Bioethics and academic freedom: thoughts on the “Bad Girls” case

Bioethics-in-the-News-logoThis post is a part of our Bioethics in the News series. For more information, click here.

By Monica List, DVM, MA

In early 2014, Atrium (Northwestern University’s Medical Humanities and Bioethics Journal) published a special issue entitled “Bad Girls,” edited by that university’s medical historian Alice Dreger. The issue presented a series of articles showcasing women (or groups of women) who defied norms and established practices in the realm of health and healthcare. As expected, most of the articles were provocative, but one article in particular, “Head Nurses” by William Peace, proved to be more inflammatory than the rest. The article is a personal narrative of the author’s experience as a young, newly disabled person, questioning the extent to which his disability would change his life, and specifically his sexuality. Peace addresses a number of sticky issues, including intimate relationships between patients and healthcare providers, and the lack of attention to the topic of sexuality in the disabled population. However, it was perhaps Peace’s explicit description of an intimate encounter with one of his female nurses (the “bad girl” in this story) that sparked the controversy eventually leading to Northwestern University’s censorship of the issue and subsequent removal of Peace’s article from the journal’s online version (note: after pressure from “Bad Girls” editor Alice Dreger, the full online version of the issue was made available again; however, due to Northwestern’s establishment of an Atrium oversight committee, the journal is currently on hiatus by decision of the editorial board).

Silence, Censor, Restraint
Image Description: An individual with light skin, brown hair, and a large piece of tape covering their mouth stands in front of a wall that is covered in writing. Image Source: Kayla Sawyer via Flickr

Peace’s article presents a wealth of interesting bioethical issues, but here I will focus on a broader discussion of academic freedom sparked by Northwestern University’s censorship, and more specifically the question of whether professional organizations should play a more active role in defining and defending academic freedom. Per the American Association of University Professors (AAUP) 1940 Statement of Principles on Academic Freedom and Tenure, university faculty are free to conduct research and present results (limited by considerations of profit), to teach their subject and hold related discussions (as long as unrelated or unnecessary controversy is not introduced), and to express themselves as citizens, without the constraints of censorship or disciplinary action from their institutions. With regard to this last point, the AUUP Statement clarifies that in addition to institutional duties and regulations, academics may be bound by special obligations, including professional duties.

While a great number of professional organizations have endorsed the AAUP Statement, few (if any) have issued their own statements or guidelines on academic freedom (note: the American Society for Bioethics and Humanities bylaws- Article III, section 2.3 state: “The Society may adopt positions on matters related to academic freedom and professionalism in the fields of bioethics and humanities in health care upon an affirmative vote of two-thirds (2/3) of the full Board of Directors. The Board may consider a position on its own motion or upon request in writing signed by fifty (50) members eligible to vote,” but no further guidance is provided). Given the nature and political implications of bioethics, would bioethicists benefit from a more specific set of guiding principles in their exercise of academic freedom? The Atrium case provides good evidence that the answer to this question is yes.

The controversy over Northwestern’s censorship of the “Bad Girls” issue was featured in various media outlets, including The Huffington Post, The Chicago Tribune, and Inside Higher Ed. The professional bioethics community was less keen to respond, judging by the number of related articles and posts published in bioethics journals. A search through the journals listed on the American Society for Bioethics and Humanities website revealed only one result, a blog post by Rachelle Barina and Devan Stahl featured on the American Journal of Bioethics blog, but this response focused more on the content of the article than on the matters of censorship and academic freedom. Of course, since bioethicists are spread across multiple disciplines and professions, they could be discussing this in places other than bioethics journals, but it is more likely that they were simply silent on this matter (note: the Journal of Nursing published a reprint of Lisa Black’s Chicago Tribune article in their July 2015 issue). If this were the case, it would not be the first time that bioethicists were accused of being silent on an issue that warrants their attention, and more importantly, their voices. In “The Silence of the Bioethicists,” J.L. Nelson (1998) wonders why, until then, bioethicists had remained remarkably silent on the topic of transsexualism. Bioethicists’ relative silence continued for a number of years, prompting Nelson to revisit the topic in a related article in 2012. Although the connection between these publications and the matter at hand may not seem obvious, I see relevant links. Nelson’s proposed causes for the silence of bioethicists on matters of transsexualism may well apply to their silence on academic freedom in this case. Nelson (1998) argues that our focus on individual autonomy and moral agency often overshadows the importance of the social and political structures that distort that agency.

If academic freedom is defined and exercised as the ultimate expression of agency and autonomy, would it not be paradoxical for bioethicists to restrict it by establishing guiding principles? Perhaps yes, but it is an avenue worth exploring, given the importance of academic freedom in allowing scholars to address difficult (and often uncomfortable) issues without fearing for their livelihoods or even their personal safety. For these reasons, the guidance and backing of a professional organization would be of great value in overseeing, but not silencing or censoring their work.

list-cropMonica List, DVM, MA, is a doctoral student in the Department of Philosophy at Michigan State University. She earned a veterinary medicine degree from the National University of Costa Rica in 2002, and an MA degree in bioethics, also from the National University, in 2011.

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  1. Atrium: The Report of the Northwestern Medical Humanities and Bioethics Program. Winter 2014 issue.
  2. American Association of University Professors. 1940 Statement of Principles on Academic Freedom and Tenure.
  3. American Society for Bioethics and Humanities. Bylaws. Revised August 2015.
  4. Kingkade, T. (2015, June 17). Northwestern Faculty Magazine Censored Over Article About Nurse Blow Job. Retrieved August 10, 2015, from
  5. Black, L. (2015, June 17). Story of sex with nurse prompts censorship claims at Northwestern. Retrieved August 10, 2015, from
  6. Flaherty, C. (2015, June 17). Faculty members claim university made them remove a controversial journal issue from its website. InsideHigherEd. Retrieved August 19, 2015, from
  7. Barina, R., & Stahl, D. (2014, April 17). Blowing up bioethics: a response to Atrium’s Bad Girls and Head Nurses. Retrieved August 19, 2015.
  8. Nelson, J. L. (1998). The silence of the bioethicists: Ethical and political aspects of managing gender dysphoria. GLQ: A Journal of Lesbian and Gay Studies4(2), 213-230. 
  9. Nelson, J. L. (2012). Still quiet after all these years. Journal of bioethical inquiry9(3), 249-259.