DeGrazia, David (2025)

BA: Good afternoon. Today is February 12, 2025. My name is Brittany Acors, and I am a postdoctoral fellow in the Department of Bioethics in the Clinical Center. Today, I have the pleasure of speaking with Dr. David DeGrazia. Dr. DeGrazia is Elton Professor of Philosophy at George Washington University [GW], whose faculty he joined in 1989. This year, Dr. DeGrazia is a visiting scholar with the Department of Bioethics in the Clinical Center of the National Institutes of Health. From July 2013 through June 2021, he was also a Senior Research Fellow in the Department of Bioethics, and a visiting scholar in 2006 to 2007, so he has a long history with this department. His research interests focus primarily on applied ethics and ethical theory, and secondarily on personal identity theory and the philosophy of mind and cognitive sciences. Thank you for taking the time to talk with me today, Dr. DeGrazia.

DD: You’re very welcome. Thank you for having me.

BA: I wanted to start off by talking about your education. You earned your degrees from the University of Chicago, Oxford University, and Georgetown University, each time in philosophy. Can you tell me about where that interest in philosophy came from?

DD: I was wondering about that, and I'm not sure I have a clear answer. I think I was always disposed to be interested in this topic. When I took my first philosophy course, the issues really resonated with me. I found them fun and important. Also, it didn't hurt that an older brother had majored in philosophy, and my father was a somewhat philosophically-minded lawyer and law professor. The culture of my family, at least, gave me permission to major in philosophy, and I was, I think, always natively interested.

BA: Sounds like a pretty inquisitive family that helped shape your own interests. What were your experiences like at each of those institutions?

DD: At Chicago, I was impressed by how much really careful and well-informed thinking was going on. I learned a ton. I also found I was very anxious. The place is somewhat of a pressure cooker, and I have my own tendency towards anxiety. I think because of that, when I went to visit the university after I had graduated, and I was there with no pressure of taking courses or upcoming finals or papers, I felt so much more relaxed, and it was a little bit easier to enjoy the beauty of the place.

Let's see. Also on the list is Oxford. That is a really beautiful town and campus, or many campuses, different colleges, and I did enjoy the beauty and the way in which so many of the buildings went back to the Middle Ages, while also working very hard. I wouldn't say it was quite the pressure cooker that Chicago was, but the insistence on high quality work was something I found very admirable and I liked a lot. I learned a lot there as well.

Georgetown was a special place to do my doctorate because it was the only place in the country that had a well-developed program in bioethics at the time. It shows you how much things have changed. Georgetown was at least the only one I was aware of, and that was within the doctoral program in philosophy. I kept one foot in bioethics and one foot outside of bioethics in other areas of philosophy, and it was a good place to have that combination of interests.

BA: Great, so it sounds like even in your doctoral education, you were already thinking about bioethics. That makes some sense about how you became involved with the NIH Department of Bioethics. I was wondering how you were first introduced to your first position here as a visiting scholar from 2006 to 2007.

DD: I'll go back in time a little bit because after my first year of graduate school, in the summer of 1985, I came to NIH to work as an unpaid intern at the Office for Protection from Research Risks [OPRR]. That office covered both human research protections and animal research protections in terms of oversight. That's different now. Now at NIH, we have a OHRP [Office for Human Research Protections] and OLAW [Office for Laboratory Animal Welfare]. Two different institutes or centers, units, and different personnel. But OPRR was one place in Building 31, fourth floor, B-wing. I remember because I went there back then, and I went back. I really had a good experience. I went back in 1988, in the summer. This time I got paid. Those were in sort of the old days of bioethics at NIH. At the time, if I remember correctly, John Fletcher worked as clinical ethicist for the Clinical Center, and I think he was the very first one.

So what about the Department of Bioethics? Well, let's see. I was at home, and I got a call—maybe I even used a landline. The call was from [Ezekiel Jonathan] "Zeke" Emanuel, who asked me if I was sitting down and said, “I want to make you a visiting scholar.” It was a little awkward at first because at the Department of Philosophy at George Washington University, I had just been elected to be the next department chair, and that would start at the same time as the visiting position.

I worked it out with my GW department that someone else would continue his term as chair to allow me to visit NIH. And that was just a wonderful experience. And I stayed close to the department and then they asked me if I wanted to join them full-time in 2013, but I wasn't ready to leave the university, especially so early in my career. So I worked it out that I worked three days a week at NIH in the Department of Bioethics, and then GW owned me for the other two days, 40% of my time. I had two multiple-year contracts that covered eight years before I went back to full-time at GW, and now for the second—and I assume final—time, I'm a visiting scholar during a sabbatical this year.

BA: You mentioned that Zeke Emanuel was the first person to make you an offer in 2006, but who else was in the department then, and what was the kind of culture and training like?

DD: Christine [Grady], our current chief, was in the department. Marion Danis, Frank Miller, I’m mentioning some—well, Marion and Frank have retired, so they're not in the department anymore.

The culture then was not very different from the one you're experiencing now, and I'm experiencing now. It was very collegial, very team-oriented, interactive, interdisciplinary, and with a very healthy emphasis on doing the best work we can do. That's one reason I was interested in coming back again.

BA: Yeah, it sounds great and sounds like not only did you enjoy the position, but people enjoyed having you here. I'm wondering maybe what the difference was between being a visiting scholar and being a senior research fellow with that seven-year or six-year gap.

DD: The position that I had here when I was a regular employee, part-time, 60% time, involved more responsibility than a visiting scholar had. In some ways it wasn't so different. In both cases, I participate fully in activities of the department. I help with fellowship application review and the like. I do my own research. While I was here for eight years, though, I did more coauthoring with members of the department, and I also had responsibility for the Joint Bioethics Colloquium [JBC], pulling that together each semester—if the concept of the semester applies to the NIH. I guess those are the major—have I answered your question?

BA: I guess I'd also like to hear you say a little more about what JBC looked like then, or what the themes were, or any memorable moments from helping to lead that.

DD: Well, we had lots of different topics. Let's see, one was on moral status, which isn't too surprising. We had some involving interactions between psychiatric issues and philosophy. But the general takeaway I have in my collective memory of all of these experiences is that it was great to have people come in to give a talk for the department from a lot of different disciplines and to get to know some really prominent scholars I hadn't known before and also have the pleasure of seeing our faculty and fellows interact with them. Very often the scholar who came to give a talk was really, really impressed by the depth and persistence of the questioning he or she got during the Q&A. So yeah, on the whole, a very nice experience.

BA: That's great. Have you noticed any changes or maybe even some continuities from that first experience when you came in 2006 to now in 2025?

DD: Yes, both, I guess. The continuities are the continuations of really good things: the collegiality and the culture of excellence in work. Also, the department might be unusual in not only having really high performing members, but also managing to do that without a kind of mean competition in the air. There is much more of a sense of mutual support, and if someone does well, that means everyone does well in a way, rather than it being a zero-sum game. I really appreciate that.

There are a couple of ways in which things, I think, have changed somewhat. I believe over time there's been more involvement of the department in global bioethics than there had before, with the joint appointment with the Fogarty Institute [Fogarty International Center]. I think there's been more interaction with the [National] Institute of Allergy and Infectious Diseases, and if I'm not mistaken, the staff of the department has become more international than it was before.

BA: It sounds like not only has the department kind of grown in interest, but it's also become more integrated within the Clinical Center and the NIH.

DD: That’s right. Oh yeah, and one other change was the name change. I think that was in the year that I came first as a visiting scholar. It was the Department of Clinical Bioethics, and maybe the adjective was a way of sort of signaling the service that it was doing for NIH. Then it just became the Department of Bioethics so as not to give short shrift to all the scholarship we were doing, which is partly for NIH, but partly—in large part—for the world.

BA: It's definitely not just clinical bioethics but a lot of research ethics too.

DD: Yeah, and a lot of research in other areas of bioethics. It's both a high-functioning academic department, and it's a provider of really important clinical services and teaching.

BA: Great. On the subject of research, now that you're back for this year on sabbatical from GW, can you talk a little bit about what research you're working on while you're here?

DD: Yes. For once, I'm working on only one project at a time. It's a project that's taken me a long time. It's a book called “Investigating Moral Status”. Moral status is a somewhat technical term, but it means the value that an individual has in counting morally and how much. It's obvious that people count morally and count a lot, count equally, but it's less obvious whether non-human animals or which ones count morally. I mean, there are obviously debates in society about prenatal human beings. There are issues about future AI [artificial intelligence] and whether it might ever achieve capacities or qualities that would suggest that it, too, has its own interests and should count morally. That's really all I'm working on right now, and I have drafted the book. It needs a lot of work to revise. I'm hoping to finish in spring or early summer and submit.

BA: I know you've workshopped a few chapters in the department, so what has that experience been like?

DD: It's great. The best experience, in my experience, when workshopping is to be humbled by getting feedback, and you can only do that if you have smart people who are willing to think carefully about what you've done and give you a sense of what the challenges are that lie ahead. You get humbled, and then you sort of collect yourself, you think things through, and you figure out how to make it better. I'm convinced that virtually all good scholarship goes through that process. One reason I wanted to come here, besides just enjoying the environment, is I knew there would be faculty and fellows who would be interested in doing that with me.

BA: I noticed from your description of moral status that one of the throughlines in your experience has been animal ethics, from that first experience in the Office for Protection from Research Risks up through this current book project. Can you talk a little bit about what got you interested in that subject and what your contributions have been to that field?

DD: Sure. I think as with philosophy, animal ethics is something I've always been disposed naturally to be interested in. I didn't grow up in a culture that encouraged me to think much about this, and I had all the usual habits that most people have. For example, I grew up eating meat three times a day and didn't think about where it came from or how it got to be the way it is. A few times I thought of questions, questioning the status quo, but I got rebuffed whenever I did. I didn't know people who were serious about these issues, which is very different today—a lot of people are interested in animal protection.

In my first semester of graduate school, there was one week devoted to animal research ethics. I read exactly three articles in that week that were assigned, the only three in the anthology we were using. But they made me for the first time very explicitly consider some of my assumptions about animals. I found myself captivated, and I think, maybe by the end of that week, I knew what I would write my dissertation on, which was just a great thing.

I think I was always disposed to be interested. I was always interested in other minds. As a child in elementary school, I always wanted to be friends with the foreign students just because they're coming from a somewhat different place. If you extend that sort of logic, you can go beyond humanity and wonder about the minds of other sorts of beings. I've always been interested in that and always, I guess, empathic. And so there it is.

What have I contributed? I suppose a lot of writing, a lot of articles ranging from several on moral status itself, different dimensions of it or different issues, a few on dietary ethics, some on animal research ethics, one or two on issues about the confining animals in homes and zoos, one or two on the harm of death for animals. Then among my books, the first was called “Taking Animals Seriously: Mental Life and Moral Status”. Another one was for a broader audience called “Animal Rights: A Very Short Introduction”, and then much more recently, with Tom Beauchamp [DeGrazia’s doctoral advisor and a prominent figure in the field of bioethics], a book called Principles of Animal Research Ethics. So sorry, a long answer, but a lot of my work has been in that area.

BA: Great. Have you seen changes in your time at the NIH as to how animal ethics has been incorporated?

DD: Certainly, in the department, because when I came in 2006–’07, I think I might have been the only one who was doing any work in that area. But some of the fellows were, which makes sense, because younger people were growing up with slightly different attitudes and more openness about some of these issues. Over time, there's been more interest in animal research ethics and animal ethics generally in the department. There are some changes, I think, at NIH as a whole, probably more in the department.

BA: I'd like to turn to some of your service outside the NIH. In 2012, you worked part time as Senior Advisor to the staff of the Presidential Commission for the Study of Bioethical Issues. How were you introduced to that group, and what did you do as a senior advisor?

DD: Right. It began when I was invited to give a talk to that commission. They had meetings that I think were open to the public, and there was one in Washington, D.C. Maybe they were all in D.C. Anyway, I was asked to talk about what I thought should be the appropriate standards of protecting children in pediatric research. I guess the co-chair, Amy Gutmann, liked my presentation and suggested to the head of the staff—because they have a large staff, which is different from the Commission itself—to have me follow up on the talk, talk informally to them. And then, if she saw fit, to ask me if I could work for them.

And so I did. And she did. And so we worked—I still had to teach—so we just worked it out that I would work one day a week with the staff as a senior advisor. They were working on a big report on pediatric research ethics, and that was eventually published the next February or March. I think I just worked there for half a year, through December 2012, and then a few months later, the report came out. It was called “Safeguarding Children: Pediatric Medical Countermeasure Research.” My job was to advise the staff on ethical and philosophical issues.

BA: It sounds like a great contribution to a report that could have a lot of impact.

DD: It was a good experience, yeah.

BA: Then in 2018, you were named a fellow of the Hastings Center, which is one of the oldest programs for bioethics in the U.S. Can you tell me more about that role?

DD: Yes, I don't think it's much of a role. It's sort of an honorific. To be an honorary fellow of the institute is an honor or is supposed to be an honor. I don't want to sound cynical, but I do think that sometimes these things have as much to do with whether or not you happen to know someone who wants to nominate you as whether you deserve it. I think there are lots of people who are not fellows of the Hastings Center who would deserve it, and there might be some who are who don't. [laughs] I don't do anything as a fellow, but I am one.

BA: Well, I'll interject to say, I think you're being humble. It's a great recognition of the work you’ve done.

DD: Oh, well, thank you. 

BA: It kind of goes along with some other really interesting roles you've had in diverse settings. On your CV are so many things, but a few that stood out to me were ethics consultant in team rounds for Psychiatry at George Washington University throughout the 1990s; chair of the Committee on Philosophy and Medicine of the American Philosophical Association from 2004 to 2006; and visiting bioethicist at the University of Cape Town, South Africa, in 2016. Can you tell me what appeals to you about these kinds of service opportunities, and how they find you or you find them?

DD: Yes. Well, the first two were genuinely service opportunities, and the third is different, as I’ll explain. When I went to George Washington University, my original position was actually not a tenure-track position, but a visiting one for multiple years. My secondary appointment was in health care sciences, so it was especially appropriate for me to get involved with the medical school and with the hospital if possible. I was very interested in psychiatry, so I offered to serve as an ethicist during team rounds in the psychiatric unit, and in these rounds either a medical student or resident would get practice by interviewing patients, in-patients, people who had come in for treatment for mental illness, substance abuse, or both. My job was basically to listen very carefully to the interview, and then after it was over and the patient wasn't there, to let the team know if I thought there were any special ethical issues that had arisen during that time. And I think by doing this, I became a lot more clinically savvy than I had been before, at least in psychiatry. And the team became more ethically savvy. They became more attuned to what an ethical issue is and maybe a good way of addressing it. In a way, that was just part of my job, to do something like that, but it was very rewarding. It was the most extensive clinical experience I've had.

Let's see, the second one. I was chair of that Committee on Philosophy and Medicine for the American Philosophical Association [APA]. I had actually only just wanted to be on the committee and have a role, but the person who nominated me for some reason nominated me to be chair. [laughs] I was made chair. And let's see, what did we do? What did I do? This committee, unfortunately, does not exist anymore. But it, for a long time, had a presence in the APA, and every APA meeting—or at least every Eastern Division meeting—there was a panel that we set up on different topics and bioethics or philosophy and medicine. I remember one, for example, that was just extremely good on assistance in dying and different ways to try to deal with those sensitive issues in a thoughtful, well-informed way. We set those up, and I sort of spearheaded that effort. There was a newsletter, and the papers that were given, the presentations, there was always an offer to publish them in the newsletter, if the scholar wanted to. And I think I always wrote a little column, editor's column or chair's column, for that. And that's more or less what that role was.

I shy away from having positions of massive responsibility, despite the fact that I was department chair. But you might have noticed I was only department chair for one term. Conveniently, I had a sabbatical immediately after, so I had a good excuse for not continuing. [laughs] But it's been valuable sometimes to accept such responsibility, which includes if things go wrong, you get complaints. You need to, you know, respond to them. I'm saying that in part because I wouldn't say I was drawn to these services. I think to some extent, I thought they were expected of me, and I wanted to do my fair share.

Let's see. The third one was about Cape Town, South Africa. In that case, it was an opportunity for me. It was an opportunity to visit a university in Africa where someone I knew, who had been a visitor here, a visiting scholar here, David Benatar, was the department chair. I may have benefited more than they did, but I worked fairly hard. I think I was there for six days, plus travel days. And in those six days, I gave four talks on different topics. So that was a way of their, I guess, benefiting from what I knew or thought about. They set me up in a little office, and they took really, really good care of me. So very much an opportunity for me, and I hope they got something out of my talks and my collegiality.

BA: Yeah, it sounds like a great opportunity for some international exchange. I wanted to go back to that first experience. When you started at GW in health care sciences, was it common to have philosophers or ethicists in the medical context? 

DD: It was becoming a little more common. I started in, let's see, my first semester of teaching there was Fall 1989. Officially, I started July 1st of that year. Anyway, we're talking late 1980s, and it was becoming at least not so strange to have philosophers interact in this way with medical centers, helping to teach, to guide discussions about ethical issues, and the like.

BA: Sounds like another great opportunity for exchange, to both learn and do some teaching.

DD: Yeah, and I was really lucky because here was this job in the one city I really wanted to stay if I could, and it just happened to mirror my training in graduate school.

BA: Great, yeah. Looking ahead a little to the future, I'm wondering what you see as some of the greatest challenges and opportunities confronting bioethics in the next 5 to 10 years, or even further out?

DD: I'm probably not the best at making predictions, but I think, well, it requires support to do bioethics. You need to have centers or institutes that are funded. Of immediate uncertainty is whether, for example, the Department of Bioethics will continue to have the support that it's enjoyed before, because it's not clear to what extent the current administration has that as a priority. That is always a concern, really for any kind of think tank situation or any academic department. In this case, even with a department that provides clinical services, government funding, you know—different people can have different priorities. I think I would say that's a concern.

As for the field itself and its content and its work, I think there's always a risk that bioethicists, or a lot of bioethicists, will try to follow trends too much, get into what's trendy, pursue it. Sometimes that can be kind of superficial. I think that's always a challenge, and maybe that's true in other fields just as much as in bioethics. But I do consider it a challenge to think very carefully about what's really important and to try to devote one's energies and talents to those issues rather than what most people happen to be talking about at a given time.

BA: Now that you're 35 years into your career in bioethics, what advice do you have for aspiring bioethicists who are maybe starting their education or early in their careers?

DD: That's a good question. One is that, although there can be competing demands on you and it's hard to know what to do to have the chance of having a career, especially a satisfying career, there's no substitute for really good work. Do what you can to do really good work. It tends to be rewarded, not always right away. So further advice is: be persistent if you don't get a good job right away. Be persistent and be patient. I've seen a lot of fantastic people, including some former fellows of this department, who did not get a really good job right away, but who were patient and persistent and ended up with really, really good jobs where they had the support needed to make valuable contributions and also enjoy some job security. I guess that's my advice. It's not very original, but hopefully it's valuable. 

BA: Then just to kind of bring it back to the NIH Department of Bioethics, do you have any really memorable experiences or anecdotes that have stayed with you throughout your time in the department?

DD: Boy, maybe if I thought longer, I would. I do remember a sort of funny moment when I was a visiting scholar in 2006 –’07. The department has a practice of going around the room at the end of a meeting and asking everyone, “Do you have any news or any concerns, anything you want to say in a minute or two?” And Zeke, who was then the chair, was going around the room and he got to me, he said, “David, anything, anything about animals?” [laughs] He was teasing a little bit, and I certainly didn't mind. Maybe that's not the best anecdote, but it was for some reason what came to mind.

BA: No, it's great. It shows how early on in your career you were recognized for that specialty. Is there anything else you'd like to add or any questions you wish I had asked you that you'd want to answer?

DD: Not really, but I think it's important to appreciate that NIH has a history of reflection on bioethics and providing clinical bioethics services. And I think the NIH should be proud of this. I think the government as a whole and the society should appreciate how valuable NIH’s contributions to bioethics, have been—both scholarly, absolutely first rate, and in terms of the important clinical services that it provides, which is done extremely well as a consult service, and very capable people leading the way.

BA: I love to hear that. Thank you so much for taking the time to speak with me. It was a pleasure talking with you and getting to know your background and your time in the department a little better. I really appreciate you taking the time.

DD: I appreciate your questions and making me think about all these things. It's been fun. Thank you.