Assistant Professor Jeffrey Byrnes’ desk is a couple layers deep in books critiquing naïve notions of artificial intelligence and the ethical shortcomings of algorithms that impact our daily lives, whether we are aware of it or not.  He’s designing a course on data ethics.

“For some, the idea of ‘philosophy’ can be a little off putting,” Jeffrey observes, “but a lot of people get the need for ‘ethics’.”

That need for ethics and ethicists is certainly not lost on Spectrum Health which has had an ongoing relationship with Jeffrey on its ethics panels.  Since 2016, a couple at a time, Grand Valley students have had the highly responsible opportunity to participate in internships in this important area.

Students who have taken classes in ethics and have a particular interest start by accompanying Jeffrey to meetings such as Spectrum’s research or IRB meetings to learn what the discussions are like.  These introductory meetings are not the most high drama or high risk cases, but they serve to demonstrate what the work is like and whether interests align.  These meetings also serve to begin to equip students with the language and process used in this work. 

“I was raised by two teachers and saw that as the only job.  To a certain degree, students see the job prospects illustrated by a handful of adults they know growing up.  Spectrum Health has 36,000 employees with jobs in areas across the disciplines.  It’s great to get students in to see what those are.  Research meetings, policy meetings, lots of one-on-one time with those people—in some cases the very executives who might interview them down the line.”

The most responsible students may even be allowed into clinical care settings though that requires more paperwork and vetting.  “HR has to sign off on any patient contact and additional vaccination may be required,” Jeffrey notes.

Jeffrey knows these students well, usually from his own ethics course, and can spot interest in medical ethics.  He is also approached by students, such as a nursing student and one desiring to be a Physician’s Assistant, who, because they are intending to go into a medical field, see the value in this experience.  Those seeking health careers locally are often introduced to people with whom they can form important work relationships.

“The ethics track at a hospital also tends to be a management track.  This can definitely lead to bigger things.  I also find that executives sit on ethics boards because they relish this work.”

Since his own professional reputation is on the line, Jeffrey looks for students with the requisite ethics coursework and a high maturity level.  The seven interns so far have been a resounding success.  “The students have been really impressive,” Jeffrey reports, “capable, and often mistaken for graduate students.”

He’s excited about his newest and eighth intern who is interested in public health since this is an important aspect of medical ethics.

“Grand Rapids is out ahead of peer and larger cities on medical ethics.  Here they look for evaluative ethical markers.  That’s exciting.  Even the other medical systems are increasingly modeling their programs on what we at Grand Valley have done—Metro, Mercy, Cherry Health.  I see these as future placements for our students.”

Ethics is well appreciated by many different people within the hospital system.  Certainly by surgeons and nurses, but also by chaplains, administrators, and many others in the complex network of jobs. 

“These are weighty decisions made under deadlines.  Different ones stick with people—they have long-lasting effects.”  Jeffrey explains the almost traumatic impact of some cases on the people working closely with them.  “Having the ethics team to help them debrief the decisions, to parse the ethical from emotional issues involved, helps them to think about it, to feel calmer, to get some distance.  This can really help.  I wouldn’t have predicted this,” Jeffrey acknowledges about the ethics-as-therapeutics aspect of his work.  “It is a high pressure environment.  People can be swimming in it.  A hospital is a cycle of recurring traumas, small and not so small.”

For Jeff, a day at the hospital has a demanding tempo.  His academic preparation did not quite ready him for that but he found he learned quickly.  Because Spectrum is not a teaching hospital system, GVSU had a special opportunity.  Grand Valley is for them accessible, local, understands the community, and has the virtues of nimbleness and responsiveness.  These attributes make GVSU a preferred partner.

Interns often begin interning in summer and fall.  Jeffrey uses a contract that specifies the time commitment, availability, privacy requirements (including social media), and need for professionalism.  These become some of the important learning benefits. 

“The Spectrum people we work with note about our student interns that they are ‘never deer in the headlights’,” Jeffrey recalls proudly.  He observes that while physicians are very bright and skilled, they find parsing ethical issues a little outside their skill set.  Students can really help them. 

“And there is less ego than you’d think,” Jeffrey states.

“So much of medicine is being automated, which heightens the concerns about ethics.  There is anxiety about privacy, about algorithmic decision-making.  We can’t let machines go on their own, and cost streamlining means that there will be more automation, but adding a person into the loop makes the process more expensive.  In the fall, we’ll have a conference here about what we do about telemedicine and algorithmic diagnosis. These have a relationship to health disparities, and that is a whole other conversation.”

Happily for the community, Professor Byrnes and Grand Valley ethics interns are excited and ready to parse those difficult conversations.