Senate Bill No.:  0405-06

UNIVERSITY SENATE

UNIVERSITY AT ALBANY

STATE UNIVERSITY OF NEW YORK

Introduced by:              Graduate Academic Council

Date:                            November 11, 2004

PROPOSAL TO ESTABLISH AN INTER-INSTITUTIONAL DUAL DEGREE PROGRAM

M.S. BIOETHICS, ALBANY MEDICAL COLLEGE/THE GRADUATE COLLEGE OF UNION UNIVERSITY

WITH

PH.D. PHILOSOPHY, UNIVERSITY AT ALBANY, SUNY

IT IS HEREBY PROPOSED THAT THE FOLLOWING BE ADOPTED:

1.                  That the University Senate approves the attached “Proposed Dual Degree Program” as approved and recommended by the Graduate Academic Council

2.                  That this proposal be forwarded to the President for approval.


Proposed Dual Degree Program

PhD at the University at Albany Department of Philosophy/SUNY

&

MS in Bioethics, Albany Medical College/

The Graduate College of Union University

7 January 2004

Title:     Dual Degree Program in Philosophy and Bioethics

Proposed Degrees:  PhD in Philosophy

MS in Bioethics

Academic Units that will offer the program:

University at Albany /SUNY Department of Philosophy

Albany Medical College & The Graduate College of Union University

(PhD awarded, University at Albany; MS awarded, Graduate College Union University.)

Proposed beginning date:  September 2004

Summary of Program

The University at Albany Department of Philosophy/SUNY offers MA and Ph.D. programs in philosophy.  The Ph.D. in Philosophy was reinstated by the New York State Department of Eduction in 1993.  The Master of Science in Bioethics is offered jointly by the Center for Medical Ethics at Albany Medical College and the Center for Bioethics and Clinical Leadership of the Graduate College of Union University.  The AMC-GCUU MS in Bioethics program was registered by the New York State Department of Education in 2001.


The proposal is to offer a dual masters and doctoral program in Philosophy and Bioethics, in which each program recognizes course credits in the other program as counting towards completion of their degree.  The Doctorate in Philosophy requires 60 credits of philosophy, including up to 8 credits in a cognate field.  The MS in bioethics program requires 40 credits, including a thesis project and two elective courses. The total number of credit hours normally required to complete both programs is100. The proposed dual degree program requires 82 credit hours: 52 credits in the PhD in Philosophy program and 30 credits in the Master of Science in Bioethics.  Eighteen credits count towards both degrees: Eight credits from the masters program count towards the doctoral degree and ten credits from the doctoral program count towards the masters degree.  The students will attend the Albany campus for Philosophy work.  Bioethics courses will be either online, or in person on the Albany Medical College campus.  Anticipated admissions: one or two students a year.

Rationale for the program

Advances in biomedical sciences and medical technology raise urgent questions that must be addressed at the philosophical and public policy level.  Bioethics has become a recognized specialty in philosophy, and there are jobs advertised in Jobs for Philosophers (the publication of the American Philosophical Association that lists all jobs in philosophy) that explicitly require expertise in bioethics.  The proposed dual doctoral and master's degree in philosophy and bioethics will provide an education designed to serve precisely this need.   On a more practical level it will open up career opportunities outside the academy, for example, in hospitals, medical schools, government agencies and elsewhere, that are normally unavailable to those who have only a philosophy PhD without training in clinical ethics and public policy.

Potential Demand:  One or two students a year.  The combination of degrees is unique in New York State and unusual anywhere.  There are no other graduate bioethics programs in New York State. The need for persons trained in bioethics will increase dramatically due to increasing complexity of medical interventions and increases in the need for medical care among an aging population.

Enrollment in the Philosophy PhD program at The University at Albany is 2-5 a year.

Enrollment in the masters in bioethics program is 10 to 15 students a year, mostly working professionals in health care fields who appreciate the part-time distance-learning program.  Three graduate students in philosophy are currently enrolled in the program.

Admissions:  Students must apply to each program separately.  They must be accepted by each program through its own admissions process to be enrolled in the dual degree program. 

Curricula of the Two Programs: 

Ph.D. Degree Program in Philosophy

A. Requirements

[All requirements are spelled out in detail in the Graduate Bulletin and Graduate Handbook, available on the Philosophy Department’s website: www.albany.edu/philosophy.]


1. 60 credit-hours of graduate course work, distributed as indicated in B below.

2. A passing grade on the Ph.D. Comprehensive Examinations.

3. A passing grade on the Ph.D. Topical Examination.

4. Satisfaction of the logic requirement.

5. Satisfaction of the foreign-language/research-tool requirement.

6. Admission to candidacy.

7. A dissertation in philosophy.

8. Satisfactory oral defense of the dissertation.

B. Course Work Requirements

All students must take 60 credits of philosophy (achieving at least a grade of A or B in each), including at least 28 credits of core courses and history-of-philosophy courses (distributed as below) and 20 credits in one of the two areas of specialization: Knowledge and Representation (focusing on cognitive, linguistic, and cultural systems of representation) or Values and Society (focusing on moral and political values in relation to the social context). The remaining 12 credits may be chosen from any graduate philosophy courses, as long as all departmental regulations are satisfied.

With the permission of the Graduate Studies Committee, up to 8 credits in a cognate field may be substituted for 8 of the 20 credits in the area of specialization when the student's program warrants.

1. Core courses: All students in either area of specialization take three core courses (12 credits), one from each of the following groups:

(a) Phi 522 (Theory of Knowledge) or Phi 520 (Philosophy of Science)

(b) Phi 512 (Metaphysics) or Phi 515 (Philosophy of Language) or Phi 516 (Philosophy of Mind)

(c) Phi 523 (Ancient Ethical Theory) or Phi 524 (17th-19th Century Ethical Theory) or Phi 525 (Contemporary Ethical Theory)

2. History-of-philosophy courses: All students in either area of specialization take three courses (12 credits) in history of philosophy. Students must choose at least one course from each of groups (a) and (b); the third course may come from either (a) or (b) or from group (c):

(a) Phi 550 (Plato), Phi 552 (Aristotle), Phi 553 (Medieval Philosophy)

(b) Phi 544 (British Empiricism), Phi 546 (The Continental Rationalists), Phi 554 (Kant and Continental Idealism)

(c) Phi 523 (Ancient Ethical Theory), Phi 524 (17th-19th Century Ethical Theory), Phi 542 (Phenomenology), Phi 555 (19th Century Continental Philosophy), Phi 556 (Pragmatism), Phi 572 (History of Political Philosophy), Phi 624 (Topics in the History of Philosophy), Phi 627 (History of Logic)


3. Students must take one more course (4 credits) from either the core areas (1(a), 1(b), or 1(c)) or the history areas 2(a) or 2(b).

4. Courses in the area of specialization: All students must take at least 5 courses (20 credits) in their area of specialization.  Up to 8 credits may be taken in a field outside Philosophy, with permission of the GSC.

Values and Society courses:

Phi 505 Ethics and Public Policy

Phi 506 Philosophical and Ethical Issues in Public Health

Phi 517 Bioethics

Phi 525 Contemporary Ethical Theory

Phi 528 Theory and Function of Religion

Phi 530 Philosophy and Public Affairs

Phi 535 Philosophy of Race

Phi 560 Philosophy and the Humanities

Phi 568 Philosophy and Literature

Phi 574 Contemporary Political Philosophy

Phi 616 Topics in the Philosophy of Religion

Phi 621 Topics in Ethics

Phi 632 Topics in Applied Ethics

Phi 634 Topics in Philosophy of Law

Phi 674 Topics in Political Philosophy

Impact of the Dual Degree Program on the Philosophy Curriculum:

Students in the dual degree program would specialize in the Values and Society track.  They would fulfill all the requirements of the Philosophy Ph.D. as above. In addition, the 8 credits permitted in a cognate field would be fulfilled in the AMC/Union MS in Bioethics program as the credits.  However, no permission from the Albany Philosophy Department’s GSC would be needed for students admitted to the dual degree program.  Instead, the following three courses offered by the Albany Medical College/Graduate College of Union University Masters in Bioethics will be recognized as credits in an area of specialization outside of Philosophy, and counted as 8 credits towards the philosophy doctorate at the University at Albany.

MED 202: Clinical Ethics (3.33 credits)

MED 301: Clinical Practicum (3.33 credits)

 MED 302: On-Line Clinical Practicum (3.33 credits)


MS in Bioethics Curriculum

The 12 course (three-year) MS curriculum is designed to serve the needs of working health professionals and to meet current or prospective requirements of such accrediting and funding bodies as the Joint Commission on Accrediting Healthcare Organizations (JACHO) and the National Institutes of Health (NIH). It is also designed to impart the advanced skills and knowledge recommended in the report on Core Competencies in Clinical Ethics Consultation ( issued by the American Society of Bioethics and Humanities (ASBH), the field’s professional society.

1 Proseminar in Health and Human Values

This introductory two-week intensive seminar in bioethics, taught by leading scholars from around the US, introduces students to the field, acquaints them with computer-based education, and affords them the opportunity to meet their professors and fellow students in person.

4 Core Courses

In compliance with the recommendations of the Core Competencies report, four core courses are required on the following subjects: Med 281, Healthcare Policy; Med 274, Biomedical Ethics; Med 202, Clinical Ethics; and Med 284, Bioethics and the Law

2 Elective Courses

Elective courses satisfy the needs and interests of individual students in such areas as: Empirical Research Methods in Bioethics, Research Ethics, Reproductive Ethics, and the Philosophical Foundations of Bioethics.

2 Practica (one on-site, one on-line)

Practica provide supervised experiences in clinical ethics consultation. On-site practica are offered through Albany Medical College and the medical institutions in the Bioethics Consortium.

2-term Thesis Project

A project, paper or initiative designed to investigate some area of bioethics, or to recommend or implement changes in policy or practice.

A Capstone Seminar

A two-week intensive on-site seminar in which students demonstrate their mastery of bioethics and clinical ethics consultation.


The following courses offered by the Philosophy program at The University at Albany will be recognized as satisfying 3 course requirements (10 semester credit hours) towards the MS in Bioethics degree.

In place of two (2) 3.33 credit elective courses students may take

Any two courses listed as satisfying the Philosophy Departments Values and Society requirement as well as any course in the following list:

Phil 520 Philosophy of Science

Phil 538 Philosophy of Social Science

In place of one (1) 3.33 credit required course, students may substitute study and passage of the topical examination administered by the Philosophy Department at the University at Albany (provided that one faculty member from the MS in Bioethics Program serves on the examining committee).

Sample Program:  A Student in the Dual Degree MS, PhD program

Year 1: Typically, students are awarded fellowships in the first year, which requires them to take 3 courses each semester.

Fall:     

Phi 512, Metaphysics

Phi 518, Analytic Philosophy

Phi 525, Contemporary Ethical Theory

Spring:

Phi 522, Theory of Knowledge

Phi 506 (Hpm 605), Philosophical and Ethical Issues in Public Health

Phi 572, History of Political Philosophy

Summer Year 1:   Proseminar in Bioethics (AMC/Union)

Year 2: Typically, students are given assistantships beginning in the second year, and take 2 courses each semester.

Fall:

Phi 517, Bioethics

Phi 550, Plato


Spring:

Phi 546, The Continental Rationalists

Phi 574, Contemporary Political Philosophy

Spring Trimester (March-June)   Med 202, Clinical Ethics

Summer Year 2    Med 301, On-Site Clinical Practicum

Year 3

Students normally take their Comprehensive Exams at the end of the summer before their third year.

Fall:

Phi 505, Philosophical Reasoning in Public Policy Analysis

Fall Trimester, MED 302, On-Line Practicum

Spring:

Phi 621, Topics in Ethics

Phi 634, Topics in Philosophy of Law                                                                                       

Topical Examination on the Dissertation Prospectus (one faculty member from the MS in Bioethics Program serves on the examining committee).

Year 4                                   

Thesis and completion of coursework MS in Bioethics

May Year 4  Graduation, both programs.


Syllabus

MED 301

Clinical Practicum

Albany Medical College

July 14-25, 2003

 

Description

This required Clinical Practicum (CP) occurs during the second summer of the master’s program. The overarching learning objective at each clinical site will be to provide students with an intense clinical orientation and foundation for approaching cases and issues in clinical bioethics and functioning as a clinical bioethicist in the hospital setting.

The CP will be the basic building block that will prepare you to move on to the Online Practicum and to conclude the master’s program with the Capstone. Of course it is our hope that all of the master’s courses will add to and support these practical, clinical skills.

Learning objectives for the students include developing the following skills:

_    To listen and gather facts systematically

_    To be open, self-aware.

_    To analyze, think clearly and draw conclusions

_    To empathize with others

_    To manage conflicts and be a facilitator

_    To build consensus between opposing sides of a conflict

_    To make helpful recommendations on the basis of a consensus

These skills will flow out of the management of 5 cases that we have drawn from our ethics consultation service. The cases have been selected so as to require the use of a broad range of clinical skills that reflect the clinical requirements of the ASBH’s Core Competencies.

SCHEDULE

WEEK 1, JULY 14-18

Monday, July 14

8-9 AM—Orientation

_    Goals and objectives of the clinical practicum

_    The steps in an ethics consultation

_    Three main responsibilities of ethics committee members: policy development and review   

_      Relationship between ethicist as consultant and educator

9 AM-12 Noon—Rounds at AMC


_    D7—Neonatal ICU  

_    D3—Medical ICU  

_    D3—Heart Transplant Unit   

_    D3—Surgical ICU 

_    C4—HIV/AIDS  

_    D4E—Hem/Onc

_    E7—OB/Gyn 

1-3 PMThe Chart Review

_    Review of medical terminology

_    How to do a chart review—we will meet in Medical Records and review charts in pairs. Students will know the location and significance of the following:

face sheet for name, age, physician, admitting date, admitting diagnosis, advance directives, NOK, social work/case management notes, medical prognosis, specialists/consultants, length of stay, major interventions, consents forms

_    How to record chart information for use in consultation (working in pairs)

3-5 PM— A Simulated Ethics Consultation

_    Review consultation process, including ethics case analysis. We will role-play through every phase of a simulated ethics case. The steps will include:

_            Answering the initial call and notifying the attending physician

_    Chart review

_    Stating the initial reason for the consult

_            Identifying the players

_    Pre-meeting with health team in preparation for the family meeting

_            Interviewing parties involved, including setting up a family meeting

_    The ethics case write up and chart note

8-12 AM-Beginning a Consult on a Real Patient

Students, in pairs and under supervision, will do an ethics consultation on a real case. The first steps will include:

_    Taking the call from the physician or nurse who is requesting the consult.

_      Preparations for going to do the chart review—contacting the attending and organizing what you know and what need to know more about.

_    Doing a chart review in pairs under supervision.

_    Do a preliminary write-up of the case—a summary of the facts, unanswered factual questions, the apparent ethical conflicts in the case and a plan for how to proceed.

1-5 PM—The Art of Interviewing

The basics skills of interviewing will be reviewed by an experienced social worker. We will focus on how to apply these skills to the process of ethics consultation. In particular, we will discuss ways to deal with patients and families who in grieving. This session will include practical exercises relevant to ethics consultation scenarios.


_    Body language and non-verbal communication

_    Use of certain questioning techniques, such a open-ended versus closed-ended questions

_    Clarification of key facts and patient perceptions

_    Listening ability

1-5 PM—Interviewing a Real Patient Under Supervision and a Process Recording

In pairs students will follow up with their real cases, and now go and interview the players in their assigned case, which includes:

_    The patient, if possible, or a close family member to the patient

_    The medical team including physicians, nurses, social workers, and others.

Following the interviews, students will go back to the classroom and complete a process recording what happened in their interviews. In short, they will attempt to reproduce the communication exactly as it occurred in the interviews. If time permits, there will be some discussion of each student’s interviews.

8-11:50 AM-The Ethics Cases Analysis: Pulling Things Together

Students will use the content they gathered from the previous day to use as the basis for writing an ethics case analysis which is a full, detailed ethical analysis of the case. From this full analysis each student will also write a chart note, which will be a succinct version of the analysis. The chart note will be written for the caregivers who called the consult and crafted to help give them a moral direction in the case. This session will also include a review of:

_    Ethical Theory, Terminology and Reasoning

_    Method of Case Analysis and the Identification of Ethical Conflicts

_    Elements of a Full Ethics Case Analysis

_    Elements of Chart Note

12-1 PM— ETHICS GRAND ROUNDS 12 NOON

Professor of Infectious Disease

Albany Medical College


2-5 PM—Presentation and Discussion of Chart Notes

Students will present and discuss their chart notes from the morning session, and focus on what particular recommendation they made in their assigned case. We will conclude this session by reviewing some of the readings that were assigned during this two week period.

8-12-Preparing a Bioethics Presentation

Students will report to the library for a 2 hour tutorial focused on how to do a literature search on some major topics in bioethics. Individual topics will be assigned to each student and each student is expected to find at least 2 important articles on their topic. Students will then be given time to prepare a 10-15 minute presentation of their topic for working health care professionals in a hospital. In preparation for this session, we will first go over:

_    The elements of an effective presentation

_    How to gauge your audience

_    How to incorporate the content from articles into your presentation

1-5—Student Presentations

Students will take turns doing their presentations to a diverse audience of health professionals at AMC. After each presentation, a least five minutes should be set aside for questions and answers.

WEEK 2

Monday, July 21

8-12 AM—Conflict Resolution in Ethics Consultations

This session will provide some basic tools to help in serving as a moderator in family meetings. We will review the basics of conflict resolution and its application to ethics consultations. A range of scenarios will be presented to illustrate various types of conflict, including:

_    Among family

_    Patient-family

_    Among team

_    Family-team

_    Patient-team

In this session, we will address:

_    The task of consensus building and being a consensus builder

_    When conflict resolution is appropriate and when it is not

_    Why all outcomes are not morally acceptable

_    How to view players with special legal standing


1-5 PM—Role Playing in a Simulated Case #1—Tube feeding for an elderly patient with dementia

A real case from our consultation service will be presented with different names. We will work through the following steps:

_    Case presentation (the facts of the case up to the point of an ethical dilemma)

_    Analysis of the case and development of action plan

_    Role playing of action plan. All characters will be well defined and each student will either play a character in the case or be a critical observer. This exercise will be video taped.

8-12 AM-Review of Case #1

We will review the video from the previous day in order to discuss and critique the ethical conflicts and how well they were address. Students will work pairs to prepare a chart note that summarizes the outcome of the meeting and the plan of care for the patient.

1-5 PM—Legal and Risk Management Issues

Our hospital attorney and risk management director will lead a discussion on how their respective fields mesh with ethics. Two cases will be presented to illustrate the issues covered and a handout will be distributed. The following topics will be covered:

_    Capacity

_    Withdrawal

_    Legal authority for third parties to make decisions for an incapacitated patient

_    OMRDD special situations

_    Precedent setting cases

_    Federal versus State regulations regarding self determination, withdrawal, artificial nutrition, hydration

_    Adolescent issues: mature minor, emancipated minor, reproductive issues

8-12 AM-Role Playing in Simulated Case # 2—Life-sustaining treatment for a patient in PVS

A real case from our consultation service will be presented with different names. We will work through the following steps:

_    Case presentation (the facts of the case up to the point of an ethical dilemma)

_    Analysis of the case and development of action plan

_    Role playing of action plan. All characters will be well defined and each student will either play a character in the case or be a critical observer. This exercise will be video taped.

1-5—Review of Case #2

We will review the video from the previous day in order to discuss and critique the ethical conflicts and how well they were address. Students will work pairs to prepare a chart note that summarizes the outcome of the meeting and the plan of care for the patient.


8-12 AM-Confronting Death and Dying

A hospice physician will lead a discussion and engage the students in practical exercises on the topics of death and dying. As the basis for this session we will watch a video from the Bill Moyers series “On Our Own Terms” (edited version). We will discuss in depth the scenarios covered in the video.

1-5 PM—Policy Review and Development

We will provide an overview of  some key policies both at the national and institutional level. They will include:

_    Role of ethics committees in light of JCAHO requirements (Patients’ Rights sections).

_    Review AMC policy on DNR

To conclude this session students, in pairs, will be asked to complete a policy exercise. Based on Case #2, the CEO of AMC has asked the Ethics Center to develop a hospital policy on medical futility. You are now members of the Ethics Center and it is your job to complete this task. You should review any relevant existing policy and write a new policy for AMC physicians. Detailed handouts will be provided.

Friday, July 25

9-1—Policy Presentations and Wrap Up

_    Students will present and explain in pairs their policy proposals.

_      Conversations with staff, family members and others who have utilized our consult service

_    Closing comments and good-byes

SYLLABUS:  MED 202: Clinical Ethics:

 CLINICAL ETHICS, A BIOETHICS/GMI  > COURSE INFORMATION  > COURSE OBJECTIVES

Objectives

1. To be able to identify and describe the clinical conflicts, questions and problems that arise in the clinical setting in a range of clinical cases--some are classic historical cases, some hypothetical and some from real hospital settings.

2. In general, to learn and be able to apply a systematic method of ethics case analysis, i.e. to be able to write a thorough, clear and methodical case analysis.

3. To be able bring to bear and apply relevant philosophical and ethical principles, concepts and distinctions to specific cases.

4. To take into account relevant contextual features including the role of organizational ethics in specific cases.

5. To be be able to see the patient as human being with a life story whose values and preferences must be matched appropriately with medical options.

6. To be able to formulate reasonable recommendations that flow coherently from thorough systematic analyses of real ethical dilemmas.

This course deals with the practical applications of clinical ethics, including clinical ethics consulting and its recording and documentation, the work of ethics committees and IRBs, and other practical ethics of clinical ethics.

Readings

(Note the abbreviations for the readings below are used in the Syllabus)

REQUIRED BOOKS:

1. John M. Freeman and Kevin McDonnell, Tough Decisions: Cases in Medical Ethics, Second Edition, Oxford University Press, 2001. (TD)

2. Thomas A. Mappes and David Degrazia, Biomedical Ethics, Fifth Edition, McGraw-Hill, 2001. (BE)

3. Gregory E. Pence, Classic Cases in Medical Ethics, Third Edition, McGraw-Hill, 2000. (CCME)

4. Albert Johnson, Mark Siegler and William J. Winslade, Clinical Ethics, Fourth Edition, McGraw-Hill, 1998. (CE)

BOOKS USED BUT NOT REQUIRED (excerpts provided online)


1. John C. Fletcher, et.al., Introduction to Clinical Ethics, Second Edition, University Publishing Group, 1997. (ICE)

2. Jeffrey Olen and Vincent Barry, Applying Ethics, Fourth Edition, Wadsworth Publishing Company, 1992. (AE)

3. Gregory E. Pence, Classic Works in Medical Ethics: Core Philosophical Readings, McGraw-Hill, 1998. (CWME)

4. Tom L. Beauchamp and Leroy Walters, Contemporary Issues in Bioethics, Second Edition, Wadsworth Publishing Company, 1982. (CIB)

5. Albert R. Jonsen, The Birth of Bioethics, Oxford University Press, 1998. (BB)

6. Edward M. Spencer, et.al., Organization Ethics in Health Care, Oxford University Press, 2000. (OEHC)

7. John D. Arras and Bonnie Steinbock, Ethical Issues in Modern Medicine, Second Edition, Mayfield


 COURSES  > CLINICAL ETHICS, A BIOETHICS/GMI  > COURSE INFORMATION  > SYLLABUS

Syllabus  MED 302

(See Course Materials for key to abbreviations)

WEEK ONE

1. Let's jump in and get started with a case!! (See assignment)

Readings:

TD, Chapter 11, Billy

2. The Basis of the Physician-Patient Relationship

Readings:

BE, pp. 56-87.

TD, pp. Chapter 5, Ms. Williams

Thomas S. Szaz and Marc H. Hollender, "A contribution to the philosophy of medicine: the basic models of the doctor-patient relationship", Arch. Int. Med., Vol. 97, 1956, pp. 585-592.

CAH, pp. 1-20.

3. Informed Consent

Readings:

ICE pp. 89-105

BE pp.93-109

CE 2.1-2.1.5

WEEK TWO

1. Privacy and Confidentiality

Readings:

ICE pp.41-53

BE pp. 183-224


CE 4.2-4.2.4.

TD, Chapter 6, Wanda

2. Determining Capacity

Readings:

BE pp. 109-116

ICE 71-88

CE 2.2-2.2.4.

WEEK THREE

1. Communication, Families, Truthtelling and Disclosure

Readings:

ICE pp. 55-70

BE pp. 85-93

CE 2.4-2.4.2

TD, Chapter 4, Leon

3. Diversity and Conflicts of Interest

Readings:

BE pp. 117-147

CE 2.3, 4.0.3-4.1.5

WEEK FOUR

1. Moral Theory, Method and Principles: Some Useful Tools for Your Toolbox (Hopefully).

Readings:

AE pp. 2-47

ICE pp. 21-38


CAH, pp.21-46.

Suggested Readings:

CE pp. 1-12

TD 185-223

WEEK FIVE

1. End of Life Issues: Advance Directives, Medical Futility, Defining Death and Refusal of Life-Sustaining Treatment

Readings:

CCME, pp. 29-55.

BE, pp.335-369.

TD, Chapter 1, Maggie

TD, Chapter 12, The Castelli Baby

Suggested Reading: (it's ok to read this at some future date)

CIB, pp. 87-116.

BB, pp. 233-281.

WEEK SIX

1. Requests From Patients To Assist in Dying

Readings:

CCME, pp.56-113

BE, pp.421-445

TD, pp. Chapter 2, Jill.

2. Suicide and Active Euthanasia

Readings:

BE, pp. 381-407 (Don't get bogged down with Kant, focus on pp. 398-407)


TD, pp. Chapter 3, Ed Martinez

TD, pp. Chapter 9, Marti

WEEK SEVEN

1. Abortion, Maternal-Fetal Conflicts and Surrogacy

Readings:

BE, pp. 454-500.

CCME pp. 169-195.

TD, Chapter 14, The Harrisons' Plans

Case: Fetal Distress and Rejection of Surgical Delivery

WEEK EIGHT (NO SET READINGS)

1. It's your turn to set the agenda. Each student should email to me by the beginning for Week Eight (sooner is better) the following items: 1) the topic of your research paper, 2) the key research questions that guided (or will guide) your paper, 3) an detailed outline of what is covered in the research paper, and 4) full references to two key papers that proved valuable in completing this research. (Remember, due date for final submission of your paper is Monday of Week Nine --early submission is fine and even appreciated)

2. Also, post and explain a topic of current interest. We will all work to find some useful readings.

WEEK NINE

1. Organ Donation and Transplantation

Readings:

CCME, pp. 320-339

EIMM, pp. 649-662.

CWME, pp. 262-284.

2. Involuntary Psychiatric Treatment

Readings:


CCME, pp.363-387.

3. Genetic Testing

Readings:

CCME, pp. 388-416.

Chapter 15, The Smyth Saga

WEEK TEN

1. Organizational Ethics

Readings:

OEHC, pp. 3-48; 136-185; 200-210.

CAH, pp. 47-86.

2. Resource Allocation, Justice and Rationing

Readings:

BE, pp.598-634.

TD, Chapter 8, Joey, Jessica, Roger, Tom and Marti


COURSES  > ON-LINE PRACTICUM  > COURSE INFORMATION  > COURSE PURPOSE AND OBJECTIVES

Course Purpose and Objectives

This course has two overarching goals. The first is to help to prepare you for the capstone course -- the final one in the program's curriculum -- in which you'll need to demonstrate your mastery of ASBH's Core Competencies for Health Care Ethics Consultations, as detailed in its 1998 report. The second goal is to help you to prepare for your thesis project, which will comprise the term immediately following this one.

In order to accomplish these goals, the course will emphasize three basic activities or assignments. Each is perhaps primarily directed at one or the other of the overarching goals, but not exclusively so; all of them should facilitate your thesis work and your capstone work to at least some degree.

One key element of the course will be an extended, individual project. Examples might include an educational program for residents on the topic of advance directives and the withholding or withdrawal of life-sustaining interventions, a preliminary qualitative review of the practicum institution's human subjects research program which may be used to guide a thesis project to plan a restructuring of the institution's IRB, or a pilot study (involving, e.g., survey or interviews) of disclosure practices in a genetic counseling unit. Ideally, the project should be something that arises from your practicum setting, but it is possible to do a project that is unrelated to your current environment. This assignment is intended to give you an opportunity to jump-start your thesis by allowing you to explore in depth a topic on which you think you'd like to write or even to complete some preliminary or background work on which your thesis will build. Even if you choose to do a project that isn't related to your prospective thesis work, the task of conceiving and completing a longer term, self-initiated project should be a worthwhile exercise before you undertake the thesis.

A second key element of the course will be your observation of and possibly participation in ethics-related activities in your practicum setting. The nature and variety of these activities will differ from setting to setting, but each student should have a chance to see and, in some cases, to contribute to the actual practice of bioethics at your practicum site. This should help you to acquire and to sharpen the practical skills that you'll need in your work after graduation, as well as those that will be assessed in the capstone. For example, if you are working in a service that provides clinical ethics consultations, you'll want to observe how your mentor elicits information from staff, communicates with families, mediates and builds consensus in cases of conflict, develops an analysis of the issues and ensures that the results of the consultation are carried out. These are among the ethical assessment, process, and interpersonal skills (ASBH's terminology) that you'll need to be able to demonstrate as a part of the capstone. You'll be asked to write about your experiences in a journal, which should help you to keep track of what you've done and to reflect on those experiences after the fact.


The third and final element of the course involves reading and writing assignments on ethics consultation and case analysis processes. In this component of the course all students typically will be working with the same material. It will provide a framework in which to develop common themes out of diverse practicum experiences and give you an opportunity to reflect at a more abstract level on the practices with which you are involved in your practicum work setting. The knowledge base and skills we'll cover should also help you to build your competencies for the capstone course, and since writing skills will be important both for the core competencies and for your thesis work, the written assignments and online discussions should help you to refresh and further develop your writing proficiency, as well.

Ethics consultation and ethics committee services, ethical analyses, and ethics education are among the critical functions that bioethicists and clinical ethicists routinely perform. With this in mind, the substantive material covered in core reading and writing assignments are intended to introduce you to the literature on ethics consultation, ethics committees, and the institutional organization in which ethical issues arise, as well as on context-sensitive case analysis. Assignments and online discussions in these areas will encourage you to bring this literature to bear on the real-world work of clinical ethics.

The course syllabus contains the schedule of topics we'll take up in our core reading and writing assignments, and objectives for specific modules will be outlined in each week's folder.

Syllabus

In addition to individual projects and on-site activities, readings and assignments throughout the term will focus on a core set of topics designed to advance competence in health care ethics consultation and related bioethics services. Guest faculty may be invited to lead some of these modules, and so the schedule may need to be adjusted in order to accommodate their schedules. As in all things, flexibility will be a virtue.

Tentative Schedule of Core Topics

Week 1: Getting started (introduction to the course, developing ideas for individual projects, familiarizing each other with our practicum sites and projects)

Week 2: Review of ethics consultation literature

Week 3: Review of ethics committee literature

Week 4: Institutional organization

Week 5: Communication and mediation

Week 6: Narrative Ethics

Week 7: Putting it all together: ethics case analysis

Week 8: Preventive Ethics: Ethics Education

Week 9: Individual Project Presentations

Week 10: Thesis Preparation