Stephanie Kraft

Stephanie Kraft ‘13

Research Associate, Stanford Center of Biomedical Ethics and Visiting Scholar, Seattle Children’s Research Institute

 
 
 
 
 
 


Do you consider yourself to be a health lawyer? And what does it mean to you to be a “health lawyer”?

I don't practice law, and I haven't practiced law since graduating from law school. When I describe my job to other people, I don't typically start by saying I am a health lawyer. But that said, a broad definition of health lawyer might fit. I certainly work in the heart of what you might describe as health law or health policy. I am not necessarily directly engaged with the law at any given moment, but it certainly informs how I think about things, and it's a player in the universe where I work.

I do bioethics research, and I work with a number of different people from a number of different disciplines, situated in a medical school and a hospital. I work with doctors, sociologists, biology PhD's, philosophers and a few other lawyers. I do empirical bioethics research. That means we find interesting bioethics questions, develop surveys, and do interviews or focus groups to analyze people's perspectives on these issues.

The other aspect of what I do is called clinical ethics. I spend time in a hospital as a clinical ethics consultant. When there is a question about ethical issues that comes up in the hospital, or sometimes in an outpatient setting, we'll get a call and I’ll advise the physicians, nurses, social workers or sometimes the patients, on how to navigate a particular issue. So, what I do goes beyond just looking at the law. It's certainly part of it, but we try to go a step beyond that to really engage with the ethical issues rather than the legal issues.

I know a number of people who do what I do who have JD's. Other people have MD's, other people have PhD's and you know everybody approaches it in different ways and you train to fill in the gaps. I had to do some training to fill in the clinical gaps where someone with an MD might have to do more training to fill in the philosophy that they might have missed out on. My legal training has definitely been useful. It's an element of what can make a person successful in this job.

 

What was your impression of healthcare law back when you were a student at UC Hastings?

When I was a student, my impression of health law, in the narrow sense, was sort an image of an attorney doing medical malpractice lawsuits. To be really honest, some of the work I do now, the clinical ethics in particular, I didn't even know was an option when I was a student. I only got exposed to it once I started doing my training. I did a post-doctoral fellowship at Stanford after law school, and when I was doing that, I learned about clinical ethics and got to do a lot of it and the more I did, the more that I learned. I think the field of bioethics is something I knew was a piece of health law, but there is lot more to it that I hadn't been exposed to while I was a student.

 

What most excites you about your work?

It’s exciting to publish a paper and to get the final proofs back. I think that it's easy to point to something like that and say that that is a really cool moment. But what is even more exciting about my work is the nature of the field of bioethics. It is huge and interdisciplinary and there are all sorts of different pieces of it and different types of people working together on all sorts of different projects.

The moments that are the best for me are when I feel like I have a particular topic or particular issue that I have spent a lot of time thinking about, and I am able to show that. For example, I teach seminars to medical students about how to deal with ethics issues in their practice. I go through my set lesson plan, but then sometimes somebody asks a question, and it's something that I have actually done a lot of research on, and I can share that perspective. Or in the research context, when I am writing a paper and have that moment of clarity when everything comes together, and I can sit down and write and get excited about what the findings are saying.

For instance, a couple days ago I was working on a draft of a paper for a study my research group had just finished. We had our survey results, and I had my outline, and I had read enough of the literature to be able to sit down and just write. It was almost like being in a law school exam that you’ve prepared for really well, when you can just sit down and know exactly what you’re going to say, and write for three hours, and it comes out more or less how you want it to sound.

"It is huge and interdisciplinary and there are all sorts of different pieces of it and different types of people working together on all sorts of different projects."

The other thing that comes to mind is an earlier stage of a different project that I am working on. I had a long conversation yesterday with a colleague with whom I am working on the project, which is an interview study about patient-physician communication. We have been analyzing the data using a qualitative methodology that I have been able to practice during the couple of years that I have been working at Stanford, although my colleagues on this project haven’t had as much experience with qualitative research. So yesterday we had a long conversation and I got the chance to help guide where the project is going next, and what our next steps are. It was really exciting to feel like I am playing a major role in getting this work to progress to the next step.

 

What is the biggest challenge in your work?

The biggest challenge for me, especially as someone who is early on in my career, is trying to simultaneously maintain a sense of flexibility about where I am going, in terms of what topics I cover and what issues I'm interested in, and at the same time have enough focus to progress in my career. It is very tempting when you see all of these really interesting issues, but I can’t get involved in every single research project that's out there. I try to maintain a breadth of coverage in terms of topics and activities, but not so broad a focus that I stretch myself thin.

 

What aspects of your training or background most inform the work you do now?

The analysis skills I learned in law school underlie everything I do, from analyzing empirical results, to thinking through how they fit with the literature, to doing clinical ethics consultations. It’s on the ground ethical analysis, and integrating whatever laws or policies might be relevant. Being able to do that thinking on my feet reminds me a lot of being in law school.

Also, a lot of the time, when I'm doing consultations, I might be sitting in a room with a doctor and a patient, or a social worker or a number of other people, navigating those conversations, and I am reminded of taking negotiation classes in law school, and being able to navigate a bunch of different personalities, and thinking through how to how to get through a situation in a way that makes everybody as happy as they can be, while still keeping in mind whatever ethical principles we are working with.

Since law school, in my post-doctoral fellowship at Stanford, I did training in qualitative social science methodology. I use that every day. And before law school I had a little bit of a statistics background, so that also comes in here and there. In all of my studies from undergrad through law school through post-doc, it’s all about being able to look at the evidence and to look at the literature and to decide what’s trustworthy, what’s not, and how everything fits together.

Throughout law school I knew I was interested in these broad health law and policy issues. And I knew that bioethics was a part of that. I spent a couple of summers doing traditional legal internships, and that was helpful to get a picture of law firm life. I also did research during law school, and I really enjoyed doing it, and wanted to keep doing more, so I ended up doing the fellowship and learning more about the field. In doing that, I took a leap of faith, and so far it's worked out. I do something that I enjoy, and there are good career options in it. I hadn’t decided on a set career path going in to law school, but I developed it while I was there.

 

Tell me about a day in the life of you.

Until recently I was doing some work at the hospital, but these days I am mainly focusing on research. So basically, I spend a lot of time at my computer, probably like most lawyers do. I go to the office, or on some days I work from home. I spend some time writing and some time reading articles. I also spend a lot of time on conference calls, and working with colleagues developing projects. It depends on what stage of the project we are at. If we’re actively doing interviews, for example, I'll be on the phone sometimes for several hours a day, just talking to people and collecting data. Or maybe we are at the end of the project, and we are thinking about analysis, and brainstorming papers, and writing up the results.

When I was doing clinical ethics consultation, I was on call for a couple of weeks at a time, and in between phone calls I would be doing research. But I would carry around a pager, and if there was an issue in the hospital, where somebody needed advice on an ethics matter, I would get paged and call them back. Sometimes it was a matter of a couple of phone calls, and then talking the caller through the relevant hospital policy. Other times, it was a more involved process, where we had multiple phone calls, and we had to coordinate people, and come together for a big family meeting. That work can be pretty variable. It adds a nice contrast to the research that I do, because usually in these cases you get an immediate solution to the problem, whereas the research process can take months or years, and it’s a long time from development of the concept to publication of the paper. Clinical ethics is ethics in action, and it is satisfying to help people work through the difficulties involved in medical care. By people, I mean patients, their families, and the doctors and staff, as well as all the other people involved who are having to deal with these situations.

 

Can you say a little bit about your work/life balance and how it might compare to some of your colleagues who work in other areas of the law?

As I mentioned, I have a lot of flexibility in terms of my work, which is both good and bad. I can work from home pretty much whenever I need to. And, nobody is keeping track of whether I'm in the office, or not, or if I have to take a couple of hours in the afternoon to do something else. As long as I get my work done I have a lot of flexibility. This is good, but it also means that it can be easy to get overwhelmed and overburdened, especially if you have a tendency to take on too much. With that said, I think I have a pretty good work/life balance and I work well having a routine, so I try to either go into the office on most days, or when I am working from home, have set hours for when I am working, and when I am off. And, I think it works pretty well. It's about how I manage my own time, and how I get my own projects done. I stay accountable to myself.

Outside of work, I try to make it to my nightly yoga class, and cook with my husband, and for the most part manage to keep my weekends relatively work free, aside from checking emails. I do a good job of separating my work life from my home life.

 

Now, more than ever, there is pressure on lawyers entering the workforce. Do you have any advice you would like to give the next generation of law students interested in healthcare law?

My advice would be to be skeptical about the advice that you get. When I was getting advice about what to do after law school, particularly when I was making the decision to not practice law, some people were fully supportive and had suggestions for what I could do, and others were much less supportive. Their thinking was that to go through all this training, and take the bar and do the whole thing, and then not actually practice was crazy. What I realized in that process is that everybody has gotten to where they've gotten. Everybody can only take one path, and it hopefully works for them. But when you are trying to get advice, and trying to make those decisions going forward, I think you have to keep in mind that these are all individual experiences, and I think it's helpful to not just take one person’s opinion and run with that, but to hear from a lot of different people and keep an open mind about what makes sense for you, and for the future that you see yourself having.

In the bioethics field, like I said, I work with JDs, MDs, PhDs, RNs, and people with all sorts of other combinations of letters at the ends of their names. It's such an interdisciplinary field and I really like that about it. So, I think you can have a successful career without following one particular career path. I think there is a trap that's easy to fall into, especially in law school, where there's a lot pressure to follow one particular career path. But I don't think it has to be that way.

 


Interview by: 

Rachel Goodman, MFT

Senior Academic Program Coordinator with the UC Hastings Center for State and Local Government Law. She is also a psychotherapist in private practice in Berkeley, CA.