the U.S. This has led to scandals as officials in the EU such as Eva Kaili (a VP of the European Parliament) and member Pier Antonio Panzeri were arrested on bribery charges. As bribery investigations were underway, Qatar warned the EU that the investigation could threaten negotiations for natural gas that would be needed to replace Russian sources. In the U.S., Senator Bob Menendez has been accused of corruption by accepting bribes from Qatar. Smith’s edition of Tablet Magazine explores, “Qatar’s State-of-the-Art Foreign Lobbying Campaign.” But this effort is not restricted to politicians. Qatar has become a major donor to Universities, Think Tanks, and other institutions. Qatar is the top foreign donor to U.S. academic institutions, and they have paid top dollar to get universities in the U.S. to open campuses in Doha. When efforts were made to publicly disclose how much money Texas A&M receives from Qatar, their government protested that it would reveal proprietary information, presumably the details of their campaign to influence academia. Qatar has been criticized for both sportswashing and greenwashing their reputation with dollars to promote their interests.
The primary vehicle for funding influence in academia and science is the Qatar Foundation, a state-sponsored nonprofit organization. The Qatar Foundation is the primary sponsor of their local branches of multiple U.S. Universities (these relationships have recently been the subject of investigations by the Department of Education). The upcoming Congress is being run in a partnership with the World Innovation Summit for Health (WISH) which the Qatar Foundation describes as their “flagship healthcare forum.” The host institution is Hamad Bin Khalifa University, which is part of the Qatar Foundation. Far from a distant relationship with an independent entity, the IAB Board has chosen to take funding and form a partnership with the government of Qatar’s primary vehicle for buying influence in academia.
These relationships are far flung and include many leading institutions, including BMJ. And there is little doubt that WISH and the Qatar Foundation has funded many worthwhile projects to promote global public health and science. But the tobacco industry for many decades similarly funded academia (often for good science) as a way of influencing and blunting potential criticism. Given the repressive policies of Qatar and abuses of migrant workers (not to mention the funding of terrorists), taking funding and partnering with the state is problematic (even if IAB is in good company).
In summary, while in-person conferences serve important functions, they often primarily serve the interests of elite academic institutions and may promote an academic caste system. The choice of Qatar as a venue creates real safety concerns for many members and reflects values that are inconsistent with an ethics organization. Finally, far from there being no connection between the government of Qatar and the meeting, the funding and partnerships being created are funded by a group dedicated to promoting Qatari influence in academia. This was a major mistake by the IAB board.
Bioethics’ Duty to Conference in Qatar: Reply to Magnus
Nancy S. Jecker, Julian Savulescu, Arthur Caplan, Alexander Capron, John McMillan, Mohammed Ghaly, Gustavo Ortiz Millán, Caesar Atuire, Jeff McMahan , Voo Teck Chuan, Jean-Christophe Bélisle-Pipon , Vina Viswani, and Vardit Ravitsky
Is it unethical to host an international bioethics conference in Qatar? In an editorial in this issue, David Magnus argues that conferencing in Qatar, or other places where human rights violations occur, is not ethically justified. According to Magnus, the International Association of Bioethics’ (IABs’) decision to host the 2024 World Congress of Bioethics (WCB) at a Qatari-based university was “a major mistake by the IAB board.”
We hold a much different view. In the face of unjust laws and human rights violations, more than one response is ethically defensible – as some of us have argued. Boycotting is one way to seek to change an unjust situation, but so too is engaging with people who are willing to host, hear, and take seriously challenges and objections to their prevailing norms. Qatari-based hosts have invited bioethicists from around the world to engage with them in an open exchange of ideas, and offered a conference venue where this can occur. Bioethicists should engage, and should foster open and respectful dialogue.
To avoid redundancy with arguments some of us have developed elsewhere, we limit our response mostly to points not considered previously.
Magnus’ Objections
Magnus suggests four new objections to the IAB’s hosting the WCB in Qatar. First, IAB is partnering with Qatar’s government:
(1) No sharp line divides the government of Qatar from WCB host institutions. The IAB has effectively, “chosen to take funding and form a partnership with the government [of Qatar].”
It is true that that the line separating the government of Qatar from WCB host institutions is not sharp. WCB’s host, Hamad Bin Khalifa University, and co-host, the World Innovation Summit for Health (WISH), have ties to the Qatar Foundation, a state-sponsored nonprofit organization. Yet Georgetown, Cornell, and Northwestern universities also have ties to the Qatar Foundation. Should IAB avoid conferencing there as well?
Qatar is not particularly unique with regard to funding academia, either in the Middle Eastern and North Africa (MENA) region, or the world. At universities across the globe, the line between academia and government is increasingly blurred, as even wealthy private institutions rely on government funding for a large portion of their annual budgets. Being enmeshed with the state does pose challenges, as universities in the United States (US) experienced at a heightened level during the presidency of Donald Trump, who was highly critical of science and academia.
Yet the crucial question for bioethics is not the relationship between governments and academic institutions, but how much freedom academics enjoy within that relationship. The 2022 Academic Freedom Index (AFI), a comprehensive assessment of academic freedom worldwide, finds political interference with academia on the rise across the globe, including in liberal democracies, where significant declines in academic freedom are apparent. In the US, subnational government interference with academic institutions rose sharply in 2021. A population-weighted average decline in academic freedom has occurred for all world regions, except sub-Saharan Africa, leading AFI to conclude, “for the average global citizen academic freedom is back to a level last registered four decades ago”. A 2023 European Parliament report also documents political interference with academia in every European state, including state governments revoking accreditation from gender studies programmes; transferring authority of public universities to government-controlled foundations; using pro-government media to target academics, programmes and institutions; and fostering a climate of self-censorship.
These findings provide a compelling reason to double our efforts –to engage with one another, rather than further isolate ourselves and our bioethics colleagues facing challenges. The IAB Constitution commits to “supporting scholars whose freedom to discuss bioethics has been restricted or is under threat”. IAB requires Congress hosts to ensure the free exchange of ideas at the Congress venue, creating an opportunity to openly discuss bioethics without political interference. Doha hosts have provided such assurances and there is no reason to question their willingness or ability to make good on these assurances.
Magnus sees injustice in Doha’s selection:
(2) In-person conferences “often primarily serve the interests of elite academic institutions and may promote an academic caste system” due to the “differential in resources to attend.”
While more research is needed, preliminary evidence shows that the ability to meet conference costs is directly related to the income level of a participant’s country. This suggests a strong reason to enhance equity, not to abandon in-person congressing. Among the needed changes are holding conferences in more diverse locations, including low- and middle-income countries; making conference fees and hotel accommodations as affordable as possible; making bursaries more available to people from low- and middle-income countries; and inviting keynote speakers from underrepresented groups.
Hosting WCB 2024 for the first time in an Arab nation in the Middle East, a location infrequently visited by Western academics, addresses equity too, by helping dismantle structural injustices facing bioethicists in the MENA region. Recognizing that bioethics certainly needs to reach out beyond Europe and North America, the IAB has held four of its 16 world congresses in the Global South, most recently in 2018 in Bangalore. (At that time, the IAB was not called upon to defend its choice to meet in India, where the AFI has been falling for the past ten years, with particular declines in freedom of academic and cultural expression.) This was clearly not to promote an academic caste system, but aimed at mentoring and supporting bioethicists in countries where bioethics needed support. The IAB’s President has called for holding the 2026 WCB on the African continent, and the Board will be making an exciting announcement about the 2026 WCB site at the closing ceremony of the Doha congress.
Magnus doubts in-person conferences are serious academic events:
(3) Attendees at in-person meetings “want to travel to new, interesting, or nice places…that allow (mostly high resourced) academics and medical professionals to have free vacations…[and] enjoy nice restaurants.”
This is an empirical claim—is there evidence to support it, beyond the author’s personal experience? While some well-resourced attendees may make fine dining a top priority, many others lack the means to even consider this. While some conference organizers do cater to the well-heeled, the IAB is not among them. The IAB is not promoting Doha as a vacation spot. Organizing, running, or presenting ideas at an international conference is challenging and exhausting work; there are easier ways to vacation or go to “nice restaurants.”
Magnus again objects to in-person meetings:
(4) There are reasons to doubt that “social aspects of networking are closely linked to the exchange of ideas rather than other aspects of socialization…this view is supported by at least some social science research.”
Evidence about the value of virtual versus in-person networking and exchange of ideas is still emerging. In a 2023 review of literature on virtual networking Wenger reported, “researchers view networking inefficacy as the main drawback of VC’s [virtual conferences] due to a lack of social interaction and discussion. VC attendees … can lack a sense of community because sensory cues, nonverbal communication and a sense of other people are missing”.
Perhaps the strongest argument in favor of hybrid or online conferencing is the seriousness of the climate crisis. It is for this reason that IAB committed to a hybrid format for all future WCBs. Some of us have argued (in this issue of the journal) that online-only conferencing merits further exploration because it is greener.
In any event, concerns about in-person conferencing apply to all conferences, not just those located in Doha. In this respect, they are tangential to the key question at hand –should we engage with people who hold radically different ideas than our own, or should we boycott them as a show of protest?
Hard Choices
In addition to these new objections, Magnus reiterates concerns raised and responded to previously: Siting WCB 2024 in Qatar breaches a duty to help socially marginalized groups: lesbian, gay, bisexual, transgender, queer, plus (LGBTQ+) bioethicists traveling to Qatar face safety threats.
We affirm a duty to help socially marginalized people and interpret it as extending to all marginalized people. At the 2024 WCB, there will be multiple, intersecting marginalized groups, including not only LGBTQ + people participating from outside the region, but also: LGBTQ + people living in the region who face daily discrimination, and MENA scholars, who have been historically under-represented in bioethics.
In situations where fully supporting all marginalized groups is impossible, conference organizers face difficult, even tragic, choices, where “there are no unambiguously right answer[s]” and “to act is, necessarily to do wrong”. Deciding to support one group rather than another leaves a moral residue –rather than resolving moral conflict, some obligations remain unfulfilled.
Recognizing this, appeals to help socially marginalized people ring hollow unless they are enacted in an enduring way over time. Given that who is at the center and who is on the margin varies over time and based on context, a commitment to help the least well off must be continuously reexamined and reenacted. Although “siting the World Congress in Qatar offsets credibility deficits that arise from never holding the World Congress in the Middle East or an Arab country”, this does not make right its negative impact for some marginalized people. The WCB must lend support to LGBTQ + people and other marginalized groups in the MENA region by seeking to open respectful dialogue, generate new understandings, and foster academic freedom and collaboration.
Conclusion
Wholesale boycotting of any congress can breed resentment and anger. It shows intolerance and a refusal to listen. It will probably not convince anyone of the truth of one’s beliefs. By contrast, engagement between scholars with radically different ideas invites better understanding. It throws the door open to people defending their views by giving reasons backed by evidence. It allows us to listen to other academics express their views and explain their reasons.
To the extent that we are a bioethics community, it is imperative to recognize that some among us are “hurting, disappointed, and even angry”. Many people feel excluded. Standing together to share ideas with people willing to listen and discuss, even when they hold radically different views, can go a long way to eventually righting these wrongs.
Acknowledgments
All views expressed are solely the authors’ own. They do not represent the International Association of Bioethics (IAB), its Board of Directors, or its membership, nor do they represent the Research Center for Islamic Legislation and Ethics (CILE), its faculty, or its associates.