For one physician-scientist-lawyer, teaching bioethics is a calling
Dr. Pablo Rodriguez del Pozo crisscrossed the globe en route to the Qatar campus, where he has taught bioethics for the past 12 years. After graduating from medical and law schools in his native Argentina, Dr. del Pozo earned a doctorate in bioethics in Spain. Now he works with students in the Arabian Gulf, exposing them to ethical questions that are intrinsic to the study and practice of medicine around the world. His curriculum for medical students parallels that of the New York campus, sensitively adapted to fit the society in which it's taught. "I'm trying to triangulate between cultures," he says. "I want to put students on the right footing to deal with medical ethics problems they may experience later on in their careers, but in a non-threatening way."
Dr. del Pozo infuses the humanities into medicine, so students learn to approach patient care by focusing on the whole person rather than just on his or her medical conditions. Pre-med students in his introductory ethics course analyze literary classics to gain insights into the patient experience. Franz Kafka's The Metamorphosis chronicles the life of a traveling salesman who transforms into a giant insect and sees how his new condition transforms him and the people around him. Leo Tolstoy's The Death of Ivan Ilyich depicts the often disparate worlds that doctors and patients inhabit. Dr. Del Pozo hopes his students find in these stories and characters elements to which they can relate. "Fiction has a level of abstraction," he says. "This story represents all stories; this patient represents all patients; this situation represents all situations."In his program, Dr. del Pozo imparts elements of medical ethics that are universal — the Hippocratic Oath; the patient always comes first; do no harm — while reflecting the local culture. He notes that healthcare in Qatar embraces two seemingly contradictory styles: a 21st century, hyper-specialized approach akin to that in the West, and a more traditional system where patients see a single doctor and don't necessarily play an active role in their own care. "The challenge is to show the students that medicine is universal, and that medical ethics has some universal elements," he said. "But the patient is always local, and we have to cater to the local patient and their culture, family and environment."
He takes a semester-long longitudinal approach with second-year medical students that weaves together a theoretical framework with real-world examples — clinical cases and patient interactions — to explore the ethics surrounding such issues as beginning- and end-of-life care, reproduction, and informed consent. At the end of the semester, they analyze bioethics in the context of a case they've witnessed while spending time at doctors' offices as part of other courses in the medical program. While the course is nearly identical to the one taken by students in New York, Dr. del Pozo tailors the subject matter to accommodate cultural differences. In the Middle East, he notes, individuals consider themselves extensions of their families, and are diligent to represent them and their mores respectfully. And importantly, much of Middle Eastern culture — and the ethics that go with it — are deeply rooted in religion. Dr. del Pozo doesn't seek to indoctrinate his students or to change their values and culture, but rather help them develop a brand of ethics that reflects their own beliefs. "I want the students to produce a new breed of medical ethics that belongs to them, that they understand, and they themselves contribute to defining," he says. "That would be the real success."
In the third year, Dr. del Pozo contributes to an exercise on medical ethics during the medicine clerkship; in the fourth, he oversees a two-week clerkship that happens to be the students' last requirement before graduation. For the soon-to-be doctors, it's something of a capstone experience on the issues Dr. del Pozo has discussed with them throughout their Weill Cornell careers. With no specific clinical responsibilities, they are tasked with interacting with patients in chronic care settings — learning about them, their values, and what they expect from their care. Such concepts, he says, are too often overlooked. "We usually do fast-paced medicine," Dr. del Pozo says. "But I think as a doctor you will be a lot happier — and feel truly fulfilled — if you always keep in the back of your mind that every patient has a personal history, not just a clinical history."
Dr. del Pozo took a circuitous journey to his calling. After earning his medical and legal degrees, he began a residency in forensic medicine in a coroner's office in Argentina. He knew that it was important work, but he wasn't passionate about it and couldn't envision doing it for his whole career. Then, while taking a course on health legislation at the Universidad Complutense in Madrid, where he was doing specialty training in legal and forensic medicine, he had an epiphany during an animated discussion about patients' rights. "I realized, this is what I want to do," Dr. del Pozo recalls. "This is why I studied medicine and law — I just combined them in the wrong way with forensic medicine."
He completed his residency, went back to school for a doctorate in law with a focus on bioethics, and never looked back. In the years since, he has published 32 articles in peer-reviewed journals in English and Spanish, co-authored a book and written 24 book chapters and essays. He is a founding member of the Spanish Bioethics Association in Madrid, serves as a senior advisor to the Institute for Argentine Social Development and is a member of the American Society for Bioethics and Humanities. He also routinely receives teaching awards from his students. "Pablo Rodriguez del Pozo is one of the leading bioethicists in our generation," says Dr. Joseph Fins, chief of the Division of Medical Ethics and the E. William Davis, Jr., MD, Professor of Medical Ethics at Weill Cornell Medicine. "He's a great fount of scholarship, and he has enhanced the experience of our students. I have had the pleasure of meeting many of them in New York, and they always have a smile on their face when they talk about Pablo."
— Alyssa Sunkin-Strube
This story first appeared in Weill Cornell Medicine, Vol. 14, No.2.