Everyday ethics

By Taylor Utzig

Patients and their families can encounter a mountain of questions when faced with health care challenges. What is the best course of treatment? What are the patient’s wishes if they are unable to advocate for themselves? In situations where those questions are unclear or concerns arise, a bioethicist can provide a unique perspective and help ensure the patient receives the best care.

This patient-centered approach to bioethics distinguishes Stritch’s Neiswanger Institute for Bioethics and Healthcare Leadership. Rather than focus on issues commonly associated with bioethics, such as stem cell research or artificial intelligence, the Neiswanger Institute has built its reputation on educating students to address the concerns facing health care professionals every day at the patient’s bedside. “I wanted to utilize Loyola's strengths, its history, and its values to build something that would advance Loyola’s mission,” says Mark Kuczewski, director of the Neiswanger Institute. Today, the institute’s impact can be seen in its hundreds of alumni, as well as its national advocacy for students with Deferred Action for Childhood Arrivals (DACA) status.

When the Neiswanger Institute launched in 2000, it was one of only a dozen bioethics centers in the United States. Realizing his opportunity to build the institute from the ground up, Kuczewski went to work recruiting professionals from a variety of backgrounds to join the faculty. “Each person has brought something new to the vision: global health, public health, medical professionalism, awareness for ethnic disparities,” he says. Now, their contributions are embedded into the fabric of Loyola and our community.

A leader in online education

One of the first faculty members Kuczewski brought on board in 2002 was Kayhan Parsi, who helped launch Neiswanger’s online graduate program. “Even then, in the early years, it became clear that there was a demand for advanced, high-quality bioethics education for people in the U.S.,” says Parsi. At the time, there were almost no online options for graduate learners. Kuczewski and Parsi thought it important to create a master’s in bioethics program accessible to anyone, regardless of geography. “In a way, we fulfilled the Jesuit mission of meeting the needs of people where they are,” says Parsi. “And that has remained our ethos: to create a community of learners and alumni."

Eight years later, in 2010, the same idea helped launch Neiswanger’s hybrid professional doctoral program in bioethics. Patrick Herron (DBe ’14), director of bioethics education at New York’s Albert Einstein College of Medicine, was one of the first students to enroll in the doctoral program, despite his initial skepticism of online learning. “When I began the program, I had some strong biases against online education,” he says. But honestly, I was incredibly impressed because the rigor of the program was no joke. It was the best choice I made in my career.

Part of that rigor is due to blended courses, where online students visit Loyola’s Health Sciences Campus for three or four days to participate in a mixture of didactic and clinical workshops and simulations. “There were clinicians, nurses, social workers, people from all health care fields; it was interdisciplinary education before it was a buzzword,” says Herron. "Now, when I talk to people considering an online graduate program, I tell them to look for that intensive, interdisciplinary component.

With hundreds of graduates across the country, Neiswanger has helped educate an estimated 15 percent of all certified, clinical ethicists in the U.S.

Forming physicians for the future

Along with its leadership in online education, Neiswanger’s roots extend deep into the Stritch curriculum. Even though there’s not a single course labelled “bioethics,” students get a hefty dose of ethical training throughout their four years. “Every medical student comes in wanting to help people, heal people, save people,” says associate professor Katherine Wasson. “But the hard reality is that all of them will see people die. It’s important that we help them develop as human beings, not just scientists,” she says.

Wasson directs the Bioethics Honors program and believes Stritch and Neiswanger’s commitment to student reflection and professional formation are what differentiate Loyola from other medical programs. For instance, Neiswanger faculty engage students in challenging conversations about treating a dying patient or end-of-life care. “It’s not the goal to make every student a clinical ethicist. The goal is to have good, ethically-sound doctors who can reason, think, feel, and cope,” says Wasson.

Although for some Stritch graduates, bioethics has become central to their medical career. When Alyssa Burgart (MD/MA ’10) began applying to medical schools, she had her eyes set on Loyola because of Neiswanger. Today, she is a board-certified pediatric anesthesiologist and bioethicist at Stanford University. “After working as an ethics assistant for a medical center in Los Angeles, I knew I wanted to have a career where I could practice medicine and pursue bioethics,” says Burgart. “Loyola was one of the only programs in the country that allowed me to do that with its dual-degree MD and MA in bioethics.”

Neiswanger’s robust network of alumni is a point of pride for the institute as it continues to expand and exemplify Loyola's impact on the broader bioethics community. Burgart is also one of four alumni, including Herron, returning to campus during this anniversary year to share their work. “This will be my first trip back to campus since I graduated from my residency at Loyola in 2014,” she says. “I’m really looking forward to being back in Maywood and seeing all my colleagues.”

The next 20 years

It’s no surprise that since the Neiswanger Institute began, the ethical concerns facing health care professionals continue to evolve. Kuczewski points to the recent consolidation of health systems and the growing challenge of institutional medicine. In addition, the country continues to struggle with other health-related crises: the opioid epidemic and an increase in suicide rates. “If you asked me 20 years ago what issues bioethicists would be facing today, I would have said gene editing. You can’t see a crisis before it comes, but now we need to respond,” says Kuczewski.

With new ethical issues coming to the forefront of health care each year, Loyola stands poised to confront them head on with the unwavering focus of caring for the whole person. Which, according to Kuczewski, is nothing new for Stritch. “The same Jesuit values that have guided us in the past will light our way forward.”

Neiswanger is perhaps most well-known for its role in helping Stritch become the first medical school in the country to welcome applications from Deferred Action for Childhood Arrivals (DACA) students. “Stritch opened its doors to me with so much love, support, respect, and encouragement,” says alumna Johana Mejias-Beck (MD ’18), who was in the first cohort of DACA students to graduate from Stritch.

During her time at Stritch, Mejias-Beck worked closely with the Neiswanger Institute to develop the Sanctuary Doctor website, an online resource for clinicians across the country to help them meet the needs of patients who may be undocumented or suffering stresses related to close family who are undocumented.

“I was taught that to truly care for our patients, we must understand who they are and what they go through on a daily basis," says Mejias-Beck. Today, Stritch stands as a national model in fostering justice for DACA recipients, in large part due to the support and guidance of the Neiswanger Institute.

In 2019, Mark Kuczewski was named a Hastings Center Fellow, a prestigious title held by fewer than 300 people around the world. Hastings Center Fellows are a group of elected individuals whose work has informed education and public understanding of complex ethical issues in health, health care, life sciences research, and the environment. Founded in 1969, the Hastings Center was the first bioethics research institute in the United States.