Santa Clara University

Ethics, Life, and Death

Maria Miranda '06 always had an interest in medicine. But until her junior year at SCU, she hadn't seen many real issues or real patients first-hand. As an intern in Santa Clara's Healthcare Ethics Internship Program, Miranda spent a year at a local hospital, shadowing doctors and nurses and learning about the ethical challenges they face each day.

O'Connor Hospital, operated by the Daughters of Charity, is Santa Clara County's oldest hospital. The partnership with SCU began in 1994, with the Markkula Center for Applied Ethics providing resources to hospital staff. The ethics internship program began in 2001.

The healthcare internship at O'Connor is open to all undergraduates, particularly those interested in medical careers, and about 15 students participate each year. Although the students get valuable exposure to clinical procedures, the most important goal is teaching future medical professionals to think ethically about patient care.

Margaret McLean, Ph.D., director of biotechnology and healthcare ethics for the ethics center, is the founder and director of the internship program. "[Students] have the opportunity in a safe space to think and approach these questions," she says, noting that the interns are primarily observers in charged situations. "It's not their mothers, not themselves, not their patients."

Now a first-year medical student at Dartmouth, Miranda appreciates the empathy she was able to build for patients in critical moments. "Emotions are always running high. Patients and their families are totally overwhelmed by the commotion around them. I understand how difficult it would be to make tough decisions in this environment," she says.

Rotations at O'Connor are only part of the curriculum; the program also includes regular meetings where the interns meet to recount the cases they've encountered. Ethics center staff, like McLean and Health Care Program Coordinator Susanne Lee, help the students identify ethical issues, examine differing viewpoints, and negotiate their emotional responses.

"They talk a lot about end-of-life decision making, organ transplants, and health care access," says McLean. These larger social issues are as much a part of a compassionate, conscientious physician's life as biology and diagnostics.