The following Q and A is from a discussion we had with Dr. Jim Lavery on Episode 2 of The Last Mile Podcast.
What did the biggest lesson you have learned in your work?
My work is largely about trying to get people to think differently about things that have really deep, baked conventions. So when you start talking about fairness or ethics people come to those ideas with, they think it’s an IRB or institutional review board or a research ethics committee. They have preconceived ideas about what it’s about. So the biggest lesson that I’ve learned is that you just have to be patient and you have to try to tell your story to people in ways that can help them formulate their thinking about why these aspects of global health are so important. I think the real lesson is that we have to be better at how we tell the stories about why fairness should be considered alongside coverage as an indicator of the effectiveness of a health campaign.
What is one myth you would like to dispel in the community?
One of the burdens that we have as people who work in ethics Is that we have this kind of regulatory system largely driven by the US federal government common rule regulatory standards for research with human beings. That has very little to do with ethics, to be honest, it’s essentially a framework for institutional accountability and liability for potential harms to people through research.
And one of the myths, I think that I kind of battle all the time is that people think that the work that we do is the same kind of work that IRB or research ethics committees do.
The way I’d like to try to dispel the myth is that what we’re really trying to do is analogous to what biostatisticians do. Biostatisticians help us try to express very complex ideas in mathematical reasoning. And what we try to do in our work to dispel this myth is to try to argue that look, what we’re trying to do is, we’re trying to address and help explain and articulate these issues in ethical reasoning – in reasoning that is deeply tied to practice and to the real challenges that people face in the work, it’s not abstract. And it’s not just what you send to an IRB to get your study approved.
So if we could dispel that myth, I think, we’d be really well on our way to a very different place for ethics in reasoning and in NTD programming.
What would be your advice to the next generation of NTD researchers and advocates?
I have the luxury and privilege of getting to hang around a lot with the next generation of NTD researchers and advocates as a professor, not only in the school of public health but in a department of global health. And so one of the main thrusts of my advice, I think for them is to not allow all of these kinds of deep human challenges of fairness of compassion of equity – don’t allow them to be too easily displaced by our conventions of having to view the world strictly in terms of quantitative algorithms. There is a really important and central place, I think for the human side of what we do in global health. And my advice would be to not let people shove that aside too easily for you. Fight for that and advocate for it and make sure that it has, its fair place In the pantheon of privileged approaches to thinking or ways of reasoning in Global Health.
