For many students, taking various classes in bioethics simply amounts to their way of getting a good, rigorous liberal arts education. Others, however, may be interested in eventually pursuing some sort of bioethics-related career. As a relatively new interdisciplinary field, bioethics lacks the sort of tried and true career paths that we find in the worlds of business, law, teaching, medicine, and so on. Indeed, all of those who are now in the senior ranks of professors in bioethics pretty much stumbled or sleepwalked into their current interests and professional positions. Our commitments to bioethics more or less developed along with the field itself. And because bioethics is an interdisciplinary field, there is often controversy about fundamental issues, such as what sorts of things people in bioethics should know and what sort of training they should obtain. That said, things are now much more settled than they were twenty years ago, and some distinct career paths have begun to emerge.
The first (obvious) thing to note is that a minor or interdisciplinary major in bioethics won't exactly allow you to graduate, "hang up a shingle," and start offering reimbursable ethical advice to people. Entry into the field of bioethics can only be successfully accomplished through one of the contributing traditional disciplines that jointly constitute this field. This means that anyone serious about "doing bioethics" in some capacity must also take seriously the need to master some related discipline, such as medicine, nursing, public health, law, or an academic discipline like biology, philosophy, religious studies, politics, anthropology, etc. This list suggests three general rubrics for thinking about careers in bioethics: Health and health care, law, and academics.
The World of Health and Health Care
Probably the most tried and true route to a successful career in bioethics, both now and in the foreseeable future, is through the health professions-i.e., medicine, nursing, public health, and medical social work. One reason for this is that the best way to be taken seriously within the world of health care is to be oneself a physician or nurse. Another reason is that it's economically more advantageous for health care institutions to hire ethically trained health care professionals who can also do some sort of clinical work than it is to hire "outsiders" (e.g., philosophers and lawyers) to give ethical advice on cases or policies. Each of the "job tracks" listed below requires proper credentialing in medicine, nursing, public health, or social work. (Undergraduates should note that admissions committees in medicine, nursing, public health, and law schools generally do not mind if students major in a traditional discipline or in an interdisciplinary major like Bioethics, Human Biology, Political and Social Thought, or Philosophy, Politics & Law.)
- Working as an ethically informed health professional in a hospital, nursing home, etc., serving on or staffing an institutional ethics committee (IEC), institutional review board (IRB), helping draft hospital policies, consulting on individual cases, etc. For more information on the nature, goals, and skills required for clinical ethics consultation, see: http://www.annals.org/cgi/content/abstract/133/1/59 (MD, RN, MSW)
- Teaching and scholarly work in bioethics in a medical or nursing school. Such positions are usually split between work in a bioethics center and clinical work in a regular medical or nursing specialty. The bioethics institutes at UVA http://www.healthsystem.virginia.edu/internet/bio-ethics/ , University of Pennsylvania http://www.bioethics.upenn.edu/ , Johns Hopkins http://www.hopkinsmedicine.org/bioethics/ and Minnesota http://www.bioethics.umn.edu/ are typical examples of such centers. (This sort of work usually, but not always, requires both a medical/nursing degree and some sort of additional credentialing, such as a masters in bioethics, a doctorate in a related discipline, or a post-graduate [i.e., post MD or RN] ethics fellowship.)
- Health policy work for various medical organizations (AMA, ANA), non-governmental agencies (NGOs), and government departments (e.g., FDA, CDC, NIH, Veterans Affairs). See, e.g., the Center for Clinical Bioethics at the NIH http://www.bioethics.nih.gov/ and The AMA's Institute for Ethics http://www.ama-assn.org/ama/pub/category/2558.html .
- Work in public health and ethics. Includes working as public health officer at the local level; policy, research, and public health interventions at the national level (e.g., through the Centers for Disease Control [CDC]), and global outreach through the CDC, World Health Organization [WHO], and NGOs. For more information about all aspects of public health, see http://www.apha.org/ (Masters or doctorate in public health or combination MPH-JD or MPH-MD degree. The doctorate and latter degree combinations are especially useful for people who wish to do policy work in public health.)
- Health care administration. Includes work with government agencies and the private sector - e.g., administering managed care organizations, hospitals, nursing homes, etc.. (MD, MPH, RN, MA/PhD in policy studies)
- Genetic counseling. Advising prospective parents about genetic risks has long been a separate career path that intersects with bioethical issues. For advice about graduate programs, credentialing, etc., see: http://www.nsgc.org/careers/index.asp
- Hospital chaplaincy. This is one of the few reliable non-medical routes to ethics-related hospital work. The primary mission of hospital chaplains is to offer spiritual comfort to patients and their families, but the cases chaplains confront often implicate bioethical issues. FAQs on hospital chaplaincy available at: http://www.healthsystem.virginia.edu/internet/chaplaincy/faq.cfm (Credentialing requirements vary in this field, but most practitioners have a BA, a masters of divinity (M.Div.), and training in a program of Clinical, Pastoral Education [CPE]).
- Bioethics-related legal practice -- e.g., working for a general health law firm or niche firm specializing in an area like elder law or intellectual property and patent law. (JD)
- Bioethics consulting in a hospital setting. Many lawyers split their time between doing standard legal work for hospitals (contracts, malpractice defense, risk management, etc.) and working with hospital-based bioethics consulting groups and ethics committees. (JD - an MA in bioethics would help)
- Law and health policy work for medical school-based bioethics centers, various NGOs (e.g., Gay Men's Health Crisis), medical societies (AMA etc.), governmental departments (FDA, CDC, NIH, GAO), and international organizations (WHO, CDC, etc.). (JD - an MA in bioethics would help)
- Teaching law and bioethics. On the academic side, many lawyers have fulfilling careers teaching bioethics within a law school setting. Those who follow this path must, of course, teach some standard legal topics (contracts, torts, constitutional law, patents, etc.) in addition to bioethics-related courses. ( Careers in law schools usually require a JD from a top-ranked law school such as Yale, Harvard, Stanford, Chicago , Michigan , NYU, Berkeley , Virginia , etc., as well as a post-graduate clerkship in a state or federal court)
The final route into a bioethics-related career is through teaching in academe. Religious Studies and Philosophy are the most frequently encountered specialties in bioethics, but opportunities also exist through graduate study in such fields as Anthropology, Biology, History, Politics, and Sociology. This is a viable option for students who excel in any one of these fields and appreciate the full range of sub-disciplines that constitute them. It is not a good idea for students who are simply and exclusively interested in bioethics - i.e., students who do not wish to "pay their dues" by doing the hard work stretching over 4-6 years required in any self-respecting doctoral program. For example, anyone doing a Ph.D. in Philosophy will be expected to do well in logic, metaphysics, epistemology, history of philosophy, etc., as well as in ethics and political philosophy. The same holds true for Religious Studies or any of the above fields. (This career path requires a Ph.D. in an established discipline. Graduate admissions committees in such fields prefer that students first obtain a broad education in their respective field , rather than in an interdisciplinary major like bioethics.)
Although most Ph.D.s in bioethics-related fields occupy teaching positions in disciplinary departments (e.g., Philosophy, Sociology, Religious Studies, etc.) in colleges and universities, some work in interdisciplinary bioethics centers within medical schools - indeed, the current directors of the centers at Virginia, Penn, Minnesota, and Indiana are all philosophers by training - or in research institutes not affiliated with universities, the most distinguished of which is The Hastings Center http://www.thehastingscenter.org/ .