Eight Questions with GE3LS Researchers – Dr. Vardit Ravitsky

Vardit Ravitsky, Ph.D.
Associate Professor, Bioethics Programs
School of Public Health
University of Montreal

1. Where did you grow up?
   • I grew up in Jerusalem, Israel, in a Jewish modern-orthodox family, embedded within a homogeneous tight-knit community that was culturally rich. The only emphasis in our family was on education and scholarship. We were never encouraged to pursue jobs that make money, but rather careers that will challenge us intellectually and allow us to grow. As a young girl, I thought that being a philosopher is the most prevalent occupation, because I was completely surrounded by academics from this field. My uncle, who is like a second father to me, is a philosopher and one of Israel’s leading intellectual figures, and all the ‘kids’ ended up in the humanities, including my brother who is a professor of – surprise! – Jewish philosophy. Funnily enough, in my family I’m considered the ‘black sheep scientist’ because what I do is very applied and includes empirical research.
2. Apart from your present one, what’s the best job you ever had?
   • Perhaps not the best (because it was really difficult), but the most challenging job I ever had was actually what I did for my military service. Israel has obligatory conscription, which means that after high school everyone becomes a soldier for 2-3 years. So at 18 I joined the army like everyone else. I got quick training as a teacher and then went on to officers’ course. As a 19-year-old Lieutenant I found myself serving as the principal of a small school. The students were ‘career soldiers’ who, at a young age, were forced to drop out of school to support their families. The army was giving them the opportunity to get a high school diploma. They would spend 6 months with us, studying full time while still getting their salaries. They were 10-20 years older than me, experienced soldiers who found themselves in the middle of life facing books and homework, and having to follow every order given by the higher-ranking but young and inexperienced school principal (uhm, me). I was terrified inside, of course, and faking my authoritative posture. Looking back, I’m not sure how I survived it, but the lessons I’ve learned serve me to this day.
3. What’s your academic/research background? How did it lead you to GE³LS research?
   • My academic background is in philosophy. I did my BA at the Sorbonne University in Paris because I thought everything sounded better in French. Little did I know that decades later, this language will open doors for me in Canada. I then did my MA in the US, and at that point was already drawn to bioethics and specifically to reproductive ethics, which is my field to this day. My MA supervisor, who later became a lifelong mentor and emotionally a second mother, opened my eyes to the richness and nuance that philosophy can bring to the most pressing real-life issues in medicine.  I then went back to Israel and was the first student to graduate from Israel’s first PhD program in bioethics (within a philosophy department).My PhD thesis was already in GE3LS – I asked what ethical principles should guide our choices if we ever have the technical capacity to edit the DNA of embryos. At the time it was a science fiction question. Now, CRISPR makes it real and urgent. Interestingly, I have never held a position in a philosophy department. I did my postdoc at the NIH and then got an academic position at U Penn’s School of Medicine. So while I’m a ‘philosopher by training’, this is not how I define myself. I call myself a ‘bioethicist’, which captures much more accurately my career path.
4. How would you describe your research to a group of Canadian students? Why is your work important to them?
   • My research explores the ethical, social and legal implications of advances in genomics and reproductive technologies. My team uses conceptual (philosophical, normative) analysis, comparative policy analysis, as well as empirical methods such as surveys and interviews, to better understand how we should – or should not – implement emerging biotechnologies. We look at, for example, new uses of IVF, pre-implantation and prenatal genetic testing, germline gene editing, amongst others. We explore arguments for and against certain uses of these technologies. We study their impact on the lives of individuals, families and communities. We seek ways to better inform the users of such emerging technologies – patients and clinicians. And we try to produce knowledge that would be helpful to regulators and legislators when they make policy decisions.This means that we need to be – at least – good ethicists (know how to make strong consistent theoretical arguments); good social scientists (master empirical methodologies to explore what people want, what their concerns are, and what role cultural values play); and good legal/political science scholars (know how to analyse policies and how to make recommendations that resonate with decision makers). That’s why I talk not about ‘my’ research, but rather about the research of my team. We need the brain power and the inter-disciplinary expertise of a team to tackle such complex undertakings. I’m lucky to be working with brilliant and very knowledgeable colleagues and students who keep me on my toes every single day.
5. What kind of response has there been to your research? What impact have you seen?
   • The kind of work that we do is particularly rewarding because we see its impact in the very short term. Take, for example, the work we did through the PEGASUS project on the implementation of a new technology for prenatal genetic testing, through detection of fetal cell-free DNA in the blood of the pregnant woman (NIPT). Our ethical-legal-social work was embedded within the scientific part of the project that looked at the reliability of this new test, and within the economic part of the project that checked how much its implementation will cost the healthcare system.Shortly after we delivered the results of our project, the Quebec government decided to cover the cost of the test for some pregnant women based on our recommendations. Other provinces are considering our results as well. This means that our study led directly to more women having access to a test that is safer for their pregnancies (involves no increased risk of miscarriage), a test they wanted but some could not afford. Our GE3LS work allowed us to promote women’s informed decision-making and to inform the government about the societal implications of this new test, so that it can be offered responsibly. We have seen similar impact in other areas, such as IVF, where the outcomes of our research inform clinical practice in a very real way.
6. What’s the most unusual or unexpected thing about your work as a GE³LS researcher?
   • To me, the most unexpected aspect is the ‘knowledge translation’, particularly the production of informational materials based on the outcomes of our research. For example, we are creating a website for pregnant women, their partners and their healthcare providers, to help them make informed decisions about prenatal testing. This means that we’re producing videos, writing accessible materials for the general public, and designing online interactive tools to help people process enormous amounts of relevant information and think through it as they make their decisions. I’m not a graphic designer, or a video producer, or trained to write informational materials for a lay audience, but I find myself doing all of these things. This is in collaboration with my research team and hired professionals, of course, but still – it’s challenging and often scary to take on such a responsibility. At the same time, it’s creative and fun in ways that I never expected when I chose to be a researcher.
7. What do you think is the biggest issue facing genomics in the next decade?
   • I must name two. The first is gene editing, especially of the germline (sperm, eggs and embryos), that will give us unprecedented control over the course of the evolution of our species. If successful, it may usher in a new era of medicine. And if not, it may cause a lot of harm before we decide to pull the plug.The second is whole genome sequencing, which is already here and at a fast-reducing cost. It is forcing us to face enormous challenges in clinical practice (for example, what to do with incidental genetic findings) and in policy making (for example, how to protect the privacy of citizens when their entire genome can be used for anything from forensic identification to public health promotion). To me, one of the most intriguing aspects of whole genome sequencing is what to do when prospective parents wish to use prenatal non-invasive testing to get their hands on the entire genome of their fetus. This could lead to children being born with their entire genome ‘exposed’ without their consent, including any disease-causing mutations, increased risk, or even the genetic basis of non-medical traits. I find this prospect intimidating, but maybe in 20 years we’ll think of this as a routine part of having children.
8. Finally, we’re all going out later for karaoke. What song do you sing and why?
   • Don’t stop me now, by Queen. It’s a song that has been getting me going for many years. And it may sound corny, but in recent years when I sing along with it (usually in the car, doing the Wayne’s World thing) I also think about my research. I’m “having such a good time” that I really hope nobody stops me for many years to come!