Medical Ethicist

The Rev. David O'Leary has been the university chaplain at Tufts University and a senior lecturer in medical ethics on the health sciences campus since 2002. Although he holds a glittering raft of academic credentials from St. John's Seminary, Boston College and Oxford University, he began humbly enough in the working-class town of Lynn, Mass., where his dad punched the clock at the United Shoe factory and his mom worked for the phone company. "We weren't active Catholics," says O'Leary quietly, "but church was part of the life."

His doctoral dissertation at Oxford was titled The Roman Catholic Perspective on the Morality of Withdrawing or Withholding Food and Fluid Administered to an Individual in the Persistent Vegetative State. He survived his oral defense despite the presence of a pesky Dominican priest on the faculty panel who quizzed him repeatedly about the metaphysics of the soul of a dying person. Each time the priest bore in, O'Leary responded that this topic lay beyond the scope of his thesis. "I didn't know anything about it, other than the definition of metaphysics as looking for a black cat in a dark room that isn't there," he laughs.

O'Leary wears many hats. In addition to his regular teaching responsibilities at several Tufts schools and his day-to-day work in the trenches of campus ministry, he also serves as a member of the Institutional Review Board (IRB) at Tufts Medical Center. We spoke in O'Leary's sunlit office on the ground floor of Goddard Chapel on the Medford/Somerville Campus.

Q: When you first expressed an interest in entering the church, what was your parents' reaction?
Oh, they weren't that pleased. They would have preferred grandchildren and didn't understand how a son could become a priest. The idea grew on them after a while.

Q: Why did you pursue your doctorate in medical ethics, as opposed to some other focus?
I was drawn towards moral theology, and then I got my licentiate degree in Catholic social ethics. I figured I had a great foundation in moral Catholic social teaching, and then the field was getting more and more involved in medical issues, so I said, well, let's jump on that.

Q: Tell me about the class you teach at the medical school.
When I'm there I just try to raise the question: Who is the doctor or the researcher working for? It's not one answer - it's profession, practice, patient. You have to figure out where your lines are. And then I always try to pass on what I learned from a great doctor at Georgetown, Dr. Edmund Pellegrino. He always used to say to his interns that the first question to ask is "How may I help you? and not "What is wrong?" Why put the person in the negative to begin with? You are there to help. Let the patient start the conversation. In that way you're restoring dignity.

Q: What sorts of issues come up in your Institutional Review Board role?
All research on human subjects has to be approved by an ethics committee, according to federal guidelines. Everyone on the committee has their one category where they like to be a specialist, and for me it's to make sure the subject has the freedom to say yes or no to participation. If someone's coming at you with a clipboard, and it's your doctor-well, where's the line of freedom? Can the person say no?

Q: Freedom seems to run through a lot of what you care about, whether it's freedom at end of life or freedom to determine one's own course. Yes. Now I'm betraying my own training. I trained under a great priest, Josef Fuchs, a German theologian. His thing was freedom. He said the human person is so constitutive of a being that's created with freedom that even after the point of physical death, God would give us the freedom to choose.
I've used that many times in celebrating the sad occasion of someone's funeral due to suicide to say, OK, he or she might have made a wrong decision based on a clinical depression or a chemical imbalance in the brain, but the next time they were given a choice I'm sure they chose God. TM