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 PM—The 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
