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Course Descriptions

Required Courses

The required courses are fundamental to clinical ethics and research ethics. A basic understanding of these elements will aid the trainees participating through the proposed project as they have to consider the community in which they serve, the means of communication for recruitment and retention, including health literacy for clinical trials with minority populations, and the design and evaluation of their work. The courses in Research Ethics; Ethical Issues in Public Health, Social Programs and Policies; Informed Consent; and End of Life all highlight the trainee’s ability to address minority cultural needs in the respective areas.

Clinical Ethics Foundations

This seminar course is designed to introduce trainees to the fundamentals of clinical ethics and the basic terminology and framework of ethical analysis in clinical ethics. Topics are intended to offer trainees a foundation for more in-depth studies of issues encountered in clinical practice such as informed consent, patient capacity, decision-making, end of life issues, advance directives, medical futility, pediatrics ethics, organ transplantation, cultural competence and diversity of beliefs, and others. The course will also study key ethical principles essential for the development of knowledge and skills relevant to health care ethics. Course topics will include the Principles of Beneficence, Common Good, Distributive Justice; Double Effect; Formal and Material Cooperation; Human Dignity; Integrity and Totality; Proportionate and Disproportionate Means; Autonomy; Respect of Persons and Stewardship.

Clinical Ethics Methods I and II

An introduction to the study of the principal applied areas of practice for health care ethicists such as ethics committees, clinical bioethics, ethics consultation and mediation, government commissions, policy development, human research subjects protections, the press and the courts. The course will provide discussion into the strengths and weaknesses of different ethics consultation methods including professional ethics consultants, multidisciplinary teams and committees. Trainees will learn how various methods are not mutually exclusive and can co-exist within an institution.

The second unit of this course will be a study of the core areas of knowledge essential for ethics consultation, integrating processes and outcomes, developing the skills to identify, analyze, and resolve ethical dilemmas, patient-specific or protocol-specific cases, and issues that emerge in the larger context of patient care and research studies. Trainees will review the principal ethical norms that inform clinical ethics discussions; review the most utilized models for conducting clinical ethics consultations; and present a framework for analyzing cases which is suitable for the clinical record or report to research bodies and writing case studies.

Research Ethics

This course will inform the trainees of issues scientists in biomedicine, social science and other areas, as well as policy makers face with rapidly evolving challenges today. Studies will include issues that arise in deciding how best to protect human subjects, best practices in recruitment of minority and underserved populations, obtaining informed consent, protecting privacy and confidentiality, how to finance research without biasing results, and avoiding inappropriate behavior among scientists.

Foundations of Clinical Trials

This course introduces the trainees to the purpose of clinical trials, their definition, protocol design, phases, ethical and safety requirements, methodology selection, analysis, and result reporting. Trainees are provided the opportunity to draft a study and have it reviewed by an experienced researcher.

Ethical Issues in Public Health, Social Programs, and Policies

This course focuses on the philosophical underpinnings of Clinical Ethics. Trainees learn to assess current organizational structures for assuring that Clinical Ethics regulations are enforced in the medical research industry, and analyze the political issues and forces that impact assessment and regulation of Clinical Ethics at each level of government.

Integrated Ethics, Leadership, and Professionalism

This course examines key dimensions of organizational ethics in health care such as, establishing and maintaining an ethical culture, workforce organization, conflicts of interest, quality improvement, and responding to medical errors. The course also provides a study of codes of ethics and conduct for various healthcare related disciplines, including researchers, with case studies of violations and their effect on all those involved. Trainees will be asked to make recommendations for how to deal with the inappropriate behaviors involved from a healthcare leader position.

Informed Consent

Studies of informed consent, capacity evaluations and decision-making on behalf of incapacitated patients, and cultural and socio-economic differences. Topics include a study of the autonomy of individuals when making decisions and standards health professionals must meet in disclosing information, the legal and ethical foundations for informed consent and principles used by surrogate decision makers. There will be a central focus on the distinctions between the informed consent process utilized for treatment decisions versus that which is employed for research and innovative studies.

End of Life and Advance Care Planning

This course provides an overview of End-of-Life issues, including the process of facing death, palliative and hospice care, the needs and responsibilities of caregivers, grief and bereavement, the moral and ethical challenges of suffering near the end of life, and spiritual considerations. The course will also discuss a study of empirical processes where patients, in conjunction, with their physician and family explore and make decisions about their future health care throughout the health/disease process.

Genetics and Ethics

The Ethics of Genetics responds to the need for enhancing the knowledge and application of ethical principles to genetic and genomic research. Instructors will address emergent genetics research and its ethical and policy implications, as well as the newest regulations and policies. Sessions will promote the opportunity for information exchange and discussion of how to advance basic, translational, and clinical genetics research ethically.

Elective Courses

Pain Management and Palliative Care

A study of practical data concerning pain management and palliative care to identify major issues relevant in the clinical setting; the ethical framework for physicians and institutions in providing pain management and palliative care; and legal norms regarding pain management, including statutes, cases, professional guidelines, and accreditation.

Ethics in Cancer Critical Care

The course topics include the use of critical care resources, setting goals of critical care intervention, predicting long term outcome, and the costs of critical care. Appropriate for trainees interested in health care policy, critical care medicine (medical, surgical, pediatric, and neurological), geriatrics, end-of-life care, health care resource management. Special attention is given to the needs of minority and underserved patients and their families in end of life care decisions as this is commonly a reason for differences of opinion regarding care and possibly removing a patient from a research study.

Theories of Nursing Ethics

An investigation of ethical considerations or approaches that focus on critical thinking and ethical reasoning. Contradictions, inconsistencies, and competing views that lead to dilemmas in nursing care will be examined with emphasis on resolving ethical dilemmas.  Participants will explore theories, models, and approaches in the analysis of clinical cases that facilitate meeting ethical obligations of nursing care provider and patient advocate, fostering effective nurse-patient relationships.   

Nursing Practice and Ethical Dilemmas in Care at the End of Life

Exploration of ethical dilemmas inherent in End of Life (EOL)/palliative care. Current theoretical, research, and cultural perspectives pertinent to the issues found in contemporary nursing practice will be explored using case study analysis with emphasis on resolving the issue through ethical reasoning.

Ethics in Organ and Tissue Donation

A study of ethical and legal issues that arise in facilitating organ donation in the context of brain death, cardiac death, and living organ donation: Special attention will be given to common concerns of family members and clinical staff with current donation policies and practices. Attention is also given to consideration of minority and underserved populations and the lack of tissues and organs for transplantation in these communities.

Disability and Ethics

Public health seeks to improve the health of populations, but has not always understood the ethical impact of its role for approximately 20 percent of the world's people with congenital or acquired diseases or disabilities. The course offers a study of ethical issues related to patients with autism, mental challenges, physical disabilities and geriatric patients. These patients are often underserved and left out of clinical trials, especially since so many of them also are from populations already considered as minorities.

Ethics in the Care of Pediatric Patients

A study of ethical issues that arise in the care of children and adolescents, such as genetic testing and counseling, parental refusals of and demands for treatment, care of critically ill newborns, adolescent decision making, intra-familial organ and tissue transplants, end-of-life decisions, and confidentiality. The ethical standards for making health care decisions on behalf of children will be examined.

Cultural Diversity and Ethics

A study of the hermeneutical significance of different methods in religious/spiritual and geographic ethics and a critical analysis of the implication of these methods for the development of ethical theory and practice related to healthcare.

Practicum

The practicum offers experiential learning in an area of interest to the trainee.  The practicum is designed to complement the trainee's existing clinical experiences.  The practicum supplements formal coursework by helping trainees better appreciate how ethical deliberation, teaching and consultation can be practically applied in clinical contexts.  This is a mentored practicum of 120 clock hours and may be done at the trainee's institution.   All required courses must be completed.  Affiliation Agreements with practicum sites will be required.

Project

The project provides an opportunity for trainees to expand their understanding of the complexities of the issues involved in a specific topic within clinical ethics. They work closely with the core faculty member to whom they are assigned, and often with an additional faculty affiliate as well, depending on their interest. Trainees identify and focus on a topic and conduct a rigorous review and analysis of the relevant theoretical and/or empirical literature. Trainees are encouraged to choose a topic that draws on their specific interests, past experiences, and/or future professional or academic goals. This is to be an action project with a summary paper.


© 2014 The University of Texas MD Anderson Cancer Center