I am a medical student at Stanford University concentrating in biomedical ethics and medical humanities. Prior to beginning my medical studies, I received a BA in University Scholars from Baylor University and an MA as a Theology, Medicine, and Culture fellow from the Duke University Divinity School.
I am currently interested in studying (1) the influence of norms/cultures on communication and decision-making practices, (2) how adopting the perspectives of linguistic anthropology and philosophy of language can provide insight into patient-physician and physician-physician miscommunication, (3) the impact of institutional design choices (e.g., EHR menus, policy documents) on physician practices, and (4) how the tension between patient autonomy and physician beneficence is negotiated in various sociocultural contexts (e.g., different states, different institutions, different specialties).
Clerkship Ethics: Unique Ethical Challenges for Physicians-in-Training.
HEC forum : an interdisciplinary journal on hospitals' ethical and legal issues
Three ethical conflicts in particular are paradigmatic of what we define as "clerkship ethics." First, a distinction that differentiates the clerkship student from the practicing physician involves the student's principal role as a learner. The clerkship student must skillfully balance her commitment to her own education against her commitment to patient care in a fashion that may compromise patient care. While the practicing physician can often resolve the tension between these two goods when they come into conflict, the clerkship student is left with a more ambiguous set of choices. Second, evaluative scrutiny during clinical clerkships often forces medical students to balance doing what is morally fitting against the perceived expectations of the medical teams in which they work. Third and finally, a deeply entrenched culture of medical hierarchy presents a particular challenge to innovation and improvement in ethics education during the clerkship years. Students regard faculty as exemplars, but are not provided with the tools to assess when technical medical competence is not matched by moral competence; moreover, these faculty are unlikely to have experienced the ethics education in which students are asked to demonstrate mastery.
View details for DOI 10.1007/s10730-020-09400-0
View details for PubMedID 32185597
Recognizing the Role of Language in the Hidden Curriculum of Undergraduate Medical Education: Implications for Equity in Medical Training.
Academic medicine : journal of the Association of American Medical Colleges
Medical education involves a transition from "outsider" to "insider" status, which entails both rigorous formal training and an inculturation of values and norms via a "hidden curriculum." Within this transition, the ability to "talk the talk" designates an individual as an insider, and learning to talk this talk is a key component of professional socialization. This article uses the framework of "patterns of medical language" to explore the role of language in the hidden curriculum of medical education, exploring how students must learn to recognize and participate fluently within patterns of medical language in order to be acknowledged and evaluated as competent trainees. The authors illustrate this by reframing the objectives for medical education which are outlined by the Association of American Medical Colleges as a series of overlapping patterns of medical language which students are expected to master before residency. We propose that many of these patterns of medical language are learned through trial-and-error, taught via a hidden curriculum rather than through explicit instruction. Medical students come from increasingly diverse backgrounds and therefore begin medical training further from or closer to insider status. Thus, evaluative practices based on patterns of medical language, which are not explicitly taught, may exacerbate and perpetuate existing inequities in medical education. This article aims to bring awareness to the importance of medical language within the hidden curriculum of medical education, to the role of medical language as a marker of "insider" status, and to the centrality of medical language in evaluative practices. We conclude by offering possible approaches to ameliorate the inequities that may exist due to current evaluative practices, and call for further discussion and innovation to explicitly address the role of language in the hidden curriculum of medical education.
View details for DOI 10.1097/ACM.0000000000003657
View details for PubMedID 32769473
- Response to "Will We Code for Default ECMO?": Clarifying the Scope of Do-Not-ECMO Orders. AMA journal of ethics 2019; 21 (10): E926–929
- "Not Shared" Need Not Mean "Not Patient Centered": Deciding That a Patient Is Not a Candidate. JAMA internal medicine 2019; 179 (6): 851–52
- No Escalation of Treatment: Moving Beyond the Withholding/Withdrawing Debate AMERICAN JOURNAL OF BIOETHICS 2019; 19 (3): 63–65
THE RELATIONSHIP BETWEEN DO-NOT-RESUSCITATE AND NO ESCALATION OF TREATMENT
LIPPINCOTT WILLIAMS & WILKINS. 2019
View details for Web of Science ID 000498593400363
- Informed Consent: A Matter of Aspiration Since 1966 (At Least) AMERICAN JOURNAL OF BIOETHICS 2019; 19 (5): 3–5
"Just do your job": technology, bureaucracy, and the eclipse of conscience in contemporary medicine.
Theoretical medicine and bioethics
Market metaphors have come to dominate discourse on medical practice. In this essay, we revisit Peter Berger and colleagues' analysis of modernization in their book The Homeless Mind and place that analysis in conversation with Max Weber's 1917 lecture "Science as a Vocation" to argue that the rise of market metaphors betokens the carry-over to medical practice of various features from the institutions of technological production and bureaucratic administration. We refer to this carry-over as the product presumption. The product presumption foregrounds accidental features of medicine while hiding its essential features. It thereby confounds the public understanding of medicine and impedes the professional achievement of the excellences most central to medical practice. In demonstrating this pattern, we focus on a recent article, "Physicians, Not Conscripts-Conscientious Objection in Health Care," in which Ronit Stahl and Ezekiel Emanuel decry conscientious refusals by medical practitioners. We demonstrate that Stahl and Emanuel's argument depends on the product presumption, ignoring and undermining central features of good medicine. We conclude by encouraging conscientious resistance to the product presumption and the language it engenders.
View details for PubMedID 30460467