Episode 169: Medical Ethics When the Stakes Are Life and Death with Dr. Deborah Kozik

In this episode, we step into new territory for the Healthcare Leadership Excellence Podcast and take on medical and biomedical ethics as it actually shows up in real clinical life.

My guest is Dr. Deborah Kozik, a pediatric cardiac surgeon I’ve worked closely with over the past year. Alongside performing some of the most technically demanding surgeries in medicine, she also earned a Master of Science in Bioethics from Harvard University.

We talk about why ethics rarely feels urgent until a crisis hits. Most leaders don’t think about ethics day to day, yet when emotion, identity, power, and life collide, many feel unprepared. Dr. Kozik walks us through a practical Ethics 101, including the tension between duty-based and outcome-based thinking, and why ethical decisions are often about competing goods rather than right versus wrong.

A central theme is decision-making under emotional pressure. We explore how clinicians support parents facing life-altering decisions for their children, why surgeons cannot answer the question “What would you do if this were your child?”, and how honoring autonomy means respecting each family’s values and circumstances.

We also dig into communication failures that create ethical crises unnecessarily. Dr. Kozik explains how fragmented conversations, unclear language, and lack of team alignment can escalate conflict, and how slowing down, using multidisciplinary conversations, and asking families to repeat back what they understand can change outcomes.

We close with a simple primer on the four core principles of Western medical ethics, autonomy, beneficence, non-maleficence, and justice, and why none should outweigh the others.

This is a challenging but important conversation for physicians, nurses, administrators, and executive leaders alike. Ethics shows up any time decisions affect real people in irreversible ways. My hope is that this episode gives you clarity and language you can use before the crisis arrives.

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