Although many bioethicists have given attention to the special health issues of Africa and to the ethics of research on the continent, only a handful have considered these issues through the lens of African moral thought. The question has been for the most part neglected as to what a distinctively African moral perspective would be for the analysis and teaching of bioethics issues. To address the oversight, the authors of this paper describe embarking on a project aimed at incorporating (...) African moral perspective, values and philosophy into a teaching curriculum. The authors clarify the rationale for the project and discuss the strategies employed in Africanizing the bioethics curriculum. (shrink)

While disability has emerged as a major theme in academic and political discourses, a perusal of many bioethics textbooks reveals that most editors and philosophers still do not consider disability to be central to developing either critical perspective or social conscience in addressing the core questions in bioethics. This essay explores how disability issues are typically portrayed in bioethics textbooks by looking at the examples of genetic testing and medically assisted death. It explains how incorporation of disability (...) perspectives helps to provide students with opportunities for a fuller understanding of many concepts that are central to moral and political philosophy, such as equality, justice, the good life, moral agency, and autonomy. (shrink)

A belief that high school students have the cognitive ability to analyze and assess moral choices and should be encouraged to do so but have rarely been helped to do so was the motivation for developing Exploring Bioethics, a six-module curriculum and teacher guide for grades nine through twelve on ethical issues in the life sciences. A multidisciplinary team of bioethicists, science educators, curriculum designers, scientists, and high school biology teachers worked together on the curriculum under (...) a contract between the National Institutes of Health and Education Development Center, a nonprofit research and development organization with a long history of innovation in science education. At the NIH, the Department of Bioethics within the Clinical Center and the Office of Science Education within the Office of the Director guided the project.Our overarching goal for Exploring Bioethics was to introduce students to bioethics as a field of inquiry and to enable them to develop ethical reasoning skills so they could move beyond “gut reactions” to more nuanced positions. (shrink)

The aim of this study is to examine the current profile of bioethics education in the nursing curriculum as perceived by nursing students and faculty in Korea. A convenience sampling method was used for recruiting 1223 undergraduate nursing students and 140 nursing faculty in Korea. Experience of Bioethics Education, Quality of Bioethics Education, and Demand for Bioethics Education Scales were developed. The Experience of Bioethics Education Scale showed that the nursing curriculum in Korea (...) does not provide adequate bioethics education. The Quality of Bioethics Education Scale revealed that the topics of human nature and human rights were relatively well taught compared to other topics. The Demand for Bioethics Education Scale determined that the majority of the participants believed that bioethics education should be a major requirement in the nursing curriculum. The findings of this study suggest that bioethics should be systemically incorporated into nursing courses, clinical practice during the program, and during continuing education. (shrink)

In 2017, UNESCO introduced an Undergraduate Bioethics Integrated Curriculum to be taught in Indian medical schools, with an implied suggestion that it could subsequently be rolled out to medical schools in UNESCO’s other member states. Its stated aim is to create ethical awareness from an early stage of a doctor’s training by infusing ethics instructions throughout the entire undergraduate medical syllabus. There are advantages to a standardised integrated curriculum where none existed. However, the curriculum as presently (...) drafted risks failing to achieve its laudable aims. There are important lessons to be drawn from UNESCO’s First Syllabus for Youth Bioethics Education (2018), which is aimed at schoolchildren and teenagers, and represents a creative, effective and culturally sensitive way to teach bioethics. (shrink)

The National Medical Commission of India introduced the Competency Based Curriculum in Medical Education for undergraduate medical students in 2019 with a new module named Attitude, Ethics and Communication (AETCOM) across the country. There was a consensus for teaching medical ethics in an integrated way, suggesting dedicated hours in each phase of undergraduate training. The AETCOM module was prepared and circulated as a guide to acquire necessary competency in attitudinal, ethical and communication domains. This study was aimed to explore (...) the perceptions of students and medical teachers and identify the challenges in teaching and learning process of the newly implemented AETCOM module. It was a mixed method designed study with structured questionnaires for students and teachers at various medical schools in India. Based on the quantitative data, in-depth interviews with medical teachers were undertaken. Challenges were perceived by both students and teachers. The students had a mixed perception, facing difficulties in passive learning with scarce resource materials. Challenges identified by teachers were a lack of knowledge and skills required for teaching bioethics, the logistics of managing large numbers of students in the stipulated time frame, interdisciplinary integration—both horizontal and vertical, and assessment program in terms competency-based education. The study draws the attention of all stakeholders for a revision and efforts for further improvement in the teaching and assessment process, and setting a standard model in medical education in India. (shrink)

To help ensure the ethical conduct of research, many have recommended educational efforts in research ethics to investigators and members of research ethics committees (RECs). One type of education activity involves multi-day workshops in research ethics. To be effective, such workshops should contain the appropriate content and teaching techniques geared towards the learning styles of the targeted audiences. To ensure consistency in content and quality, we describe the development of a curriculum guide, core competencies and associated learning objectives and (...) activities to help educators organize research ethics workshops in their respective institutions. The curriculum guide is divided into modular units to enable planners to develop workshops of different lengths and choose content materials that match the needs, abilities, and prior experiences of the target audiences. The content material in the curriculum guide is relevant for audiences in the Middle East, because individuals from the Middle East who participated in a Certificate Program in research ethics selected and developed the training materials (e.g., articles, powerpoint slides, case studies, protocols). Also, many of the activities incorporate active-learning methods, consisting of group work activities analyzing case studies and reviewing protocols. The development of such a workshop training curriculum guide represents a sustainable educational resource to enhance research ethics capacity in the Middle East. (shrink)

Designing bioethics curriculum for international postgraduate students is a challenging task. There are at least two main questions, which have to be resolved in advance: (1) what is a purpose of a particular teaching program and (2) how to respectfully arrange a classroom for students coming from different cultural and professional backgrounds. In our paper we analyze the case of the Erasmus Mundus Master of Bioethics program and provide recommendations for international bioethics education. In our opinion (...) teaching bioethics to postgraduate international students goes beyond curriculum. It means that such a program requires not only well-defined goals, including equipping students with necessary skills and knowledge, but also it should first and foremost facilitate positive group dynamics among students and enables them to engage in dialogue to learn from one another. (shrink)

Bioethics and humanities (inclusive of medical ethics, health care ethics, environmental ethics, research ethics, philosophy and medicine, literature and medicine, and so on) seems like one field; yet colleagues come from different academic disciplines with distinct languages, methods, traditions, core curriculum and competency examinations. The author marks six related "framework" features that unite and make it one distinct field. It is a commitment to (1) work systematically on some of the momentous and well-defined sets of problems about the (...) human condition that drive our field (such as death and dying, disability, confidentiality, professionalism, informed consent, abortion, euthanasia, assisted suicide, personhood, health-care resource allocation and environmental ethics, as well as the impact of new technologies, including genetic and reproductive); (2) use interdisciplinary approaches to unravel them; (3) employ cases and practical reasoning to understand problems and solve answers; (4) apply teaching methods and goals associated with John Dewey to make students better problem-solvers; (5) find morally justifiable solutions to the problems driving our field; and (6) seek interdisciplinary and collaborative scholarship, service or teaching. (shrink)

A dispute exists about whether bioethics should become a new discipline with its own methods, competency standards, duties, honored texts, and core curriculum. Unique expertise is a necessary condition for disciplines. Using the current literature, different views about the sort of expertise that might be unique to bioethicists are critically examined to determine if there is an expertise that might meet this requirement. Candidates include analyses of expertise based in "philosophical ethics," "casuistry," "atheoretical or situation ethics," "conventionalist relativism," (...) "institutional guidance," "regulatory guidance and compliance," "political advocacy," "functionalism," and "principlism." None succeed in identifying a unique area of expertise for successful bioethicists that could serve as a basis for making it a new discipline. Rather expertise in bioethics is rooted in many professions, disciplines and fields and best understood as a second-order discipline. (shrink)

The issues of bioethics have been present in the Romanian space starting with the past century and have been tackled in different ways, according to context and the people interacting with them. Nonetheless, as a science, it became visible within the university context only towards the end of the past century when the faculties of theology in collaboration with those of medicine managed to introduce in the curriculum of the former and later on in that of the latter (...) the problems of bioethics, as well as their possible solutions. Though being a young science, bioethics succeeded in gaining ground as a university subject due to some doctors, famous in Romania and known as prestigious teachers lecturing in it, and due to its multiple challenges with which the Romanian society has been confronted lately. (shrink)

The residency years comprise the last period of a physician’s formal training. It is at this stage that trainees consolidate the clinical skills required for independent practice and achieve a level of ethical development essential to their work as physicians, a process known as professional identity formation (PIF). Ethics education is thought to contribute to ethical development and to that end the Royal College of Physicians and Surgeons of Canada (RCPSC) requires that formal ethics education be integrated within all postgraduate (...) specialty training programs. However, a formal ethics curriculum can operate in parallel with informal and hidden ethics curricula, the latter being more subtle, pervasive, and influential in shaping learner attitudes and behavior. This paper reports on a study of the formal, informal, and hidden ethics curricula at two postgraduate psychiatry programs in Canada. Based on the analysis of data sources, we relate the divergences between the formal, informal, and hidden ethics curricula to two aspects of professional identity formation (PIF) during psychiatry residency training. The first is the idea of group membership. Adherence to the hidden curriculum in certain circumstances determines whether residents become part of an in-group or demonstrate a sense of belonging to that group. The second aspect of PIF we explore is the ambiguous role of the resident as a student and a practitioner. In ethically challenging situations, adherence to the messages of the hidden curriculum is influenced by and influences whether residents act as students, practitioners, or both. This paper describes the hidden curriculum in action and in interaction with PIF. Our analysis offers a complementary, empirical perspective to the theoretical literature concerning PIF in medical education. This literature tends to position sound ethical decision-making as the end result of PIF. Our analysis points out that the mechanism works in both directions: how residents respond to hidden curriculum in ethics can be a driver of professional identity formation. (shrink)

The idea of the Internet as Gutenberg 2.0—a true revolution in disseminating information—is now a routine part of how bioethics education works. The Internet has become indispensable as a channel for sharing teaching materials and connecting learners with a central platform that houses materials to support an online or hybrid curriculum or a traditional course. A newer idea in bioethics education reflects developments in web-based medical education more broadly and draws on design principles developed for the Internet. (...) This approach to online bioethics education requires thinking about web-based learning as an engaging, potentially immersive experience, about learners' expectations concerning web-based learning, and about differences between self-directed learning and teaching to support group learning. In clinician education in bioethics, the interrelated goals of ethical reflection and practice for professionals and of continuous quality improvement in health care are supported by a focus on real-world challenges and by encouraging the habits of self-directed learning. In this paper, we describe how an international, interdisciplinary team used a web-based framework to develop a health care ethics casebook whose content, design, and pedagogy were tailored to the needs and expectations of health care professionals and other audiences in Singapore; we also explain how they used this framework to make the casebook accessible nationwide and to support cross-cultural learning. (shrink)

Objective: The purpose of this study was to demonstrate how educators involved in the teaching of bioethics to healthcare university students in Japan would cope with ethical disagreement in the classroom, and to identify factors influencing them.Methods: A cross sectional survey was conducted using self administered questionnaires mailed to a sample of university faculty in charge of bioethics curriculum for university healthcare students.Results: A total of 107 usable questionnaires were returned: a response rate of 61.5%. When facing (...) ethical disagreement in the classroom, coping behaviour differed depending on the topic of discussion, was influenced by educators’ individual clear ethical attitudes regarding the topic of discussion, and was independent of many respondents’ individual and social backgrounds. Among educators, it was commonly recognised that the purpose of bioethics education was to raise the level of awareness of ethical problems, to provide information about and knowledge of those issues, to raise students’ sensitivity to ethical problems, and to teach students methods of reasoning and logical argument. Yet, despite this, several respondents considered the purpose of bioethics education to be to influence students about normative ethical judgments. There was no clear relationship, however, between ways of coping with ethical disagreement and educators’ sense of the purpose of bioethics education.Conclusions: This descriptive study suggests that educators involved in bioethics education for healthcare university students in Japan coped in various ways with ethical disagreement. Further research concerning ethical disagreement in educational settings is needed to provide better bioethics education for healthcare students. (shrink)

The curriculum design, faculty characteristics, and experience of implementing masters' level international research ethics training programs supported by the Fogarty International Center was investigated. Multiple pedagogical approaches were employed to adapt to the learning needs of the trainees. While no generally agreed set of core competencies exists for advanced research ethics training, more than 75% of the curricula examined included international issues in research ethics, responsible conduct of research, human rights, philosophical foundations of research ethics, and research regulation and (...) ethical review process. Common skills taught included critical thinking, research methodology and statistics, writing, and presentation proficiency. Curricula also addressed the cultural, social, and religious context of the trainees related to research ethics. Programs surveyed noted trainee interest in Western concepts of research ethics and the value of the transnational exchange of ideas. Similar faculty expertise profiles existed in all programs. Approximately 40% of faculty were female. Collaboration between faculty from low- and middleincome countries (LMICs) and high-income countries (HICs) occurred in most programs and at least 50% of HIC faculty had previous LMIC experience. This paper is part of a collection of papers analyzing the Fogarty International Research Ethics Education and Curriculum Development program. (shrink)

Ethics has an established place within the medical curriculum. However notable differences exist in the programme characteristics of different schools of medicine. This paper addresses the main differences in the curricula of medical schools in South East Europe regarding education in medical ethics and bioethics, with a special emphasis on research ethics, and proposes a model curriculum which incorporates significant topics in all three fields. Teaching curricula of Medical Schools in Bulgaria, Bosnia and Herzegovina, Croatia, Serbia, Macedonia (...) and Montenegro were acquired and a total of 14 were analyzed. Teaching hours for medical ethics and/or bioethics and year of study in which the course is taught were also analyzed. The average number of teaching hours in medical ethics and bioethics is 27.1 h per year. The highest national average number of teaching hours was in Croatia, and the lowest was in Serbia. In the countries of the European Union the mean number of hours given to ethics teaching throughout the complete curriculum was 44. In South East Europe, the maximum number of teaching hours is 60, while the minimum number is 10 teaching hours. Research ethics topics also show a considerable variance within the regional medical schools. Approaches to teaching research ethics vary, even within the same country. The proposed model for education in this area is based on the United Nations Educational, Scientific and Cultural Organization Bioethics Core Curriculum. The model curriculum consists of topics in medical ethics, bioethics and research ethics, as a single course, over 30 teaching hours. (shrink)

Contemporary bioethics education has been developed predominately within Euro-American contexts, and now, other global regions are increasingly joining the field, leading to a richer global understanding. Nevertheless, many standard bioethics curriculum materials retain a narrow geographic focus. The purpose of this article is to use local cases from the Asia-Pacific region as examples for exploring questions such as ‘what makes a case or example truly local, and why?’, ‘what topics have we found to be best explained through (...) local cases or examples?’, and ‘how does one identify a relevant local case?’ Furthermore, we consider the global application of local cases to help extend the possible scope of the discussion, opening new avenues for the development of practical bioethics educational materials. We begin with a background description and discussion of why local cases enhance bioethics education, move to an overview of what is currently available and what is not for the region, and then outline a discussion of what it means to be local using example cases drawn from Hong Kong, Australia, Pakistan, and Malaysia. We are not creating a casebook but rather constructing by example a toolbox for designing active and dynamic learning cases using regional diversity as contextualised cases with generalised principles. (shrink)

This paper provides a rationale for the inclusion of biotechnology courses in the secondary science curriculum. In years to come our students will need to make important political, moral and social decisions about their future and the future of others. If our students are to become informed decision makers they need to understand the theory, practice and ethical ramifications of biotechnology. Important topics related to biotechnology include euthanasia, human organ and tissue transplantation, reproductive technology, cloning, and the production and (...) use of genetically modified organisms. Science teachers have an obligation to help their students develop an understanding of these issues.Data is presented from two science teachers, Catherine and Mark, each of whom taught innovative Year 10 Biotechnology courses . The effectiveness of the courses in enabling students to better identify and resolve ethical issues is discussed. (shrink)

Post-war Japan has seen profound and rapid social change and transformation. One of the most visible areas of change in Japan has been medicine, and particularly the ethical practices and policies that guide medical decision-making. The formal discipline of bioethics, Seimei Rinri in Japanese, has grown by leaps and bounds since the late 1970s, when it began to appear in the curriculum and professional activities of Japanese medical schools and philosophy departments. The introduction of bioethics to Japan (...) was timely, as innovation in medicine and technology was evolving in ways that revealed that the intersection of medicine, traditional Japanese values, and new cultural trends was an area of great moral complexity. In its infancy, bioethics in Japan was more or less an import from the United States, where the discipline took its roots. Quickly, however, it became clear that Japan's history and tradition would call for a different approach, and the engagement of slightly different ethical issues. Organ transplantation, for example, sparked much greater controversy in Japan than it ever did in the United States. Today, Japan has one of the most dynamic bioethics programs in the world, and it is one that reflects both traditional Japanese culture and the need for inter-cultural engagement in an increasingly global world. Through a series of original chapters written by bioethicists and covering a range of ethical issues, this anthology shows that, in contrast to previous assumptions, Japanese bioethics has, in fact, taken on an identity that is undoubtedly separate from its American origins. Rich philosophical questions raised by medicine, human subjects research, and psychiatric care are being posed by scholars in a way that reflect Japanese tradition and is no longer simply reflective of, or shaped by, American traditions and philosophical problems. The book highlights and showcases these trends through a series of chapters written by some of the leading scholars in contemporary Japanese bioethics, many of whom were pioneers of the field when it began and are now nearing retirement. (shrink)

Anesthesiology training programs are tasked with equipping trainees with the skills to become medically and ethically competent in the practice of anesthesia and to be prepared to obtain board certification, yet there is currently no standardized ethics curriculum within anesthesia training programs in the United States. To bridge this gap, and to provide a validated ethics curriculum to meet the aforementioned needs, in July 2021, a survey was sent to anesthesia scholars in the field of biomedical ethics to (...) identify key areas that should be included in such an ethics curriculum. The responses were rated on a Likert scale and ranked. This paper identifies the top ten topics identified as high priority for inclusion in an anesthesiology training program and consequently deemed most relevant to meet the educational needs of graduates of an anesthesiology residency: (1) capacity to consent; (2) capacity to refuse elective versus lifesaving treatment; (3) application of surrogate decisionmaking; (4) approach to do not resuscitate (DNR) status in the operating room; (5) patient autonomy and advance directives; (6) navigating patient beliefs that may impair care; (7) “futility” in end-of-life care: when to withdraw life support; (8) disclosure of medical errors; (9) clinical criteria for “brain death” and consequences of this definition; and (10) the impaired anesthesiologist. (shrink)

Bioethics Education in the Anglo-European context developed since 1970 and was incorporated into the undergraduate and postgraduate education, residency training, and continuous education. In the Asia-Pacific region, bioethics education is less structured and often dependent on contextual constraints. This paper provides a cross-sectional analysis, describing institutional experiences in developing bioethics curriculum at two medical schools in Malaysia and Hong Kong. The medical programmes of the two institutions are distinctive in terms curriculum framework, teaching approach, and (...) topic selection, and common challenges include implementation of bioethics courses, students’ resistance to bioethics, and limited teaching capacity, emerged as they evolve. The reported experiences revealed that there is room for improvement regarding how medical schools integrate bioethics education in regions where curriculum development remains at an early stage. At least, a bioethics education requires both top-down support from the faculty to improve teaching and educational quality, as well as from the bottom-up approach to empower students to raise awareness and concerns toward bioethics, and helps students developing reasoning through challenging issues. (shrink)

Health disparities education is an integral and required part of medical professional training, and yet existing curricula often fail to effectively denaturalize injustice or empower learners to advocate for change. We discuss a novel collaborative intervention that weds the health humanities to the field of health equity. We draw from the health humanities an intentional focus retraining provider imaginations by centering patient narratives; from the field of health equity, we draw the linkage between stigmatized social identities and health disparities. We (...) describe a longitudinal health equity curriculum for the Hospice and Palliative Medicine fellowship in Memphis, Tennessee, to give trainees exposure to the concept of structural violence and how it affects clinical care. The curriculum was developed in partnership with humanities and social sciences faculty who staff a Health Equity academic program at a small liberal arts college in Memphis. This curriculum has been implemented for the past four years in support of 22 hospice and palliative medicine fellows. Group debriefs and a mixed methods survey have revealed widespread and lasting impact towards understanding health equity concepts, enhanced communication and treatment of patients, and empowerment to address the broader needs and policies affecting patients and the communities in which they live. Ultimately, we model an educational initiative that integrates equity across the full scope of healthcare practice and equips learners with skills for sustaining compassionate practices, focusing on equity-oriented, person-centered care across the full scope of healthcare practice. (shrink)

This essay describes and critically evaluates a co-operative educational program to train Ugandan health care workers in bioethics. It describes one bottom-up effort, a week-long intensive workshop in bioethics provided by the authors to health care professionals in a developing country—Uganda. We will describe the background and circumstances that led to the organization of the workshop, and review its planning, design, curriculum, and outcome. We will focus especially on measures taken to make the workshop relevant for the (...) audience of Ugandan professionals, and describe lessons learned after two presentations of the workshop. Finally, we will discuss the strengths and weaknesses of such a format, and its potential value in raising bioethical expertise in developing countries. (shrink)

In response to the increasing need for research ethics expertise in low and middle income countries (LMICs), the NIH's Fogarty International Research Ethics Education and Curriculum Development Program has provided grants for the development of training programs in international research ethics for LMIC professionals since 2000. This collection of papers draws upon the combined expertise of Fogarty grantees, trainees, and other experts to assess the state of research ethics in LMICs, and the lessons learned over 12 years of international (...) research ethics education; to assess future needs; and to chart a way forward to meet those needs. In this introductory paper we briefly sketch the evolution of research ethics as applied to LMIC research, the underpinning and evolution of the Fogarty bioethics program, and summarize key conclusions from the other papers in the collection. (shrink)

A multidisciplinary faculty committee designed a curriculum to shape biomedical graduate students into researchers with a high commitment to professionalism and social responsibility and to provide students with tools to navigate complex, rapidly evolving academic and societal environments with a strong ethical commitment. The curriculum used problem-based learning (PBL), because it is active and learner-centred and focuses on skill and process development. Two courses were developed: Scientific Professionalism: Scientific Integrity addressed discipline-specific and broad professional norms and obligations for (...) the ethical practice of science and responsible conduct of research (RCR). Scientific Professionalism: Bioethics and Social Responsibility focused on current ethical and bioethical issues within the scientific profession, and implications of research for society. Each small-group session examined case scenarios that included: (1) learning objectives for professional norms and obligations; (2) key ethical issues and philosophies within each topic area; (3) one or more of the RCR instructional areas; and (4) at least one type of moral reflection. Cases emphasised professional standards, obligations and underlying philosophies for the ethical practice of science, competing interests of stakeholders and oversight of science (internal and external). To our knowledge, this is the first use of a longitudinal, multi-semester PBL course to teach scientific integrity and professionalism. Both faculty and students endorsed the active learning approach for these topics, in contrast to a compliance-based approach that emphasises learning rules and regulations. (shrink)

Training residents to become humanistic physicians capable of empathy, compassionate communication, and holistic patient care is among our most important tasks as physician educators. Narrative medicine aims to foster those highly desirable characteristics, and previous studies have shown it to be successful in fostering self-reflection, emotional processing, and preventing burnout. We aimed to evaluate pediatric residents’ perceptions of a novel narrative medicine curriculum. After the initiation of a longitudinal narrative medicine curriculum, focus groups were conducted with residents who (...) participated in at least one narrative medicine session. The curriculum was viewed positively, and residents found the sessions to be helpful in developing empathy, offering a space for reflection, and introducing new perspectives. Challenges noted were perception of relevance, timing of sessions, and interpretation by non-native English-speaking residents. With attention to linguistics and thematic undertones, narrative medicine is a feasible, replicable, and accepted teaching modality for pediatric residents to foster empathy, process emotions, and participate in self-reflection. (shrink)

BackgroundCurrently a variety of novel scenarios have appeared within nursing practice such as confidentiality of a patient victim of abuse, justice in insolvent patients, poorly informed consent delivery, non-satisfactory medicine outputs, or the possibility to reject a recommended treatment. These scenarios presuppose skills that are not usually acquired during the degree. Thus, the implementation of teaching approaches that promote the acquisition of these skills in the nursing curriculum is increasingly relevant.ObjectiveThe article analyzes an academic model which integrates in the (...) curriculum a series of specific theoretical concepts together with practical skills to acquire the basic ethic assessment competency.Research designThe project includes designing two subjects, General Anthropology and Ethics-Bioethics, with an applied approach in the nursing curriculum. The sequential structure of the curriculum in both subjects is constituted by three learning domains (theoretical, practical, and communicative) with different educational strategies.Ethical considerationsNo significant ethical considerations as this is a discussion paper.FindingsThe model was structured from the anthropology’s concepts and decision-making process, applied to real situations. The structure of the three domains theoretical–practical–communicative is present in each session.DiscussionIt is observed that theoretical domain fosters the capacity for critical analysis and subsequent ability to judge diverse situations. The practical domain reflected two significant difficulties: students’ resistance to internalizing moral problems and the tendency to superficial criticism. The communicative domain has frequently shown that the conflicting points are in the principles to be applied.ConclusionWe conclude that this design achieves its objectives and may provide future nursing professionals with ethical competences especially useful in healthcare practice. The three domains of the presented scheme are associated with the same process used in decision making at individual levels, where the exercise of clinical prudence acquires particular relevance. (shrink)

Current challenges in medical practice, research, and administration demand physicians who are familiar with bioethics, health law, and health economics. Curriculum directors at American Association of Medical Colleges-affiliated medical schools were sent confidential surveys requesting the number of required hours of the above subjects and the years in which they were taught, as well as instructor names. The number of relevant publications since 1990 for each named instructor was assessed by a PubMed search.In sum, teaching in all three (...) subjects combined comprises less than two percent of the total hours in the American medical curriculum, and most instructors have not recently published articles in the fields they teach. This suggests that medical schools should reevaluate their curricula and instructors in bioethics, health law, and health economics. (shrink)

While Bioethics is now taught at all medical colleges in the United States as well as in other nations, and while discussions about Bioethics have become frequent in most medical journals there are increasing barriers to teaching and incorporating what has been taught into daily practice. I shall discuss some of these barriers and suggest that integrating the teaching of Bioethics throughout the curriculum after presenting some of the basic theory and methodology is the most effective (...) way of teaching this vital subject. Furthermore, courses in health care ethics are often taught as something distinct and distinguishable from one's medical practice. I shall emphasize what I consider to be the failure of Bioethics to participate effectively in creating a context whereby what has been taught can be put into praxis. In this brief article I will discuss such barriers and suggest several approaches and remedies. (shrink)

The last twenty-five years of published literature and curriculum development in bioethics suggest that the field enjoys a successful and stable marriage to philosophical ethical theory. However, the next twenty-five years could be very different. I believe the marriage is troubled. Divorce is conceivable and perhaps likely. The most philosophical parts of bioethics may retreat to philosophy departments, while bioethics continues on its current course toward a more interdisciplinary and practical field.I make no presumption that (...) class='Hi'>bioethics is integrally linked to philosophical ethical theory. Indeed, I assume that the connection is contingent and fragile. Many individuals in law, theological ethics, political theory, the social and behavioral sciences, and the health professions carefully address mainstream issues of bioethics without finding ethical theory essential or breathtakingly attractive. This is not surprising. Moral philosophers have traditionally formulated theories of the right, the good, and the virtuous in the most general terms. (shrink)

ABSTRACT The demand for basic research ethics training has grown considerably in the past few years. Research and education organizations face the challenge of providing this training with limited resources and training tools available. To meet this need, Family Health International (FHI), a U.S.‐based international research organization, recently developed a Research Ethics Training Curriculum (RETC). It was designed as a practical, user‐friendly tool that provides basic, up‐to‐date, standardized training on the ethics of human research. The curriculum can easily (...) be adapted to different audiences and training requirements. The RETC was reviewed by a group of international experts and field tested in five countries. It is available in English, French, and Spanish as a three‐ring binder and CD‐ROM, as well as on the Web. It may be used as either an interactive self‐study program or for group training. (shrink)

Work purpose: to present and analyze pedagogical strategies and the communicational approach to definitions of bioethics, a mutual part of the bioethics contents being realized on the university studies of Dentistry, Organization, Planning and Management in Healthcare, and professional studies of Medical Radiology at the Medical School in Rijeka. Methods: the method of content analysis was used to research and present encyclopaedic and some authorial definitions of bioethics, with special emphasis on definitions of bioethics by authors (...) – bioethicists from Croatia; the method of pattern 1: included the curriculum of Medical Ethics and Bioethics and the Ethics of Healthcare, and researched standpoints of forty-five students educated in studies where bioethics courses are being realized. The pattern is specifically stratified because it: a) included students whose curriculum is being realized in shifts – intensive lectures in a duration of two weeks, and those whose lectures are being realized each week during one semester; b) different year of education . 2. The scale of assessment was used to research and obtain standpoints of students on the contents of the curriculum, methods of its performance, and the achieved level of communication among students and communication with the professor. Expected results: the presented method of work and results obtained by the scale of assessment should display the acceptability and successfulness of the presented pedagogicalmethodological means of work and point out to weaknesses and deficiencies, and finally conclude the extent to which the presented concept, and approaches to the actualization of the definitions of bioethics contribute to the realization of dialogue and communication in which students simultaneously experience the curriculum as necessary, useful, interesting, and one that may motivate them to think, exchange ideas and offer possible solutions. The scale of assessment should point out to different standpoints of students depending on the length of their study and commitment to a method of class realization. (shrink)

In the paper, the topic of teaching ethics in schools in Poland according to the Core Curriculum is analyzed. The authors refer to the historical background of introducing Ethics into schools and controversies accompanying it. They also refer to some fundamental problems affecting the teaching of Ethics in Polish schools. The main focus of the article is the idea that most of the problems result from setting Ethics in opposition to Religion, which appears invalid as far as the (...) class='Hi'>curriculum is concerned. Ethics should be an obligatory subject for all levels of education. The aim of the authors is not to exhaustively present all the problems that are making the teaching of Ethics in Poland difficult, but to present to the foreign reader the curriculum and a broad outline of the difficulties that teaching Ethics faces in Polish schools. (shrink)

Professionalism is demonstrated through attitudes and behaviors. Medical education is concerned with teaching and evaluating it among students. It is often bioethicists who teach professionalism to medical students. Most bioethics curricula use lectures and group discussions to introduce principles and theories, but there is variation in number of credit and contact hours, placement in the curriculum and alongside which courses bioethics is placed), the extent of individual mentoring, and the emphasis placed on any particular philosophical approach. (...) class='Hi'>Bioethics curricula also vary in whether and how explicitly and extensively they address topics, including professionalism, cultural competence, medical humanities, spirituality, death and dying, and community service, and in the number and topics of vignettes, controversies, assignments, and course activities. (shrink)

I believe that the purpose of history in a medical school can be related to two simple goals: first, to make students a bit skeptical about everything else they are to be taught in the other lectures—skepticism fosters humility and life-long learning; second, to make them aware that medical history is a research discipline as compelling as any of the basic and clinical sciences they are traditionally taught. In the fall of 1988, I was given an opportunity to build a (...) “course” in history for medical students—a course with no fixed time slot, no fixed syllabus, and no fixed content. I wanted to teach history of anatomy during anatomy sessions, history of pathology during pathology, history of obstetrics during obstetrics, and so on. I hoped to end each session with a disciplinary controversy that extended into present pratice. The ultimate manifestation of infiltration would be to have one question on every exam that the students would write during their medical school experience. This is the story of how my medical history teaching moved from nothing to a program integrated throughout four years of medical studies, complete with goals and objectives and two questions of every exam. The content, advantages, and problems of the approach in the Queen's University experience will be presented. (shrink)

Introduction The Brazilian national curriculum guidelines for undergraduate medicine courses inspired and influenced the groundwork for knowledge acquisition, skills development and the perception of ethical values in the context of professional conduct. Objective The evaluation of ethics education in research involving human beings in undergraduate medicine curriculum in Brazil, both in courses with active learning processes and in those with traditional lecture learning methodologies. Methods Curricula and teaching projects of 175 Brazilian medical schools were analyzed using a retrospective (...) historical and descriptive exploratory cohort study. Thirty one medical schools were excluded from the study because of incomplete information or a refusal to participate. Active research for information from institutional sites and documents was guided by terms based on 69 DeCS/MeSH descriptors. Curriculum information was correlated with educational models of learning such as active learning methodologies, tutorial discussions with integrated curriculum into core modules, and traditional lecture learning methodologies for large classes organized by disciplines and reviewed by occurrence frequency of ethical themes and average hourly load per semester. Results Ninety-five medical schools used traditional learning methodologies. The ten most frequent ethical themes were: 1 – ethics in research (26); 2 – ethical procedures and advanced technology (46); 3 – ethic-professional conduct (413). Over 80% of schools using active learning methodologies had between 50 and 100 hours of scheduled curriculum time devoted to ethical themes whereas more than 60% of traditional learning methodology schools devoted less than 50 hours in curriculum time to ethical themes. Conclusion The data indicates that medical schools that employ more active learning methodologies provide more attention and time to ethical themes than schools with traditional discipline-based methodologies. Given the importance of ethical issues in contemporary medical education, these findings are significant for curriculum change and modification plans in the future of Brazilian medical education. (shrink)

Objectif de l’étude : exposer et analyser les stratégies pédagogiques et l’approche communicationnelle des définitions de la bioéthique, un contenu bioéthique commun aux études universitaires de Stomatologie, aux études universitaires d’Organisation, de planification et d’administration des soins de santé, ainsi qu’aux études professionnelles de radiologie médicale à la Faculté de médecine de Rijeka. Méthodes : la méthode d’analyse de contenu a été utilisée pour examiner et présenter les définitions encyclopédiques de la bioéthique et quelques définitions d’auteur, avec l’accent sur les (...) définitions de la bioéthique données par les auteurs experts en bioéthique croates ; la méthode de panel incluait 1. le curriculum de L’Éthique médicale, de Bioéthique et de L’Éthique des soins de santé, et examinait les points de vue de 45 étudiants qui suivaient les matières relatives à la bioéthique. Le panel a été stratifié car il prenait en compte : a) les étudiants dont le curriculum se déroule par alternance, avec des cours intensifs durant deux semaines, puis les étudiants dont les cours avaient lieu chaque semaine au cours du semestre ; b) les différents niveaux d’études ; 2. une grille d’évaluation utilisée pour l’examen et la collecte des points de vue des étudiants à l’égard du contenu du curriculum, des méthodes de mise en oeuvre et du niveau de communication – entre étudiants ainsi qu’avec le professeur – accompli. Résultats attendus : la méthode de travail exposée et les résultats obtenus par le biais de la grille d’évaluation devraient montrer la recevabilité et l’aboutissement des moyens pédago-méthodologiques cités, indiquer leurs faiblesses et leurs insuffisances, puis conclure dans quelle mesure le concept et les approches de l’actualisation des définitions de la bioéthique présentés contribuent au dialogue et à la communication, ce qui permet en même temps de vivre le curriculum comme nécessaire, utile, intéressant et incitant à la réflexion, à l’échange d’idées et de propositions. La grille d’évaluation devrait mettre en relief les différents points de vue des étudiants en fonction de la durée de leurs études et de leur adhésion à une méthode de cours. (shrink)

The American Society for Bioethics and Humanities has developed a curriculum leading to a certificate in health care ethics consultation. A certification in ethics consultation initially seems to fit nicely into the biomedical model of clinical expertise espoused by modern biomedicine, but examining what exactly constitutes moral expertise, particularly for traditional Christians, reveals a significant problem: the certification relies on an implicit view of ethics as essentially procedural. It leaves virtually all serious moral content to be filled in, (...) if at all, after an ostensibly neutral scaffolding has been erected. Such an approach does not help answer deep moral questions about how one should live, and it is these questions that ought to be encouraged during some conflicts that result in requests for ethics consultations. This paper suggests that, in certain circumstances, and for a subset of patients, encouraging conversion can help remedy the deficiency of an overly mechanized approach. A system open to conversion would have more room for Traditional Christians, regardless of the outcome, as it would take morality as lived, communal experience more seriously and help others, if desired, to do so as well. (shrink)

This article argues that environmental considerations fall within the scope of medical bioethics, and there are implications specific to medical education. It endorses the need to expand the scope and epistemology of contemporary medical bioethics discourse by including themes related to environmental considerations. Our discussion begins by providing a brief history of environmental bioethics. It then offers a critique of three specific health and environmental issues, namely technology, toxics, and consumption, and discusses how these issues are key (...) to articulating moral considerations of human health and subsequently medicine and its teaching. Lastly, it explores criticisms of including environmental issues into the bioethical debate before providing suggestions of how environmental ethics can be included into the medical curriculum. This article concludes by suggesting theoretical possibilities for environmentally inclusive bioethics, such as reorienting bioethical discussions to its original environmental advocacy and supporting environmental bioethics as a competency in medical education. (shrink)

Part 1. Foundations -- Reasoning about ethics -- Ethical theories and perspectives -- Three core concepts in medical ethics : best interests, autonomy and rights -- An introduction to law -- Doctors and patients : relationships and responsiblities -- Part 2. Core topics -- Consent -- Capacity -- Mental health -- Confidentiality -- Resource allocation -- Children and young people -- Disability and disease -- Reproductive medicine -- End of life -- Organ transplantation -- Research -- Part 3. Extensions -- (...) Neuroethics -- Genethics -- Information ethics -- Public health ethics. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Origins and Evolution of Bioethics: Some Personal ReflectionsEdmund D. Pellegrino (bio)AbstractBioethics was officially baptized in 1972, but its birth took place a decade or so before that date. Since its birth, what is known today as bioethics has undergone a complex conceptual metamorphosis. This essay loosely divides that metamorphosis into three stages: an educational, an ethical, and a global stage. In the educational era, bioethics (...) focused on a perceived “dehumanization” of medicine by the rising power of science and technology. Remedies were sought by introducing humanities, ethics, and human “values” into the medical curriculum. Ethics was one among the humanistic disciplines, but not the dominant one. In the second era, ethics assumed a dominant role as ever more complex dilemmas emerged from the rapid pace of biological research. As such dilemmas were applied to medical practice, the need for a more rigorous and more formal analysis of their moral status was clear. Philosophically-trained ethicists had an obvious role. They began to teach, write, and profoundly influence medical education and practice. In the third—and present—period, the breadth of problems has become so broad that ethicists must, themselves, draw on disciplines well beyond their expertise—e.g., law, religion, anthropology, economics, political science, psychology, and the like. The era of bioethics as a global enterprise is upon us. The original hope for humanizing medicine has not been overtly successful; however, much has been accomplished of value to patients, the profession, and society. Medical morality has been transformed into a formal, systematic study of a whole range of issues of the greatest significance to humanity. Now the major challenge is one of identity, or inter-relationships and connections between the theoretical and the practical. Bioethics has outgrown its beginnings.I have been invited to give a “personal recollection” of the early development of bioethics. Such invitations are notoriously hard to resist, but also problematic when they are the recollections of a participant [End Page 73] in the events to be described. We need only be reminded of the vagaries common to the plethora of memoirs on the book stands today. Few have escaped the perils of selective memory, self-promotion, or the settling of old scores. Yet their perils notwithstanding, memoirs may serve some useful purpose. They are the raw material—verbal kitchen middens so to speak—out of which historians can later sift fact from fancy. They enable “tribal elders” to give witness to the past from which the present can fashion some sense of continuity.I will organize my reflections around three very arbitrary time periods that represent my own way of thinking about the evolution of bioethics: (1) an era of “proto-bioethics” (1960–1972), (2) an era of philosophical bioethics (1972–1985), and (3) an era of global bioethics (1985-present). Each era, of course, overlaps with the others, and the dominant strand of each runs through the others as well.In the proto-bioethics period, the language of human values predominated; in the era of bioethics philosophically construed, it was the language of philosophical ethics; and in the era of bioethics globally construed, the social and behavioral sciences have gained greater prominence. In each period, interest in the traditional humanities other than philosophy waxed and waned. In the earlier years, religion and theology predominated. Beginning in the 1970s, philosophy took a dominant role. In the last two decades, other disciplines, like law, literature, and the social sciences, have exerted more and more influence (McNeur 1963; Pellegrino 1997; Barker 1987).I make no pretense here of writing any part of the formal “history” of bioethics. Works of this nature are beginning to appear (Rothman 1991; Jonsen 1998 ; Dell’Oro and Viafora 1996). Thomas McElhinney and I are preparing our own account of the work and influence of the Institute on Human Values in Medicine, one of the influential programs of the Society for Health and Human Values (Pellegrino and McElhinney, n.d.). Space limitations as well as prudence preclude any attempt to do justice to all the events, institutions, and people who have made the field of bioethics what it is today. I apologize for these omissions, for any unintentional lapses of... (shrink)

Berger and Miller argue that contemporary medical education directed toward “cultural competency” fails to address the structural inequities and systemic racism underpinning health dispariti...

Reflection in medical education is becoming more widespread. Drawing on our Jesuit Catholic heritage, the Loyola University Chicago Stritch School of Medicine incorporates reflection in its formal curriculum and co–curricular programs. The aim of this type of reflection is to help students in their formation as they learn to step back and analyze their experiences in medical education and their impact on the student. Although reflection is incorporated through all four years of our undergraduate medical curriculum, this essay (...) will focus on three areas where bioethics faculty and medical educators have purposefully integrated reflection in the medical school, specifically within our bioethics education and professional development efforts: 1) in our three–year longitudinal clinical skills course Patient Centered Medicine (PCM), 2) in our co–curricular Bioethics and Professionalism Honors Program, and 3) in our newly created Physician’s Vocation Program (PVP). (shrink)