Elective Rotations: Bioethics

This is the third in our series about student elective rotations.  Second year students in the UC/CCHMC GCP who are on track to complete their clinical logbook requirements are given the option to develop their own elective rotation.  Students choose these rotations based on their interests or on skills they would like to obtain.  Along with input from program faculty, they develop the learning objectives and outcomes for their rotation.  Previous elective rotation posts were about the International Adoption Center and Starshine Hospice.

Throughout my education I have made a conscious effort to supplement my science background with opportunities to engage in critical thinking from outside a scientific perspective. I feel it is important for me to remain well-rounded and I think developing myself in and out of hard science will help me better serve my patients in the future. During my undergraduate education, I achieved this by obtaining a minor in Philosophy to balance out my major in Human Biology. UC’s Genetic Counseling Program has allowed me to continue this personal development with an elective rotation in Bioethics at Cincinnati Children’s Hospital. Aside from rounding me out as an individual, my rotation in Bioethics has allowed me to critically examine ethical dilemmas and understand how an Ethics committee works through cases to come to their recommendations. As with any medical specialty, ethical dilemmas arise in genetics. In fact, NSGC has an ethics advisory committee, made of up Genetic Counselors with an interest in this area, which I hope to one day be a part of.

I was fortunate enough to rotate with the Cincinnati Children’s Hospital Ethics Committee for the entire academic year, steadily increasing my involvement as the year progressed.  The Ethics Committee is an interdisciplinary team made up of doctors, nurses, pastoral care, social workers, lawyers, and even parents and families from the community. Ethics consultations can be requested by any hospital employee, patient, or family member. When an ethics consultation is requested, that request is first reviewed by a committee member to ensure that it is within the scope of practice for the committee. Next, the consultation is assigned to two committee members and they begin gathering information. Once all information is gathered, the consultation is presented to the consult team (a subcomponent of the Ethics Committee) for discussion and development of recommendations. 

I began my rotation by observing the committee meetings, where we discussed cases that were at or near their resolution. These meetings are opportunities to get a wide array of opinions on a topic and take the time to learn important lessons from each case. I later began attending the consultation meetings, in which new and ongoing consultations are discussed among the smaller consult team. Here I was able to get a glimpse into the process of coming to a recommendation on difficult cases that are currently developing.

My next step is to attend consultations when they are called, which would be an opportunity for me to follow a case from start to finish and see the evolution of ideas as the case is discussed in the meetings.

Overall this rotation has been a wonderful learning experience and has allowed me to push myself to continue my well-rounded education and to grow as a professional. I know the principles I learned in this rotation will allow me to better understand the process of ethical decision making and make more informed decisions when faced with an ethical dilemmas as a practicing genetic counselor and I will be able to understand when I need to get a hospital committee involved in the decision-making process.

--Sara Fernandes