Courses

Spring 2018

BIOE 551 – NARRATIVE ETHICS: HEALTH, MEDICINE, AND LITERATURE
Instructor: Lance Wahlert
Time: Thursdays, January 11 - April 19
Location: BLK 1319, Blockley Hall, 13th Floor, 423 Guardian Dr.
What is it like to live with a chronic, debilitating, or fatal illness? What does it mean to treat a sick person as a doctor, nurse, or other medical professional? And how does it feel to be a caregiver, witness, or outside party in such circumstances? All of these questions will inform the central query of this course: How do personal narratives inform, explain, or complicate our understandings of the medical world? In recent decades, medical humanities scholars and bioethicists have striven to include the perspectives of multiple persons in the history and storytelling of medicine. Moreover, leading medical, nursing, and public health schools have incorporated narrative studies as a part of the training of their future doctors, nurses, and clinicians. While such strategies have been innovative at the level of revamping scholastic curriculums, they are hardly new in medical history. From the case study to the medical history to the talking cure, storytelling has been a central component in the diagnostic, therapeutic, and pastoral strategies of medical cosmologies for centuries. As a trans-historical study of medical storytelling, this course will be concerned with the power of narratives to bring coherence and meaning to the lives of sick persons, caregivers, and medical professionals at moments of great physical and emotional crisis. Accordingly, this course will consider a range of historical and contemporary topics that speak to the bioethical dilemmas of telling, reading, disseminating, and interpreting medically relevant narratives. While we will largely focus on non-fictional accounts (memoirs, medical records, journals, and testimonials), we will also consider how fictional literary sources (stories, poetry, films, and works of art) explore and affect matters related to the topic of “narrative and bioethics.”

BIOE 602 - 401/402 – FOUNDATIONS OF BIOETHICS
Instructor: Autumn Fiester
Time: Mondays OR Thursdays, 4:30-7:00, January 10/11-April 19/23
Location: BRB 251, Biomedical Research Building II/III, 421 Curie Boulevard
This course is one of the 2 foundational courses in the MBE program, which together provide students an entre into the field of Bioethics. In Conceptual Foundations, students examine the various theoretical approaches to bioethics and critically assesses their underpinnings. Topics to be covered include an examination of various versions of utilitarianism; deonotological theories; virtue ethics; ethics of care; the fundamental principles of bioethics (autonomy, beneficence, distributive justice, non-maleficence); casuistry; and pragmatism. The course will include the application of the more theoretical ideas to particular topics, such as informed consent, confidentiality, and end of life issues.

BIOE 550 – BIOETHICS AND THE LAW
Instructor: Jon Merz
Time: Mondays, 4:30-7:00, January 10-April 23
Location: BLK 1319, Blockley Hall, 13th Floor, 423 Guardian Drive
This course will present a broad survey of topics at the intersection of law and bioethics. Much of bioethics deals with topics of public policy, and law is the tool of policy. Areas to be covered will range from an overview of American law making to enforcement mechanisms, topics including FDA regulations, state interventions into beginning and end of life issues, privacy, malpractice, healthcare reform, and international issues, including those related to innovation and access to medicines.

BIOE 560 – PEDIATRIC ETHICS
Instructor: Steven Joffe and Jennifer Walter
Time: Tuesdays, 4:30-7:00, January 16-April 24
Location: BRB 251, Biomedical Research Building II/III, 421 Curie Boulevard
In this course, we will explore the history, conceptual frameworks, and landmark debates of bioethics related to children. We will examine common ethical challenges (e.g., transplantation, critical illness, end of life) when the patient is a child. We will also examine issues unique to children, such as newborn screening, consent vs. assent, the rights and responsibilities of parents, and the role of the courts and the state. We will draw upon theories from moral philosophy, clinical cases, and seminal legal decisions to demonstrate the breadth and complexity of pediatric ethics.

BIOE 565 – RATIONING AND RESOURCE ALLOCATION
Instructors: Ezekiel Emanuel & Harald Schmidt
Time: Wednesdays 4:00-7:00, January 17 - April 25
Location: STIT B21, Stiteler Hall, 208 South 37th St.
You have one liver but three patients awaiting a liver transplant.  Who should get the liver?  What criteria should be used to select the recipient? Is it fair to give it to an alcoholic?  These are some of the questions that arise in the context of rationing and allocating scarce health care resources among particular individuals, and concern what are called micro-allocation decisions.  But trade-offs also need to be made at the meso- and macro-level.  Budgets of public payers of healthcare, such as governments, and of private ones, such as health plans, are limited: they cannot cover all drugs and services that appear beneficial to patients or physicians.  So what services should they provide? Is there a core set of benefits that everyone should be entitled to? If so, by what process should we determine these? How can we make fair decisions, if we know from the outset than not all needs can be met? Using the cases of organs for transplantation, the rationing for vaccines in a flu pandemic, and drug shortages, the course will critically examine alternative theories for allocating scarce resources among individuals.  Using both the need to establish priorities for global health aid and to define an essential benefit package for health insurance, the course will critically examine diverse theories for allocation decisions, including cost-effectiveness analysis, age-based rationing and accountability for reasonableness.  

BIOE 545/547 – MEDIATION INTENSIVE I/III  
Instructors: Edward Bergman, Autumn Fiester, and Lance Wahlert
Time: Jan 12-15, 2018
Location: Blockley Hall, 14th Floor, 423 Guardian Dr.
This is an immersion experience of learning through role-playing mediation simulations. It has the same format of the other Mediation Intensives, but will NOT duplicate simulations. Students will:

  • Learn to effectively manage clinical disputes among and between caregivers, patients and surrogates through mediation
  • Discover how to define problems and assess underlying interests to generate mutually acceptable options
  • Role-play in a variety of clinical situations as both disputants and mediators
  • Practice mediation with professional actors
  • Receive constructive feedback in supportive environment

Click for a downloadable flyer.

BIOE 546/548 – MEDIATION INTENSIVE II/IV 
Instructors: Edward Bergman, Autumn Fiester, and Lance Wahlert
Time: May 17-20, 2018
Location: Blockley Hall, 14th Floor, 423 Guardian Dr.
This is an immersion experience of learning through role-playing mediation simulations. It has the same format of the other Mediation Intensives, but will NOT duplicate simulations. Students will:

  • Learn to effectively manage clinical disputes among and between caregivers, patients and surrogates through mediation
  • Discover how to define problems and assess underlying interests to generate mutually acceptable options
  • Role-play in a variety of clinical situations as both disputants and mediators
  • Practice mediation with professional actors
  • Receive constructive feedback in supportive environment

Click for a downloadable flyer.

Summer 2018

BIOE 555 – NEUROETHICS
Instructor: Jonathan Moreno
Time: Tuesdays, TBD
Location: TBD                                                                                                                      Neuroethics might well be the most rapidly growing area within bioethics; indeed, in some respects neuroethics has grown as an independent field, with its own journals, professional society and institutional centers. This growth over the past decade is partly attributable to the growth of neuroscience itself and to the challenging philosophical and moral questions it inherently raises. A 2012 Royal Society report, observes that an increasingly mechanistic understanding of the brain raises a host of ethical, legal, and social implications. This has laid the foundation for the emergent field of Neuroethics, which examines ethical issues governing the conceptual and practical developments of neuroscience. Irrespective of their validity, even the claims that modern neuroscience entails the re-examination of complex and sensitive topics like free will, consciousness, identity, and responsibility raises significant ethical issues. As such, neuroethics asks questions that extend beyond the usual umbrella of biomedical ethics. This course will, therefore, consider the new knowledge and ways of learning about the brain from scientific and ethico-legal and social standpoints. We will examine the core themes of neuroethics, including cognitive enhancement, the nature of the self and personhood, neuroimaging and privacy, and the ways that all these themes are brought together in matters affecting national security.

BIOE 566 - PERSONAL RESPONSIBILITY FOR HEALTH IN POLICY AND PRACTICE
Instructor: Harald Schmidt
Time: Wednesday 4:30-7:00, May 23 - August 1
Location: TBD
Excess body weight is often associated with higher healthcare cost. Should overweight and obese people pay more for health insurance? If we want to encourage people to quit smoking, is it best to give insurance discounts to those who succeed, or impose surcharges on those who do not? Should companies be permitted not to hire smokers? Globally, more than seven in ten deaths are due to chronic diseases, such as stroke, cancer, diabetes or heart disease. In the US, rates are even higher. Good or poor health is typically the result of a number of interacting factors. Genetics, social status, environmental conditions and personal behavior all play a role. In the best case, appeals to personal responsibility can motivate people to achieve oftentimes challenging behavior change. But in the worst case, policies penalize people for factor that are beyond their control. We will critically assess how personal responsibility is conceptualized in law and policy in different countries, and evaluate philosophical, political, economic and health-science related rationales in favor and against personal responsibility for health. Some of the material will be conceptual in nature, but throughout, the discussion will be focused on concrete cases, including obesity, smoking, breast screening, organ donation and medication adherence.

BIOE 580 – RESEARCH ETHICS
Instructor: Jon Merz
Time: TBD
Location: TBD
This seminar is intended to give students a broad overview of research ethics and regulation. The students will come out of the class with an understanding of the historical evolution, moral bases and practical application of biomedical research ethics. The course includes reading assignments, lectures, discussions and practical review of research protocols and in-class interviews with researchers and study subjects. Course topics include: history of human subjects protections, regulatory and ethical frameworks for biomedical research, informed consent theory and application, selection of fair research subjects and payment, confidentiality, secondary uses of data and stored tissue, ethics of international research, pediatric and genetic research and conflicts of interest in biomedical research.

BIOE 546/548 – MEDIATION INTENSIVE II/IV 
Instructors: Edward Bergman, Autumn Fiester, and Lance Wahlert
Time: TBD
Location: Blockley Hall, 14th FL, 423 Guardian Drive
This is an immersion experience of learning through role-playing mediation simulations. It has the same format of the other Mediation Intensives, but will NOT duplicate simulations. Students will:

  • Learn to effectively manage clinical disputes among and between caregivers, patients and surrogates through mediation
  • Discover how to define problems and assess underlying interests to generate mutually acceptable options
  • Role-play in a variety of clinical situations as both disputants and mediators
  • Practice mediation with professional actors
  • Receive constructive feedback in supportive environment 

BIOE 545 /547 – MEDIATION INTENSIVE I/III 
Instructors: Edward Bergman, Autumn Fiester, and Lance Wahlert
Time: TBD
Location: Blockley Hall, 14th FL, 423 Guardian Drive
This is an immersion experience of learning through role-playing mediation simulations. It has the same format of the other Mediation Intensives, but will NOT duplicate simulations. Students will:

  • Learn to effectively manage clinical disputes among and between caregivers, patients and surrogates through mediation
  • Discover how to define problems and assess underlying interests to generate mutually acceptable options
  • Role-play in a variety of clinical situations as both disputants and mediators
  • Practice mediation with professional actors
  • Receive constructive feedback in supportive environment

Fall 2018

BIOE 551 - Bioethics and Film
Instructor: Lance Wahlert
Time: Wednesdays, 4:30 - 7:00, August 29 - December 5
Location: TBD
In reality and metaphorically, cinema has served for generations of moviegoers as a site of communal congregation, pedogogical dissemination, and sometimes disease infection. Accordingly, how and where we watch films are just as important as what films have to say about doctors, disease, and death. This course will consider the epidemiological and cultural implications of cinema on bioethics, including how movies and movie theaters themselves have functioned as spaces of contentious discourse regarding public health. Bearing in mind the recent scholarship of film and medical theorists such as Lisa Cartwright, Paula Triechler, and David Serlin, we will study not only the possibility for film to register and comment on cultural understandings of the clinic, but also the ways cinema itself works out, reimagines, and even changes how the clinic is put into practice. Focusing on themes such as quarantine, vaccination, sexual health, end of life care, professional competence, and globalization, we will be watching and discussing public health films and feature-length films by directors such as Alfred Hitchcock, David Croneberg, Tamara Jenkins, and Todd Haynes. No background in either cinema studies or bioethics is required for this course.

BIOE 553 - History of Bioethics
Instructor: Jonathan Moreno
Time: Mondays, 4:30 - 7:00, September 10 - December 10
Location: TBD
This course will offer a survey of key documents in the history of bioethics- such as the Hippocratic Oath, the Nuremberg Code, and the Belmont Report- alongside important works in the philosophy of medicine that collectively created the foundation for the young field. We will also consider the documentary value of certain films, such as Who Should Survive? and Dax's Case. The great documents will be supplemented by important readings that place them in context and help show how understandings of bioethical principles and themes have been modified and refined, revealing how these documents have responded to key contemporary triggers of ethical reflection.

BIOE 575-401 - Health Policy [Cross-Listed as HCMG 250/HCMG 850]
Instructor: Ezekiel Emanuel
Time: Tuesdays AND Thursdays, 4:30 - 6:00, August 28/30 - December 5/7
Location: TBD
The U.S. health care system is the world's largest, most technologically advanced, most expensive, with uneven quality, and an unsustainable cost structure. This multi-disciplinary course will explore the history and structure of the current American health care system and the impact of the Affordable Care Act. How did the United States get here? The course will examine the history of and problems with employment-based health insurance, the challenges surrounding access, cost and quality, and the medical malpractice conundrum.  As the Affordable Care Act is implemented over the next decade, the U.S. will witness tremendous changes that will shape the American health care system for the next 50 years or more. The course will examine potential reforms, including those offered by liberals and conservatives and information that can be extracted from health care systems in other developed countries. Throughout, lessons will integrate the disciplines of health economics, health and social policy, law and political science to elucidate key principles.  This course will provide students a broad overview of the current U.S. healthcare system. The course will focus on the challenges facing the health care system, an in-depth understanding of the Affordable Care Act, and its potential impact upon health care access, delivery, cost, and quality.

BIOE 578 - Bioethics and Human Rights ***New Fall 2018 Class***
Instructor: Harald Schmidt and Matthew McCoy
Time: Wednesdays, 4:30 - 7:00, August 29 - December 5
Location: TBD
The constitution of the World Health Organization enshrines “the highest attainable standard of health as a fundamental right of every human being.” If such a right exists, it is far from being realized. Worldwide, over 1 billion people are living in hunger. Every day, 21,000 children die before their fifth birthday of pneumonia, malaria, diarrhea and other diseases. Even wealthy countries are marked by significant health disparities. In the U.S., for instance, infants born to African-American women are 1.5 to 3 times more likely to die than infants born to women of other races. This course explores the moral principles and the political and legal structures that inform a human rights approach to health. What sorts of freedoms (e.g., to bodily integrity) and entitlements (e.g., to accessible and affordable health care) does a right to the highest attainable standard of health entail? If countries cannot ensure their citizens’ right to the highest attainable standard of health, what responsibility does the international community bear for intervening? Should undocumented and irregular migrants have the same access to health care as citizens? Is a human rights approach to health compatible with using the market to allocate health-related goods? Finally, what are the limitations of analyzing health and formulating health policy using a human rights framework?

BIOE 590 – Ethics in Mental Healthcare
Instructor: Dominic Sisti
Time: Mondays, 4:30 - 7:00, September 10 - December 10
Location: TBD
Mental healthcare—which includes, but is not limited to, psychiatry, psychology, and clinical social work—is an especially ethically fraught subdiscipline of the larger medical enterprise. Issues range from garden-variety problems related to informed consent, patient capacity, and clinical professionalism to novel issues related to involuntary treatment, research on mentally ill persons, questions about free will and nosological categories. This course will present a survey of these ethical issues by first introducing foundational concepts from ethical theory and the philosophy of psychiatry and mind. Students will be expected to become conversant in several bioethical approaches and methods and be able to use them to critically examine both historical and contemporary questions in mental healthcare and research.

BIOE 601/401 - 401/402 - Introduction to Bioethics
Instructor: Autumn Fiester
Time: Tuesdays OR Thursdays, 4:30 - 7:00, August 28/30 - December 5/7
Location: BRB 251, Biomedical Research Building II/III, 421 Curie Blvd
This course is intended to serve as a broad introduction to the field of bioethics. The course will focus on the central areas in research and clinical ethics: genetics, reproduction, end-of-life, informed consent, the history of human subjects research, and surrogate decision-making. In this course, we will study case analysis, bioethics concepts, relevant legal cases, and classical readings in the field of bioethics.

Spring 2019

BIOE 602 - 401/402 – FOUNDATIONS OF BIOETHICS
Instructor: Autumn Fiester
Time: Mondays OR Thursdays, 4:30-7:00, January 16/17-April 25/29
Location: TBD
This course is one of the 2 foundational courses in the MBE program, which together provide students an entre into the field of Bioethics. In Conceptual Foundations, students examine the various theoretical approaches to bioethics and critically assesses their underpinnings. Topics to be covered include an examination of various versions of utilitarianism; deonotological theories; virtue ethics; ethics of care; the fundamental principles of bioethics (autonomy, beneficence, distributive justice, non-maleficence); casuistry; and pragmatism. The course will include the application of the more theoretical ideas to particular topics, such as informed consent, confidentiality, and end of life issues.

BIOE 570 – GENETICS
Instructor: Pamela Sankar
Time: Tuesdays, 4:30-7:00, January 22-April 30
Location: TBD
More than 20 years have passed since the inception of the Human Genome Project. Where are we now? The results of the HGP have shaped medical practice and have changed the way people talk about themselves and their relationships. In this course students will be introduced to basic genetics and to recent advances in the genetic and genomic sciences. We will explore the ethical, legal, and social implications of these trends while discussing topics such as whole genome testing, ancestry and race, forensic genetics, and the relationship of genetics to health disparities.

BIOE 572 – GLOBAL BIOETHICS
Instructor: Ezekiel Emanuel & Harald Schmidt
Time: Wednesdays 4:30-7:00, January 23-May 1
Location: TBD
According to the WHO, around 30 million people with HIV/AIDS should receive anti-retroviral treatment. But only 10 million do. Drugs containing tenofovir--the standard of care in developed countries—are expensive. Stavudine-based treatments are much cheaper but have worse side-effects. Is it ethical to use stavudine-based rather than tenofovir-based treatments in sub-Saharan Africa? Smoking rates have decreased drastically in most developed countries. But they are increasing in many developing countries. Established public health measures are not implemented, and the tobacco industry pursues a range of marketing activities that would be unacceptable in developed countries. As a consequence, global deaths from smoking are expected to increase to 1bn by the end of the 21st century, with 80% of deaths in developing countries. Is industry’s behavior immoral or normal in a global market? ARDS is a disease of premature newborns. Is it ethical to test a new ARDS drug in Bolivia if the drug--if proven to be effective-- will be very expensive and accessible only to the richest people in Bolivia and other developing countries? An overarching question that these different cases raise is whether there are universal ethical standards that should apply to all people, or whether regional variations should be acceptable. Universalists typically argue that there must be no double standards, and that people should be treated the same regardless of where they live. Pragmatists raise concerns about moral imperialism, neo-colonialism, or insufficient respect for cultural or other differences. Increasing globalization fuels debates about which of competing sets of moral standards is the right one. Looking at a range of diverse cases including healthcare research, health policy, flu pandemics, family planning, smoking and obesity policy, and genetically modified crops, this course explores controversies in the cross winds of market forces, politics and ethics, and examines the roles and responsibilities of key actors and international policy guidance.

BIOE 580 – RESEARCH ETHICS
Instructor: Jon Merz
Time: TBD
Location: TBD
This seminar is intended to give students a broad overview of research ethics and regulation. The students will come out of the class with an understanding of the historical evolution, moral bases and practical application of biomedical research ethics. The course includes reading assignments, lectures, discussions and practical review of research protocols and in-class interviews with researchers and study subjects. Course topics include: history of human subjects protections, regulatory and ethical frameworks for biomedical research, informed consent theory and application, selection of fair research subjects and payment, confidentiality, secondary uses of data and stored tissue, ethics of international research, pediatric and genetic research and conflicts of interest in biomedical research.

BIOE 603 – CLINICAL ETHICS
Instructor: Dominic Sisti and Steven Joffe
Time: Tuesdays, 4:30-7:00, January 16-April 29
Location: TBD
Since the 1960s, medical technology has rapidly expanded our capacity to intervene in peoples’ lives.  At the same time, profound changes in the health professions as well as in society at large have led to a renegotiation of the relationship between medicine and society.  The field of clinical ethics has worked to understand and to shape these radical changes. Although the reality of human vulnerability to illness may not have changed over the millennia, who qualifies for personhood or what it means to respect human dignity have been up for debate. In this advanced course in clinical ethics, we will explore key ethical debates across the entire life course. We will emphasize an interdisciplinary approach that acknowledges a variety of health care providers' experiences, and will consider some of the challenges in clinical decision-making for and with patients, such as rationing at the bedside and requests for assistance in ending a patient's life. We will also examine policies that impact clinical practice, including systems for organ allocation in transplantation. We will draw upon theories from moral philosophy, clinical cases from our practices and from the media, and seminal legal cases to demonstrate the live ethical challenges of clinical practice today

BIOE 545 /547 – Mediation Intensive I/III                                                                            Instructors: Edward Bergman, Autumn Fiester, and Lance Wahlert
Time: TBD
Location: Blockley Hall, 14th FL, 423 Guardian Drive

BIOE 546/548 – Mediation Intensive II/IV                                                                            Instructors: Edward Bergman, Autumn Fiester, and Lance Wahlert
Time: January 12-15
Location: Blockley Hall, 14th FL, 423 Guardian Drive

This is an immersion experience of learning through role-playing mediation simulations. It has the same format of the other Mediation Intensives, but will NOT duplicate simulations. Students will:

  • Learn to effectively manage clinical disputes among and between caregivers, patients and surrogates through mediation
  • Discover how to define problems and assess underlying interests to generate mutually acceptable options
  • Role-play in a variety of clinical situations as both disputants and mediators
  • Practice mediation with professional actors
  • Receive constructive feedback in supportive environment

Summer 2019

Research Ethics

Disability Bioethics - Wahlert and Largent

Ethics of Public Health - McCoy

 

 

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