Toronto, Home of Canada’s First Centre for Bioethics

Toronto, Home of Canada’s First Centre for Bioethics

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Frederick H. Lowy, OC, MD, FRCPC
Psychiatrist-in-Chief, Clarke Institute of Psychiatry
Professor, Department of Psychiatry, University of Toronto
Director, Centre for Bioethics, University of Toronto
Dean of Medicine (1980-1987), Faculty of Medicine, University of Toronto
Former Member, Institute of Medical Science, University of Toronto

By: Ekaterina An

Toronto has long been the site of groundbreaking biomedical research, but it is also the birthplace of the Centre for Bioethics (now known as the Joint Centre for Bioethics, JCB), one of Canada’s first academic bioethics research centers. Since its inception in 1989, the JCB has grown to include partnerships with 15 interdisciplinary healthcare and science organizations, with a community of over 200 ethicists, and legal and medical experts. In 2002, it was also selected as the first World Health Organization Collaborating Centre for Bioethics, expanding its reach internationally. However, despite the JCB’s current status as a heavyweight in the field of bioethics, the centre—founded by psychiatrist Dr. Frederick Lowy—had a very humble beginning right here at the Institute of Medical Science (IMS).

Dr. Lowy arrived in Toronto in 1974 to take on the positions of Psychiatrist-in-Chief and Director of the Clarke Institute of Psychiatry, and chair of the University of Toronto’s Department of Psychiatry. Six years later, Dr. Lowy was appointed the Dean of the Faculty of Medicine, succeeding Dr. Richard Holmes. During his tenure as Dean, Dr. Lowy not only strove to train excellent physicians and promote meaningful research, but also wanted to instill “a broader sense of what medicine was about, in addition to the technical features—the art of medicine, the human aspects.” At the time, no formal bioethics course was offered at the University of Toronto. So when Dr. Lowy learned that a group of medical students, among whom was Peter Singer (who went on to be appointed Officer of the Order of Canada for his contribution to research in health and bioethics) was organizing voluntary ethics lectures, he was astonished. He recalls thinking, “If it is important enough for students to do this on their own time, as a faculty we ought to be doing this in a more formal fashion.” This marked the beginning of what would become the JCB.

Having completed his term as Dean, and with the idea of creating a formal bioethics program, Dr. Lowy looked to the United States, where the field of bioethics was more developed. Specifically, he traveled to Georgetown University’s Kennedy Institute of Ethics as a visiting fellow to learn from Dr. Edmund Pellegrino, the founding director of the Center for Clinical Bioethics at Georgetown, now known as the Edmund D. Pellegrino Center for Clinical Bioethics. After a year at the Kennedy Institute, Dr. Lowy returned to Toronto, ready to establish Canada’s first formal bioethics program.

During that time, Dr. Lowy was also a faculty member at the IMS, which placed him in a perfect position to begin developing the Centre for Bioethics. Dr. Lowy assembled a group of colleagues at the University of Toronto to be the driving force behind this project, including Bernard Dickens (Faculty of Law), Barry Brown (Department of Philosophy), James Till (Department of Medical Biophysics), and the late John Senn (Faculty of Medicine), along with two graduate students (Peter Singer and Eric Meslin), and administrative support from Carol Nash. “Initially, we had no budget and no physical location,” recalls Dr. Lowy. “Dr. Silverman [director of the IMS at the time] was cooperative and gave us space in the Medical Science Building.” And so, the Centre for Bioethics came into existence in 1989, with Dr. Lowy at the helm as Director. “We started with lectures and then went on to develop formal programs. When we outgrew the accommodations, we got space in the adjoining Tanz Neuroscience building [now known as the C. David Naylor building]. As the program grew further, we went on to occupy a former church at the corner of Elizabeth St. and College.” Today, the JCB resides at 155 College Street, in the Dalla Lana School of Public Health.

“[The Centre] operated on a shoestring budget at first,” recalls Dr. Lowy, “with everyone being kind enough to donate their time.” A joint effort between numerous departments at the university, the establishment of the Centre occurred at a fortuitous time, when interest in and demand for a formal bioethics program was growing. “I’m amazed at how little resistance there was, especially because we had no formal mandate from governing council,” said Dr. Lowy. “I was also fortunate enough that I had personal relationships with a number of people at the university that allowed me to establish the program.” One of the first significant sources of funding for the Centre came in the form of a Government of Ontario grant for over $2 million. “As soon as we started writing papers and getting students, the university took notice and we were able to get things formalized through IMS and the Faculty of Medicine,” Dr. Lowy recounts. “As the program expanded, it entered the mainstream. And under the direction of Dr. Peter Singer [who succeeded Dr. Lowy as Director of the Centre], we formed our first partnerships with the local hospitals.” Today, the JCB has formal partnerships with nine academic departments at the University of Toronto, as well as 13 partner organizations in the health center. The Centre has also trained over 150 students, published more than 500 articles, and obtained $28 million in research grants.

Although Dr. Lowy stepped down as director of the Centre for Bioethics in 1995, he continued to be active in the field of bioethics, serving as the first Chair of Canada’s Tri-Council Working Group on Ethics of Research on Human Subjects. His work with the Tri-Council was a coast-to-coast effort to consider the ethical aspects of healthcare and the problem of research involving human subjects. “Without research with human subjects, the progress that we take for granted would not occur. At the same time, one has to be respectful and careful concerning the rights of patients or any human being who is subject to potential risk,” states Dr. Lowy. “We took what we considered to be the best of any existing codes, for example the Nuremberg Code, and we tried to hammer out a set of regulations for Canada. The core of these recommendations is still a part of the current guidelines around research with human subjects.”

The field of bioethics in Canada continues to evolve with new healthcare legislation, such as Bill C-14 on medical assistance in dying, introducing unique ethical considerations. Today, under the direction of Dr. Jennifer Gibson, the JCB continues to expand and is undoubtedly a leader in its field.

Dr. Lowy left Toronto for Montreal in 1995 to serve as President and Vice-Chancellor of Concordia University. Since then, he has returned to Toronto and is a Senior Fellow at Massey College.