Community Health
Bioethics Course
1. Bioethics Course
2. Years 1, 2, 3, 4, 5
The Bioethics Course spans the 5 year MBBS course contributing to the
Community Health Curriculum. The subject is intended to improve patient
care and professional conduct. The course focuses on teaching of
analytical skills in a systematic and comprehensive manner suitable to the
identification and resolution of ethical issues inherent in medical practice
and research. Practical aspects in terms of dealing with daily dilemmas in
health care are mainly covered in Year 2 and Year 5.
3. Topic
Bioethics
4. Description of topic
The aim of the course is to provide some skills for addressing moral
dilemmas in medicine and research using the ethical theories, principles,
guidelines and professional codes. This is a practical oriented course
designed to promote problem solving. Particular emphasis is placed on
the steps that are necessary in analyzing a dilemma and in coming to a
decision on how to address the particular dilemma.
5. Educational Objectives
Knowledge
1. An understanding of ethical theories and principles and how they
are applied in analyzing and solving medical and research
dilemmas
2. Describe the various pieces of legislation that affect patient care.
3. Explain the Malawian professional codes of conduct
4. Ethical issues related to various health technologies and specific
diseases
Skill
1. Appropriate use of ethical theories, principles, guidelines and
professional codes in solving moral dilemmas in the practice of
medicine and clinical research.
2. Distinguish ethical and unethical practices in medicine and
research.
3. Assess the impact of health decisions and policies on persons and
communities.
4. Argue coherently using ethical theories, principles and codes in
discussions on proposed courses of action and policies.
Attitudes
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Community Health
Bioethics Course
1. An appreciation of ethical theory and principles in dealing with
patients and research participants
2. An appreciation of the complex ethical issues in health care
decision making
3. An appreciation of the importance of professional codes in
promoting patient care
4. Demonstrate appreciation of the balance between individual rights
and collective good.
5. Act responsibly in dealing with patients and research participants
6. Respect privacy and confidentiality of data
Values
1. Try to practice medicine and research in an ethical way at all times
2. Advocate sound patient-professional relationships
3. Encourage adherence to ethical principles, guidelines and
professional codes
5. Student workload
Year 1
Year 2
Year 3
Year 4
Year 5
6. Course Content
Year 1
Aim: To provide a basic introduction to the subject of Bioethics and
a critical appreciation of the various Bioethics theories and
principles.
Content :Definition of Bioethics, Medical ethics, Research ethics,
Theories : consequentialism, duty-based theories, rights-based
theories, contractarianism, virtue ethics, casuistry, Deontology,
Teleology, Umuntology/Ubuntuism, Applied ethics, Ethics, law,
human rights and religion; Ethical principles, Autonomy,
Beneficence, non-maleficence and justice
Year 2
Aim : To provide some skills for addressing moral dilemmas in
medicine using the Bioethical principles.
Outline: Moral Theory and Healthcare Ethics, Moral dilemmas in
medicine, Criteria for assessing competing ethical theories,
Allocation of scarce resources, Ethics consultation, Genetic
manipulation: cloning, stem cell and embryos research, Abortion,
Human Genetics, Cloning, Genetic screening, Enhancements,
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Community Health
Bioethics Course
Prenatal diagnostics, Birth Control, Eugenics, Emergency
Treatment, Death and end of Life issues, Introduction to African
Worldviews on health, Life and death, Euthanasia and assisted
suicide, Ethics of palliative care, Doctor involvement in capital
punishment, Assisted reproductive Technologies (ART), Organ
donation, harvesting and transplantation, Ethics of HIV and VCT
(HIV/AIDS prevention, treatment and research including vaccine
and microbicide research),
Year 3
Aim :To provide an understanding of the basic principles of health
law as well as an appreciation of the various pieces of medical laws
and professional ethics.
Outline : General principles of law, Sources and hierarchy of law
(including international law), Differences between law, soft law,
morality, religion, ethics; Classification of law (public, private, civil,
criminal) in the context of the legal Relationships between
government, public careprovider, doctor, patient, health insurances
(overview), Health law and human rights, Hippocratic oath, Doctor
Patient Relationship, Patients rights and responsibilities, Doctor’s
rights and responsibilities, Paternalism and informed consent,
Standards of professional behaviour for physicians, Organisational
values and Clients charter , Medical negligence: Duty of care,
standard of care, Medical strike, Medical futility, Therapeutic
priviledge, Samaritan Law, Refusal of treatment, Duty of medical
confidentiality, Selected public health legislation in Malawi on
prevention of diseases and accidents, Public Health Act,
Environmental Management Act, Occupational Safety Health and
Welfare Act, 1997, The role of Malawi Bureau of Standards,
Enforcement mechanisms
Year 4
Aim : To introduces students to ethical issues that arise in the
conduct of research with human beings.
Outline: Introduction to research ethics, History of Research
Ethics, Research Ethics codes, Nuremberg Code, Declaration of
Helsinki, CIOMS, Belmont Report , Applying Ethical principles in
health research, Obtaining informed consent and designing oral
and written consent scripts, Proxy consent and assent, Risk benefit
assessment, Justice in recruitment, Independent review by
Research ethics committee, constitution, composition and function,
Ethical issues related to other research designs and methods,
randomized controlled trials, use of placebos, double blinding,
scientific validity, Research with animals, guidelines on research
with animals, Data and safety monitoring of clinical trials, Medical
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Community Health
Bioethics Course
research record management and confidentiality, Ethical issues in
Community based research, International collaborative research,
justice in international research, ethical considerations in cross
cultural settings
Year 5
Aim: To prepare students for practice by looking at various issues
such as current or proposed policies or pieces of legislation and
current health problems.
Methods: Integrated seminars
7. Teaching Methods
Lectures
Group discussions
Case analysis and case development
Debates
Film and video presentations
Directed reading and research
Direct observation and review
8. Staff
See workload schedule
9. Infrastructure
Lecture theatre
Transport to health facilities
10. Equipment
LCD projector in Blantyre
Library facilities
Photocopying and paper
11. Core text
Beauchamp T.L. &J.T. Childress. 2001. Principles of Biomedical
Ethics. Oxford University Press
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