Student’s work published in American Medical Association Journal of Ethics
As a philosophy major at St. Olaf College, Annika Beck ’17 is used to exploring ethical arguments. And applying those skills outside the classroom led to her work being published in a recent issue of the American Medical Association Journal of Ethics.
Beck co-authored an article with Mayo Clinic physicians Bjorg Thorsteinsdottir and Jon Tilburt titled “Grow a Spine, Have a Heart: Responding to Patient Requests for Marginally Beneficial Care” that was published in the November issue of the Journal of Ethics.
The article revolves around the case study of a 42-year-old woman with family history of breast cancer who requests a mammogram before it is strictly medically necessary. In all, the article argues that it doesn’t make sense for the physician to feel obligated to deny the request in the interests of resource allocation.
“The lack of consistency and accountability in U.S. insurance policy, and the lack of reliable and fair redistribution of resources on a societal level, ought not to be compensated for by individual physicians’ actions to limit care at the bedside,” the article states. “We believe instead that, collectively, physicians have a social responsibility to share their knowledge and experience at the policy level for the benefit of society at large and move our society toward fair and equitable systems.”
The opportunity to be published stemmed from the work Beck did with Thorsteinsdottir as part of the Summer Undergraduate Program in Biomedical Ethics Research at Mayo Clinic. Thorsteinsdottir is interested in the ethical issues in end of life care and resource allocation, specifically in dialysis, and exploring the messy ethical dilemma of who receives what limited medical resources. Beck’s task this summer was to complete a review of the philosophical literature surrounding resource allocation and the age of the patient.
Using Dan Callahan’s controversial text Setting Limits as her starting point, Beck sorted through piles of philosophical writings on age and resource allocation and then paraphrased their arguments, ending up with 50-60 pages of material that Thorsteinsdottir will be able use as a reference in her work, and several pages of summary.
“Dr. Thorsteinsdottir wanted help sifting through the literature on resource allocation and age, much of which is philosophical,” Beck says.
Beck’s goal was that “[Thorsteinsdottir] wouldn’t have to worry about starting from scratch on that. While it wasn’t exhaustive, I feel that I’ve been able to give her a grounding and a tool to use.”
After completing her work at Mayo, Beck received an email inviting her to help Thorsteinsdottir edit “Grow a Spine, Have a Heart.”
“She had great arguments, and I was able to help her refine them,” Beck says. “Just having a critical eye, which you really kind of cultivate when you study philosophy, I was really able to help refine her message to what she wanted.”
Beck intends to pursue biomedical ethics as her life’s work, and is debating between going to law school and getting a master’s degree in bioethics, or pursuing a Ph.D. in philosophy with an area of interest in biomedical ethics.
For now, she urges other students to apply to the Summer Undergraduate Program in Biomedical Ethics Research.
“I want to see other Oles do that program,” Beck says. “I’d love to see Oles continue to represent in Rochester.”