“Bioethics Is Hard”: Kayla Wiebe on Teaching, Research, and Organizational Ethics

Published: February 10, 2022

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Kayla Wiebe, a PhD candidate whose dissertation focuses on the concept of autonomy and who also serves as a bioethicist at SickKids hospital, recently won the 2021 Martha Lile Love Teaching Award for her course PHL 440—Clinical Bioethics. The course introduced students to this subfield of biomedical ethics, which zooms in on the ethical issues that can arise in the relationship between patient and physician. Against the backdrop of the current coronavirus pandemic and heightened attention to structural inequities in health care, students discussed anything from decision-making capacities, to refusal of care, the impact of mental health, and potential limits to a physician’s duties.

We spoke with the teacher, scholar, and ethicist about her approach to the classroom, keeping a balance between multiple commitments, and advice she might have for anyone interested in the study and application of bioethics.

What do you try to bring to the classroom, and what do you most seek, or seek to encourage, in your students?

It sounds cliché, but the most important thing to me is ensuring that the conditions for genuine learning obtain. Due to the reputation philosophy can sometimes have of being combative, I focus on encouraging intellectual humility, curiosity, and open-ended creativity about ideas, while actively discouraging perfectionism and the fear of ‘getting [x] wrong.’

The award committee gave particular praise to your efforts to make your teaching and class materials accessible. Could you speak to us about what you did and students’ responses?

I love that this is the case! I understand accessibility as a principle of equity in teaching; basically, ensuring that the class and class materials are meaningfully accessible and available to a range of different needs. One of the simplest things I’ve done to meet this goal is make sure there are multiple ways of engaging with the course material to earn their participation grade: written responses to discussion questions, attending office hours, doing a presentation on a topic they’re particularly interested in. I also check in with students throughout the semester with an anonymous survey to gauge what is working, what isn’t, and what to keep on doing. And for written assignments, I have as lenient of a late policy as is possible within the university rules.

Student response to this is overwhelmingly positive. Students working full time, coping with mental health issues, providing familial support, and students for whom English is a second or third language (and who are therefore sometimes more hesitant to speak up) have all reflected that the opportunity to engage with the material in alternative, accommodating ways has helped them achieve success.

Do you have a standout fulfilling moment/experience in the classroom?

A few weeks into PHL 440, we were discussing spectrums of manipulation and coercion. After a lengthy discussion on whether and when manipulation counts as autonomy-undermining in a significant way, after some silence, one of my students blurted out “wow, bioethics is hard.” Any tension in the room immediately dissolved, and I saw most of my students burst out laughing with their mics off on Zoom, and discussion quickly resumed. This became a catchphrase of sorts for the course. What I liked about this moment was the acknowledgment that something (i.e., philosophy, bioethics) can be incredibly hard, and the fact that we find it so does not mean we’re doing it wrong, or that we aren’t ‘cut out’ for the task at hand. It took me far too long to learn this about my own capabilities to do my own work, and it’s an attitude (i.e., curiosity over perfectionism) that I try to instill in any classroom I’m a part of.

Besides pursuing your PhD and teaching in the Department of Philosophy, you also work at SickKids hospital. Please tell us a little bit about your work there, its joys and challenges, and how it interweaves with your more theoretical work in philosophy, bioethics in particular.

Yes! Since May 2020, I’ve been working with an enormously passionate, creative, and supportive team of clinicians, ethicists, and parent and family advisors at SickKids. We developed an ethics framework for surgical prioritization and operative resource allocation and are working to implement concrete ways to operationalize the principle of equity and reduce health inequities within surgical waitlist management. The challenge is really the time management. As it turns out, working full time and completing a PhD is a lot! Another challenge has been meaningfully implementing theoretical ideals into practice and being patient with the (very normal and human) resistance to change.

Of course, the joys are wrapped up in that process as well. I’ve learned to appreciate the smaller wins, which has been an excellent antidote to my own perfectionism. I also think that the experiential education I’ve gotten in how a hospital functions—from clinic visits to ethics consults to institution-level allocation decisions—has made my theoretical work more informed, nuanced, and realistic in the practical recommendations I hope to make.

Besides the obvious switch to online everything, has the pandemic changed your approach to or outlook on your research, hospital work, and teaching? If so, how?

The pandemic sparked my interest in the ethics of rationing, resource allocation, and prioritization, along with all the aspects of political philosophy that are wrapped up in these discussions. All I read for months were triage protocols, allocation ethics, and utilitarian, egalitarian, and capabilities approaches to distributive justice. This has considerably widened my expertise within bioethics in general, and it’s added another dimension to my own work. The chapter of my dissertation I’m working on currently explores how to think about autonomy relationally under conditions of injustice and oppression, whereas before I was more focused on the internal capacities needed to count as autonomous. With respect to teaching, I found that the pandemic made it much easier for me to make course work accessible and for my students to attend class. I was also able to engage with students more than in the past.

What advice would you give to undergrads or incoming graduate students interested in bioethics?

The field of professional bioethics is still an emerging discipline, so the path toward a career here isn’t linear. Connect with as many people as you can and conduct what the non-academic job market calls “informational interviews.” Ask those you’re meeting with about their educational background, volunteering, and fellowship opportunities, and how they arrived at their current job. The other recommendation aligns with advice I received when I entered the PhD: be prepared for and open to your mind changing about what you want to do. The ideas we might have about doing clinical ethics and actually providing an ethics consult within a particular system will likely be very different. I started fairly certain that I wanted to work in clinical ethics, and have since discovered I’m much better suited to and interested in organizational ethics and policy development.

What might we find Kayla Wiebe doing when she is not thinking or practicing philosophy/bioethics?

Really, anything that gets me out of my head: reading fiction, hiking, yoga, playing with our dog, teaching myself to paint, and of course spending quality time with people in my community. I’ve also recently joined the widespread obsession with WORDLE, am doing my best not to doom-scroll the news, and am working to cut down my coffee consumption (of course, only one of these things is going well).