A day in the life of a Mayo Clinic medical ethicist

How should doctors handle end-of-life care or use new medical innovations like genetic technologies? How can they ensure they’re fairly and equally providing healthcare? How can providers build trust with patients?

These are just a few of the big questions medical ethicists study and advise on. Richard Sharp, a professor of biomedical ethics at Rochester, Minnesota-based Mayo Clinic, is one of these professionals. For decades, he has been a bridge between patients and providers as well as advocates and innovators to ensure medical practices are safe and fair.

“As an academic discipline, biomedical ethics is the study of moral issues that arise in the context of healthcare and in the context of scientific research,” Sharp told Healthcare Brew. “But biomedical ethics as an activity is really about giving patients a voice and helping their perspectives to be heard by scientists and physicians, and to influence the care that they receive.”

Sharp took Healthcare Brew through a day in his life at Mayo Clinic, which he said has over 20 medical ethicists on staff. If you find yourself thinking it sounds like he has a lot on his plate, you would be correct!

Day-to-day. No day is quite the same for Sharp.

“In many ways, our work is responsive to the kind of questions that emerge in the context of patient care,” he said.

One of his regular tasks—a day or two each week—is his research. Sharp studies how patients understand new technologies and the impact those technologies have on them. This is the work of a “traditional university professor,” he said, like conducting interviews and surveys, analyzing data, writing up research, and participating in conferences.

“Our work has really been focused on this question of what things patients would want to know about as they look to the future, and things that they might be concerned about,” he said.

For example, if a patient gets a genetic test that shows they may be likely to contract a disease, an insurance company could deny them coverage. Medical ethicists work to understand how patients perceive genetic testing and any reservations they may have. Lately, a lot of his research has also revolved around the rise of AI in healthcare, which has introduced issues of hallucination and privacy into care.

Other days, Sharp helps with conflict resolution at Mayo Clinic.

“We have colleagues that might not agree with each other with regard to what the right thing to do is in relation to either providing care or how to structure their research, and will often get involved to help to mediate those disputes,” he said.

These are rarely issues that are glaringly unethical, he said. A recent dispute, he said, was over when certain research should be published, as the authors disagreed on timing.

But that’s just some of his job. He said his most fun work is helping develop hospital policies. At Mayo Clinic, he said there’s a number of governance and oversight structures he’s involved in.

“We’re often charged with developing institutional safeguards and approaches for really innovative forms of research,” he said.

Lately, xenotransplantation has been an area of ethical interest nationwide, he added.

“It’ll be really important for us to have confidence that that’s being done in a way that’s both ethical but also transparent to the people that we care for,” he said. 

Practicing ethics. Sharp said the core commitments of bioethics really haven’t changed throughout his career. What he said has changed is the number of technologies or circumstances that make ethics complicated.

“The types of technologies that we focus on now are so much more advanced from a medical perspective and have the capacity to look much more deeply into our bodies and consider sources of disease,” he said, naming end-of-life care as an example.

Otherwise, he said the job has become more politicized compared to the beginning of his career. Bioethicists were previously seen as apolitical or neutral.

“No one would look at us and say, ‘Well, you’re a liberal group of academicians or a conservative group of academicians,’” he said.

But one of a bioethicist’s concerns is “the fair distribution of health resources,” Sharp said.

“We’re concerned about matters of fairness and equity in the delivery of healthcare,” Sharp said. “Twenty years ago, that wasn’t a controversial thing to advocate for, but as the scope of political issues has expanded…we’ve had to be a little bit more thoughtful in terms of how we position our work and ensure that it really is remaining neutral.”