by Craig Klugman, Ph.D.

Alice Dreger resigned from Northwestern University Feinberg School of Medicine/Memorial Hospital this week. The slash is because last year the hospital and the medical school merged. For the Medical Humanities & Bioethics program at Northwestern, that has meant a tumultuous year as it is readjusted to the new landscape.

Alice Dreger is a medical historian and advocate. Her position at the Medical Humanities & Bioethics program at Northwestern was a part-time, non-tenure track faculty member at Northwestern. She was working there when she had a Guggenheim Fellowship and worked there during the release of her latest book, Galileo’s Middle Finger: Heretics, Activists, and the Search for Justice in Science, a book that looks at freedom in science and censorship.

Ironically, Dreger resigned as a result of a case of censorship. The Program used to publish a cutting edge journal, Atrium. Each issue would focus on a theme and solicit manuscripts that spoke to that idea. Dreger was guest editor for an issue on “Bad Girls” and one of the articles, “Head Nurses” was written by William Peace, a Syracuse University professor, who tells of being 18 in 1978, paralyzed, and depressed. He describes a compassionate sex act by a nurse that helped him to recover.

The Northwestern administration was appalled that a journal under their “brand” would publish such a text. They demanded that Atrium create a “vetting committee” that would review articles and decide what could be published. The administration claimed that since Northwestern paid for it and its name was used, that the journal was part of the brand and the administration gets to control how the University/Hospital are represented to the world. Around the same time the university cut the budget for the journal. Rather than be subject to a group of censors, the journal editor closed the publication.

Dreger resigned now because the administration did not respond in a way that addressed her concerns about censorship, nor did they promise not to do it again. Dreger discusses her thoughts on working at Northwestern Medicine (not university) and her discussions with administration here. She also talks about her reasons for resigning and what her future holds here.

According to the American Association of University Professors (1940):

“Academic freedom is essential to these purposes [the search for truth and its free exposition] and applies to both teaching and research. Freedom in research is fundamental to the advancement of truth.“

Cary Nelson, president of the AAUP and an English professor says that academic freedom:

“Gives both students and faculty the right to express their views — in speech, writing, and through electronic communication, both on and off campus — without fear of sanction, unless the manner of expression substantially impairs the rights of others or, in the case of faculty members, those views demonstrate that they are professionally ignorant, incompetent, or dishonest with regard to their discipline or fields of expertise.”

Even the American Society for Bioethics & Humanities, which is known for not taking positions on “substantive moral and policy issues,” does take positions to support academic freedom and has done so in the past.

Since 1940, the notion of academic freedom has been a core tenet of university and faculty life. The idea was born in response to centralized governments telling researchers what they could and could not study and what they should and should not teach.

In the history of bioethics, there have been a few cases where a single individual has stood up for academic freedom and their rights or the rights of others: Mary Faith Marshall with the Medical University of South Carolina where her promotion was derailed because of her involvement in testifying under subpoena against her university in a lawsuit. Or consider Carl Elliott’s (controversial) fight against alleged research improprieties at the University of Minnesota.

One of my mentors told me that a problem with being a bioethicist employed by a university is that we consistently live with a conflict of interest. On the one hand we have an interest in maintaining our positions within the university and on the other hand, as bioethicists, we have an obligation to act rightly when we know what is right. There are times where these two things come into conflict: When a university would rather not have an event made public, but which ought to be. Or when a university is joined with a corporate entity that holds a business mindset about the bottomline and reputation with little regard for academic freedom or controversial scholarship.

Most universities do a good job balancing a good reputation (i.e. brand) and honoring academic freedom. However, when the university is viewed as a business or when the academic mission is viewed as secondary to the business, then this freedom can disappear. In any academic endeavor, the freedom and liberty of the faculty to teach and research according to the standards of his or her discipline that which is truthful, honest, proven, and authentic ought not be abridged. In bioethics and medical humanities we deal with real life, often the most dark moments of real life. To be told that we cannot speak the truth diminishes us as professionals.

Having courage is a difficult thing. Acting on courage is heroic.