Topsy's Midlife Career in Healthcare Ethics

When I reflect on the seemingly unrelated academic degrees I have earned over the years (education, political science, theology), I am reminded of what Topsy said about herself in Uncle Tom's Cabin: "Don't think nobody ever made me. I s'pect I just grow'd" (Stowe 1852, 255) It appears, however, that this eclectic academic background, along with various interesting employment opportunities and rich life experiences, was the perfect preparation for the doctoral program in healthcare ethics that I am now completing at Saint Louis University (SLU).

Begun in 1996, the program's interdisciplinary nature and flexibility makes it ideal not only for students with diverse academic backgrounds, but also for those such as I, who bring to it a wide range of life and educational experiences that we seek to pull together into new, integrated, midlife careers. Not only does the SLU program accommodate us, but one can reasonably argue (and I do) that a multifaceted academic background, coupled with the proper variety of life and work experience, may be the most beneficial qualification.

Having earlier made the choice to focus on family rather than career, I found myself in 1997 with a newly bestowed M.A. in theology, a grown child, and the ability at last to focus purposefully on my own career goals. I was introduced to Saint Louis University's Ph.D. program in healthcare ethics. What it offered me was a long-imagined opportunity to synthesize my lifelong interests in education, theology, and policy development, as well as an overarching interest in all things medical. (Being hopeless in hard sciences, a career in medicine per se had never been an option.) I greeted my acceptance into the program with heartfelt enthusiasm.

Undertaking any doctoral program, though, is a difficult, challenging, and sometimes lonely and depressing endeavor. Perhaps it is an easier task to assume while on a continuum from undergraduate- to master's-level work. Still, entering with substantive life experience can make the end result all the richer. I believe this is especially so in the field of healthcare ethics, where a sensitivity to the complexity of life's problems is often critical. The Saint Louis University Center for Health Care Ethics program has allowed me to capitalize on previous experience, while maximizing my potential through carefully planned academic work and practical exposure to the "real world" of contemporary healthcare.

The program has not been easy. The academic work, focused on the development of skills in normative health-care ethics, is rigorous. As I write my dissertation, I look back over the last four years and see things that I might have done differently (taking advantage of the program's Certificate of Empirical Research Methods in Descriptive Ethics, for example). But the opportunities were always there. The program offers access to interdisciplinary coursework appropriate for many different career paths; good mentoring and constant support from the faculty; rich practical experience in internal and external assistantships and practica; and freedom to shape one's own program, within reasonable boundaries.

I have especially appreciated the opportunities I have had to teach and make ethics presentations to healthcare professionals and to students in various healthcare fields. It has been interesting to see the disparate attitudes expressed toward ethics, for example, by medical, nursing, physician's assistant, and dental students. Amazingly, not all are as taken by the importance of applying ethical theory to their work as I! But then, some are, and the discussions have been challenging and greatly beneficial in honing my skills in ethical discourse.

I have also enjoyed the wide variety of students. In the four years I have been in the program, I have studied with physicians, nurses, and lawyers, as well as a pharmacist, a veterinarian, a missionary, and a politician. They have come to the program not only from the United States, but from Canada, Europe, Asia, and Africa. The richness of perspectives they bring is invaluable...