“Medical ethics do not provide pre-fabricated solutions”

With her appointment in October 2020, Claudia Bozzaro is the new Professor of Medical Ethics at Kiel University. In her interview with unizeit, she talks about challenges, answers to major health policy issues and the limits of medicine.

unizeit: Professor Bozzaro, you hold a doctorate in philosophy and also studied art history, contemporary history, theology and psychology in Paris and Freiburg before you became involved in medical ethics. What brings a humanities scholar to medicine and in particular to medical ethics?

Claudia Bozzaro: Ethics is a branch of philosophy that I was always interested in during my studies. When I was doing my PhD, I was given the opportunity to work in an interdisciplinary research project, which is where I first came into contact with medical ethics. I realised immediately that this area interests me enormously and that, especially as a humanities scholar, I’m in a position to follow up on important questions and provide innovative impulses.

And anyway, both as a science and in practice medicine depends on methods of knowledge that come not only from the natural sciences but also from the social sciences and the humanities. Medical ethics itself has always been an interdisciplinary subject. The classic questions of medical ethics, such as when exactly human life begins and ends, what moral obligations medical doctors have towards their patients or how scarce medical resources can be distributed fairly, are not questions that can be answered from a medical perspective alone. These are complex issues that are also linked to anthropological and cultural presuppositions; the answers depend on social developments and also have legal and moral implications.

What does a medical ethicist do? What does the teaching involve? And how important is it to cover the subject in medical school?

My work has many facets: in addition to doing teaching and research, I’m also involved in several committees like the ethics committee that reviews clinical research applications.

In my view, it’s extremely important for medical students to learn about ethical issues during their training. When I was providing further education for physicians, I learned that many doctors are confronted with ethical conflicts and problems in their profession, for which they feel inadequately prepared by their training. At the same time, it’s important to note that medical ethics is not about providing pre-fabricated solutions to ethical problems. Actually, the focus is on training the ability to reflect and to deal individually with moral questions.

What challenges arise for you as a medical ethicist from the COVID-19 pandemic?

Indeed, the COVID-19 pandemic presents us with many ethically relevant and difficult questions. We are now forced to think about triage decisions, which refer to the question of how we allocate scarce resources: including prioritisation when it comes to vaccine distribution, the discontinuation of certain medical services in the healthcare sector and, last but not least, the difficult trade-offs between the benefits and potential damages of lockdown measures. What’s more is that the pandemic confronts us with fundamental questions that will continue to concern us for a long time to come, such as the issue of how people age and die with dignity, considerations about how we treat our natural environment or a discussion of the conditions for effective and solidary healthcare in a globalised world.

What issues are particularly important to you?

In the past decades, the focus of medical ethics discourse was on safeguarding the individual autonomy of patients as well as on clinical ethics issues with regard to the treatment of individuals. While these questions continue to be important, I believe – and the pandemic has also made us more acutely aware of this – that we need to place more emphasis again on questions concerning relationships, organisations and society as a whole. This is best indicated by some key words that I deem important: altruism, solidarity, responsibility for ourselves and others, fairness and sustainability. These concepts bring us to complex debates and far-reaching ethical questions. And they will definitely also become more and more important in the field of medical ethics over the next few years.

What will be the priority of your own research?

Interdisciplinary exchange is very important to me. This also involves building bridges between the Faculty of Medicine and the other faculties. Furthermore, I’d like to focus on ethical issues at the end of people’s lives, challenges in the treatment of chronic diseases and the field of fair and sustainable healthcare. Moreover, medicine in general is increasingly influenced by digitalisation, which will bring many new opportunities, but also a whole range of new challenges. This means I won’t be at a loss for interesting subjects in the years to come.

This interview was conducted by Jennifer Ruske.