Educating ELSI

By Matthew L Baum

“Examining the intersection of law and health care, biotech & bioethics”

– the subtitle of the Bill of Health blog.

I approach this intersection like many of my fellow students: outfitted with the tools and spectacles of a specific discipline. Whether that is health law, policy, medicine, engineering, philosophy, genetics, or cognitive science, none of us have had the ideal education that would enable not only an approach, but an inhabitation of this intersection.

What would that ideal education be? To consider the ideal education for a citizen, Rousseau conducts an elaborate thought experiment giving that education to a fictional young boy named Emile (hence the title of the work: Emile, or On Education). Let us begin a similar experiment to consider the ideal education for someone to inhabit the intersection of law and health care, biotech & bioethics.

Let’s call our fictional young person, ELSI.

One important part of ELSI’s education must surely be lingual. There are many foreign languages at this intersection: legalese, statistish, neurosciench, philosophan, etc. Those of us who have journeyed here try to learn bits and pieces of the languages the best we can; we produce ethics modules for neuroscientists and neuroscience boot camps for others. We want to communicate with each other, but perhaps because we are well trained to write with the ideas and jargon valued by our own disciplines, too often we report back in our native languages to our home countries; we talk past each other, and fail to capitalize on the progress made on an issue in another discipline (sometimes hundreds of years of progress).

Fortunately, however, ELSI is young and her language centers are still pliable. She can be raised in a multi-lingual household.

What would it look like?

To me, comparative literature programs offer the best blue-print. The Harvard Comparative Literature Department, for example, requires its students not only to learn to a high level four different languages, but to critically pursue works of literature within each. How many programs require its students to work in a genetics laboratory and biotech company, clerk for a patents court, observe in a pediatric genetics clinic, and critique the philosophical literature surrounding justice? Not one comes to mind.

But ELSI could do this. And to me it seems like this degree of fluency would be required to inhabit the intersection.

We might wonder at the demandingness of this fluency. A senior student working in the field of neuroethics once told me, for example, that she thinks a useful level of fluency might require PhD-level training in more than one discipline. Would this even be sufficient for ELSI? This seems very demanding indeed.

But let’s return to ELSI. In our thought experiment we’ll make sure that, long as the path may be, she becomes multi-lingual. Where does she go from there?

The Harvard Comparative Literature Department gives its students the following illustrative advice:

“Students are advised that most academic employment opportunities are in national literature or area studies departments; there are very, very few full-time comparative literature positions in the United States.”

If ELSI – even ELSI – ends up being funneled back into the silos of traditional disciplines… If ELSI, fluent in many languages ends up using only one… then perhaps we ought to restructure more than just education.

What do you think?


During his fellowship, Matthew Baum was a second year MD-PhD student in the Health Science and Technology (HST) combined program of Harvard and MIT where he integrated his interests in clinical, scientific, and ethical aspects of mental health. He holds a DPhil at the Oxford Centre for Neuroethics where his doctoral work, supported by a Rhodes Scholarship, concerned the ethical implications of the development of predictive biomarkers of brain disorders. Matthew also completed an MSc in Neuroscience at Trinity College Dublin as a George Mitchell Scholar and holds a BS and an MS in Molecular Biology from Yale. During his medical and neuroscience training he maintained a strong engagement with neuroethics; he has acted as the student representative to the International Society for Neuroethics. During his time at the Petrie-Flom Center, Matt researched the intersection of biological risk and disorder.

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