An Integrated Bioethics: A Reflection on Laudato Si

Michael P. McCarthy, PhD
Pope Francis's social encyclical, “Laudato Si”, issues an urgent call for responsible action rooted in solidarity, with both human and non-human others, to recognize the interconnectedness of a shared reality suffering from neglect. As a theologian, several items of significance stood out:

1) the use of gender inclusive language, the first for a social encyclical;

2) the footnotes incorporate non-Catholic, theological, and scientific resources in addition to references to other papal documents; 

3) the attempt to engage and join with non-believers in concern over the state of the environment.

These items are being well-covered elsewhere, and you would do well to read further. However, as a theologian and bioethicist, Pope Francis also strikes an important chord with his critique of a what he describes as a “dominant technological paradigm,” a paradigm prevalent in both the medical practice and medical research. 

Chapters Three and Four—of this well-researched and crafted encyclical—prove most pertinent to questions of bioethics because of its call to resist control over care as the dominant framework for discerning a course of action (106). While scientific research often claims an air of neutrality, Pope Francis describes reality as interconnected, and “that technological products are not neutral, for they create a framework which ends up conditioning lifestyles and shaping social possibilities along the lines dictated by the interests of certain powerful groups” (107). He expresses some skepticism towards established research priorities, such as Genetic Modification, that utilize resources (financial, environmental, intellectual) that take away from other potential gains with no promise of benefit for the common good (133). While he notes that the techniques employed may pose little risk, “improper or excessive application” contributes to the unjust burdens born by the “poorest of our brothers and sisters” (158). Focusing on technology and increased control, both of which present opportunities for financial gain, draws our attention away from the present sufferings of the majority of human beings and its correlation to the inattention given to environmental degradation.  

Francis wants us to connect the global inattention to the premature and unnecessary deaths of the majority of the planet’s population, reflective of a global health crisis, with the disposable utilization of environmental resources. In order to rectify these injustices, both human and environmental, we need “to hear both the cry of the earth and the cry of the poor” (49, emphasis original). In so doing, he calls for an “integral ecology” that expresses a concern for the environment understood as “a relationship between nature and the society which lives in it” (139). His integral approach raises questions about priorities and practices for medical research and the development of new technologies to impact clinical care.

A more socially conscious approach will consider the technological resources at the hospital: do they promote control or flourishing, enhancement or sustainability? Hospital executives should more deeply probe the environmental impact for developing, using, and disposing of particularly technologies, while also considering the clinical efficacy and patient populations that stand to benefit from the technologies used. For medical research, Francis explicitly cautions against research with animals that does not offer a reasonable possibility of contributing to “caring for or saving human lives” (130). Caring for and saving human lives remains the fundamental goal of medical research, and serves as a guard against research that prioritizes economic gain and scientific development at the expense of more immediate health benefits.

Medical research and health care delivery on a global scale has historically prioritized the health needs of a few over those of the majority. Francis’s encyclical challenges us in the bioethics community to consider not only an integral ecology, but an integral bioethics that argues for a balance between the natural costs of advancement with its potential for sustainability and broad applicability for and with the society in which we live. So while a bioethics blog might be an unlikely place to read about a papal encyclical, Pope Francis’s insights challenge us to more comprehensively consider the global context of bioethics.

The Dreamer Committee* of Loyola University Chicago: Promoting Dignity through Education

Loyola University Chicago has been a leader in working for educational opportunity for Undocumented students, i.e., persons who were brought to the United States as children and were raised and educated in this country, but remain without a path to normalization of their immigration status. They are often said to be “Americans in every way but on paper.”







The Dreamer Committee is a university-wide standing committee that succeeds a major task force that reviewed Loyola’s progress in meeting the needs of these students. The task force found that Loyola University Chicago had become an emerging national leader in promoting equity for these students. Achievements included the Stritch School of Medicine becoming the first U.S. medical school to openly welcome DACA-eligible students (www.stritch.luc.edu/daca) and the incredible undergraduate effort that create the Magis Scholarship Fund for Undocumented students

from a self-imposed student activity fee. Such “firsts” have brought the university renown and highlighted the value all levels of the university place on social justice. However, progress was uneven across the schools of the university and sustained attention needed to be given to these issues. The collaboration of dedicated faculty, administrators, and students is needed to further opportunity for Undocumented students at Loyola and to seek systemic change in our nation’s immigration system through scholarship and advocacy.


Mission
The mission of the Dreamer Committee is to develop equitable policies and practices to promote educational opportunities and improve the lives of undocumented students at Loyola University Chicago. This will be achieved by through multidisciplinary collaboration, and the promotion of research, education, advocacy and service that is informed by the lives and experiences of undocumented students seeking higher education.

Mark Kuczewski

The mission of the Dreamer Committee is grounded in the Catholic and Jesuit mission to promote social justice and in the bedrock principle that acceptance of undocumented students is part of Loyola University Chicago’s broader culture of acceptance, inclusion, safety and support. As a Catholic university that is sponsored by the Society of Jesus (the Jesuits), we firmly believe in the dignity of each person and in the promotion of social justice. The dignity of persons calls us to steward the talents of qualified applicants rather than reject their contributions for arbitrary and arcane reasons, including immigration status. Social justice requires that we foster the conditions for full participation in the community by all members of our community. Undocumented, DACA, and DACA eligible applicants are typically woven into the fabric of our communities and have a basic right to contribute to the fullest extent of their abilities. This approach echoes a long tradition articulated by the U.S. Conference of Catholic Bishops (USCCB) of advocacy for immigrant members of our communities.[Excerpt from the UCUS report]


What the Dreamer Committee will do: Policy, Scholarship, Education
As indicated in our mission statement, the admission and financial aid policies and practices of each school will be studied. Progress and successes will be noted and best practices shared across schools. Strategies for fundraising and funding students will be priorities for action. As noted, there is an urgency to the issue of funding for these students as they lack eligibility for federal student aid, a key element in the financial aid packages of many students.

The main work of a university is scholarly and educational. Thus the Committee will develop a network of support for the many faculty currently creating relevant scholarship. The Committee will foster collaboration among these scholars and promote their work. And, creative educational approaches and programming will be shared and new educational efforts will follow from this cross fertilization. This kind of inquiry and teaching that is in the service of the University’s Jesuit ideals of social justice and human dignity is central to the university’s self-understanding and strategic vision.

Loyola University Chicago believes in education that is transformative of the person. Those who participate in a Jesuit education are intellectually and personally formed such that they are aware of persons who are unjustly marginalized and this understanding results in action. The Dreamer Committee seeks to model this Ignatian dynamic within our university community and to promote justice for our immigrant neighbors within and beyond the walls of our campus.







Co-Chairs:

Bruce Boyer, JD
Loyola University Chicago School of Law


Mark Kuczewski, PhD
The Fr. Michael I. English Professor of Medical Ethics
Loyola University Chicago Stritch School of Medicine







*The name of this working group, Dreamer Committee, is to convey the commitment to Undocumented students at Loyola who inspire, strive for more, and achieve excellence.The members of the Dreamer Committee welcome serving as allies and sources of information regarding university policies and opportunities for undocumented students. Students and applicants to Loyola University Chicago should feel free to contact any one of them via e-mail.

Committee Co-Chairs:


Bruce Boyer, School of Law, bboyer@luc.edu

Mark Kuczewski, Stritch School of Medicine, mkuczew@luc.edu




Committee Members:



Jennifer Boyle, Academic Affairs, jboyle5@luc.edu



Paula Camaya, SDMA, pcamaya@luc.edu



Michael Canaris, Institute of Pastoral Studies, mcanaris@luc.edu



Aurora Chang, School of Education, achang2@luc.edu



Alex Escobedo, MAGIS Scholarship, aescobedo@luc.edu



Kelsey Gerber, Financial Aid, kgerber1@luc.edu



Ruth Gomberg-Munoz, Department of Anthropology, rgombergmunoz@luc.edu



Philip Hale, Government Affairs, phale@luc.edu



Ezgi Ilhan, Student Government, eilhan@luc.edu



Eric Immel, Arrupe College, eimmel1@luc.edu



Kathryn Jackson, Career Development Center, kjackson9@luc.edu



Judith Jennrich, Acute Care Programs, jjennri@luc.edu



Katherine Kaufka-Walts, Center for Human Rights for Children, kkaufkawalts@luc.edu



Timothy Love, Student Life, tlove@luc.edu



Ronald Martin, Graduate & Professional Enrollment, rmarti17@luc.edu



Virginia McCarthy, SSOM Ministry, vmccarthy@luc.edu



Cristina Nunez, MAGIS Scholarship, cnunez@luc.edu



Sullibert Ramirez, MAGIS Scholarship, sramirez4@luc.edu



Isabel Reyes, Admissions Arrupe, mreyes15@luc.edu


William Rodriguez, Student Life, wrodriquez1@luc.edu


Julian Ruiz, Latin American Student Organization, jruiz12@luc.edu


Peter Sanchez, Political Science, psanche@luc.edu



Joseph Saucedo, Student Diversity & Multicultural Affairs, jsaucedo4@luc.edu



Maria Vidal De Haymes, Social Work, mvidal@luc.edu



Sean Whitten, Admissions, swhitten@luc.edu

Loyola Stritch DREAMers Advocate for Students of DACA Status at LMSA Policy Summit



Loyola Stritch DREAMers

On March 27, 2015, the House of Delegates of the Latino Medical Student Association (LMSA) held its second annual policy summit.  This meeting considers resolutions that set policy for the organization, especially in regard to its policy advocacy and education efforts.  This year, the delegates considered a resolution related to the eligibility of Dreamers of DACA status to apply to medical schools.  This resolution was of great interest to the Loyola University Chicago Stritch School of Medicine (SSOM) because of its position of national leadership in promoting social justice for this student population.  See www.stritch.luc.edu/daca.  Four of Stritch’s first-year medical students who have DACA status attended the summit.  Below is the text of the resolution that carried and the testimony of the two Loyola Dreamers who spoke in support of the resolution, Manuel Bernal and Diana Andino.  For more on this event, click here.

RESOLUTION #2
RESOLVED, that our LMSA provide a safe environment for the edification and advancement of Latino students applying to medical school, irrespective of their immigration status; and be it further
RESOLVED, that the LMSA strongly encourage medical schools, residency and fellowship programs to clarify their DACA admission and match policies; and be it further
RESOLVED, that our LMSA supports regulatory relief to DACA eligibility in the absence of comprehensive reform as seen by the Executive Action declared in 2014, and be it further
RESOLVED that the LMSA strongly encourage medical schools, residency and fellowship programs to support the admission, retention and promotion of DACA eligible students; and be it further
RESOLVED, that our LMSA write an open letter to the AAMC asking for regulatory relief for DACA eligible students who are accepted into medical school but are unable to matriculate; and be it further
RESOLVED that the LMSA work with medical advocacy organizations to develop policy language that promotes the admission, retention and promotion of DACA eligible students.

Congressional Action: ADOPTED as amended.

Testimony of Manuel Bernal, MS-1, Loyola University Chicago Stritch School of Medicine



Manuel Bernal, SSOM

Thank you Mr. Speaker for letting me share why I think this resolution that we will be voting on is crucial for improving healthcare delivery to Hispanic populations, especially the immigrant community.  My name is Manuel Bernal a first year medical student and a DACA beneficiary. I also speak on behalf of the community of future physicians from Loyola University Chicago Stritch School of Medicine and our LMSA chapter.  I am a firm believer that that a reduction in health disparities will only be possible when the community of health professionals better reflects the population of patients that we will serve in the future. By encouraging more medical schools to open their doors to DACA recipients we will produce a pool medical providers that are more culturally competent and that will be able to relate to the struggles that immigrant patients face during their journey to the American Dream. So let's continue this fight together, for current and future DACA medical students, but most importantly for our future patients. Thank you.

Testimomy of Diana Andino, MS-1, Loyola University Chicago Stritch School of Medicine

Thank you, Mr. Policy Chair. My name is Diana Andino, a current medical student, speaking on behalf of myself, students of the Stritch School of Medicine and other DACA students present here, as supporters of this resolution.

With the passage of DACA, support of mentors, and institutions, myself along with few other students are one step closer in becoming healthcare providers. We have been able to overcome many obstacles. For example I was not able to apply to graduate school, internships, nor work during my undergrad due to the lack of a nine digit number. My dream of becoming a physician was deferred until DACA allowed me to apply to medical school.

The passage of this resolution is of interest not only to the medical profession, but to our community. We call for more actions like the ones being done today, to be implemented in other schools and continue to open more opportunities for DREAMers like ourselves. Thank you.

Medical School Dreams & DREAMers: What the New Contributors to Medicine Have Taught Us

Mark Kuczewski & Linda Brubaker

Mark Kuczewski, PhD & Linda Brubaker, MD, MA
(Remarks delivered at the 19th Annual Meeting of the National Hispanic Medical Association, March 28, 2015)

What We’ve Learned from these Medical Student DREAMers
In the early fall of 2011, we received an email from Professor Herbert Medina, chair of the mathematics department at Loyola Marymount University in Los Angeles. In the e-mail he described a student whom he had characterized as one the best students he’d ever had. She had a very high grade point average, was a double major in biology and Spanish, had significant service involvements, and a variety of other qualifications. We have told this story in several places. (1, 2, 3) But it bears repeating that this student, who also happened to be a DREAMer, captured our interest for several reasons intrinsic to the mission of a medical school.

1. Best and brightest – Isn’t that who we all seek to recruit?
2. Unique Skills – Such students are bi-lingual, bi-cultural and understand our large, recent immigrant patient populations. 
3. Service to patients – DREAMers usually are persons of color from underserved communities and thereby fit the profile of potential physicians who are more likely to desire to serve underserved populations
4. Fairness for this DREAMer – This student has all the talents and qualifications to become an outstanding physician in addition to being incredibly motivated in the face of seemingly insurmountable barriers. On what grounds could we justify her exclusion from the profession?

However, in 2011, a DREAMer could procure no authorization to work in the United States and therefore would be denied a license to practice medicine by every state medical board. As a result, we did not think it would be wise to admit and utilize copious school-based aid to graduate a physician who could not practice. Fortunately, on June 15, 2012, President Barack Obama granted a kind of temporary reprieve to “DREAMers” when he created the Deferred Actions for Childhood Arrivals Program which has become commonly known as DACA. As is well-known, DREAMers are young people who were brought to the United States without authorization as children and have lived and been raised here for more than five years. They have often received a substantial part, if not all, of their education in the United States and become integrated into the fabric of their communities. The DACA program is an exercise of prosecutorial discretion that removes any concern of deportation for eligible DREAMers during the covered period (originally two years but it is now conferred for three).  In addition, DACA status includes conferral of an Employment Authorization Document (EAD) and the recipient may apply for a social security number.

Because DACA alleviated the barrier to practicing medicine, the Loyola Stritch School of Medicine became the first medical school in the country to openly accept applications from DREAMers of DACA Status shortly after the creation of DACA. While some schools quietly accepted an occasional DREAMer, we felt it was important to be open and clear about our intent. We characterized this effort as “bringing them in the front door” or a “front-door approach.” Seven such DACA-documented DREAMers are currently thriving as they complete their first year at Loyola Stritch School of Medicine.

We think that on a societal level, the Loyola Stritch DREAMers are very important because they help us to move beyond the “makers” versus “takers” debate in which our political dialogue is mired. The Loyola Stritch DREAMers highlight that the image of undocumented immigrants as “takers” is mistaken. They are not here to take something to which they are not entitled. They are talented contributors. Their story shows that to a large extent, whether one becomes a maker or a taker is society’s self-fulfilling prophecy, and this is not exclusively (or at all) related to immigration status. Society can be inclusive and provide the conditions that enable these young people to use their God-given talents and motivations to serve sick patients and improve health within communities and populations. Or it can continue to reinforce barriers such as not allowing access to the same funding mechanisms that enable nearly all medical students to secure their educations, e.g., federal student loans. We sometimes half-jokingly say that the Loyola Stritch DREAMers are superheroes. They have hurdled so many barriers and obstacles on their way to a college education and a level of achievement that simply makes it unthinkable for us to turn them away from our medical school. “Leaping tall buildings in a single bound” seems like child’s play next to their accomplishments. But, even they needed the protections and opportunities that DACA affords them and a medical school - state partnership that provides a realistic funding vehicle. (4) They remind us of the many undocumented young people who are not superheroes like the Loyola Stritch DREAMers, but ordinary people like us. For ordinary people, removal of such artificial barriers is even more important to reaping the benefits of their contributions to society.

Society must own up to its responsibility in deciding whether it will enable our undocumented neighbors to be makers or will shackle them and demand that they be takers. This dynamic is also in effect in other sectors of health care.  For instance, we can bar the door to the opportunity to buy health insurance through the provisions of the Affordable Care Act and complain about the burden they pose on our emergency room charity care systems or we can provide the conditions for these neighbors to take responsibility for their health. (5) The choice is ours, not theirs.

The Importance of the Loyola University Chicago “Front Door Approach”
With the realization that the medical profession and the medical education community is engaged with individuals being marginalized unfairly by society, a “front door approach” to their plight is morally required of us.

First, the front door approach means that we welcome these students for who they are.  Our admissions policy states that applicants of DACA status are welcome to apply and we recognize them as their own category of applicants. (6) We are not trying to force them into an international student category but recognize that they bring their own particular qualities to the table and that they are best considered in terms of being evaluated by the same criteria we apply to citizens and permanent residents, not students applying from other countries.  This is a pragmatic consideration. But, we must not make too sharp a distinction between pure pragmatism and idealism.  Injustice has very pragmatic consequences as health and health care disparities demonstrate. In terms of ideals, our medical schools must not simply be a tolerant community; we must be a hospitable and welcoming community. Imagine if we were living in the era before desegregation. It would not be enough to occasionally entertain an application from an African-American, have them check boxes on their applications indicating that they are from racial or ethnic groups to which they do not actually belong, and pretend that they are white after matriculation. No, they must be welcome for who they are. This will entail a commitment to educating the entire medical education community (and our alumni community) lest the environment simply mirror much of the prejudice and implicit hostility of the larger society. (7) For instance, at Loyola, we have made a conscious effort not to use the common method of describing DREAMers as young people who were brought to the United States “through no fault of their own” as if migrating to feed one’s family is a fault and their parents are guilty of it. We will not speak that way in our institution. Thus, the issues that DREAMers confront and the larger context of immigration in the United States will become a thematic focus of education at all levels on the campus of our health science centers. Of course, this will yield the additional benefit that all health-care providers on the campus will likely become more culturally aware and competent in caring for immigrant patient populations.

Second, a front-door approach is important in gathering support.  Medical students of DACA status, like all medical students, are raw assets to our society. But we must invest in them in order to develop them into physicians who can serve the community.  DACA status students are denied access to basic resources such as federal student loans. We need support from the community such as medical school alumni, friends, and related health-care institutions. It’s hard to know how one gathers support without articulating commitment. Clearly our ability to partner with the Illinois Finance Authority to provide loans to these students was dependent on our public commitment.

Finally, the presence of such DREAMers ultimately is transformative for our campus, for medical education, and for medicine. One cannot look at the contributions of these students, come to understand the realities of immigration in the United States and globally, and simply remain indifferent. We must advocate for change and for justice.  As we’ve seen, these injustices have implications for the health of our communities and for the development of physicians and health-care professionals to treat our communities. And beyond those pragmatic aspects, we find ourselves looking at a situation that is just plain wrong. To look at the Loyola Stritch DREAMers is to immediately recognize how wrong it is that they live with the insecurity of a temporary immigration status subject to the will of the nation’s chief executive. And while they are rapidly becoming community leaders, they lack the basic right to self-determination through voting or participating in systems in which we are all commonly invested, such as social security. While we live in the practical and pragmatic world of advocacy and in that world, we often confine our speech to the art of the politically possible, we must never stop simply saying the truth. As academics and health care professionals we must never stop saying that our present immigration policies from the militarization of our southwest borders, through the lack of qualified and effective representation of immigrants in our courtrooms, to the confining of migrants for long periods in our detention centers and prisons, to the failure to provide a path to citizenship for long-time members of our communities, are unhealthy and just plain wrong. These injustices must be changed.

1. Mark G. Kuczewski, Linda Brubaker. (2015) Equity for ‘DREAMers’ in Medical School Admissions. AMA Journal of Ethics 17(2): 152-156. Article  |  Podcast

2. Mark G. Kuczewski, Linda Brubaker. (2014) Medical Education for “Dreamers”: Barriers and Opportunities for Undocumented Immigrants. Academic Medicine 89(12): 1593-1598.

3. Mark G. Kuczewski, Linda Brubaker. (2013) Medical Education as Mission: Why One Medical School Chose to Accept Dreamers, Hastings Center Report 2013;43(6): 21-24.

4. Kristen Schorsch, “A Year Later, Loyola Still Alone in Enrolling Undocumented Students.” Crain’s Chicago August 9, 2014 http://www.chicagobusiness.com/article/20140809/issue01/308099984/a-year-later-loyola-still-alone-in-enrolling-undocumented-students#

5. Mark G. Kuczewski. (2011) Who is My Neighbor? A Communitarian Analysis of Access to Health Care for Immigrants. Theoretical Medicine and Bioethics 32(4): 327-336.

6. DREAMers of DACA Status Welcome.  Loyola University Chicago Stritch School of Medicine Website. www.stritch.luc.edu/daca

7. “Loyola University Chicago Medical Students Show Support for DREAMer Peers”, Ignatian Solidarity Network, August 14, 2014. http://ignatiansolidarity.net/blog/2014/08/14/loyola-university-chicago-medical-students-show-support-dreamer-peers/


Mark G. Kuczewski, PhD is Fr. Michael I. English Professor of Medical Ethics, Director of the Neiswanger Institute for Bioethics & Health Policy, and Chair of the Department of Medical Education at the Loyola University Chicago Stritch School of Medicine. Follow him on Twitter: @BioethxMark

Linda Brubaker, MD, MA, is the Dean and Chief Diversity Officer of the Loyola University Chicago Stritch School of Medicine and she also currently serves as the Interim Provost for the Health Sciences Division of Loyola University Chicago. Follow her on Twitter: @StritchMedDean

Social Media for Health-Care Professionals: A Starter Kit

Mark G. Kuczewski, PhD

Facebook, Twitter, LinkedIn and a host of other social media platforms seem to be everywhere. It can seem as if everything we read and watch is accompanied by a call to “Follow us on Twitter” or “Like us on Facebook.” You may already use one or more of these platforms for personal purposes.  For instance, having a Facebook account on which one posts items such as pictures about oneself and family for friends and others. Quite commonly, we might find ourselves facing certain questions such as whether to accept friend requests from patients or others and what kinds of disclosures about one’s work life are appropriate. Health systems are always concerned that the confidentiality to which patients are entitled may be violated by a member of the staff and result in the fabled “HIPAA violation.” And, they might simply prefer to control all communications that can be interpreted as emanating from the institution so that their facility “speaks with one voice.” Fear of getting into some kind of trouble at work can lead us to conclude that we’d be better off simply not engaging in social media.

Social media poses many opportunities to improve one’s professional life and to further one’s vocation of serving others. And, it can be fun. As a result, many institutions are now taking a far more positive approach. For instance, the Mayo Clinic has put together a video that encourages their employees to engage on social media and offers a few caveats.  The Loyola University Health System has a very minimalist policy. For the most part, it articulates the principle that is the prime directive of health care professionals in the modern age: Do not make any disclosure of the Personal Health Information (PHI) of any patient in your care or the care of the institution. And, the policy affirms that you may use LUHS work stations to access such platforms for educational and business purposes. In other words, it recognizes that your work can be enhanced through these media.

It’s About Who You Are

Busy professionals do not have time for one more thing they “should” do. There’s no point in trying to convince them that like going to the gym and getting more vitamin D, they should participate in social media. I’ll make the simplest case for it: You are very likely to enjoy it on many levels.  You probably went into health care for a variety of reasons. You have an intellectual curiosity that led you into a field that combines science, art, and people skills. And, you enjoy sharing your wisdom and insights for the benefit of others. If you could, you’d like an easy way to put forward your professional persona, keep current on all sorts of relevant issues, and share helpful information and insights.  And, of course, it would be wonderful if this led to satisfying interactions, perhaps more patients, and even injected some humor into your day. It sounds like making use of social media in your professional life is right up your alley. So, how do you get the fun started?

What to do

1. Establish Facebook, Twitter, and LinkedIn accounts for your professional use. -  While there are many interesting social media platforms, these have become more or less standard equipment. If you use a platform such as Facebook for personal use, you might consider a second account that is for your professional use so that you can share information and links with colleagues and relative strangers without also sharing private materials such as your family photos.
2. “Like” (on Facebook) and “Follow” on Twitter people and institutions that will bring you the kind of news you enjoy. -  Think about what kind of information you try to obtain in your daily life. Most of your favorite news outlets, reporters and columnists post their stories to Twitter. Similarly, professional societies and journals often have accounts or Facebook pages.  Search for conferences or meetings you like to attend or even people you admire.  Chances are that you’ll be able to get information directly from them through social media.  Once you have connected to the kinds of information sources that you enjoy, you’ll go into your account frequently in order to get information.  You will slowly but surely become a master of these tools.
3. Share the information you find interesting and relevant. Comment on some of it. - You might find some of your favorite writers or folks you admire in your field engaging in “conversation” with you.  How cool is that?
4. Establish a LinkedIn account and build your profile page. – I’ll write more in this space in the future about LinkedIn. It’s tame, static, and boring. But it is the one platform that is quickly becoming mandatory for all professionals. It is your public CV and you need to have a decent profile page on LinkedIn. It’s what people will get when they Google you. Without it, you risk being seen as unengaged in your profession.

What Not to Do

1. Do not share any information about particular patients on social media. - You can talk about illnesses and common issues, but no identifiable patient information should ever be included. And be careful with pictures at your facility.  Capturing even a glimpse of an unaware person in a background discloses that they were at the facility.  That shouldn’t happen.
2. Don’t diagnose people on social media. -  If people ask particular questions about their health, you can suggest they see a health-care provider and/or tell them about reputable information sources. But you definitely should not be treating patients on a social media outlet.
3. Sleep on it. – People will say the darnedest things. Some will put forward caustic, bombastic and even hateful viewpoints.  Generally, such persons will not want to be persuaded by you.  If you do respond at all, it should be mainly to provide factual or well-reasoned counter information so that it can be seen by others who follow your posts. If you find yourself about to respond in anger, take a time out, maybe even overnight.  Rest assured it’s a pretty good strategy even if your lesser angels want to get back at this person for their rudeness; such interlocutors will find your delay uncomfortable and it gives you time to decide whether any response is worthwhile.  And don’t feel you need the last word.  Once you have made any relevant factual points, do not persist in posting simply because the other person is.
4. Don’t engage others criticizing your hospital or health-care institution – You may “represent” your institution because people’s impression of a facility is partly drawn from their experiences of particular professionals they know work there.  But you are not the spokesperson charged with responding to any particular allegations and unless you are a senior administrator appropriately so charged, you do not speak for the institution. And, you may find your words twisted and used against you and your institution if you engage.

In general, be yourself- the bright, engaging professional that you are.  And have fun!

Here are a few of my favorite Twitter and Facebook sites related to bioethics or health-care professionalism to get you started. On Twitter, you search for the site by the “handle” e.g., @BlahBlah, whereas on Facebook, you search for a page by its name.

Follow on Twitter

Bioethics:
@LoyolaBioethics
@BioethxChat
@LifeMMedia
@ArthurCaplan
@HastingsCenter
@JournalofEthics
@Bioethics_net
@NoHiddenMagenta

Health Care/Policy:
@Health_Affairs
@NEJM
@JAMA_current
@NHMAmd
@NationalMedASSN
@ANANursingWorld
@NNEC2015
@AcadMedJournal
@LMSA_National
@TheCHAUSA
@HSHPS96

News:
@CitizenCohn
@ThinkProgress
@NYTimesHealth
@NYTimes
@WSJhealthblog
@HuffingtonPost
@FiveThirtyEight
@BoldFaithType
@IGsolidarityNET
@TheOnion - humor

Like On Facebook

Bioethics:
LoyolaBioethics
BioethxChat
Life Matters Media
ASBH
Bioethics – AJOB Discussion Group
Bioethics International – Discussion Group


Health Care/Policy:
National Hispanic Medical Association
New England Journal of Medicine
American Journal of Nursing
Hispanic Serving Health Professions Schools
Latino Medical Student Association
Student National Medical Association
Catholic Health Association

News:
Jonathan Cohn
Think Progress
The New York Times
The New York Times – Well – Health
FiveThirtyEight
Faith In Public Life
Ignatian Solidarity Network
The Onion - humor


Mark Kuczewski, PhD, is the Chair of the Department of Medical Education and the Director of the Neiswanger Institute for Bioethics and Health Policy at Loyola University Chicago Stritch School of Medicine.  Dr. Kuczewski teaches Clinical Bioethics and Organizational Ethics in the Bioethics & Health Policy Graduate Program at Loyola University Chicago.  You can follow him on Twitter @BioethxMark or friend him on Facebook (Mark G. Kuczewski).