Tag: curriculum

Bioethics Blogs

Pornography as a Public Health Issue

Jacqueline Gahagan advocates for a national sexual health promotion strategy.

__________________________________________

Pornography is concerned with the development and the circulation of sexually explicit books, magazines, videos, art, and music aimed at creating sexual excitement. Public health is concerned with keeping people healthy and preventing illness, injury and premature death. With the growing use of internet-based pornography and the relative ease by which it can be accessed, the effects of “online violent and degrading sexually explicit material on children, women and men” have become an important public health issue. This issue is best addressed through the development and introduction of a national sexual health promotion strategy – a strategy that includes current and comprehensive sexual health education in our primary, secondary, and post-secondary schools.

Health promotion, in concert with public health, involves encouraging safe behaviours and improving health through healthy public policy, community-based interventions, active public participation, advocacy, and action on key determinants of health. I am confident that several of these strategies can be used to address concerns about the ready access to internet-based pornography. For example, health promotion initiatives that take a harm reduction approach to healthy sexuality include an emphasis on screening and testing for sexually transmitted infections, the use of condoms, a shared understanding of consensual sex, as well as the use of other safer sex interventions.

A review of existing sexual health education in Canadian schools, however, reveals that many Canadian youth do not receive the level of sexual health education they need to help them make informed decisions about sexual risk-taking.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

After the Loss of a Patient: Reflection and Connection Through Prose

By Hedy S. Wald

Lean machine of prose, stripped down to the essence, and a power-packed way to care for the caregiver… this was my experience of the 55-word story genre1 at a writing seminar. While I had some experience writing haiku, I was generally accustomed to reflective narratives3 as “story” so was nothing short of surprised when a compact 55-word prose “small jewel”2 about a patient who touched my heart and soul spontaneously emerged onto the paper.  It chilled me to the bone and warmed my heart. I was asked to read it aloud for the attendees – the hush afterward was a moment of sacred silence…

“Honoring Alan” I titled it…Alan I., MD was my patient on the rehab unit, the unit with the “vent” patients where I was the psychology consultant, where I provided supportive counseling.  Was my patient. Yes, he passed. But before that, despite the indignities and ravages of disease, he managed to muster the strength, both mental and physical, to undertake rehab exercises, vent and all.  And sometimes his devoted wife would be singing show tunes as he did so and I was in awe.  On tougher days, amidst the pop and swish sounds of the vent machine, I’d read poetry and see a flicker of brighter light in his eyes.  I may have imagined that, but I don’t think so – his wife told me he liked poetry.  Now, in another space, another time, he still liked poetry – sometimes. Before starting our sessions, I’d pause at his door to collect myself, to be able to enter the room intentionally4 as the combination of serious illness and ventilator posed challenges for a caring practitioner.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Bridging the Education-action Gap: A Near-peer Case-based Undergraduate Ethics Teaching Programme

Guest Post: Dr Selena Knight and Dr Wing May Kong

Paper: Bridging the education-action gap – a near-peer case-based undergraduate ethics teaching programme

Medical ethics and law is a compulsory part of the UK undergraduate medical school curriculum. By the time they qualify, new junior doctors will have been exposed to ethics teaching in lectures and seminars, through assessments, and during clinical placements. However, does this really prepare them for the ethical minefield they will encounter as doctors?

Following my own graduation from medical school I started as a foundation year doctor in a busy London teaching hospital. Despite having had more exposure to ethics and law teaching than most by having completed an intercalated BSc in the subject, I found as a new doctor that I was often encountering ethical dilemmas on the wards but felt surprisingly ill-equipped to deal with them. I was generally able to identify that I was facing an ethical dilemma, but frequently found myself stuck when coming up with a practical solution.

If I felt like this having had an additional year of studying ethics and law, how on earth were other new doctors coping? In fact, when questioning my peers about their experiences they described that they also encountered dilemmas, but either didn’t specifically identify them as ethical in nature (e.g. they described feeling uncomfortable or uneasy with a decision made or a particular situation but couldn’t pinpoint why) and frequently described being unable to do anything to improve the situation either because they didn’t know what to do or they didn’t feel confident to speak up/rock the boat e.g.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Medicine and the Holocaust in Medical Education: International Holocaust Remembrance Day – January 27

By Hedy S. Wald

“Medicine was used for villainous ends during the Holocaust.  The Holocaust was an enormous trauma inflicted on human dignity and the human person; medicine was implicated in crimes against humanity.”  His Eminence Daniel Cardinal DiNardo, Archbishop of Galveston-Houston.1

January 27 is International Holocaust Remembrance Day, a day designated by the United Nations General Assembly resolution 60/7 in 2005 after a special session marking the 60th anniversary of the liberation of the Nazi concentration camps and the end of the Holocaust. In the words of Secretary General Ban-Ki Moon (2008), “The International Day in memory of the victims of the Holocaust is a day on which we must reassert our commitment to human rights… We must also go beyond remembrance, and make sure that new generations know this history.  We must apply the lessons of the Holocaust to today’s world.”2

Indeed.  A recent medical humanities article (co-authored with my colleagues Drs. Rubenfeld and Fins)1 was a resounding call for teaching lessons of the Holocaust within medical education.  We joined others in the medical education/bioethics community calling for a curriculum that would create space for a mix of reflective practice and historical awareness to grapple with the medical profession’s central role in “using science to help legitimize persecution, murder and ultimately genocide.”3

“Almost every aspect of contemporary medical ethics is influenced by the history of physician involvement in the Holocaust,” Wynia and colleagues wrote.1  The United States Holocaust Memorial Museum’s (USHMM) “Deadly Medicine: Creating the Master Race” exhibit3 documents the moral failures of individual physicians and the medical establishment during the Third Reich including participation in horrific experimentation and medicalized genocide. 

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

Before the Bridge Falls Down

January 12, 2017

(Undark Magazine) – In practice, this means that unless they are exposed to a robust curriculum of professional ethics at the college or university level, many engineers — licensed or not — will have only a perfunctory education in the importance of doing the right thing. “Engineers and computer scientists are in a position to have a disproportionate impact on society,” says Richard Burgess, an instructor at the National Institute for Engineering Ethics at Texas Tech University. “We could be doing a better job, and so could every other university as well.”

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Albany Medical College May be the Best Medical School in the Country

I realize that this is not the assessment of the US News and
World Report, or other major organizations that rank US medical schools, but I
believe it quite possibly is true.  Organizations
that rank medical schools look at dollars of research grant funding, or the
test scores of the students, but what is really important is the quality of the
physician they graduate.  But what do we
mean by quality?  And who should be the
judge of this?

A survey of
patients in a primary care setting revealed that the most important quality
that they sought in their physicians was empathy.  More important than even clinical skill or
knowledge, they wanted a physician who listened and cared.  This response cut across demographics—the
old, young, rich, poor, all ranked empathy as the most important quality of a
physician. And shouldn’t patients be the ones to tell us what is most valuable
in a physician, and by extension what the most important mission of medical
schools must be?

The
curriculum of medical schools across the country differs little in terms of the
basic sciences taught and clinical rotations of the last two years.  Students from Harvard and Albany need to pass
the same standardized tests to graduate, but that doesn’t mean there aren’t
differences.  Students at Albany Medical
College spend more time learning ethics, and discussing the humanistic aspects
of clinical care during their last two years of medical school than any other
medical school I have yet discovered. 
When Dr Shelton and I discussed our curriculum at a national bioethics
conference two years ago, educators from other schools were shocked at how much
curriculum time we had with students during their clinical years, and none had
anything close to comparable.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Doctor as Data Entry Drone

by Craig Klugman, Ph.D.

Most people choose to go into the health professions to help others, to make a secure living, and to challenge themselves on a daily basis. Few people would rank “doing paperwork” as a reason to choose a career in health. However, according to a new study in the Annals of Internal Medicine, paperwork in the form of electronic health records (EHR) might be the activity on which doctors spend the most time. According to Sinsky et. al, who conducted direct observations, motion studies, and self reports of 57 physicians in 4 specialties in 4 states, doctors spent over 49% of their time on record keeping and 27% on direct patient care.

Two decades ago, physicians only spent one-fifth of their time on record keeping. A 1998 study of emergency departments found 21% of time was spent on records and 32% on patient care. As recently as 2014, another study found that administrative work occupied only one-sixth of physician time. This same study also found that the more time spent on administration, the less happy physicians were in their work. Perhaps this is one reason for the dramatic decline in physician satisfaction of their work life. The trend is clear: Doctors are spending less time with patients and more time with computer records.

The main move to electronic health records came about as part of the Affordable Care Act. A provision in the ACA aimed to “reducing paperwork and administrative costs” began in October 2012: “Using electronic health records will reduce paperwork and administrative burdens, cut costs, reduce medical errors and most importantly, improve the quality of care.”

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

In Memoriam: John A. Balint, MD

After over three decades of dedicated service to Albany
Medical College as a researcher, practicing physician, administrator, and
mentor, when some people might consider retirement, John Balint in the early
1990’s was just beginning to redefine his career. It was during this time that
I first met John at the University of Chicago, Center for Clinical Medical
Ethics, when we were both members of the 1993-1994 Fellowship class. I was
privileged to learn about his amazing life up to that point, but what seemed
more important at that time, were his high hopes for the future.

John sought out this fellowship opportunity to prepare
himself to lead the new Center for Medical Ethics which would be charged with
teaching a new course that was being created in the curriculum reform process
called Health, Care, and Society (HCS). To say John was excited about the new
direction of his life was an understatement. As one of the leaders of this
four-year longitudinal course, John was now able to focus on his deepest
passion in medicine: the physician-patient relationship and the elements of
good doctoring.

Of course I know now that John had been preparing for his
new role from the beginning of his life. He often said his interest in the
physician-patient relationship was passed along to him from his father, Michael
Balint, the prominent physician-psychoanalyst and early thought leader on this
topic. As a small boy growing up in Budapest, Hungary, John told me the story
of joining his dad on a trip to Vienna to visit Sigmund Freud, where John
played under Freud’s desk while the two men talked about their patients.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

DAUGHTERS OF THE DUST, STANDING @ THE SCRATCH LINE: Bioethics meets real Cross Cultural Competency

Director July Dash (Daughters of the Dust and Scratch Line)
at the MVFF 39 October 14, 2016

As a member of  the National Writers Union and affiliate of  the International Federation of Journalists, it is my profound honor to represent the California Film Institute in presenting  director Julie Dash the Mill Valley Film Festival Award. This award honors the excellence of  her lifetime body of work.” —None of  these words could I have imagined coming from my mouth. But, on October 12, 2016, that is what I said at the 39th Mill Valley film festival. MVFF is one of the longest running Film Festival’s in North America with an audience this year of more than 65,000. 

Recently digitally remastered by the Coleman Library, director Dash’s DAUGHTERS OF THE DUST aesthetic remains incomparable with a message persistently timely. An African American family prepares to leave their Gullah Island home. They and their descendants have lived on that land since long before the Emancipation Proclamation. Tensions between the power of the familiar and perils of a new existence are made abundantly clear by a matriarch. She is a first degree relative to those brought as slaves from Africa. 

The re-released version of DAUGHTERS OF THE DUST, screened at the MVFF39, was preceded by the premiere of Dash’s provocative new short film, STANDING @ THE SCRATCH LINE. This new work is a part of the Great Migration Project. It lyrically traces the arrival of the first Africans on the Gullah Island shore their generations of migration from the Gullah Geechee Lowcountry to Philadelphia, PA.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Perspectives in learning; Incorporating discussion materials and activities on ethics into science curriculum.

The Presidential Commission for the Study of Bioethical Issues has released over 60 educational resources that can be used as tools to teach students, researchers, clinicians, and other professionals to recognize and address ethical aspects of their work and understand how deliberation can inform ethical decision-making. These resources draw from the Bioethics Commission’s reports, and while all reports produced to date have been topic-specific, bioethics education and improving bioethics literacy has been a constant thread throughout the Bioethics Commission’s work.

The Commission’s most recent report, Bioethics for Every Generation, outlines a variety of models that can be used to teach ethics, and emphasizes that ethics education is about preparing students how to think ethically, rather than what to think. Bioethics for Every Generation also emphasizes that ethical questions and topics can be incorporated into existing courses, such as biology, chemistry, social studies and history courses, among others.

Frank Strona, the Bioethics Commission’s Senior Communications Analyst and Adjunct Faculty with National University’s Department of Health Sciences recently had an opportunity to sit down and interview Steven Kessler, Instructor of Biology and Microbiology at Santa Rosa Junior College in Petaluma, CA and former Visiting Fellow with the Bioethics Commission, discusses how incorporating bioethics into his science curriculum has affected his students and his work as a science educator.

FRANK STRONA: Tell us about how you have used bioethics to enhance traditional science education.

STEVEN KESSLER:  I incorporate bioethical issues into my traditional science classes in a number of ways.  The most satisfying way is to spend an entire class period delving deeply into one or two (if they are related) issues. 

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.