Dr Andrew Papanikitas
Dr Andrew Papanikitas is a Module Co-ordinator for Ethics for Bioscience. He also teaches on the MSc EBHC modules History and Philosophy of Evidence-Based Medicine, and Introduction to Study Design and Research Methods.
What was your earliest ambition?
My earliest ambition was to read and enjoy as many storybooks as possible, to be an astronaut, to be a doctor, to be an actor, to play Doctor Who on TV, to be a doctor, to be a GP, to be a teacher. Depends who you ask…
Who has been your biggest inspiration?
Honestly? BBC television’s Doctor Who – someone who can be quintessentially British and yet cosmopolitan – a humane and fallible hero who observes humanity from the outside and is prepared to engage with it as well. But he is also someone who can resurrect himself anew when defeated – capable of both change and resistance. A love of sci-fi, history, language and literature is also very useful when teaching Bioethics!
Why did you get into EBM?
Aside from the EBM that is the bedrock of modern medicine, I’ve been more involved with EBM since joining the department and teaching the Ethics for Bioscience module. Ethics education is not always recognisably evidence-based – how do you get evidence to show that duties outperform regard for consequences, or whether a virtues-based approach to practice is better? The evidence for ethics education is largely based on consensus statements about useful topics and useful philosophical methods. Evidence-based ethics that might be recognised by the medical ethicists takes the form of good arguments that rely on good moral values and good factual data – unfortunately in any area of debate the arguments, the values and even the data may be contested!
What do you feel has made the most difference in EBM?
A constant reminder that the best evidence is that which best answers the question. As an ethicist many of the questions I ask (or attempt an answer at) cannot always be answered by statistical data, and a meta-analysis of randomised controlled trials may be less appropriate than a rigorous ethnography. The approach of Iain Chalmers and others to question the administrative excesses of research review and the ethical need for equipoise – are you wasting resources proving something that has already been proven? – is also refreshing. If you are a researcher and the term equipoise is a new term – look it up! It is a critically important idea and underlies the emphasis on systematic literature reviews.
Describe your approach to research in three words.
Imagination, collaboration, perseverance.
What do you like most about teaching?
Students and the classroom discourse, whether this is online or face-to-face.
Do you have any regrets about becoming a doctor?
I would have liked to have been an actor on stage and a chef. Whilst I still experiment with home cuisine, the performance and the tension between principle and recipe have become metaphors in my teaching and research. Always happy to discuss this further over a coffee!
What has been your most innovative piece of teaching?
Next month I am trying a flipped classroom for the first time. A couple of years ago I interviewed Baroness Mary Warnock about the committee that considered the law regarding human fertilization and embryology. I asked her about how philosophy, culture and science met in the shaping of UK government policy. The class will be able to access the interview either in audio or transcript form. They will then use the classroom to discuss her experience as a philosopher involved in shaping bioscience policy at a national level. I am doing the Oxford Learning Institute’s diploma in teaching and learning at present, however, so expect the possibilities for innovation to unfold in further teaching!
When are you having the most fun at work?
Teaching people who want to learn and seeing them take ideas and make them their own. It could be a patient who learns how to safely self-manage a minor illness, a medical student who suddenly gets the relevance of the sociology lectures or a senior educator who better understands the ethical undercurrents of contemporary healthcare practice.
If you weren’t a doctor/teacher what would you be doing instead?
I would have written a few novels alongside an editorial career – the novels would venture into fantasy and crime genres – I reckon everyone has an award-winning children’s picture book inside them. I am reasonably confident that I would still be a university academic – possibly a social historian.
What do you find hardest when teaching?
Teaching is time when you are not doing anything else – everything requires squeezing around it. Moreover good teaching often requires considerable preparation, planning, reading, consideration of feedback etc.
If you were given £1 million for research, what would you do?
I would use it to seed the first centre for primary healthcare ethics. This would draw on expertise from academic medicine, philosophy and law, the social sciences, the humanities and most importantly medical education. Bringing these groups together offers a shot at what is sometimes called translational bioethics – getting a conversation between classroom and clinic. Oxford is a particularly great place for such a centre, because institutions like the Health Experiences Research Group offer vicarious access to patient-narratives and the expertise to involve patients more meaningfully in bioethics research.
What one resource should every EBM enthusiast read?
Only one? I am a little torn – I’d recommend Jeremy Howick’s book The Philosophy of Evidence-Based Medicine. Understanding something is often I find the key to doing it well. For new enthusiasts I’d recommend either Trish Greenhalgh’s How to Read a Paper or Carl Heneghan and Douglas Badenoch’s Evidence-Based Medicine Toolkit. Then on to the collected works of Sackett, Glasziou, Chalmers et al!
For more interviews in this series, please click here.