Windsor University School of Medicine Brightons Estate, Cayon, St. Kitts Medical Ethics Syllabus Semester : January- April 2016 Course Code: BEHS 630 Lecturer: Dr Idara C. Eshiet E- mail: idara4care@ yahoo.com Office Hours: 9:00 am – 5:00pm Course Credits: 2 Lecture Hall: Classroom 5 Lecture Times: Wednesday: 2:00pm- 3:15pm Thursday: 3:15pm-4:30pm Course Description: Medical Ethics is aimed at educating medical Students about ethical issues that arise in healthcare. It aims to provide a better understanding of the various issues and how they are handled. Medical Ethics begins with an account of the virtues that should define a physician as a professional and then identifies ethical principles that should guide the physician’s behavior towards patients. Course Objective: Upon completion of this course, students should: 1. Be thoroughly familiar with the criteria necessary to make sound ethical decisions. 2. Be able to effectively analyze and evaluate different points of view 3. Acquire basic skills in approaching ethical issues and understand the relevant ethical principles. 4. Be able to have a dialogue in both interdisciplinary and inter-professional discussions that focus on patient care, treatment, rules and regulations that govern such care. 5. Be able to distinguish between relevant and irrelevant information 6. Students should be able to analyze information for implied as well as stated meaning 7. Students should be able to apply abstract, creative and logical reasoning Materials: TEXTS: 1. INTERVENTION AND REFLECTION 9th Edition, by Ronald Munson 2. Principles of medical Ethics by Beauchamp and Childress 7th Edition Handouts would also be given as a substitute to power points. Course Requirements: It is mandatory that students read the handouts when given before coming to the lecture hall. Assignments will be awarded and students will be selected at random to present them. A mid- semester quiz would be given which would be used as a self – assessment tool for the students. Grading: There will be a mid- semester test before the finals. The finals account for 80% of your scores and then you have an NBME exams, which account for the remaining 20% Behavioral science and Ethics is combined for the examinations. The grading scale is as follows: A+ : 100- 80% A: 79-71% B: 70- 666 % C: 65% F: Less than 65% Academic Honesty: Academic honesty is fundamental to the activities and principles of this university. All members of the academic community must be confident that each person's assignment has been responsibly and honestly acquired, developed, and presented. Any effort to gain an advantage not given to all students is dishonest whether or not the effort is successful. Breaches of the academic integrity rules are seen as extremely serious matters and any student caught faces sanctions from the Disciplinary Committee. Attendance Policy: Students are expected to be professional at all times. This includes coming on time to classes, not disrupting the classes and not making noise during lecture times. Students are expected to have an 80% attendance in order to qualify to write the final exams. It should be noted that emergency situations fall under the 20% left. Students with Disabilities: Any student with a disability or having emergency medical information to share with me should register and provide documentation to the dean of student affairs. The student should also bring a letter to the instructor from the Dean of Student Affairs stating that he/ she needs academic accommodations. This should be done within the first three (3) weeks of resumption. Specific arrangements should be made with the instructor five (5) working days prior to each exam for which accommodations are being requested. Class 1 & 2 : Introduction to Medical Ethics - Origin of the field and its current status - Prevalence of Medical Ethics Week - Historical points 1 - Personhood - Autonomy - Quality of life Class 3&4 : Autonomy, Competence and the capacity to make Decisions - Understanding the concepts of Autonomy, Competency and Paternalism - Competency in minors Week - Partial emancipation 2 - Emancipated minors - Psychiatric Patients Case Study: Dax Case, Scholendorf vs. NYS Hospital Class 5: Informed Consent, confidentiality and medical records - Understanding the concept and elements of Informed Consent - Understanding the obligations and requirements of Informed Consent - Understanding the concept and obligation of Informed refusal - Consent for an incompetent person - Pregnant women - Confidentiality and when it can be breached Week - Medical records 3 Case Study: Tarasoff's case, Demasi case Class 6: Informed Consent and Research Ethics - Criteria for obtaining Informed Consent for research Class 7: Advance Directives, DNR Orders, Fluid and Nutrition issues Case Study: Wanglie Case, Cruzan Case, Terri Schiavo case, Karen Ann Quinlan Week 4 Class 8: Truth Telling and Withholding Information - Lying, Deception, misrepresentation and nondisclosure; Definitions - Ethical Objections to deception - The Placebo Effect - Parameters for breaking bad news Class 9: Health Care Delivery and Resource Allocation Week 6 - Role of allocational issues in Medical Ethics Key concepts: Resources, allocation and cost Criteria for evaluating allocations Theories: Utilitarian, Rawls Class 10: Review some ethical questions Class 11:The persistent Vegetative state, Determination of Death and Brain Death Week 7 - Death and Dying Definition of death Controversial moral constraints Persistent Vegetative state and other states; definition Class 12: Baby Doe case: Can parents refuse life saving therapy from their children? ; Good Samaritan Laws Class 13: Euthanasia and Physician-Assisted Suicide, terminal sedation of the “ Law of Double Effects” - Definition - Is Euthanasia legal? Week - What is the law of Double effects? 8 - What is Physician – Assisted Suicide and is it legal? - Is Terminal Sedation ethical and/or legal? Case Study: Brittany Maynard case, Dr Jack Kervokian ; Debbie Case Class 14:Reproductive Issues - Abortion: Rights/ Privacy - Contraception: To notify or not? Week - Sterilization, 9 - Donation of sperm and eggs Case Study: Rowe vs. Wade Class 15: HIV issues Class 16: Doctor/ patient Relationship; Doctor/ Doctor Relationship - Overview of the roles of each - Beginning and terminating the Doctor Patient Relationship Week - Sexual Relations between Doctors and patients 10 - Sexual Relations between a doctor and a medical student - Abandonment Class 17: Professionalism Class 18:Reporting - Child abuse, Week - Elder Abuse, 11 - Domestic violence, - Torture Class 19: Cross cultural Issues and religious differences Class 20: Malpractice - Tort Theory - Intention vs negligence Class - Res Ipsa Loquitur 12 - Liability of a physician Class 21: Examination Review Assignments/ Selected Discussions/ readings: It's Over, Debbie Dax case Scholendorf vs. Society of NY Hospital Wanglie Case Terri Shiavo Case Karen Ann Quinlan Nancy Cruzan Case The Brittany Maynard case Marlise Munoz case Tarasoff case Demasi case HIPPA EMTALA Obamacare Students Who Fail: Remediation of courses will be planned and implemented by a combined decision of the evaluation and promotion committee in collaboration with the Examination controller and course director. Students may be eligible for a retake exam beginning of the semester or subsequent semester end exams. Note: 1. Ask questions when you do not understand something. I am here to help you learn the concept of Medical Ethics. Take advantage of my office hours and class time to develop your knowledge. 2. Stop me if I am going too fast. It is important for you to note the issues discussed in class. Those are the ones that will appear on the exams. Read…Read…. Read your book because everything cannot be thought in a classroom setting. You must do the extra miles (readings, practicing questions, explaining the concept learned to your classmate…). 3. Follow closely what is covered in class. I will try my best to emphasize the important topics during class. Remember not everything can be taught in the class, so you have study. 4. Study for understanding. Don’t just “get through” the material. Too often students read a text just to read the text. They may read it but have no clue what it was they read. When you study, try to achieve a general understanding of the concepts – not a list of memorized facts or simply to ―get through the material. Learning takes time and effort. One hour of focused study is worth much more than 3 hours of mindless reading to get through the chapter, etc. 5. Feel free to consult with me. Communication about expectations, requirements, etc. is crucial for your success. Feel free to see me about any questions that you have. I do not want the path to success for this course to be a mystery. 6. Come to class prepared. If there is an assigned reading, questions, etc., have it done before class. It makes your class time more efficient and improves understanding. Try to read the material ahead of time…it will help you to pinpoint your weaknesses & to overcome them by asking for necessary help. Don’t wait for the last minutes t try to cram questions. 7. Expectation of the student. I expect you to work hard in this class. I am not going to give you anything. You will earn it. I am willing to facilitate your learning as much as I can, but it is up to you to put forth the effort to succeed. I also expect you to follow all policies regarding academic honesty. Please come to class & be active not passive!!... Remember BOOKS don’t write exams….But TEACHERS do!!!! Have a great semester and don’t hesitate to contact me if you have questions about the course!