When students first arrive at medical school, they expect to dive right into the hard science that will form the basis of their medical knowledge. This year, Rebecca Bigoney, M’79, got the chance to show incoming first-year students another side of medicine that is equally important, yet often overlooked by students early in their medical education. This fall she returned to the MCV Campus to talk about medical ethics and the puzzling dilemmas the members of the Class of 2019 will assuredly encounter at some point in their careers.
Bigoney has confronted a wide variety situations involving medical ethics over the course of her career, which includes 18 years in private practice and a term as vice president of medical affairs at Mary Washington Hospital in Fredericksburg, Va., where she now works as chief medical officer.
She shared some of her experiences with students as a guest speaker for the “Patient, Physician, and Society” curriculum. Her talk illustrated the complex situations that doctors can encounter at what Bigoney called “the intersection of ethics, liability, policy and reality.”
She told the stories of a patient who declined kidney surgery because a travelling preacher told her she had been cured, factory workers exposed to dangerous heavy metals with no protections from their company and a wife who tried to interfere with her husband’s treatment because of the race of his doctor.
These types of situations, Bigoney explained, require doctors to weigh medical, ethical and procedural decisions to arrive at acceptable, though often imperfect, conclusions.
For many of the assembled students these were new situations and questions they hadn’t previously considered. Students asked frequent questions throughout Bigoney’s presentation, wanting to clarify the decisions she’d made to resolve certain situations. At a student’s prompting, she walked the class through her logic in a hypothetical mass casualty situation — which patients would receive priority, how limited hospital resources might be divided up and how legal liability factors into such decisions.
Bigoney made sure to remind the students that “the ethical problems you face most likely will not be catastrophic or dramatic like the ones I’ve described, but you’ll encounter ethical challenges every day.”
Mark Ryan, M’00, an assistant professor in the Department of Family Medicine, was also on hand to help facilitate the presentation. He praised Bigoney for showing students that “being a good doctor is more than knowing biochemistry or physiology — it is about learning to work with people, and the often complicated and difficult situations in which they find themselves.”
Even after the presentation was over, students lined up to ask her questions one-on-one. Although they may be years from having their own patients and making ethical decisions on their own, the Class of 2019 showed Bigoney that they intend to fully explore these complex questions so that they too can make the right ethical decisions when the time comes.
By Jack Carmichael