Bioethics teaching session 23rd April 2009

@ 5 p.m. - 7 p.m. in Bethune 378

Public Health Ethics and Infectious Disease

What did you “sign on for” when you entered medicine? Do you have a duty to care when doing so would place you at risk? What obligations does the profession have to public health and how will it fulfill them in an infectious disease outbreak? How would an epidemic affect your specialty’s practice and its role in the hospital and community? What ethical issues arise between colleagues and for the healthcare system?

In this session, we will:
• Consider the special issues that arise in public health ethics, and the principles that guide their resolution, distinguishing these from clinical (bedside) ethics;
• Reflect on professional commitment (personal and social) in relation to personal risk;
• Consider arguments for and against obligatory service in infectious disease outbreaks; and
• Consider ethical approaches to ensuring healthcare professional safety in risky work environments.

Readings:

1. Bensimon, C M, C S Tracy, M Bernstein, R Zlotnik Shaul, and R E G Upshur. “A Qualitative Study of the Duty to Care in Communicable Disease Outbreaks.” Soc Sci Med 65.12 (2007): 2566-75.
2. Childress, J F, R R Faden, R D Gaare, L O Gostin, J Kahn, R J Bonnie, N E Kass, A C Mastroianni, J D Moreno, and P Nieburg. “Public Health Ethics: Mapping the Terrain.” J Law Med Ethics 30.2 (2002): 170-8.

Background materials for your reference:
Canadian Medical Association. Caring in a crisis: The Ethical Obligations of Physicians and Society During a Pandemic (2009)
Public Health Agency of Canada. The Canadian Pandenmic Influenza Plan for the Health Sector. 2006.

Bioethics Teaching Session 5th February 2009

@ 4 p.m. in Bethune 378

Session topic: Resource allocation & equity

Two volunteers (from two different specialties) will bring an article, a case, or a policy/procedure/form used in their specialty or unit, and briefly present it for discussion. How do you handle the allocation of scarce resources? The judgment that something is too expensive to provide? Wait lists and prioritization?

Lynette will briefly fill out the theoretical background and recent controversies.

Check out this brief introductory article to orient you to the topic:

McKneally, M. F., Dickens, B. M., Meslin, E. M., & Singer, P. A. (1997). Bioethics for clinicians: 13. Resource allocation. Canadian Medical Association Journal, 157(2), 163-7.

Bioethics teaching session 8th January 2009

@ 5 p.m. - 7 p.m. in Room 5168 Halifax Infirmary

Informed Consent - Case presentation: Brent Culligan

Please read the following:

Shared decision-making:
Charles, C., Gafni, A., & Whelan, T. (1999). Decision-Making in the physician-patient encounter: Revisiting the shared treatment decision-making model. Social Science & Medicine, 49(5), 651-61.
Read it here...

McNutt, R. A. (2004). Shared medical decision making: Problems, process, progress. JAMA, 292(20), 2516-8.
Read it here...

Disclosure:
Back, A. L., & Arnold, R. M. (2006). Discussing Prognosis: “How Much Do You Want to Know?”
Talking to Patients Who Do Not Want Information or Who Are Ambivalent. Journal of Clinical Oncology, 24(25), 4214-4217.
Read it here...

Truth-telling:
Helft, P. R., & Petronio, S. (2007). Communication pitfalls with cancer patients: "Hit-And-Run" deliveries of bad news. Journal of the American College of Surgeons, 205(6), 807-11.
Read it here...

And culture:
Del Pozo, P. R., & Fins, J. J. (2008). Islam and informed consent: Notes from Doha. Cambridge Quarterly of Healthcare Ethics, 17(3), 273-9.
Read it here...