HEALTHCARE ETHICS COMMITTEE (HEC)
Series Catalog
CITI Program’s HEC series focuses on developing the knowledge and skill base necessary for
being a successful HEC member. It covers basic committee attributes including general
mission, varying structures, and membership, as well as the roles, responsibilities, and
functions of HECs and case consultants. It discusses the main ethical theories and principles
for healthcare ethics, and how HEC members can use these theoretical foundations to identify,
analyze, and help resolve ethical issues.
The HEC series also addresses many common issues encountered by HECs including
informed consent, advance directives, decision making for capacitated and incapacitated
patients, end-of-life issues, medical confidentiality, neonatal and maternal-fetal ethics, and
allocation.
This catalog provides a listing, description, and language availability for each module within
the HEC series, as well as information on how to access the series.
Subscription Information
The HEC series is available to subscribing organizations starting at $1,000 USD/year, which is
in addition to the base subscription fee. Independent Learner registration is available for $150
USD. For more information on subscriptions, click here.
In order to meet the needs of subscribing organizations, the CITI Program can assist
administrators in creating courses that best meet their organizational needs, including
combining modules from across the CITI Program. To discuss course recommendations that
combine modules from different CITI Program offerings, please contact the CITI Program Help
Desk at support@citiprogram.org or (888) 529-5929.
CITI Program: Healthcare Ethics Committee (Updated: May 2016)
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Table of Contents
Basic Course
3
HEC Course
CITI Program: Healthcare Ethics Committee (Updated: May 2016)
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Basic Course
For recommendations on how to use the basic HEC course, see the Using CITI Program
Content: Healthcare Ethics Committee (HEC) document.
Healthcare Ethics Committee (HEC)
Module
Title
Recommended
Use
ID (Language)
Introduction: Healthcare Ethics Committee
(HEC) Course
Required
17023 (English)
Healthcare Ethics Committee (HEC): Definition,
Mission, and Organizational Structure
Required
17024 (English)
Healthcare Ethics Committee (HEC) Membership
Required
17025 (English)
Ethical Theories and Principles for Healthcare Ethics
Required
17026 (English)
Ethical Problem Identification, Analysis, and Solving
Required
17027 (English)
Informed Consent in the Clinical Setting
Required
17028 (English)
End-of-Life Issues: Capacitated Patients
Required
17029 (English)
Advance Directives (Living Wills)
Required
17030 (English)
Decision Making for Incapacitated Patients
Required
17031 (English)
End-of-Life Issues: Cultural Issues, Medical Futility,
and Resuscitation
Required
17032 (English)
End-of-Life Issues: Brain Death, Palliative Sedation,
Physician-Assisted Suicide, and Other Related Issues
Required
17033 (English)
Medical Confidentiality
Required
17034 (English)
Neonatal Ethics and Maternal-Fetal Ethical Issues
Required
17035 (English)
Overview of Allocation
Required
17036 (English)
Healthcare Ethics Committee (HEC) Educational
Activities and Policy Development and Review
Required
17037 (English)
Clinical Ethics Consultation: Part 1
Required
17038 (English)
Clinical Ethics Consultation: Part 2
Required
17039 (English)
CITI Program: Healthcare Ethics Committee (Updated: May 2016)
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Introduction: Healthcare Ethics
Committee (HEC) Course
This module provides a brief overview of the
HEC course.
Healthcare Ethics Committee (HEC):
Definition, Mission, and
Organizational Structure
This module discusses the historical context,
definition, major purposes, and basic structure of
modern day HECs. It also covers aspects of HECs
including organizational reporting structures, meeting
details, budgets, and liability.
Healthcare Ethics Committee
(HEC) Membership
This module identifies who should serve on an HEC
including their basic roles and ideal characteristics. It
also reviews a HEC’s optimal professional
composition, the basic conflicts of interest that may
arise while serving on a HEC, and membership
terms/expectations.
Ethical Theories and Principles for
Healthcare Ethics
This module reviews how HEC members must
understand ethical theories, principles, and arguments
to be an effective committee member. It discusses the
major types of ethical theory, basic ethical rules and
principles, and underlying ethical values that are
useful in the healthcare setting. It also describes how
the theoretical approach of an argument helps to
evaluate the argument’s merit.
Ethical Problem Identification, Analysis,
and Solving
Informed Consent in the Clinical Setting
This module discusses the importance of having a
strong knowledge of clinical informed consent to
assist healthcare professionals and/or patients/family
members in clinical ethics. It discusses the elements of
ethically and legally valid informed consent, historical
and legal trends associated with the development of
informed consent, major exceptions to informed
consent, and methods of enhancing patient
comprehension of information.
End-of-Life Issues: Capacitated Patients
Thismodulefocusesonend-of-lifeissuesforpatients
withdecisionalcapacity.Itcovershowthelegal
history,cultureofmedicine,conflictingviewsof
patientsandtheirfamilies/friends/healthcare
providers,andpotentialforcoercionindecision
makinghaveshapedtheseissues,andhowHEC
members’expertisecansupporthealthcareproviders
andpatientsinupholdingpatientvaluesandchoices
aboutend-of-lifecare.
Advance Directives (Living Wills)
This module focuses on end-of-life issues for patients
who have lost decisional capacity. It discusses advance
directives (ADs) through which incapacitated patients
can express their values and choices about end-of-life
care. The AD discussion touches on the potential
implications of honoring ADs, conditions required to
implement an AD, common problems and conflicts
that arise when honoring an AD, and major issues that
cause AD ambiguity, all of which HEC members must
understand to provide support on cases involving
incapacitated patients.
This module discusses how HEC members apply their
knowledge of ethical theories, principles, and
arguments to identify, analyze, and resolve ethical
issues in a healthcare setting. It guides the learner on
how to distinguish ethical opinions from ethical
positions, critique rationalization, recognize common
fallacies in reasoning, and identify common types of
bias in ethical analysis.
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Decision Making for Incapacitated Patients
Medical Confidentiality
This module focuses on how decision makers (either
patient-designated or state-designated) can assist in
expressing the incapacitated patients’ values and
choices on end-of-life care. It discusses how HEC
members can support healthcare professionals and
decision makers by understanding the various
standards of decision making (and their pros/cons),
best practices for terminology and communication,
and distinctions between actions such as withholding
and withdrawing life-sustaining treatment.
This module describes how confidentiality of medical
information is a fundamental value that is both
supported in professional codes and in U.S. law. It also
discusses how HEC members must understand the
underlying reasons that support medical confidentiality
in order to appreciate the ethical scope and challenges
of an ethically optimal view of medical confidentiality.
End-of-Life Issues: Cultural Issues, Medical
Futility, and Resuscitation
Thismodulefocusesonhowrecognizingdeeplyrooted
culturalandsocialperspectives,whichoftenaffect
end-of-lifedecisionmaking,areakeyaspectofcase
deliberationsforHECmembersandethicsconsultants.
Itdiscussesculturalviewsofdeathanddying,social
influencesondecisionmakingand
perceptions/expectationsofmedicine,
spirituality/religion,medicalfutility,andmanyother
factorsthatHECmembersmustunderstand.
End-of-Life Issues: Brain Death, Palliative
Sedation, Physician-Assisted Suicide, and
Other Related Issues
This module discusses how brain death, palliative
sedation, physician-assisted suicide, and other related
issues raise significant and sometimes ethically
controversial issues, which are often framed by
emotional, religious, and cultural views. It focuses on
how HEC members, especially those who are involved
in doing ethics consultation, need to understand these
issues, and that they can clearly articulate things, like
brain death, from other views of death and explain the
reasoning for the distinction to healthcare providers
and patient’s families.
Neonatal Ethics and Maternal-Fetal Ethical
Issues
This module addresses maternal-fetal issues, neonatal
issues, and pediatric issues (after the neonatal period).
It provides a background for understanding the
conflicting values and choices, which cases involving
these topics often present.
Overview of Allocation
This module explains how HECs can help draw
attention to local allocation issues, increasing fairness
and consistency. It describes the conceptual principles
of distributive justice, the distinction between
substantive and procedural justice, the use of
allocation theories and material criteria, and concerns
about bedside rationing.
Healthcare Ethics Committee (HEC)
Educational Activities and Policy
Development and Review
This module describes the crucial role of clinical ethics
education for HECs, healthcare staff, and community
members. It discusses various opportunities for interorganization collaboration in ethics education, ethics
education resources, and types of needs assessments
for designing and evaluating educational programs.
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Clinical Ethics Consultation: Part 1
Clinical Ethics Consultation: Part 2
ThismoduledescribestheHEC’scoreconsultation
This module describes the clinical ethics consultation
system, challenges and complexities associated with
carrying out ethics consultations, elements of ethics
consultation recommendations, how to write an ethics
note in the medical record, and how to gather quality
and evaluation data for the ethics consult service.
function,thevariousethicsconsultationmodels
includingadvantagesanddisadvantages,and
examplesofethicsconsultationsusingmodelswith
differingemphases.
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