Teaching Ethics Through Case-Based Methods Doug Post, Ph.D. Associate Professor Department of Family Medicine The Ohio State University
Dec 20, 2015
Teaching Ethics Through Case-Based Methods
Doug Post, Ph.D.
Associate Professor
Department of Family Medicine
The Ohio State University
Patient Centered Medicine CourseO.S.U. College of Medicine
Behavioral Medicine Human Development Professionalism Ethics Diversity Violence
Palliative Medicine Meaning in Medicine Addiction Integrative Medicine Sexuality
Teaching Medical Ethics
“Medical students and residents most commonly learn how to approach ethical dilemmas by observing faculty and through hallway discussions about what they could have done differently after a difficult case.”
- Smith, Fryer-Edwards, Diekema, Braddock, 2004
Case-Writing First, decide on a topic Review and research the topic Write a draft of a case from the viewpoint of a
person caught in the thick of the case problem Look for opportunities to introduce terms or
concepts that are important to your course
- Herreid, 2000
Case-Based Teaching Methods
Trial Case Discussion Hearing Debate Problem-Based Learning Team Learning Jigsaw Technique
Bioethics Topics Physician-Assisted
Suicide Confidentiality End-of-Life Issues Futility Autonomy Managed Care Medical Student Issues
Mistakes Physician-Patient
Relationship Parental Decision-Making Professionalism Research Ethics Resource Allocation Truth-Telling
Case #1
Choose a Topic Physician Assisted Suicide
Review & Research the Topic http://depts.washington.edu/bioethx/
Write a draft of a case from the viewpoint of a person caught in the thick of the case problem.Quill TE. Death and dignity. A case of personalized
decision making. NEJM 1991; 324: 691-94.
Case #2 Choose a Topic
Principles of Medical Ethics
Review & Research the Topic Jonsen AR, Siegler M, Winslade WJ. Clinical Ethics: A
Practical Approach to Ethical Decisions in Clinical Medicine, 4th ed. 1998; New York: McGraw-Hill, Inc.
http://depts.washington.edu/bioethx/tools/princpl.html
Write a draft of a case from the viewpoint of a person caught in the thick of the case problem
Groups within Groupshttp://www.sciencecases.org/shannon_jake/shannon_jake.asp
Break class into 4 smaller groups and assign each group an ethical principle
Two tasks for sub-group discussion: 1) Apply ethical principle to the case and determine the physician’s actions based on that principle; 2) Discuss how they anticipate Sharon and her parents would react to the decision of their group
Spokesperson from each group presents findings Group Discussion
Case #3 Choose a Topic
Patient-Physician Relationship Review & Research the Topic
Ethics manual. Fourth edition. American College of Physicians. Ann Intern Med. 1998; 128(7):576-94. Comment in: Ann Intern Med. 1998;128(7):569-71.
http://www.catholic.com/library/Birth_Control.asp Write a draft of a case from the viewpoint of a person
caught in the thick of the case problem Catholic Physician case
Debate Vote: 1) The physician should continue to practice medicine
in the same way; 2) The physician should change the way he practices medicine
Break the class into 2 groups, based on their vote Give time for groups to develop their position: arguments &
rebuttals; each group appoints 3 individuals to argue their case
Each side presents 5 minutes; 3-minute rebuttals by different spokespersons; 3-minute summaries by different spokespersons
Process discussion in the context of medical ethics
Case #4
Choose a Topic Research Ethics
Review & Research the Topichttp://www.sciencecases.org/superman/superman1.asp
Write a draft of a case from the viewpoint of a person caught in the thick of the case problemChristopher Reeves
Senate Hearing http://www.sciencecases.org/superman_ethics/superman_ethics_notes.asp
Outcome of hearing: Senators will vote on what direction they will take in writing a position paper on stem cell research
One of three votes: 1) Increase federal funding; 2) Maintain the president’s position; 3) Decrease federal funding
Four sub-groups with specific biases: 1) Stem Cell Researchers; 2) Ethicists from the National Bioethics Advisory Commission; 3) Right to Life Committee Members; and 4) Senators
Viewpoints argued to the Senators; Each group submits two questions to the Senators, who will ask these to the other two groups; groups aware of the Senators’ biases
Conduct a hearing Senate votes, majority wins
Choose a Topic End of Life
Review & Research the TopicTerri Schiavo
Write a draft of a case from the viewpoint of a person caught in the thick of the case problem
Case #5