American University of the Caribbean

School of Medicine
Course Syllabus

MEDICAL ETHICS #480

January 2018

PROFESSOR
Sue S. Edwards, PhD

Office information
Eden Hall, Flat 4 (up one floor from entrance, on the right), Room 5 (2nd door on the right)

Office Hours
1:00-2:00pm and by appointment

Lecture Hall
VELT (Vernon Building Lecture Theatre)

Lecture dates/times
Wednesday, January 17-Friday, January 19 8:05-9:50pm
Saturday, January 20 & Sunday, January 21 12noon-1:45pm
Wednesday, January 24-Friday, January 26 8:05-9:50pm
Saturday, January 27-Thursday, February 1 TBA

AUC Email: sedwards@aucmed.edu

Other email: drsuemedethics@gmail.com
--------------------------------------------------------------------------------

COURSE DATES
January 17-February 2; Final exam date: TBA

COURSE MATERIALS
All materials including assigned readings, slides used in the class presentations, and other resources
will be made available to students via Black Board (BB), and/or email. Primary sources for these
materials include:

Supplemental Course Reading – The course textbook is:

Lo B. Resolving Ethical Dilemmas: A Guide for Clinicians, 5th ed. Walters Kluwer/
Lippincott, Williams & Wilkins, 2013

It is available on BB under “Content” - “Textbook - Resolving Ethical Dilemmas: A

Guide for Clinicians, 5e.”

Other Books
Beauchamp TL; Childress JF. Principles of Biomedical Ethics, 7th ed. Oxford University
Press, 2012.
MEDICAL ETHICS Course Syllabus & Schedule: January 17-February 2, 2018
Page 2

Fletcher JC; Spencer EM; Lombardo PA; eds. Fletcher's Introduction to Clinical Ethics,
3rd ed. University Publishing Group, 2005.
Groopman J. How Doctors Think. Mariner Books (Houghton Mifflin Co.), 2008.
Jonsen AR. A Short History of Medical Ethics. Oxford University Press, 2008.
Jonsen AR; Siegler M; Winslade WJ. Clinical Ethics: A Practical Approach to Ethical
Decisions in Clinical Medicine, 7th ed. McGraw-Hill, 2010.
Junkerman C; Schiedermayer D. Practical Ethics for Students, Interns, and Residents: A
Short Reference Manual, 2nd ed. University Publishing Group, 1998.
Miller G, ed. Pediatric Bioethics. Cambridge University Press, 2010.
Pozgar GD. Legal and Ethical Issues for Health Professionals, 4th ed. Jones & Bartlett
Learning, 2014.
Singer PA; Viens AM. The Cambridge Textbook of Bioethics. Cambridge University
Press, 2008.

Some Useful Websites

American Board of Internal Medicine (ABIM) Foundation (Advancing Professionalism)
http://www.abimfoundation.org/professionalism/index.shtm
American Board of Internal Medicine (ABIM) Publications
http://www.abim.org/pdf/publications/professionalism.pdf
American College of Physicians (ACP) Ethics & Professionalism website
http://www.acponline.org/running_practice/ethics/
American Medical Association (AMA) Medical Ethics website
http://www.ama-assn.org/ama/pub/category/2416.html
American Medical Student Association (AMSA) home page
http://www.amsa.org (Search the word “ethics” for specific information)
National Reference Center for Bioethics Literature (NRCBL)
http://bioethics.georgetown.edu/nrc/
Publications
http://bioethics.georgetown.edu/publications/index.html
Scope Note Series
http://bioethics.georgetown.edu/publications/scopenotes/index.html
The President’s Council on Bioethics
http://www.bioethics.gov/
University of Washington School of Medicine, Ethics in Medicine Electronic Resource
http://depts.washington.edu/bioethx/

COURSE DESCRIPTION
This course is designed to provide medical students with an introduction to ethical, professional and
legal issues that arise in the practice of medicine. The information is presented over 14 hours of
lecture and group discussion, and is consistent with current United States Medical Licensing
Examination (USMLE) standards. The course is intended to give students the basic tools to allow
them to recognize ethical conflicts in a clinical setting, and to provide them with the resources to
critically examine and address the questions and concerns these conflicts present. The content and
structure of the course specifically acknowledge that participants are physicians-in-training who are
in the process of learning about medicine, and beginning to seriously consider what it means to be a
physician and to practice medicine. Therefore, the course materials are presented in such a way as to
encourage students to learn specific information AND to help them integrate that information into
their future roles as practicing physicians.
MEDICAL ETHICS Course Syllabus & Schedule: January 17-February 2, 2018
Page 3

Format
The course is divided into five (5) basic subject areas: (1) Introduction to Ethics/Ethics Committees;
(2) Professionalism and Professional Standards; (3) Ethics and the Law; (4) Patient Care Issues
(specific topics addressed include: Communication Issues; Privacy and Confidentiality; Caring for
Children; End of Life Issues; and Organ Donation and Transplantation; and (5) “Issues in Clinical
Research.”
The class is lecture- and discussion-based, in both live and online formats. Additional information
and materials are provided via a variety of media including PowerPoint/slide presentations, videos,
case discussions and handout materials. Group discussion is an essential component of the learning
experience, and students are strongly encouraged to share and discuss their thoughts and concerns
regarding the information presented.

COURSE OBJECTIVES
Following completion of this course, students should be able to:

▪ recognize important ethical, professional and legal standards and guidelines pertaining to
physician practice;
▪ identify the types of ethical, professional and legal issues and/or conflicts that arise in clinical
practice;
▪ discuss the physician's legal obligations and limitations with regard to patient care;
▪ differentiate between ethical, professional and legal concerns, recognizing the role and
importance of each in medical practice;
▪ describe and utilize a process for ethical decision making; and
▪ comprehend the USMLE requirements and standards regarding Medical Ethics material.

COURSE REQUIREMENTS/GRADING
Students will be required to participate in three (3) online activities on Black Board (BB): (1) the
Medical Ethics Discussion Forum; (2) student journals; and (3) daily surveys/polls. Students will also
be required to meet in person with the professor. In addition, one written assignment and an exam
will be given in this course. The final exam will be multiple-choice, and will be based on lectures,
class discussions and other assigned materials.

The AUC policy regarding examinations and grades is applied to all students: 70% or above is
required for a pass, (69.5% correct will be rounded to 70%) and 90% (89.5% will be rounded to
90%) or above is required for honors. Final grades will be determined as followed:

Discussion forum 20%

Journal 10%
Surveys/Polls 5%
Meeting with instructor 5%
Written assignment 20%
Final exam 40%
100%

Any special arrangements regarding the taking of the final exam are subject to AUC policy and
approval by the appropriate individuals.
MEDICAL ETHICS Course Syllabus & Schedule: January 17-February 2, 2018
Page 4

SPECIFIC REQUIREMENTS

Discussion Forum (20%): All students are required to post (one) 1 original discussion topic
and reply to at least four (4) topics – two (2) of which must be the two topics posted by the
instructor. In addition, each student must reply to at least 2 of the replies posted regarding their
own original discussion topic.

All students must post at least one (1) reply or post no later than Tuesday, January 23 at
11pm.
All original posts and replies must be submitted NO LATER THAN Friday, February 2
at noon!!

Discussion topics should include a specific ques3tion or topic concerning clinical ethics (e.g., is
withholding artificial nutrition and hydration from a legally dead person "murder"?) AND your
thoughts and/or opinions on that topic. Please Note - If you do not include your thoughts
and opinions about the topic you post, you will NOT receive full credit for the
assignment!

Replies must be thoughtful and include evidence of reasoned consideration in order to be

counted for credit. Replies such as "yes," "no," "I agree," or "are you crazy?" may be posted but
will not be counted for credit. As you participate in the discussion board, if you disagree with
one or more of your colleagues, make an effort to gain an understanding of their position.
Developing this skill will go a long way toward helping you deal with ethical problems - or
avoiding them - in your future practice. Please observe appropriate "netiquette" and professional
demeanor in all posts. It is always acceptable to disagree or question an opinion, but NEVER
acceptable to be rude, offensive or otherwise disrespectful.

Student Journals (10%): Each student will be required to create at least 5 journal entries over
the duration of the course. Entries may include questions or comments concerning lectures,
topics or replies posted on the Medical Ethics Discussion Forum, current topics in clinical
ethics, personal communications with regard to the course, or other topics. Please note – all
journal entries are PRIVATE; that is, only the individual student and I can view them. All
journal entries must be submitted NO LATER THAN Friday, February 2 at noon.

Polls/Surveys (5%): Poll questions will be posted daily (Wednesday-Sunday) starting Thursday,
January 18 and ending Saturday, January 27. Questions may include short articles, websites, etc.
that the student will need to read or view in order to meaningfully respond. You must respond
to each question in order to receive full credit. Responses to all polls must be completed by
11:00 pm on Wednesday, January 31.

Meeting with the Instructor (5%) All students are required to set up a time to meet with Dr.
Edwards for a “meet and greet” session, the purpose of which is to get a chance for students
and teacher to have the opportunity to learn a little about each other. Students may come
individually or meet in small groups. Meeting times should be scheduled in advance. A sign-up
sheet will be made available. All meet & greet meetings must be completed by 7pm
Sunday, January 28.
MEDICAL ETHICS Course Syllabus & Schedule: January 17-February 2, 2018
Page 5

Written assignment (20%): You will be provided with 4 written and video cases from which to
choose, and asked to answer the questions based on ONLY one of them. There is no specific
requirement regarding the length of your responses but be sure that you provide adequate
information to indicate that you have given some serious consideration to your answers. In
other words, please provide more than a one or two-word response and offer an explanation of
the thought process which underlies your answers. Also, please pay attention to the fact that
some questions may include multiple parts, all of which must be answered in order to receive
full credit. The assignment is due by 7:00pm on Sunday, January 28.

You will receive 90% for completing the assignment as directed and turning it on time. In
order to achieve 90-100%, you must demonstrate additional evidence of in-depth thought and
consideration in your responses.

▪ If you complete the assignment as directed but turn it in late you will receive 10% credit.
▪ If you do not complete the assignment as directed (that is, you do not follow the directions,
you fail to answer a question/questions, your responses indicate only a very superficial
effort, etc.), but you turn it in on time, you will receive 8% credit. If you correct the
deficiencies satisfactorily and resubmit it within 48 hours of receiving the instructor’s
comments, you can bring this up to 10%.
▪ If you do not complete the assignment as directed (that is, you do not follow the directions,
you fail to answer a question/questions, your responses indicate only a very superficial
effort, etc.) and you turn it in late, you will receive 5% credit.
▪ If you do not complete the assignment at all, you will receive no credit (i.e., 0%).

ADDITIONAL INFORMATION

Testing Accommodations
Students who have been approved for testing accommodations due to a diagnosed learning disability
will receive time plus ½ on the multiple-choice final exam if requested. Please provide written
documentation of approval for testing accommodations to Dr. Edwards at least 48 hours prior to
the exam.

Attendance Policy:
There are no mandatory attendance sessions in this course. However, this is a very short course
during which a lot of material will be covered. Further, discussion in class of the topics and issues
addressed is an integral part of the learning experience. For these reasons, regular attendance is
encouraged and appreciated.

====================================

MEDICAL ETHICS COURSE SCHEDULE

January 17-February 2, 2018

Please Note – Supplemental readings are from the course textbook (Lo B. Resolving Ethical
Dilemmas: A Guide for Clinicians, 5th ed. Walters Kluwer/ Lippincott, Williams & Wilkins,
2013), which is available on Blackboard under “Content” - “Textbook - Resolving
Ethical Dilemmas: A Guide for Clinicians, 5e.”
Materials cited under “Resources” are also available on Blackboard under “Lessons,”
“Additional Resources and Links in Slides.”
MEDICAL ETHICS Course Syllabus & Schedule: January 17-February 2, 2018
Page 6

WEEK 1

Wednesday, January 17
Welcome and IntroductionV
Video: The Terri Schiavo Story – please note, this video is the basis for one of the written
assignment options

Thursday, January 18
Introduction to Ethics/the Process of Ethical Decision Making/Ethics Consultation & Ethics
Committees
Professionalism & Professional Guidelines

Supplemental Readings
(1) Lo, Ch. 1, “An Approach to Ethical Dilemmas in Patient Care”
(2) Lo, Ch. 2, “Overview of Ethical Guidelines”
(3) Lo, Ch. 36, “Ethical Dilemmas Students and House Staff Face”

Resources:
(1) Folder on Ethical Decision-Making Models
(2) Folder on Ethics Consultation Service Examples
(3) Folder on ‘Patient Rights & Responsibilities”

Friday, January 19
Ethics & the Law
Communication

Saturday, January 20
Communication (cont.)
Capacity for Decision Making

Supplemental Readings
(1) Lo, Ch. 10, “Decision-making Capacity”

Sunday, January 21
Informed Consent & Refusal

Supplemental Readings:
(1) Lo, Ch. 3, “Informed Consent”
(2) Lo, Ch. 11, “Refusal of Treatment by Competent, Informed Patients”

WEEK 2

Wednesday, January 24
Assignment due: All students must post at least one (1) reply or post on the Discussion Board today by 11pm!
Privacy & Confidentiality
Reproductive & Pediatric Issues
MEDICAL ETHICS Course Syllabus & Schedule: January 17-February 2, 2018
Page 7

Supplemental Reading:
(1) Lo, Ch. 5, “Confidentiality
(2) Lo, Ch. 39, “Ethical Issues in Obstetrics & Gynecology”
(3) Lo, Ch. 37, “Ethical Issues in Pediatrics”

Resources:
Folder on “HIPAA Summary”

Thursday, January 25
Reproductive & Pediatric Issues (cont.)
End of Life

Supplemental Readings:
Please note that following readings on “End of Life” will apply January 25-31
(1) Lo, Ch. 12, “Standards for Decisions when Patients Lack Decision-making Capacity”
(2) Lo, Ch. 17, “Do Not Attempt Resuscitation Orders”
(3) Lo, Ch. 18, “Tube and Intravenous Feedings”
(4) Lo, Ch. 19, “Physician-Assisted Suicide and Active Euthanasia”
(5) Lo, Ch. 20, “The Persistent Vegetative State”
(6) Lo, Ch. 21, “Determination of Death”
(7) Lo, Ch. 8, “An Approach to Decisions about Clinical Interventions”
(8) Lo. Ch. 9, “Futile Interventions”

Resources:
(1) Folder on “Advance Directives”
(2) Folder on “DNR Orders”

Friday, January 26
End of Life (cont.)

Saturday, January 27
End of Life (cont.)

Sunday, January 28
Assignment due: All students must complete Meet & Greet requirements today by 7pm!
Assignment due: All students must submit the Written Assignment today by 7pm!
End of Life (cont.)

WEEK 3

Wednesday, January 31
Assignment due: Responses to all Poll questions must be completed today by 11pm!
End of Life (concluded)
Organ/Tissue Donation & Transplantation
Research Ethics

Supplemental Readings:
(1) Lo, Ch. 41, Ethical Issues in Organ Transplantation
MEDICAL ETHICS Course Syllabus & Schedule: January 17-February 2, 2018
Page 8

Resources:
(1) Folder on Organ Donation & Transplantation

Thursday, February 1
“Catch up” on any leftover materials
Review for Final Exam

Assignments due February 2

▪ Discussion Forum original posts and replies must be submitted no later than 12:00 noon
on Friday, February 2.
▪ Journal entries must be submitted no later than 12:00 noon on Friday, February 2.

FINAL EXAM – TIME TBA