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Ethics in Health-Care

New charitable trust helps more students study bioethics with the Markkula Center for Applied Ethics

An elderly woman from a nursing facility is admitted to a hospital with a life-threatening illness. She is unable to discuss treatment options or make health-related decisions; no one has visited her in years and family telephone numbers on record are no longer in service. With no one to speak for her, how do medical professionals provide the care that is in her best interest?

“This is a dilemma that we’re seeing more and more,” explained Margaret McLean, associate director of SCU’s Markkula Center for Applied Ethics and director of the Center’s bioethics program. “People are living longer; they’re geographically detached from family, and they’ve lost touch with friends and relatives.”

Moved by the heartbreaking plight of such patients, an SCU alumnus and his wife set up a $2 million charitable trust to help fund health-care ethics – ensuring that work undertaken by the University’s bioethics program will continue long after the two of them are gone.

The anonymous donors have long been “extremely passionate about medical ethics,
especially concerning end-of-life issues affecting the poor,” according to Susan Lucas, senior director for development at the Center.

Now infirmed themselves, the donors are relying on their two adult children to administer the fund. “This is a multi-generational estate gift,” said Lucas. “The couple’s children are carrying out the wishes of their parents.” She explained that the Center recently accepted a $500,000 advance from the family’s trust. Going forward, the bioethics program will receive regular interest payments from the funded endowment. “This family’s generous, ongoing gift means we can count on our work continuing in perpetuity,” Lucas noted.

When the program began 20 years ago, Center staff formed a partnership with
O’Connor Hospital in San Jose to act as consultants on ethics questions that typically arise in a hospital setting. Today, that partnership is flourishing, and several others are in place at nearby health facilities. Bioethics program staff members also teach core curriculum courses, conduct research on emerging health issues, and work with local medical teams to provide competent, sensitive care for cultural subgroups.

A major component of the bioethics program is its innovative internships for undergraduates who are thinking about medical careers. Launched in 2001, the internship program takes students to hospital and hospice settings where, during the course of an entire school year, they observe and interact with medical professionals, social workers, chaplains, patients, and families.

“They learn firsthand about ethical dilemmas,” explained McLean. “They’re in the middle of it all – all the joys and angst that people go through; they’re out of the classroom and into a context in which real-life decisions are made.” Mostly, she continued, “our students are observing families and patients dealing with end-of-life issues – and all too often, there are patients who are alone and can’t make their own decisions; it’s an increasing problem.”

McLean said the Center’s internship program is unique in the U.S., and it sets the University’s bioethics program apart from other, larger medical-ethics centers. “Usually, you see interns, residents, and bioethics graduate students talking with patients and families and participating in ethics case consultations,” she explained. “Our vision is to educate our students to be persons for others. Even if these students don’t become health-care professionals, they will at some point have to make ethical treatment decisions – that’s a life skill worth learning.”

Some 150 undergraduates have gone through the internship program since it began, and in biweekly reflection sessions, many of those students have described the impacts of their experiences. Briana Britton ’13, a program participant last year and an aspiring doctor, said the health-care ethics internship was a chance to live up to the Jesuit model of serving others.

“You have the opportunity to shadow doctors and physicians and really be present to other peoples’ situations – sometimes they’re really challenging – but for me, it was a growing experience because I was able to learn how to be present with others’ challenges,” noted Britton. “It was a really formative experience for me as well, as a future medical professional.”

Both Lucas and McLean are hoping to use some of the new, donor-provided funding to expand the internship program, which is currently open to only 15 students.

“Many more than that are applying for it,” said Lucas. “They see it as a life-changing experience.”

These funds will continue to support the Center's student fellowship in health-care ethics, which is awarded yearly to an outstanding graduate of the internship program.

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