By Bridgett Harris
UCCS philosophy professor Mary Ann Cutter was honored last month for her work advancing women in academia, and for her teaching and scholarly contributions. Winning the 2019-20 Elizabeth D. Gee Memorial Lectureship Award is another highlight in her distinguished career as an educator.
Cutter earned a Ph.D. in philosophy at Georgetown University through the Kennedy Institute of Ethics program. Although she was pre-med at Georgetown, planning to study psychiatry, Cutter also became engrossed in the philosophy classes she was taking. The Kennedy program gave her the chance to pursue both — and laid the foundation for her career as a philosopher and educator in the areas of medicine, disease, biomedical ethics and death and dying.
A prolific researcher, Cutter has to her credit dozens of articles and presentations on the philosophy of disease, biomedical ethics, and death and dying, as well as seven published books and two more in progress. Her two most recent books include Death: A Reader and Thinking Through Breast Cancer: A Philosophical Exploration of Diagnosis, Treatment, and Survival. Death: A Reader is a comprehensive philosophical exploration of themes of death and dying across cultures and throughout history. The related course she teaches at UCCS — called Death and Dying — is incredibly popular; Cutter says it has remained so for the 30 years it has been offered.
Thinking Through Breast Cancer is also a philosophical investigation, albeit with a deeply personal touch. Cutter was diagnosed with breast cancer in 2012, and her experience as a patient informed her research in a new way.
“I think, in hindsight, my work is much better because of it,” she said. “It’s much more attuned now to some of the issues that maybe others aren’t talking about.”
One of those issues is what Cutter refers to as “the uncertainty of medicine.” She points to well-regarded cancer websites that provide extensive data but do little to discuss what is unknown or how to make a decision in light of that uncertainty. Part of her work is utilizing the humanities to help health care professionals address such issues to ensure patients are thoroughly informed.
Cutter spoke with the Business Journal about her work, as well as the role of women in academia and medical ethics in the age of COVID-19.
Why did you choose to study philosophy and — more specifically — disease, biomedical ethics and death and dying?
Since graduate school, I have been interested in the ways in which classifications and descriptions of diseases frame how we treat them, and how they set up ethical challenges that we address. Since the 2000s, I have applied this approach to my work on concepts of death around the world and, again, how they frame how we respond to death and dying in the clinical setting.
Why is it important to apply philosophical studies to medicine and health care?
Because medicine isn’t that simple. The science of medicine is involved in various ways of caring for patients. The moment you have a patient involved — not just a cell under a microscope, but a patient — you have a focus of attention that goes beyond simple matter. You have a being who lives in the world and makes choices with regard to how she lives in the world. The patient isn’t an object and because of that, it gets messy. It’s not easy for the health care professional.
That’s where the philosopher comes in. I have long held that training in humanities, and in my case philosophy, is important in health care and how patients are diagnosed and treated.
Have you found it difficult to immerse yourself in the subjects of death and dying or have you grown comfortable with it?
Yes, I think I’m very comfortable talking about it — but I also realize that others [are] not and that’s important. Philosopher Michel de Montaigne says that “to study philosophy is to learn to die” — and the idea there is that if you study something enough, I think you become willing to let it go. With regard to death, I’m not afraid of dying because it’s inevitable.
You just received the CU Gee Lectureship Award in recognition of contributions to academia, including your efforts to advance women. What are some of the challenges women in academia face?
Women academics are required to satisfy the standards for academic advancement, yet, I think, still carry the majority of day-to-day responsibilities in caring for offspring, advising students undergoing challenges and serving in ways that represent women. Their responsibilities can often include caring for the elderly. I have colleagues who care for their elderly parents at home and they’re all women. I’ve also observed, in my own experience, that students or grad students who are struggling tend to gravitate toward women faculty, which adds to their workload. I am a bit surprised things haven’t changed more in society.
Why is it important for women to hold leadership roles in academia?
Good leadership is good service. Knowing what and how to serve requires a stake in the activity or event. Women bring to leadership roles — and to their service — perspectives on life and work that come about through their unique life experiences. These perspectives are important.
What advice would you give to women who aspire to tenure or administrative positions in education?
Know the reward system. Stay focused on your goals. Balance your work and home life. Ask questions and inquire into possibilities, because the worst someone can say is ‘No.’ Last, be confident in who you are; you can’t be someone else. I find that some women faculty still feel obligated to do certain tasks and I tell them, ‘Don’t. Just say no.’ I do not put myself in situations that I don’t want to be in. I don’t serve in capacities in which I do not have something to offer. I serve in ways that I believe that I can make a difference, but do not disallow me from working on projects and devoting myself to my students.
Are you engaged in any new research or writing projects?
My current projects include two sole-authored books, Managing Uncertainty in Clinical Decision-making: The Case of COVID-19 (a working title) and Practical Ethics: Readings and Reflections. The first book focuses on how we manage uncertainty in the diagnosis, prognosis and treatment of COVID-19, and addresses the ethical duty we have to recognize such uncertainty. The second book is a textbook for my course on Practice Ethics at UCCS.
Has COVID-19 affected your ability to teach?
I transitioned well because I saw the emergence of interest in online studies years ago and thought I should get involved. I teach pre-health care professional students who are really busy, and I thought it was really important to be able to offer them a flexible way to study and tailor what I do to their busy schedules. I took training classes and got certifications.
What advice do you have for students or professors who are struggling to adapt?
Find a trusted mentor or two and don’t be afraid to seek advice and feedback. After COVID-19 hit, I found myself becoming a trainer within my own department, along with a couple of others in the department who have taught online. We put together tip sheets and I made myself available. The first two weeks were pretty crazy. We’ve never forced others to learn this. I think we have yet to tell the story of how this has changed us — how delivering our content this way has changed us and changed our students. That story will need to be told. I’ll tell you this: We’re all trying to do the best we can.
What are some of the more troubling medical ethics issues presented by COVID-19?
Prior to COVID-19, our treatment, as a society, of the elderly in nursing home facilities has not been good. To be very clear, I’m not criticizing those health care professionals who work in nursing homes. It is we, as a society, who have not devoted sufficient funds to elder care.
Proper care is about giving skilled health care professionals sufficient resources, and I think we shortchange our elder care facilities. For example, a number of the nursing homes have joint rooms by necessity due to lack of space. So, in the case of COVID-19, the spread was impossible to contain and that has hit us pretty hard.
What other challenges have you seen?
In the beginning of all this, there was the situation of people dying of this virus alone in the hospital. Not only did some patients not have their families with them — even allied care professionals such as counselors or spiritual advisors were not always able to attend. I can think of no philosophical view of death that celebrates people dying alone.
I’m always working with health care providers, and the most common conversation I’ve had with health care providers regarding COVID-19 centers on questions such as: What do you say to someone who’s dying? How do I be by that person’s side when their families are not allowed to be there? We don’t train health care providers for that kind of experience. Health care providers who have come by the bedside are amazing — they are heroes. But they need a team behind them and a plan to support them and the dying individuals.
As this continues to unfold, we will need to ask ourselves: Did we learn anything? How can we be better prepared in the future? How can we do the best job with regard to respecting patients, treating patients and allocating resources?