See how a Course Works: Intro to Online Learning
Description
Our NICU course is ideal for anyone considering a career in the rewarding field of neonatal care. Treatment decisions in neonatal intensive care unit (NICU) settings can be difficult because of the medical and emotional complexities they entail. These decisions have become more prominent as advancing technology allows a larger group of neonates to survive and blurs the line between ordinary and extraordinary treatment.
Many infants born just a few weeks early or who experience minor complications at birth receive care in NICU units. The care of such children generally is uncomplicated medically and ethically. A second group of neonates whose care raises complex ethical issues includes children born with congenital or genetic anomalies, such as Spina bifida or Down Syndrome who require medical intervention at or soon after birth. In some cases, children’s conditions are so serious that it is difficult to distinguish medical treatment from futile care. In other cases, parents are hesitant to provide care to a child with an anomaly for fear that the child will survive and they will have to raise a disabled child. A third group of children whose care raises complex ethical issues in the NICU are those who are both born with very low birth weight and have congenital or genetic anomalies.
This NICU course presents the host of ethical issues raised in the neonatal intensive care setting.
Outline
Module 1: Ethics in the Neonatal Intensive Care Unit (NICU)
To identify the neonatal intensive care unit (NICU) patients whose care raises most of the complex ethical issues in the NICU.
To identify the issues physicians and parents should consider in making treatment decisions for children in NICUs.
To identify the clinical factors that make treatment decisions regarding neonatal intensive care difficult.
To identify the non-clinical factors that make treatment decisions regarding neonatal intensive care difficult.
To identify some of the reasons neonatal intensive care issues have come before judges.
Module 2: Ethical Issues Regarding the Resuscitation of Neonates
To identify the primary factors that should be considered when deciding whether to resuscitate a neonate.
To understand how health care professionals can help parents make informed decisions regarding the resuscitation of neonates.
To understand why some argue that parents should be the primary decision-makers regarding the resuscitation of neonates.
To understand why some argue that parents should not be the primary decision-makers regarding the resuscitation of neonates.
To identify factors that sometimes can influence physicians to make resuscitation decisions that are not necessarily based on the best interest of particular patients.
Module 3: Ethical Issues Concerning Decisions to Withhold or Withdraw Care in Neonates
To identify some ethical concerns surrounding the care of neonates.
To identify some reasons that care might legitimately be withdrawn or withheld from neonates.
To identify some characteristics that differentiate the withholding and withdrawing of care from euthanasia.
To identify some features of care that may help decision-makers determine that an intervention is futile or medically inappropriate.
To identify the main ways to manage uncertainty regarding prognosis and outcomes in the care of neonates.
Module 4: Decision-Making in the NICU: Providing Aggressive Treatment
To understand why parents sometimes demand aggressive care in the NICU that many consider futile.
To understand why physicians sometimes provide aggressive care for neonates even when other clinicians deem it futile or medically inappropriate.
To identify some decision-making strategies that might be successfully implemented in the NICU.
To understand how the best interest standard affects decision-making in the NICU.
To identify some ways physicians’ and parents’ values may inform treatment decisions in the NICU.
Module 5: Ethical, Legal, and Policy Concerns in the NICU
To understand why neonatal intensive care treatment decisions can raise ethical concerns.
To understand issues that have brought neonatal intensive care decisions to the attention of lawyers, judges, and policy makers.
To understand some of the issues laws and policies regarding neonatal intensive care are expected to address.
To identify some challenges to developing public policies and clinical guidelines for neonatal intensive care.
To understand why is it difficult to apply actual policies for emergency treatment to neonatal care.
Module 6: Ethical Issues Concerning Parents’ Decision-Making Authority in the NICU
To identify the conditions under which a parent might have the right to withdraw or refuse medical treatment for a neonate, even if the physician disagrees.
To understand why some people argue that parents may not be the best treatment decision-makers for their infants.
To understand why some people argue that parents may be the best treatment decision-makers for their infants.
To identify the circumstances under which parents’ opinions regarding a neonate’s treatment might not be sought, be called into question, or be superseded.
To identify ways in which clinicians can help parents make treatment decisions for their infants.
Module 7: Parents’ and Professionals’ Attitudes on Neonatal Intensive Care
To understand some ways in which nurses’ traditional role as patient advocates can be fulfilled in the NICU setting.
To understand how medical uncertainty can affect treatment decisions in the NICU setting.
To identify ways in which physicians’, nurses’, and parents’ views differ regarding decisions to withhold or withdraw treatment in the NICU setting.
To identify ways in which health care professionals can increase parents’ satisfaction with treatment decisions in the NICU setting.
To identify ways in which NICU staff can help parents of dying or recently deceased infants respond properly.
Module 8: Ethical Issues Concerning Surrogate Decision-Making in the NICU
To understand why all treatment decisions in the NICU must be made by surrogates.
To identify the standards for surrogate decision-making applicable in neonatal care.
To identify the factors that should be considered when determining a neonate’s best interest.
To identify factors that shape surrogates’ decisions regarding neonatal intensive care.
To identify the factors that complicate surrogate decision-making in neonatal care.
Module 9: Team-Based Decision-Making in the NICU: Collaboration Among Physicians, Nurses, and Parents
To understand the features of the NICU context that affect the extent to which decisions are team-based.
To understand some of the obstacles to making team-based decisions in the NICU.
To identify the essential elements for involving parents in decisions in the NICU.
To understand the benefits of team-based decision-making in the NICU.
To identify steps that can be taken to make team-based decision-making a reality in the NICU.
Module 10: The Ethics of Pain Management and Palliative Care in the NICU Setting
To understand why pain management and palliative care in the NICU setting raise ethical issues.
To understand why it is difficult to measure pain in neonates.
To understand how pain can be managed in the NICU setting.
To understand the key components of quality pain management and palliative care in the NICU.
To identify candidates for neonatal palliative care.
Module11: Social Responsibility Related to Neonatal Intensive Care
To identify ethical issues raised by neonatal research.
To identify some of the factors that affect parents’ ability to make an informed decision regarding their child’s participation in research.
To identify factors that relieve pressure on parents making decisions about whether their children will participate in research.
To understand the ethical issues raised by the use of recently deceased neonates to train health care professionals.
To identify rationing and access issues relevant to neonatal intensive care.
Module 12: Professional Ethics Standards: Neonatal Intensive Care
To understand some important features of the Baby Doe Rules and the 1984 Child Abuse Amendment.
To understand when life-sustaining treatment may be withheld under the 1984 Child Abuse Amendment.
To understand why it was necessary to develop and implement guidelines regarding neonatal intensive care.
To identify some of the professional recommendations that the American Academy of Pediatrics has issued concerning critical care decisions for children.
To understand the American Academy of Pediatrics’ recommendations on the role of parents in making NICU treatment decisions.
Additional Info
- Languages
- English
- Course Length
- 12.00 hours
- Duration of Access
- Instructor
Gerard Magill, Ph.D
Professor Magill is holder of the Vernon F. Gallagher Chair for the Integration of Science, Theology, Philosophy and Law. He is a tenured Professor in Duquesne University 's Center for Healthcare Ethics in the McAnulty Graduate School of Liberal Arts. He arrived at Duquesne University in 2007.
Previously, Professor Magill was a tenured Professor in the Center for Health Care Ethics at Saint Louis University where he served as inaugural Department Chair (1996-2005) and as Executive Director (1999-2005); also, he held secondary appointments as Professor in the School of Medicine in its Department of Internal Medicine and Professor in the School of Public Health in its Department of Health Administration. During this period he served on the University's Hospital Ethics Committee and was a member of the University's Institutional Review Board for research protocols. From 1976-1996, sequentially he held teaching posts in religious ethics in Drygrange College , Scotland , in Loyola University 's theology department in Chicago , in Saint Louis University 's theology department. He holds a Ph.D. in theology from Edinburgh University , Scotland , and an S.T.L. in moral theology, an S.T.B. in systematic theology and a Ph.B. in philosophy from the Gregorian University in Rome , Italy .
Professor Magill has published five edited or co-edited interdisciplinary books: Genetics and Ethics: An Interdisciplinary Study (2004); Abortion and Public Policy: An Interdisciplinary Investigation (1996); Values and Public Life: An Interdisciplinary Study (1995); Personality and Belief: Interdisciplinary Essays (1994); Discourse and Context: An Interdisciplinary Study (1993). Also, he has published over sixty academic essays in scholarly or professional journals. He was the lead author of Ethics Consultation Liability (2004), a national report commissioned by the American Society for Bioethics and Humanities. From 1996-2006 he was editor of the bioethics journal, Health Care Ethics USA . He has given approximately two hundred scholarly or professional presentations at conferences etc. And he is an active member of ten professional associations.
Currently, Professor Magill is completing a book on applying the imagination to the development of health care ethics and his research agenda focuses on human genomics and stem cell research.
Ethical Expert Opinions
F. Sessions Cole, M.D. Chief Medical Officer, St. Louis Children’s Hospital, Washington University School of Medicine.
Baruch A. Brody, MD, Ph.D., Leon Jaworski Professor of Biomedical Ethics and Director of the Center for Medical Ethics and Health Policy, Baylor College of Medicine
Laurie Zoloth, PhD., Professor of Medical Ethics and Humanities, and of Religion, Northwestern University, Feinberg School of Medicine
Alan R. Fleischman, MD.,Senior Vice President: New York Academy of Medicine and Clinical Professor of Pediatrics and Clinical Professor of Epidemiology and Social Medicine, Albert Einstein College of Medicine
Norm Fost, M.D., M.P.H., Chair: Health Sciences Human Subjects Committee, Chair: UW Hospital Ethics Committee, and director of the Child Protection Team.- Prerequisites/Audience
There are no prerequisites for this course.- Requirements/Materials Included
- Minimum requirements: Windows XP Service Pack 2/Internet Explorer 6.0 or Firefox 2.0. Recommended: Windows Vista/Internet Explorer 7.0 or Firefox 2.0. This course can be taken from either a Mac or a PC. There are no specific computer requirements other than a high speed Internet connection (DSL or Cable) and email capabilities. Students will need the latest version of Adobe Flash Player, Acrobat Reader or Windows Media Player which are available via free downloads.
- Certification
After completing this NICU course, you will be able to:
1 Identify the ethical issues that arise in the NICU setting
2 Understand ethical issues concerning decisions to withhold or withdraw treatment in neonates
3 Understand the ethics of providing aggressive medical treatment in the NICU
4 Understand ethical, legal and policy concerns regarding neonatal intensive care
5 Clarify the rights of parents regarding decision-making in the NICU setting
6 Understand the ethics of surrogate decision-making in the NICU
7 Understand team-based decision-making in the NICU setting
8 Understand the ethical issues regarding pain management and palliative in the NICU setting
9 Understand the relationship between social interests and ethics in neonatal intensive care