When Randi Fain (’22SPS, Bioethics) began her medical career in critical care, she faced a different ethical dilemma every day—conundrums like: How should one proceed when a family’s religious beliefs do not support undergoing the recommended medical intervention?
Dealing with the families of patients in critical condition is a challenging job, but Fain credits her own near-death experience as a young adult with helping her feel equipped for the task. What she wasn’t prepared for was the subtle shift she would experience regarding her own understanding of ethics.
Although she followed her time in the hospital setting with a busy career in academic medicine and the pharmaceutical industry, those early days navigating the ethical gray zone in critical care planted the seeds of her future work in bioethics. Those roots eventually led her to Columbia University School of Professional Studies (SPS), where she joined the M.S. in Bioethics (BIET) program.
“I really appreciate having had the opportunity to formalize the way that I approach biomedical issues,” Fain said, noting that the way she frames these topics—in language and organization—has changed through her time in the program.
Now a medical affairs consultant, Fain is building on the foundations she laid at SPS to address bioethical challenges from a position of inclusivity.
From Dancer to Designer to Doctor
The road that brought Fain to the life-and-death field of medicine was full of twists and turns. Having family members in the medical profession meant that Fain actively steered clear of that path as a young student. She studied dance and was performing in Manhattan while harboring an inkling that she might want to change tracks somewhere down the line. But a life-threatening attack on her way home from work one day accelerated her journey in another direction. Her injuries led to her flat-lining in a Manhattan emergency room, and that is when she decided to take her second chance at life to “do something different.”
“I think when something like that happens to you—it was kind of like a big rain fell and cleared the air. It made me understand a lot about myself and about what it means to face your fears,” she said.
At her first fork in the road after being resuscitated, Fain realized that her aversion to medicine stemmed from self-doubt. With that fear now behind her, she decided to give it a shot and began studying the requisite subjects to pursue a career in medicine while also learning graphic design. Despite enjoying her graphic arts class, taught by the luminary designer Milton Glaser, Fain found that she had no particular aptitude for it. Instead, the field she had been avoiding was the one that beckoned.
“The more I studied biology and science, the more I fell in love with it,” Fain said. “And that was it. I never looked back.”
Making Ethical Choices in Medicine
Throughout her career in medicine, Randi Fain worked with patients from diverse backgrounds whose expectations sometimes challenged her own moral compass. Fain recalled an episode from her time as a physician at Bellevue Hospital, speaking to a family of Chinese descent who wanted to withhold their mother’s cancer diagnosis from her while she underwent chemotherapy.
“I was very rigid about it at the time, saying, ‘No, she’s my patient and I’m going to tell her,’” Fain said. “But now I understand that that’s a very American way of looking at it and a very rugged individualist way of looking at it.”
As a medical professional, Fain maintained the authority to act based on her expert judgment. However, after many years of learning—including through the BIET program at SPS —she is now much more deliberate about her delivery of sensitive news and has gained a new understanding of what it means to be ethical.
“It took me a lot of years and holding my eyeballs open with toothpicks for a while to understand that there are meaningful differences that could coexist in an ethical society,” Fain said. “I like to think of myself as having been open-minded, but I think that this program taught me that I wasn’t.
Fain cites the program for helping build up her tolerance for accepting different opinions within an ethical society. Today, she continues to apply those lessons from the program and her experience to expand the field as a peer reviewer for Columbia’s Voices in Bioethics journal, and as a board member of the Empire State Bioethics Consortium.
Among her current interests in the field of bioethics are AI, women’s health, and end-of-life care. Cultural expectations, she explained, play a role in shaping norms around these topics, creating both ethical challenges and opportunities. Fain noted a recent book chapter she wrote about the environmental harms of traditional ways of disposing of bodies of the deceased; these conventions are often inseparable from religious and other cultural morals.
“The processes that we use are deeply ingrained in our culture, but also not necessarily safe for the environment and may conflict with our commitment to taking care of the earth for our future generations,” she said.
Finding Community at Columbia
Having joined the BIET program at Columbia later in her career, Fain was quickly able to organize a schedule that allowed her to comfortably study part-time while maintaining a full-time career.
“I was really enjoying myself and I was really learning a lot,” Fain said, but noted that “there was quite a while where I just thought, ‘Well, I’m not actually going to get a degree. I’m just going to learn for a while.’” Spoiler: Fain received her degree (and finished her thesis—on the disconnect between the legal and medical definitions of “brain death”—too).
More than the achievement of completing the program, however, what Fain took away with her was community and the relationships she built at SPS. Completing the degree over several years, including during the COVID-19 pandemic, many of her friendships were formed with people she had never met in person. Fain shared that she developed a close bond with a woman based in California who was going through a third bout of cancer. The two agreed to attend graduation together in person, recognizing how fleeting life is. “And so we met on the street outside of Columbia for the first time after years of loving each other and knowing each other and each other’s families,” Fain said.
“I learned you can make it real, even online,” she said. “And the relationships that I still have were extraordinary.”
About the Program
Columbia University’s Master of Science in Bioethics grounds students in interdisciplinary approaches and models to address pressing bioethical challenges such as stem cell research and health-care reform. The program prepares students to act as responsible and responsive leaders in this new and ever-growing field. It also includes a concentration in global bioethics—the first of its kind in the U.S. Columbia's Bioethics program offers a range of degrees and courses.
The spring 2026 application deadline for the M.S. in Bioethics program is November 1. Learn more about the program here. The program is available full-time and part-time, online and on-campus.
