3 Credit Hours
This course is open to students on the college level in either the freshman or sophomore year.
ALH5339 - Bioethics (3 hrs)
This course is designed to help the student increase his or her knowledge concerning the many ethical controversies encountered by those who work in the health care field. The student will be able to feel comfortable examining complex issues and making appropriate ethical decisions. Upon completion of the course, the student will be able to describe ethical decision making and will analyze health care issues such as confidentiality, euthanasia, distribution of health care, and family planning issues.
This course is designed to help the student increase his or her knowledge concerning the many ethical controversies encountered by those who work in the health care field. The student will be able to feel comfortable examining complex issues and making appropriate ethical decisions.
Upon completion of the course, the student will be able to describe ethical decision making and will analyze health care issues such as confidentiality, euthanasia, distribution of health care, and family planning issues.
Unit Outcomes for Criterion Based Evaluation:
The following defines the minimum core content not including the final examination period. Instructors may add other content as time allows.
UNIT 1: Introduction
Outcomes: The student will understand the need for the health care professional to develop both the science and professional conduct aspects of his or her craft.
- Explain the dual nature of health care practice and the need to match clinical expertise with appropriate professional behaviors.
- Discuss how an individual’s worldview will shape his or her decision making in the arena of morals and values.
- Compare and contrast the professional conduct areas of ethics, law, and etiquette.
- Define nihilism, relativism, and hedonism.
- Compare and contrast the sanctions associated with inappropriate legal, ethical and professional etiquette conduct.
- Evaluate a series of ethical dilemmas using his or her specialty’s code of ethical conduct.
- Identify a source for his or her profession’s code of ethical conduct, and provide an analysis of its strengths and weaknesses.
- Define standpoint theory.
UNIT 2: Human Value Development
Outcomes: The student will understand the nature of the human value system and relate this to different developmental theories.
- Differentiate between needs and values.
- Describe and compare the value development positions of Massey, Kohlberg, Gilligan and Piaget.
- Outline the nature of the controversy found in the works of Kohlberg and Gilligan in regard to value development.
- Describe the three general levels and six stages of value development as outlined by Kohlberg.
- List the highest value levels as described by Kohlberg and Gilligan, and relate them to gender development.
- Describe the four value cohorts as outlined by Morris Massey.
UNIT 3: Decision Making in Value Issues
Outcomes: The student will examine common theories and methods used in making value decisions.
- List the theorists who are considered the founders of contemporary duty-oriented, consequence-oriented, and virtue ethics reasoning.
- Outline the theoretical position known as utilitarianism, and analyze a clinical problem following its framework.
- Outline the theoretical position known of Kant, and analyze a clinical problem following duty-oriented reasoning.
- List the major criticisms of duty-oriented and consequence-oriented systems.
- Outline the theoretical position known as virtue ethics.
- List the major criticisms of the virtue ethics position.
UNIT 4: Basic Principles of Health Care Ethics
Outcomes: The student will recall the basic principles used in the analysis of moral dilemmas and show how those principles function in health care delivery.
- Differentiate between morals and ethics.
- Identify the basic principles involved in medical ethics, and show their application in our ethical codes.
- Define the basic principles found in health care ethics.
- Define paternalism and show how in the best sense it is a conflict between the principles of autonomy and beneficence.
- Outline the nature of the special fiduciary relationship between the practitioner and the patient.
- Differentiate among compensatory, retributive, procedural, and distributive justice.
- Outline the ethical problem associated with side effects and the duty of non-maleficence, and show how the principle of double effect is an attempt to resolve the issue.
- Explain how the principle of informed consent is derived from the basic principle of autonomy.
- Explain the types of cases in which benevolent deception might be justified.
UNIT 5: The Nature of Rights in Ethical Discourse
Outcomes: The student will describe the language of rights and the nature of obligations that are attendant to those rights.
- Define what is meant by a claim to a moral right.
- Explain how rights and their attendant correlative obligations are grounded in the same overarching principles and rules.
- List three examples each of positive and negative rights.
- Define and differentiate between moral rights, legal rights, positive rights, negative rights, perfect obligations and imperfect obligations.
UNIT 6: Confidentiality and the Management of Health Care Information
Outcomes: The student will gain an understanding of the current problems associated with the principle of confidentiality as it is applied in modern health care.
- Defend the principle of confidentiality within health care from a utilitarian, duty-oriented, and virtue ethics point of view.
- List the two basic principles in conflict in the Tarasoff case.
- Give five instances in which the practitioner would have a legal requirement to report confidential matters that relate to health care.
- Explain how vulnerability guides the decision-making process when confidentiality is overridden by the duty to warn.
- List five groups not involved in direct patient care that have a legitimate interest in the medical record.
- List six safeguards that should be considered in regard to allowing access to confidential patient information.
- Explain why confidentiality is considered a principle with qualifications.
- Identify the major purposes of the Health Insurance Portability and Accountability Act (HIPAA) of 1996, and list three patient rights that have been strengthened by HIPAA legislation.
- List two measures that are not required of health providers in regard to providing security for health care information.
- List the basic ethical principles that are foundational to the conduct of research using human subjects.
UNIT 7: Professional Gatekeeping as a Function of Role Fidelity
Outcomes: The student will discuss how the requirements of professionalism lead to a whole series of gatekeeping tasks under the principle of role fidelity.
- List the rationale for a profession creating a code of ethics.
- State an ethically based rationale for forbidding sexual relations between patients and health care providers.
- State an ethically based rationale for discouraging conflicts of interest.
- Outline the importance of a scope of practice as it relates to practitioner activities.
- Define disparagement and state why it is a problem that is to be avoided in health care practice.
- Outline the ethical obligation that health care providers have toward impaired colleagues.
- Define the term gaming the system, and provide three examples of the harm this practice has to the health care provider.
UNIT 8: Autonomy versus Paternalism: A Contest between Virtues
Outcomes: The student will discuss the nature of conflict between autonomy and paternalism, and discuss the requirements and elements of informed consent.
- Define paternalism.
- Describe how paternalism is, in the best sense, a result of physician beneficence.
- List and describe the four models of physician-patient interaction as outlined by Robert Veatch.
- Define and list the elements of informed consent.
- Differentiate between the professional community standard and the reasonable patient standard.
- Explain why a more subjective standard than the professional community standard or the reasonable patient standard may be needed to protect patient autonomy.
- Define therapeutic privilege and list the situations in which it is used.
- List several groups in our society that would have limited autonomy.
- Outline the major elements of competency determination.
- Explain how the First Amendment to the United States Constitution protects the autonomy of religious individuals who have beliefs that conflict with current medical practice.
- Outline the requirements of EMTALA.
- Define qualitative futility and quantitative futility.
UNIT 9: Justice and the Allocation of Scarce Resources
Outcomes: The student will gain an understanding of our current national health care crisis and examine potential solutions under the principle of justice.
- Differentiate between Medicare and Medicaid.
- Discuss how the prospective payment and diagnostic related groups were an attempt to control health care costs in the U.S.
- Identify three societal forces that have tended to cause the dramatic inflation of health care costs in the U.S.
- Define and differentiate between micro-allocation and macro-allocation as they relate to health care.
- Define and differentiate between form and material justice.
- State how the fair opportunity rule relates to material justice.
- Define and differentiate between the theoretical positions of utilitarianism, egalitarianism, and libertarianism as they relate to distributive justice.
- Define and give examples of how medical and social utility are used in the micro allocation of scare resources.
- Discuss the process of “Lifeboat Ethics.”
- Discuss the process of triage, and relate it to the micro allocation of beds in intensive care units.
- List the mechanisms used by managed care to contain costs, including those that appear to interfere in the patient-provider relationship and cause ethical concern.
UNIT 10: Withholding and Withdrawing Life Support
Outcomes: The student will gain an understanding of the various arguments used and the types of patients involved in the issues of withdrawing and withholding life support.
- Differentiate between “life” as defined in either a biological or biographical sense.
- State the necessity for redefining death beyond that of a loss of cardiac and pulmonary function, which in many circumstances can be sustained by modern technology.
- Define the concept and criteria of brain death.
- Outline the rationale for the proposal to redefine death with a neocortical definition.
- Define PVS and state the characteristics of the syndrome.
- Differentiate between the “best interest” and “substituted judgment” standards are they relate to proxy decisions.
- Define the difference between “ordinary” and “extraordinary” care.
- Outline the problems associated with the standard differentiations given for ordinary and extraordinary care.
- Differentiate between the various lines of reasoning and arguments needed to decide the following types of cases:
- Persistent vegetative states
- Profoundly retarded patients
- Baby Doe cases
- Informed non-consent
- Outline the arguments for personhood criteria.
- Define what is meant by the “clear and convincing evidence” standard
- Compare and contrast the two major types of advanced directives: living wills and durable power of attorney.
- Differentiate between active and passive euthanasia.
- State how a communitarian approach might hold a solution to a scarcity of organs for donation.
UNIT 11: Euthanasia: Practice and Principles
Outcomes: The student will gain an understanding of the national debate in regard to euthanasia.
- Define and differentiate between active and passive euthanasia.
- Discuss the two major arguments for the adoption of a “right to die.”
- Discuss the religious and non-religious arguments against the adoption of active euthanasia as a practice of modern health care.
- Outline the current position taken by the health care community in regard to the practice of euthanasia.
- Outline the nature of the Hospice Movement in the U.S. and discuss how this may impact on the euthanasia debate.
- Discuss the current ambiguity between the law and court decisions regarding mercy killing in the U.S.
- Recall the general position taken by the Supreme Court in regard to a “right to die.”
UNIT 12: Reproductive Issues
Outcomes: The student will gain an understanding of the ethical issues surrounding human reproduction.
- Recall the distinction between “human” and “person”, and the dispute regarding personhood criteria.
- Describe the distinction between “life” and “quality of life.”
- List the basic facts of fetal development.
- Outline the religious arguments against abortion.
- List the difficulties with arguments based on self-defense.
- List the elements of the doctrine of double-effect and state when it is used.
- Outline the significance of Thompson’s analogies.
- List the freedom of religion arguments.
- Explain how issues of civil disobedience are involved in the politics of abortion.
- Explain the process of in-vitro fertilization and list the ethical issues involved.
- Recall pro and con arguments for the issue of surrogacy.
UNIT 13: Aids and Health Care Practice
Outcomes: The student will gain an understanding of nature of the AIDS epidemic and will examine selected ethical problems associated with the crisis.
- Discuss the nature of the disease process of AIDS and how it is acquired.
- List the major infection control methods.
- Explain how standard precautions have reduced the risk of infection for both health care providers and patients.
- List the high-risk behaviors associated with the spread of AIDS.
- List the reasons confidentiality is perhaps more important for this patients group that for many others.
- List the conditions under which the moral duty to treat would cease to be a duty but only a moral option.
UNIT 14: Ethical Issues and Genetic Manipulation
Outcomes: The student will gain an understanding of the various areas of genetic research and the moral problems that are associated with them.
- Understand the purpose, practice, benefits, and dangers of genetic screening.
- Understand the benefits of prenatal genetic testing and how it leads to the moral issues that surround abortion.
- Describe the dangers of utilizing genetic research for the purpose of eugenics.
- Explain the human genome project.
- Understand the scientific advances possible with recombinant DNA as well as the dangers that unregulated research can create.
- Explain how ethical problems with genetics make necessary a new virtue of family planning with guidelines that help us utilize genetic counseling in an ethical manner.
- Explain the promise and ethical pitfalls associated with gene therapy.
- Explain the posthumanist position regarding genetic research and the discussion of ethics.
- Explain the current state of stem cell research and provide a pro and con argument for its continuance.
UNIT 15: Culturally Appropriate Health Care
Outcomes: The student will gain an understanding of the complex nature of trans cultural health through an examination of two non-Western health care traditions.
- Relate the concept of culture shock to modern health care provision in a multicultural nation.
- List three principles taken from traditional Chinese medicine (TCM) traditions and relate how they might affect the attitude of a Chinese patient seeking treatment in the U.S. health care system.
- List three principles taken from Hindu healing traditions and relate how they might affect the attitude of a Hindu patient seeking treatment in the U.S. health care system.
- Relate how the TCM and Hindu healing beliefs relate to issues such as abortion and holistic health care.
- List four beliefs or practices found in TCM and the Hindu healing traditions that would seem applicable to or could enhance Western health care.
- Provide an ethical rationale for the obligation of health care providers to study the issues of transcultural health.
- Provide a list of the measures that might be useful to provide for Muslim patients.
Varies, refer to the syllabus.
Contact Bookstore for current textbook.
Computer and printer.
Students should adhere to the attendance policy outlined by the instructor in the course syllabus.
The grading policy will be outlined by the instructor in the course syllabus.
Maximum class size:
Based on classroom occupancy
The U.S. Department of Education, Higher Learning Commission and the Kansas Board of Regents define credit hour and have specific regulations that the college must follow when developing, teaching and assessing the educational aspects of the college. A credit hour is an amount of work represented in intended learning outcomes and verified by evidence of student achievement that is an institutionally-established equivalency that reasonably approximates not less than one hour of classroom or direct faculty instruction and a minimum of two hours of out-of-class student work for approximately fifteen weeks for one semester hour of credit or an equivalent amount of work over a different amount of time. The number of semester hours of credit allowed for each distance education or blended hybrid courses shall be assigned by the college based on the amount of time needed to achieve the same course outcomes in a purely face-to-face format.
Refer to the following policies:
402.00 Academic Code of Conduct
263.00 Student Appeal of Course Grades
403.00 Student Code of Conduct
Disability Services Program:
Cowley College, in recognition of state and federal laws, will accommodate a student with a documented disability. If a student has a disability which may impact work in this class which requires accommodations, contact the Disability Services Coordinator.