Religion and Science—Engaging the Questions

 

 

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Life for Kevin FitzGerald, SJ, PhD, is about finding God in all things. As an ordained Jesuit priest, with a double PhD in bioethics and genetics, FitzGerald’s expertise has translated itself into a sense of wonder for the world and a drive to make it better.

One of the most important tenants of the Jesuit tradition is service to humankind. “Where is the greatest need and where can the greatest good be done?” FitzGerald asks. “The bottom line is caring for others.”

And FitzGerald is no exception to this Jesuit tradition. His office is in Georgetown University Medical Center’s Research Building. In his laboratory on the fourth floor, he studies a gene called MLL-2, which is closely related to MLL—a gene that, when mutated, can result in infant leukemias. Leukemias with alterations in the MLL gene can also occur as the result of treatment for breast cancer when therapies damage bone marrow tissue.

“In molecular biology, we pick a place to go in and start working. I picked MLL-2, in part, because there weren’t too many people there and its similarity to MLL promised to provide better insight into the many ways cancers can begin.”

In fact, FitzGerald was the first person to identify MLL-2 and recognize its potential importance for medicine.

While addressing the need for a better understanding of cancer in the laboratory for advances that are perhaps far in the future, FitzGerald also works to address immediate and personal problems today. He is part of the ethics consultation service for Georgetown University Hospital, which provides free consultations for patients, family members, and hospital staff on ethical matters. He speaks with them from an independent position, acting as a negotiator to facilitate appropriate health care for patients and their families. To FitzGerald, a solution involves not only the treatment of a cancer, but it must also address all concerns, which may include quality of life, the amount of time spent in the hospital, financial constraints, and family members’ conflicting wishes.

“One of the consequences of the rapid development of medical technologies is that their use can raise challenging ethical decisions for patients, their family members, and health care professionals,” he explains. “For example, treatments that target a tumor may do a good job addressing the cancer, but can cause complications in other parts of the body.”

As scientists make major advancements in the field of genetics, FitzGerald believes there is an urgent need to apply rigorous ethical reflection and guidance, particularly as it may apply to outcomes tied to race and ethnicity. Without such thoughtful inclusion the scientific advances in genetics “could well result in great harm, even while providing some benefits,” he says.

Information about an individual’s genetic makeup will help physicians prescribe “the right treatment, for the right person, at the right time,” explains FitzGerald. For example, taken at the recommended dose, aspirin is safe for most people. However, some individuals experience an allergy or intolerance to the drug. If a genetic marker for this intolerance is discovered, patients can be tested before the drug is given to them, preventing likely adverse effects.

In a recent article published in the peer-reviewed journal Clinical Pharmacology & Therapeutics, FitzGerald, who is the David Lauler Chair for Catholic Health Care Ethics at the Lombardi Comprehensive Cancer Center, addresses ethical challenges posed by pharmocoethnicity – the application of genetic and genomic discoveries to specific ethnicities and races.

To FitzGerald, the danger lies in the creation of new forms of categorization based on genetic factors. He believes they have the potential to lead to increased social stigmatization.

“Within a genetic condition, we may find variability. What if your condition is less treatable than others? Should we as a society invest in research to help your rare condition?” he asks. “Or is it ok to focus on those in with the more common condition? There are no easy answers.”

FitzGerald is a member of the U.S. Secretary of Health and Human Services’ Advisory Committee on Genetics, Health and Society. He notes that the country’s current health-care disparities and struggles with costs, privacy and communication of medical information demonstrate the need for a concerted effort at public engagement regarding pharmacogenomics and genetic testing.

But as he works on the big policy questions, FitzGerald has no trouble staying grounded. On ethics consultations in the hospital, he may also be called to the bedside of a patient to provide counsel and comfort as a priest.

“I have been asked to respond to situations from multiple perspectives: as a priest, as a Catholic, as a scientist, as an ethicist, and as a teacher,” he says. From his experience at the lab bench, the bedside, and in the classroom, FitzGerald brings a concrete, big-picture view of medicine. He calls the integration of his experiences both the challenge and the reward of his profession.

“People are constantly asking me, ‘Don’t you feel the tension between religion and science?’ My answer is, ‘There is no tension.’ These are two different and very powerful ways of understanding reality. All of it is about our existence, and it’s about finding God in all things.”

By Allison Whitney, excerpted from Lombardi Comprehensive Cancer Center Annual Report 2007.