Electives - Human Biology, Ethics and Society

Ethics in Healthcare Systems

Elective Number: (Oasis E16g) 3907

Rotation Supervisors: Ann Mills

Designated Signer: Carrie Gumm, 5th floor Barringer room 5364

Evaluation should be given to: Ann Mills

Available: Rotation 12 - Class of 2009

Duration: 4 weeks

Time to Report: 9:00 am

Place to Report: Barringer 5th Floor Conference Room Ctr for Biomedical Ethics

Attendance: Attendance at elective activities is mandatory.

• Anyone who is ill or has a personal or family emergency must contact Student Affairs and the Attending on Service.
• Students are allowed to take off up to 1 day per week to interview between November 1 and February 1.
  • Specific days missed must be approved by the Attending on Service.

Number of students per rotation: 3-12

Course Description: The dominance of managed care in the healthcare delivery system has forced physicians into organizations and away from the traditional model of the solo physician-entrepreneur. Delivery of healthcare is now organizationally based, and its goal has shifted from treating individuals to managing populations. This shift in the structure of the delivery of care, as well as the goal of care, has profound implications for physicians who must practice within a structure that views medical decision-making in the context of a cost/quality tradeoff. This course explores these implications through a number of cases designed to:

• Examine the roles and relationships among the critical components of the delivery system;
• Examine how these roles and relationships affect the application of the concepts and principles of medical ethics, clinical ethics, professional ethics, and business ethics.
   

Through case discussion, students will be introduced to various concepts of "quality" of healthcare delivery, "evidence based medicine," "systems" approaches to delivery of care, and emerging issues of physician accountability and control embedded in new approaches to the delivery of care. Students will be asked to identify the values on which these approaches to healthcare delivery are based, and they will be asked to attempt to reconcile these values with traditional patient care values.

This course has three goals:

1. To familiarize students with the roles and responsibilities of each of the critical components of the healthcare delivery system;
2. To familiarize students with some of the concepts, tools and mechanisms they will need in order to establish effective practices within an organization context;
3. To enhance skills by encouraging students to develop a systems approach to problem solving that involves recognizing the various perspectives of clinical, business, and professional ethics and their competing imperatives in decision making.
    

Students, either individually or in teams will analyze one of four cases from the various perspectives of clinical, professional, and business ethics, and offer a solution that satisfies the imperatives of each while meeting the Institute of Medicine's definition of "quality" in healthcare delivery.

Students will be exposed to a wide variety of practicing professionals and scholars from various schools and disciplines; including business ethicists from the Darden School of Business Administration, ethicists from the School of Medicine and the School of Nursing, and administrators from the Medical Center.

Readings will be drawn from a wide variety of medical, business, and philosophical journals, including the Journal of Clinical Ethics, the Sloan Management Review, the Journal of Business Ethics, and the Academy of Management Review. Readings will also include selected chapters from the Institute of Medicine's "Across the Quality Chasm."