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UMC turns to Millsaps professor on medical ethics

(April 24, 2002)
Dr. Patrick Hopkins occupies a place where science and the public interest intersect. Twice a month, that intersection is a seat around the conference table where the University of Mississippi Medical Center Institutional Review Board (IRB) meets.

The IRB regulates research involving human subjects to ensure that it is humane, necessary and in compliance with all federal and institutional regulations.

All members but Hopkins are UMC personnel - nurses, pharmacists, dentists, physicians, scientists and others who have a vested interest in research.

Only Hopkins speaks for the man or woman whose last encounter with science may have been in ninth grade and who may not know a petri dish from a placebo.

And only Hopkins is indispensable. If he or his designated alternate, Millsaps professor Ted Ammon, is not present, the board cannot meet. According to the federal regulations that govern the board, no meeting can take place without the person who represents the public's viewpoint.

The Assistant Professor of Philosophy at Millsaps is hardly Everyman. Hopkins has edited two books and written numerous articles in scholarly journals. Among his topics: civil rights for cyborgs, custody battles over frozen embryos, biology and the Bible, artificial wombs and pig parts. Hopkins is a scholar, perfectly at home with abstract concepts and the art of debate. But when he's seated around the table with other IRB members, he assumes the posture of a layman.

"I try to put myself in the place of my niece, my 85 year-old grandmother and the person who checks my groceries," Hopkins said.

The board spends much of its time reviewing the forms that document informed consent from research subjects.

"I always think of a person, perhaps already sick, who may read at only an eighth grade level and then try to determine if he can understand it," Hopkins said. "We spend a lot of time translating doctor- and science-speak into eighth grade-speak." Even though Hopkins pursued a science career as an undergraduate and has worked in a research lab, he is not as familiar with medical terms as most of his IRB colleagues.

"It was a little difficult at first," he said. "I didn't want to be the only one around the table who didn't understand something. But it's not a problem at all now. Part of overcoming that was my own willpower. I refused to let my embarrassment stand in the way of what I needed to do. But the group also welcomed me. They didn't roll their eyes when I asked a question. It's a very free environment in which I can express whatever concerns I have, and I'm grateful for that."

Nancy Olson, IRB administrator, estimates that IRB members spend six to eight weeks a year reviewing research, looking over as many as 78 separate proposals for one meeting. In that respect, Hopkins' scholarly background and experience in reading esoteric manuscripts work to his advantage.

All of it is voluntary. No one on the board, including Hopkins, is paid.

"It does take a lot of time," Hopkins agrees. "But I look at it as my tiny contribution to the community. At some point, some person lying in a hospital bed will be the beneficiary of a decision we made."

And Hopkins likes being around scientists. "Academics like me don't often have the opportunity to talk to scientists," he said. "It's a good experience for me. And I hope that once in a while I will bring a perspective to the table the others haven't thought of."

According to Dr. Richard Summers, an Associate Professor of Emergency Medicine and IRB member, Hopkins does that frequently. "We tend to get wrapped up in the science of the thing," he said.

"Patrick gives us a patient's point of view, as well as an ethical perspective. He'll ask us, would we want this done to us? Or ‘is this ethical?' He's not afraid to speak up when he has a concern. And he reads each proposal in detail. I'm always amazed at how thoroughly he prepares for the meetings."

IRB chairman Dr. Stan Chapman, director of the Division of Infectious Diseases, agrees. "I can always count on him to have read every proposal thoroughly," Chapman said. "He knows exactly what his charge is on the board, and he takes it very seriously. He is absolutely essential to the board, and he makes my life much easier."

Chapman credits Hopkins with the first use of the word "metaphysical" in the history of IRB at the Medical Center.

"I was looking at something in one of the proposals," Hopkins said, "and I commented that whatever it said was ‘metaphysically impossible.' Dr. Chapman said it was probably the first time that word had been used in that room."

Hopkins is a native Mississippian. He earned his B.A. at the University of Mississippi, and his M.A. and Ph.D. at Washington University in St. Louis, Mo. He did post-doctoral research at Bowling Green State University in Ohio.

"I loved science in school and actually thought I would end up doing neuroscience," Hopkins said. "I still love science, but discovered that the day- to-day life of the scientist is not for me. I found I was more interested in the big implications of science and technology and for that I needed to study social theory and philosophy."

In the classroom, he teaches courses in biomedical ethics, computer ethics, death and dying, and gender and technology. He once taught an introduction to philosophy course using some of the classics of science fiction and "Star Trek."

A veteran of 30 or 40 IRB meetings now, Hopkins says his disappointment has been in seeing how little regard corporate enterprises have for human subjects. "I see how much information they obtain from the subjects and how little they give them in return," he said.

On the other hand, he says he has been very impressed by his fellow IRB members. "I'm amazed at how thoughtful and serious they are about protecting the rights of human subjects," he said. "I come away from the meetings knowing that we're really doing work here that helps people."

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