See how a Course Works: Intro to Online Learning
Description
Our online medical ethics course is ideal for full and part time students and busy working professionals and provides a broad overview of a number of ethical questions faced by many medical professionals on an almost daily basis. In 1990, doctors diagnosed Terri Schiavo as being in a “persistent vegetative state” or PVS. These doctors claimed that she was unaware of her surroundings and unable to communicate or respond in a meaningful or purposeful way.
But, Terri’s family contended adamantly that Terri was not in a persistent vegetative state. Doctors representing the family claimed that she was brain damaged and badly disabled, but not in a PVS. As legal guardian, her husband, Michael Schiavo, claimed that his wife would not have wanted to live in a persistent vegetative state. Parents, Bob and Mary Schindler and husband, Michael Schiavo, began a 12 year court battle to determine whether Terri would live…or be allowed to die.
In 2005, this landmark case captivated the nation and for many weeks became worldwide headline news, culminating in an act of the US Congress and a hearing by the Supreme Court.
This 12 module online medical ethics course examines the in-depth clinical, legal and ethical issues that led to a Florida court decision to withdraw the feeding tube to Terri Schiavo on March 8 2005 and twenty three days later, she died of dehydration.
After completing our medical ethics course you will be in a position to give an informed opinion on whether Terri Schiavo should have lived or be allowed to die and apply this learning to PVS and other end of life cases that you might encounter.
Outline
Module 1: Patient Decision Making Capacity<?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" />
To understand the meaning of patient incompetence
To understand what determines a patient’s decision-making capacity
To understand what it means for a surrogate to make a decision based on the substituted judgment standard
To understand what it means for a surrogate to make a decision based on the best interest standard
To ascertain the basis on which a surrogate may refuse a life-sustaining treatment for an incapacitated patient
To understand how PVS is defined
To identify the most common causes of PVS
To identify important elements of a reliable diagnosis of PVS
To identify common characteristics of PVS
To identify some syndromes and conditions commonly confused with PVS
Module 3: The Purpose of Advance Directives
To identify different mechanisms for determining a patient’s wishes.
To understand what an advance directive is.
To identify different types of advance directives.
To identify some of the challenges posed by advance directives.
To identify the requirements of the Patient Self-Determination Act (1991) regarding advance directives.
Module 4: Institutional Ethics Committees
To identify the major roles institutional ethics committees play in health care organizations
To specify some of the concerns institutional ethics committees typically address
To specify some typical reasons for case consultations by ethics committee members
To identify the issues typically at stake in end-of-life care that could fall under the ethics committee’s review
To understand how family disputes may lead to ethics consultations To identify the major roles institutional ethics committees play in health care organizations
Module 5: Ethics Committees and Ethics Consultation in End-of-Life Care
To identify some of the goals of ethics consultation.
To identify some goals of the ethics facilitation approach to ethics consultation.
To identify basic requirement ethics committee members should honor in case consultations.
To identify basic requirements on medical indications and patient preferences that ethics committee members should consider in consultations.
To identify basic requirements on quality of life and contextual issues that ethics committee members should consider in consultations.
Module 6: Medical Futility and Inappropriate Care in End-of-Life Care
To explain the meaning of “futile” or “medically inappropriate” care.
To identify some conditions under which physicians might determine that treatment is medically inappropriate.
To identify some of the differences between judgments about futility and decisions to ration health care.
To identify some of the common reasons surrogates request medical treatment that is futile or medically inappropriate for a particular patient.
To understand some aspects of the institutional review mechanisms that may be adopted to address requests for futile or medically inappropriate care.
Module 7: Withholding/Withdrawing Medical Treatment: Artificial Nutrition and Hydration
To identify some of the issues that contribute to the debate regarding the administration of artificial nutrition and hydration (ANH) in PVS patients.
To understand some views concerning the ethical difference between withdrawing and withholding ANH as medical treatment.
To understand how courts and medical societies have treated the administration of ANH.
To understand some of the views about how decisions to withdraw or withhold medical treatment (such as ANH) should be made.
To identify the interests other than a patient’s welfare that may be considered in decisions to withdraw or withhold medical treatment (such as ANH).
Module 8: Professional Responsibilities in Caring for PVS Patients
To understand the nature of professional responsibility.
To understand the role codes of ethics play in health care.
To understand some of the common responsibilities and duties reflected in the codes of ethics of many health care professions.
To identify the responsibilities of physicians regarding the diagnosis of PVS that may be reflected in codes of ethics.
To identify the responsibilities that may be reflected in professional codes regarding communication with families of patients in a persistent vegetative state.
Module 9: JCAHO Accreditation Standards and Organizational Ethics
To identify the major areas of concern for organizational ethics in health care.
To identify some of the required elements of ethical behavior in hospital business practices.
To identify some of the required elements of ethical behavior dealing with conflicts of interest.
To identify some of the required elements of ethical behavior supporting the integrity of clinical decision making.
To identify some of the required elements of ethical behavior related to the denial of care.
Module 10: JCAHO Accreditation Standards on Patient Rights and Treatment
To identify some of the basic rights of patients that hospitals must respect.
To identify some of the requirements for respecting a patient’s right to be involved in decisions about medical care.
To identify some of the required elements of informed consent.
To identify some of the requirements hospitals must meet concerning advance directives.
To identify some of the main elements of protecting patients from pain and discomfort.
Module 11: Resolution of Previous Legal Cases in End-of-Life Care: cluster #1
To identify the distinctive elements of the decision in 1976 by the Supreme Court of New Jersey in the case of Karen Ann Quinlan.
To identify the distinctive elements of the decision in 1977 by the Supreme Court of Massachusetts in the case of Joseph Saikewicz.
To identify the distinctive elements of the decision in 1980 by the New York Court of Appeals in the case of Joseph Fox (In re Eichner).
To identify the distinctive elements of the decision in 1985 by the Supreme Court of New Jersey in the case of Claire Conroy.
To identify the distinctive elements of the decision in 1990 by the Supreme Court of the United States in the case of Nancy Cruzan.
Module 12: Resolution of Previous Legal Cases in End-of-Life Care: cluster #2
To identify some of the important elements in the In re Wendland case.
To identify some of the important elements in the case of Bouvia v. Superior Court.
To identify some of the important elements in the In re Wanglie case.
To identify some of the important elements in the case of Washington v. Glucksberg.
To identify some of the important elements in the case of Vacco v. Quill.
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
Daniel Callahan, MED., PhD Director of the International Program at the Hastings Center, Garrison, New YorkSenior Fellow in the Division of Medical Ethics at Harvard Medical School, Boston
Karen Lebacqz, PhD., The Robert Gordon Sproul Professor of Theological Ethics at the Pacific School of Religion, Berkeley, California
Eric J. Cassell, MD, MACP, Attending Physician at New York Presbyterian Hospital
Clinical Professor of Public Health at Weill Medical College of Cornell University
Rebecca Dresser, PhD, JD Daniel Noyes Kirby Professor of Law, Washington University, St Louis
- Prerequisites/Audience
There are no prerequisites for this course.
After completing this course, you will be able to:
1 Understand the medical, legal and ethical terminology used when considering a decision to withhold/withdraw nutrition and hydration for a patient.
2 Understand how to recognize and define persistent vegetative state (PVS)
3 Examine the implications of “Advanced Directives”
4 Understand the role of Ethics Committees in PVS cases
5 Understand the issues surrounding futility and inappropriate care in end of life care.
6 Understand the code of ethics in end of life care
7 Understand JCAHO’s accreditation standards as applied to organizational ethics and patient’s rights and treatment.
8 Draw on the findings of other landmark legal cases in end of life care.
- 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.
