Douglas S. Diekema, MD, MPH
Dr. Doug Diekema is a pediatric emergency department physician, bioethicist, and professor. He works at Seattle Children’s Hospital where he is Co-Director of Education for the Treuman Katz Center for Pediatric Bioethics and Chair of the Institutional Review Board Committee. He is also a Professor in the Division of Emergency Medicine and the Division of Bioethics and Palliative Care within the Department of Pediatrics at the University of Washington School of Medicine. Dr. Diekema grew up in a suburb near Chicago with his six younger siblings. Combining his passions, he is an avid outdoor enthusiast and photographer who teaches a wilderness medicine course to pediatric residents.
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What is Bioethics?
The field of bioethics includes the study of health care ethics or medical ethics, both which are focused on clinical patient-focused settings. Bioethicists bring together expertise and perspectives from the fields of medicine, biomedical sciences, law, philosophy, social sciences, and behavioral sciences to study complicated ethical issues in biomedical settings.
“I just always kind of knew I wanted to be a doctor. I love biology and anatomy and wanted to work in a profession that helped people in need.”
— Dr. Diekema
Dr. Diekema's Story
Dr. Diekema grew up in Illinois in a large family. Wheaton, Illinois is a suburb located about 25 miles from the city of Chicago. Dr. Diekema’s father worked in Chicago as an administrator at the University of Illinois School of Medicine. A sociologist by training, his father was the Dean of Admissions and later was promoted to become the Associate Chancellor. Although his father spent his career at a medical school, Dr. Diekema explained that his father “was not a physician, and believe it or not, had little to do with my interest in medicine (since I really didn’t know exactly what he did).” Dr. Diekema explained that his mother worked as a nurse but stopped practicing after his birth, which was followed by six younger siblings.
Although Dr. Diekema’s parents had training in medicine and the social sciences, he did not receive any particular direction from them to pursue a career in medicine. However, there was an emphasis within his family on receiving a college education. He explained that his grandparents emigrated from the Netherlands as children, and none of them received a college education. Dr. Diekema reflected, “my maternal grandfather, who operated a grain elevator in northwest Iowa, valued education and read all the time.” His grandfather, he explained, “made sure all seven of his children went to college, and I benefited from that ‘family value’ being passed down to my generation.”
Dreams of Becoming a Rural Veterinarian
By about the age of ten, Dr. Diekema started to envision a future as a doctor or a veterinarian. What sparked that interest? Dr. Diekema reflected that “maybe it was TV shows or the influence of my own personal physician or my experience in the hospital at age 10 getting surgery for a serious wrist injury that occurred when my hand went through a glass window.” Dr. Diekema explained that “being a veterinarian was definitely on the table, especially after I devoured James Herriot’s series of books on being a rural veterinarian in Britain.” He even worked at an animal hospital during his time at college.
An Interest in Ethics Sparked by Conversations
Dr. Diekema’s interest in ethics developed while he was in high school in the mid-1970s. He recalled overhearing conversations among adults who were discussing “fascinating dilemmas that were arising as technology in medicine increased.” This was a time when the world saw the development of integrated circuits, the rise of supercomputers and personal computers, the use of CAT and MRI medical scanners, along with major discoveries related to genetic engineering and the emergence of a swine flu outbreak. The 1960s and 70s were also a time of strong advocacy for patient and consumer rights, including a patient’s right to informed consent before receiving a medical procedure or treatment, or choosing to enroll in a clinical study (Scher, S., 2018). The modern field of bioethics began developing in the 1960s and 1970s to consider the ethical, legal, social, and political implications of advances in medical technology, biomedical research, and medical decision-making.
Educational Pathway
Dr. Diekema’s educational pathway toward a career in pediatric emergency medicine and bioethics took him from his hometown in Illinois to Michigan, North Carolina, Wisconsin, and finally, to Washington. Dr. Diekema’s educational path included the following:
- Undergraduate/College: B.S. in Biology, Calvin University, Grand Rapids, MI (1977-1981)
- Medical School: Doctor of Medicine (MD), University of North Carolina School of Medicine, Chapel Hill, NC (1981-1985)
- Gap Year: He spent a gap year after completing medical school to work with a team of scholars at Calvin College to write a book on medical ethics. He also taught a lab course in comparative anatomy (1985-1986)
- Residency: Pediatric Resident, University of Wisconsin Hospital and Clinics, Madison, WI (1986-1990)
- Fellowship: Pediatric Emergency Medicine Fellow, Seattle Children’s Hospital, Seattle, WA (1990-1993)
- Graduate School: Master of Public Health (MPH), Health Services/Allied Health/Health Sciences, University of Washington School of Public Health, Seattle, WA (1990-1993)
- Board Certification: General pediatrics and pediatric emergency medicine by the American Board of Pediatrics
Find out more about the path to becoming a physician in the Pursuing a MD or PharmD (clinical doctorate) section of the Becoming the Next Cancer Researcher or Clinician resource.
Finding Balance by Going Outside
Dr. Diekema has many demands on his time. He reflected, “I have many job responsibilities that frequently pull me in different directions and some days it seems like I need to be in three places at once.” While he acknowledged that at times these demands “can be stressful and hard to navigate,” he also values his life outside of work and spending time with family as a way to find balance.
Dr. Diekema enjoys travel, hiking, backpacking, and skiing, and especially, combining photography with his outdoor adventures. He also enjoys running to stay physically fit, noting that he ran cross country and track in college and continues to be an “avid fan” of those sports. His current “project” is working his way through visiting all 63 US National Parks with his wife, Susan. They have only nine parks left on the list!
He lives in Kenmore, Washington with his wife, Susan. They have two young adult children.
A Day in the Life
Dr. Diekema balances multiple roles and responsibilities across two institutions, making each day at work a little different. He works as an emergency department physician, a bioethicist, and a professor.
Emergency Department Physician
Dr. Diekema usually works one shift per week as an attending physician in the Emergency Department at Seattle Children’s Hospital. Typically, his shift lasts for nine hours. To keep the emergency department open 24 hours a day, there are multiple work shifts, meaning Dr. Diekema might begin his day early at 5:00 AM, or late at 11:00 PM and work throughout the night, or he might start his shift some time in between. In the emergency department, Dr. Diekema collaborates with other professionals to care for pediatric patients with urgent medical needs. This includes working and communicating with nurses, surgeons, specialists, social workers, paramedics, and emergency medical technicians (EMTs), as well as the patient’s parents or guardians. During his shifts, Dr. Diekema also supervises and teaches medical students, residents, and nurse practitioners.
Physicians who staff the emergency department at Seattle Children’s have special training in emergency medicine and pediatrics. They need to be able to quickly assess a young patient’s injury or illness, stabilize the patient, and determine if the patient needs further evaluation, treatment, or surgery. They may also provide care for patients who have experienced trauma or have a life-threatening condition. It takes about eleven years of education to become an emergency department physician. Emergency department physicians must complete their undergraduate studies (typically four years), complete medical school (typically four years), pass the medical licensing exam, complete a residency program (typically three to five years), and then earn board certification by successfully completing an oral and written examination. Pediatric emergency medicine is a sub-specialty that focuses on providing emergency care to infants, children, and adolescents and which requires additional years of specialized training through a residency program or fellowship.
Bioethicist
In addition to his clinical work in the emergency department, Dr. Diekema holds two important administrative roles focused on bioethics. One of these roles is Chair of the Institutional Review Board (IRB) at Seattle Children’s. Dr. Diekema described the IRB as “the committee that reviews all research taking place in our research center and hospital to determine that it is safe and ethical.” Any institution that receives federal funding to conduct research with humans (such as clinical trials), including hospitals, cancer centers, and universities, must have an IRB to ensure responsible conduct throughout all stages of the research project.
Dr. Diekema’s other role is as Founder and Director of Education for the Treuman Katz Center for Pediatric Bioethics at Seattle Children’s. The Center was named to honor a retiring Seattle Children’s CEO. It functions as a national resource on research “to improve quality of life, medical decision-making, and communication for children with serious illness and their families, as well as to address the complex bioethical issues facing families, healthcare institutions, and society” (Treuman Katz Center website). Dr. Diekema described his Director of Education role as one “that involves planning conferences and running a training program in ethics for health care professionals.”
Below are a few cases that Dr. Diekema has considered as a bioethicist:
- "Pillow Angel Ashley X," Northwest Association for Biomedical Research, 2007
- "Boy Dies of Leukemia After Refusing Treatment for Religious Reasons," Seattle PI, 2007
- "Case Sparks Debate About Teen Decision Making in Health," US News, 2015
Professor
As a professor, Dr. Diekema is focused on teaching and scholarship – although teaching medical students and young physicians is a common element across all his roles. Dr. Diekema is a Professor in the Division of Emergency Medicine and the Division of Bioethics and Palliative Care within the Department of Pediatrics at the University of Washington School of Medicine. At the UW School of Medicine, Dr. Diekema teaches a course on clinical ethics in pediatrics and runs a wilderness medicine elective. He also helps coordinate conferences on ethics for residents, participates in a week-long retreat for interns, and presents a variety of lectures on ethics in medicine. He also serves as a mentor for eight residents currently in training as physicians.
In addition, Dr. Diekema finds time to engage in scholarship related to ethical issues in pediatric medicine and public health, including medical decision-making and vaccine hesitancy. A current project involves working with a group of fifteen people from across the country. They are trying to “define the best method for deciding when a parent should not be permitted to make a decision on behalf of their child.” Dr. Diekema explained, “sometimes physicians and parents disagree about the best course of treatment for a child, and in rare cases a parent’s decision might significantly jeopardize the welfare of the child.” This is particularly true in the case of serious and life-threatening illnesses. He continued, “we are trying to develop the best process for deciding when physicians should seek to have a parent’s decision overturned,” which can be pursued through the court system.
Dr. Diekema publishes about ten to twenty articles a year on these topics. He also edited Clinical Ethics in Pediatrics: A Case-Based Textbook, which was published in 2011 and is used in medical school courses.
Advice for Students
Dr. Diekema encourages students who are interested in a career in pediatric medicine, emergency medicine, or bioethics to “read stories about people in those careers and talk to people you encounter who are in the career that you are considering.” For example, he continued, “there are some wonderful books written by physicians that give you a flavor for how those authors have experienced life as a medical student, resident, or practicing physician.” (See this reading list of books authored by doctors).
Dr. Diekema also encourages students to seek out job shadowing, internships, and mentorship experience. He said, “if you have the opportunity to spend a day with someone doing the kind of work you’re interested in, that can be very valuable.”
“I love teaching, especially spending time with trainees and getting them excited about the topics I’m excited about.”
— Dr. Diekema
U.S. Wage Information
According to the U.S. Bureau of Labor Statistics Occupation Employment and Wage Statistics in 2023:
- The median wage for a physician in the U.S. is $236,000
- The median wage for social scientists in the U.S. is $95,890
Additional Resources
Credit: Thank you to Dr. Diekema for generously participating in this project. Career profile written by Dr. Kristen Clapper Bergsman.