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Medicine, Motherhood, and Moral Obligations

The day I submitted my applications to medical school, Karen Sibert published an op-ed in the New York Times calling on young women to very carefully consider the choice to pursue a career in medicine. Sibert is convinced that with the looming doctor shortage, especially in primary care, our country simply cannot afford for doctors to work part time. She argues that women doctors far too frequently choose to work part time to raise their children and in so doing fail to live up to their moral obligation to their patients and to the taxpayers who help fund medical education.

Sibert’s essay has generated quite a buzz, especially among women physicians. Michelle Au, an anesthesiologist like Dr. Sibert, called her essay “sexist, inflammatory, and frankly discouraging.” The two anesthesiologists – both mothers – fleshed out their disagreement on NPR. And the New York Times “Motherlode” blog stirred up more discussion with the headline “Should Women Be Doctors?” A month later, the debate continues at The Boston Globe, where Dr. Suzanne Koven urged that rather than blame women doctors who work part time, “primary care needs to be restructured and better paid to attract more physicians – women and men.”

Much of the response has centered on what message to give to young women who aspire to be doctors. Diverse commentators seem to universally agree that there are trade-offs no matter how one manages to balance work and family. But Dr. Sibert goes a step further. She offers this direction to people like me:

“Students who aspire to go to medical school should think about the consequences if they decide to work part time or leave clinical medicine. It’s fair to ask them – women especially – to consider the conflicting demands that medicine and parenthood make before they accept (and deny to others) sought-after positions in medical school and residency. They must understand that medical education is a privilege, not an entitlement, and it confers a real moral obligation to serve.” (italics mine)

If I am offered a sought-after seat in a U.S. medical school, Dr. Sibert wants me to think about those students who were not offered that spot. Because I’m a woman and likely to have children and could choose to work part time while raising them, she asks me to consider the possibility that I would be denying an opportunity to somebody else, presumably a man, who would be more likely to practice medicine full time.

While certainly these conflicting demands are worth serious consideration, I find the insinuation that I should feel guilty and selfish for accepting a medical school offer rather than passing it onto someone an admissions committee already decided to waitlist or reject quite nonsensical and insulting.

At age 22, I cannot possibly know how my life will unfold. To ask me to decide how I’ll manage the work-family balance this early in the game is just unrealistic.

But even if I had a crystal ball and saw three kids and a period of part-time clinical work in my future, I’d still hit that “submit” button on my medical school applications. If I got an offer, I’d accept it.

Women from earlier generations – women like Dr. Sibert – fought hard to ensure that women of my generation have equal access to the professions. After centuries of stomping on women’s scientific and professional ambitions, parents, teachers, and other leaders now generally raise young women to believe we can accomplish anything men can. But that doesn’t mean our lives unfold exactly like the lives of men. Nor does it mean that as soon as we consider the possibility of scaling back our work to allow time for motherhood that we should start denying ourselves opportunities.

Certainly I need to be thinking about the responsibilities I’ll have to my future children and patients, since from where I sit now, being a doctor and a mother seems like a likely possibility for me. In that scenario, I will be morally obligated to provide competent care to my patients, benefiting them as I can and avoiding harm wherever possible. I’ll also have a moral obligation to care for my children, as will their other parent. Balancing these sometimes conflicting obligations will no doubt be difficult at times. I disagree with Dr. Sibert that there is one morally defensible way – working full-time – of navigating that balance.

But in weighing obligations to future patients and hypothetical children, what seems to be missing is an acknowledgment of the sacrifices I will be making at my own expense if I don’t pursue my dreams of having a medical career and a family, of serving patients and raising children. The feminist effort to allow for women to have careers and families isn’t about ensuring that women please employers and husbands, taxpayers and children. It’s about creating possibilities for women to flourish to their greatest potential, personally and professionally, as doctors and mothers and whatever else we choose to be. I won’t apologize for believing in that.

Colleen Farrell is a research assistant at The Hastings Center.

Published on: July 20, 2011
Published in: Health and Health Care

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