HEALTH CARE ETHICS (CRN 46634) RELS 300:10 (CRN 48090) NURS 330:10 (6 credits) September 2015 to April 2016 1 300/330 appleby Florence Nightingale and her medical and nursing colleagues http:// aurorae-australis-borealis.blogspot.ca/2012_06_01_archive.h tml
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HEALTH CARE ETHICS (CRN 46634) RELS 300:10 (CRN 48090) NURS 330:10 (6 credits) September 2015 to April 2016 1 300/330 appleby Florence Nightingale and.
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HEALTH CARE
ETHICS
(CRN 46634)
RELS 300:10
(CRN 48090)
NURS 330:10
(6 credits)
September 2015
to
April 2016
Florence Nightingale and her medical and nursing colleagues http://aurorae-australis-borealis.blogspot.ca/2012_06_01_archive.html
1st TERM 9 September: Introduction to Health Care Ethics and
Overview of Course 10 to 24 September: UNIT 1: Ethical Theory; Bioethics in
Canada [BC], Ch.1 (1-43)
30 September: In-class QUIZ 1 to 15 October: UNIT 2: Medical Research; BC, Ch.4 (95-
124)
21 to 28 October: UNIT 3: The Health Care Professional-Patient Relationship; BC, Ch.3 (63-93)
29 October to 2 December: UNIT 4: Intro. To Ethical issues in Reproduction; (A) Reproductive Technologies, BC Ch.5 (125-171); (B) Prenatal Genetic Testing, BC Ch.6, excerpts (165-171)
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2nd TERM 6 to 7 January: UNIT 5: Genetic testing and therapy; BC,
Ch. 6 (155-165)
13 to 27 January: UNIT 6: Abortion and Maternal-Fetal Conflicts, BC, Ch. 7 (187-212)
3 February to 10 March: UNIT 7: Death & Dying; BC, Ch.8 (213-241)
16 to 31 March: UNIT 8: Organs and Tissues: Procurement and Transplantation; BC, Ch. 9 (243-270)
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Student Evaluation, 1st TERM
30 September – In-class QUIZ on moral theory
= 20% of 1st term mark
Reflective Journal = 15% of 1st term mark• 6 weekly entries, in class• Summative reflection – due 2 December
• Reflections on moral agency, personal values, and self-assessment of learning
Group portfolio on an issue in reproductive technologies OR prenatal testing = 20%
Attendance = 5%
1st TERM EXAM = 30%
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Student Evaluation, 2nd TERM
Research Essay OR Portfolio of 4 items (may work with a partner) OR Service Learning Project
= 30% of term mark• Essay proposal due 4 Feb• Essay OR Portfolio due on or before 24 March• Service Learning Project due 30 March
Narrative Reflection: 5 in-class entries + summative reflection on one complete narrative = 20%
• Due 3 March
Group portfolio & presentation on an issue in organ & tissue transplantation & procurement = 20%
• Due on or before 23/24 March, 30/31 March as scheduled
2nd TERM EXAM = 30%
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COURSE OBJECTIVES
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• At the conclusion of this course, students will be able to demonstrate and exercise ethical skills and competence, especially with regard to issues encountered in health care settings
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1. Knowledge and conceptual competence will be assessed according to each student’s ability to:
a) demonstrate moral literacy with regard to:i. moral theories;
ii. moral principles and concepts;
iii. case study analysis;
iv. moral decision making frameworks;
v. moral duties, responsibilities and grounds for choices; and,
vi. the origins and history of contemporary bioethics.
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2. Competence in moral consciousness, perception and perspectives will be assessed according to each student’s ability to:
a) demonstrate moral literacy with regard to:i. multiple value perspectives within a moral situation;
ii. values, goals and choices within particular religious and cultural communities;
iii. respecting the choices of others;
iv. taking a whole person perspective that allows for personal definitions of well-being;
v. collaborating with others in finding consensus;
vi. demonstrating attentiveness to experiences of suffering, illness and healing; and,
vii. empathetic capacity to care and advocate.
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3. Competence in the process of making moral decisions and mobilizing moral values will be assessed according to each student’s ability to:
a) demonstrate moral insight and accountability with regard to:i. one’s ability to make informed decisions and articulate the
reasons for making one’s choices;
ii. generalizations, biases, or lack of empathy;
iii. moral values and actions of oneself and others;
iv. contributing to moral decision-making within a group setting;
v. independent self-appraisal and the development of one’s moral character; and,
vi. self-conscious reflection concerning experiences of moral uncertainty, ambiguity, and transformative responses to moral dissent and distress.
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Any questions or concerns?
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Take a sheet of paperand answer each question:
1. Are you a morning or night person?
2. If you were an animal, what would you be and why?
3. If you could visit any place in the world, where would you choose to go and why
4. If you had to describe yourself using three words, they would be…
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Form groups of 3 or 4 people;
Introduce yourselves to one another and
Share your answers in your group
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READ BIOETHICS IN CANADA [BC] CH. 1 (pages 1-43)
UNIT 1: Ethical Theory9 to 23 September
INTRODUCTION TO MORAL THEORY
17
MORAL THEORIES
provide a viewing framework highlight some elements, obscure others objects/dilemmas look different from different perspectives some perspectives are more complete than others
2 main categories of moral theories relativism
universalism or objectivism
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RELATIVISM: 2 FORMS
ETHICAL RELATIVISM:
Whatever is culturally acceptable in your society is right.
If it is culturally unacceptable, then it is immoral or wrong.
ETHICAL SUBJECTIVISM:
If you feel good and right about something,
then it is a moral act.
If you feel bad
about something,
then it is immoral
or wrong
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Cultural Relativism• There is NO ideal culture against which any other culture can be
measured or judged; cultural practices and beliefs are geographically, linguistically and socially unique
• Every culture has patterns of socially approved behaviours, habits and ideals
In societies where time is perceived to be restricted and limited, punctuality becomes a virtue. It is insulting to waste someone's time, and the ability to do that and get away with it is an indication of superior status.
In cultures where time is regarded as plentiful, circular, and constantly regenerated, no disrespect is intended when people wait all day, and then are told to come back the next day. (see http://www.analytictech.com/mb021/cultural.htm)
Actions which conform with cultural norms are regarded as morally good
There is no way to resolve a moral dilemma when different people disagree.
People make their own decisions according to what they feel or believe to be right or wrong.
Everybody creates their own morality.
If you believe something is wrong, don’t do it.
If you feel OK about doing something, then it must be right for you.
We all have to make our own decisions and live with them.
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SUBJECTIVISM asks:
What will be best for me?What do I prefer to do?What action best represents my lifestyle and principles?
What choice feels right for me?Which decision corresponds with my beliefs?Why would I try to convince someone else to make the same choice I have made when their beliefs and preferences are different?
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Cultural relativism and circumcision
• In some cultures, infant male circumcision is practiced.
• In other cultures, infant male circumcision is regarded as abusive.
• Some cultures practice female circumcision.• Other cultures regard female circumcision as abusive and discriminatory.
Is circumcision a moral practice?Is circumcision an immoral and abusive act of mutilation?
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Cultural spectrumAmong Bantu speaking peoples of sub-equatorial Africa, circumcision is an adolescent rite of passage which represents the initiation of males into a warrior status
In the US, the primary determinant of male circumcision is religion – almost all Muslim and Jewish males are circumcised. Muslim boys may be circumcised at any age between birth and puberty. A Jewish male infant is circumcised on his eighth day.
Medical studies show that circumcision status is not directly correlated with either sexual function or dysfunction • In Canada, the infant circumcision
rate in Canada has fallen from roughly half in the 1970s to its present value of 13%; only Manitoba publicly funds circumcision procedures.
• Male circumcision may be performed as a medical procedure by a health care professional, or by a religious leader in a ritual ceremony
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Female Circumcision• Female circumcision may
ensure the virginity of a bride on her wedding day.
• Studies show that female circumcision reduces sexual pleasure and contributes to sexual dysfunction.
• In areas of Africa & the Middle East, circumcision is seen as “women’s business”; circumcised women are seen as clean, civilized, wise and mature.
• Female circumcision is performed for cultural and social reasons.
• Parts of the clitoris and the labia may be removed, and the vaginal opening may be sewn smaller; typically, no anesthetic is used.
• Female circumcision is a cultural practice that is found among all religious groups in certain geographical settings.
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When medical ethics confronts cultural values
NEJM Volume 22, Number 18, Pages 1312-1315,“The Question Of Routine Neonatal Circumcision” by Ronald L. Poland, http://www.cirp.org/library/general/poland/
CMAJ Volume 148, Number 2: Pages 288-289, ”Female circumcision: When medical ethics confronts cultural values” by Eike-Henner Kluge
“Late Complications of Childhood Female Genital Mutilation” by Aseel Hamoudi & Michael Shier, http://www.sogc.org/jogc/abstracts/full/201006_CaseReport_1.pdf