Reflections from an intern in clinical ethics

This is the fourth in running chain by Center for Medical Ethics and Health Policy Summer Interns, Undergraduate/Postgraduate students interested in emerging ethical issues.

“How to become a clinical ethics expert” is a phrase I’ve Googled more times than I’d like to admit. My interest began after attending a lecture on bioethics at a national student leadership conference during my junior year in high school. The lecturer presented the intricacies of the medical decision-making process as well as the four pillars of bioethics: autonomy, benevolence, do no harm, and justice. I was immediately impressed.

In the years since, I’ve tried to learn about the different guidelines and recommendations that professional advice sites should offer about what it looks like to be an expert in clinical ethics. However, no Google search could give me the answers and confidence that I found during the 8 weeks Clinical Ethics Training at Baylor College of Medicine.

The bulk of the training activities took place in the Neuro, Cardiovascular, and Cardiac Intensive Care Units at Houston Methodist, where my fellow intern and I followed the various faculty through hospital tours, family meetings, and conversations with each patient’s care team.

Start each morning with hospital rounds or check in with a caregiver who counseled ethics. These meetings provided information about the patients we would then use while speaking with their families. Most of our conversations with families involved articulating values, as ethicists focused on knowing a patient’s identity before they became incapacitated in order to understand more about the kinds of health care decisions they would likely make for themselves.

Outside of the hospital, I have also spent my time as an intern attending a variety of meetings and participating in directed research with faculty at the Center for Medical Ethics and Health Policy. Each week, I observe and participate in handover meetings with the team at Baylor Saint Luke’s Medical Center and those at Houston Methodist, where an ethicist on call shares information about active cases to their colleagues who will replace them during the week. Other meetings included center check-ins, journal club discussions, fortnightly debriefings, fellowship seminar series and Texas Ethics Consortium gatherings.

These activities allowed me to interact with ethicists from different backgrounds such as medicine, law, philosophy, theology, and sociology. As part of my research, I was paired Dr.. Janet Malik And the Dr. Trevor Peepler Based on my interest in the field. With their guidance, I was able to dive deeply into genetic modification, parental commitment, reproductive ethics and the impact of spirituality on medical decision-making.

Each day was different than the day before, but I found comfort in asking as many questions as possible and saying yes to everything. I scheduled one-on-one meetings with several faculty members to discuss my educational and career path, stayed in the hospital whenever possible and asked to attend meetings that were not on the itinerary given to me at the beginning of my internship. Two things that have remained true during my time at Baylor are that I have gained a treasure trove of knowledge and the firm commitment of everyone at the Center to invest in the future of this field.

Before my arrival at Baylor, I of course had expectations and assumptions regarding the experiences I was about to have. In that sense, I was quite surprised to see how quickly the clinical aspect of the job could be, and I was astonished by the deep and thoughtful analyzes that played a part. My prior understanding of clinical ethics led me to believe that this was a very fractious field, so I was pleasantly surprised by the camaraderie and collaborative environment in which I was immediately welcomed.

Time and time again, the faculty and colleagues I worked with reminded me that I am not alone in my confusion and uncertainty about what lies ahead, and reassured me that there are always people there to support me along the way. They taught me that it’s okay to ask questions and that sending a cold email to people is more common (and less scary) than I thought.

My colleagues and my experiences at Baylor have taught me that you learn the most from the people around you. As a college student, I realize that most of what I’ve learned about my career field will happen outside of the classroom, something I hadn’t experienced yet before this internship. Everyone you meet can teach you a lot if you listen to their stories, ask them meaningful questions, and watch their eyes light up when they solve a problem or talk about their interests.

I joined this internship with the hope of solidifying my career goals and engaging in exciting conversations with people I share interests with. While I think I’ve achieved these goals, I’m leaving after learning a lot about who I am, who I want to be and how I’m going to get there.

Clinical ethicists give voice and concern to people who cannot share or express their own desires. I think the significance of this appeals to Gen Z people like myself, who want to make big impacts on the world around them.

Emily Beau, Clinical Ethics Intern, Center for Medical Ethics and Health Policy at Baylor College of Medicine; Graduated from California State University, Long Beach

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