All medical students are required to attend FOUR Ethics Grand Rounds sponsored by the Neiswanger Institute by the end of their third year and submit an Ethics Case Analysis Paper during the spring semester of the third year. The complete description for each of the bioethics and professionalism graduation requirements are listed below. The Institute also offers a Honors Program, Elective Courses and a MD/MA Joint Degree in bioethics and health policy.
SSOM Medical Student Ethics Grand Rounds
Sponsored by the Neiswanger Institute For Bioethics
As you become responsible for some patient care or move closer to that responsibility, participation in discussions regarding the ethical dilemmas arising from patient care is important. At ethics grand rounds, you will see how faculty and guests approach the resolution of difficult ethical issues in patient care, and you will be able to enter a discussion of the case. The objective is that this experience will assist in your practice and help you acquire an ease in addressing ethical and public policy issues.
- Students need to attend FOUR Neiswanger Institute for Bioethics sponsored grand rounds by the end of their third year. Approximately twelve Bioethics sponsored grand rounds are scheduled each year.
- Attendance is recorded by SIGN-IN SHEET for each Bioethics Grand Round.
Students seeking grand rounds credit to meet their bioethics & professionalism requirement should consider sessions from:
Tuesday, April 22, 2014, 9:00AM - 1:00PM, SSOM 170
Bioethics Doctoral Capstone Presentations
Presenters: Nancy Brown, Susan Brown, T. Lynne Caples, Maureen Cavanagh, Ann Marie Natalie, Anne Margaret Shuham
Please check announcements for upcoming ethics grand round events.
One of the requirements for graduation at Stritch School of Medicine is completion of a paper in which the student reflects on the ethical or human dimensions of caring for one of their patients. You have a choice of two assignments: (1) Ethics Case Analysis or the essay on (2) Spiritual Care and the Death of a Patient.
- Ethics Case Analysis - For those writing the “Ethics Case Analysis,” the case is to be analyzed following the framework provided below called Instructions for Preparing Ethics Case Presentations. Those instructions provide six sections that you should complete: (1) Narrative of the Case, (2) Language and Issues of the Case, (3) Perspectives and Key Points of View, (4) Facilitating Resolution, (5) What Actually Happened, and (6) Commentary. In order to provide this information, the paper is expected to be a minimum of five pages in length (double-spaced). No references are necessary but you may wish to consult some standard works if you are struggling with putting the case into the language of ethical analysis or trying to figure out if your position falls within the range of solutions typically considered ethically acceptable by current practice standards.
- Spiritual Care and Death of a Patient - For those writing this paper, Instructions for Preparing Essay regarding Spiritual Care and the Death of a Patient are provided below. This assignment does not provide specific sections that you must complete. But, in general, we ask you to tell us about a patient you cared for who died. You should describe the case and tell us about the patient’s needs, beliefs, and wishes and how they were addressed or not addressed. Please tell us about anything in particular that seemed important about the case. And, please describe your reactions to and feelings about the case. We expect that such papers will need to be at least five double-spaced pages in length in order to be complete. No references are necessary.
PURPOSE: No matter which assignment you choose, the purposes of this exercise are the same. First, the written assignment serves to demonstrate your ability to recognize interpersonal, communication, spiritual and ethical aspects of medical care and write a well reasoned description and commentary. Second, the paper provides an opportunity for you to develop your own ability to think about such issues, articulate your own independent thinking, and express your reactions and feelings about these dimensions of care regarding a situation involving one of your patients. Third, the paper can illustrate one facet of what we hope is the kind of doctor that Stritch educates: a woman or man who is profoundly aware of the human dimension of medical practice, committed to a high standard of care in personal practice, and dedicated to a careful consideration of what it means to honor the doctor-patient relationship.
Ethics Case Analysis
Instructions for Preparing Ethics Case Analysis Paper
Select a Case: Identify a case from your experience that contains an ethical issue. What constitutes an ethics case or issue? Students often select cases in which there is a conflict of opinion regarding the best course of action or treatment to pursue. Such conflicts can arise between physicians and patients, among members of the health-care team, between physicians and family members, between patients and family members, and among family members. Conflicts of this type can often be analyzed by focusing on the competing values of each party (e.g., extending life versus minimizing suffering). Presentations of cases involving conflicts can lead to discussions of such ethical issues as autonomy, competence (decision-making capacity), informed consent, paternalism, and the rights and responsibilities of physicians, patients, and family members. Cases can be presented which do not involve any interpersonal conflicts. Students may wish to present a case because they believe that a decision was incompatible with an important ethical norm, value or principle. For example, decision makers who seek to promote a patient's best interests (as perceived by the physician and family) may neglect the patient's right to information regarding the diagnosis, prognosis, and treatment alternatives. Thus, even though a physician and a patient's family may agree that the patient will not be told that she has cancer, the decision to withhold information may merit ethical examination. Almost any case contains ethical issues because the norms of the doctor-patient relationship are, ideally, based on ethical principles and motivations. To identify ethical issues, students can select a case and observe how the physician-patient relationship is conducted. Particular attention can be given to how the attending and house staff interact with the patient, what and how information is conveyed, how and by whom treatment decisions are made, and how the patient's decision-making capacity is assessed. If a surrogate decision maker is involved, students might consider the following questions: How and by whom was it decided that the patient lacked decision-making capacity? How was the surrogate selected? Was sufficient information given to the surrogate? Was sufficient consideration given to the patient's values and best interests in the decision-making process? Students are encouraged to discuss the decision-making process with the attending, house staff and the patient or family. Such cases can facilitate an exploration during ethics conferences of the proper role of each party in treatment decisions, effective methods of communication, and means to minimize conflicts through better communication.
What information should I present?
There should be six sections covered in your case presentation:
- The Narrative of the Case: The student should attempt to present all relevant medical and social facts about the patient. Ethically sound decision-making is based on good medical care and a good factual basis regarding patient care. Much relevant information is easily obtainable from the patient's chart.
- The Language and Issues of the Case: Cases are often discussed in terms of a particular topic, e.g., informed consent, the decision-making capacity (competence) of the patient, forgoing life-sustaining treatment, physician-assisted suicide, etc. The reasons for choosing one course of action over another are often explained in terms of one of the prima facie duties of physicians to patients, respect for autonomy, nonmaleficence, beneficence, or justice. You should not jargonize your write up unduly. However, you should be able to identify the topic under which your case falls and to identify the duties to the patient that are involved in the case.
- Perspectives and Key Points of View: This is probably the single most important part of any case analysis. You should go person by person and explain how each saw the situation. Very often, you will find that one or more of the points of view are not well understood by you or others involved in the case. Attempting to understand the reasons and preferences of the parties involved can help to identify important conflicts and their sources. On the other hand, seemingly unresolvable conflicts can be resolved when a sincere effort is made to understand the underlying reasons and values.
- Facilitating Resolution: What approaches might have been taken to bring about case resolution? e.g., family and caregiver conference? Ethics case consultation? A discussion among certain members of the health-care team? Is there any way you could have contributed to the solution?
- What actually happened? Please be sure to include the outcome of the case.
- Commentary: Your commentary should highlight the professional duties that physicians have to patients and how these duties were respected or compromised in the case resolution.
The papers are graded on a Pass/Fail basis. Papers that are complete and well-written will pass. Failing papers must be re-written and re-submitted.
Spiritual Care and ther Death of a Patient
Instructions for preparing the essay
ASSIGNMENT: Please tell us about your experience in caring for a patient who died. Your paper should focus on your personal experience of this patient and all the people involved in this process. We also hope that you will tell us about the ways in which you and the other members of the healthcare team took care of the patient and his or her family’s spiritual needs. Consider telling us about issues that were important from your perspective, this might include matters of communication, the ways in which particular care givers did/or did not demonstrate compassionate presence, the extent to which the patient and patient’s family’s spiritual needs were evident to, assessed or addressed by the caregivers. Share any insights regarding the spiritual needs or resources of the members of the healthcare team, including yourself. Please close your paper with a discussion of how this experience has impacted how you care for yourself today and/or how this has influenced your care of patients, if at all.
GOALS: The paper will allow you to explore how spiritual care is integrated into the overall care of the patient. Acquire some foundational knowledge necessary in integrating spirituality into the care of patients. Provide you an opportunity to incorporate spirituality as part of your professional and personal development.
OUTCOMES: This reflection should enable you to recall how the various members of the healthcare team, including yourself, communicating with patients, families, and each other about spiritual issues. You will identify behaviors and attitudes that contribute to or detract from providing healthcare that appropriately addresses a patient’s spiritual needs.
EXPECTATION: These papers will be graded on a Pass/Fail basis. The papers are expected to be thoughtful, thorough, and well written. Furthermore, the paper should follow standard grammar and spelling and that you proofread your work. Papers that are complete and well-written will pass. Failing papers must be re-written and re-submitted. If you need assistance in identifying or processing an experience, please see Drs. Michelfelder, Kuczewski, or Michael McCarthy (Ministry).
This requirement can be an opportunity for you to show your ability to reflect, write, and wrestle with important issues in a respectful manner on a topic crucial to patient care. Although the paper is not due until April 19, 2013, it is not too early to begin to consider some of the end of life situations you may have encountered during your clinical rotations.
GRADING: The papers are graded on a Pass/Fail basis. Papers that are complete and well-written will pass. Failing papers must be re-written and re-submitted.
DUE DATE: Papers are due April 18, 2014 at 4:00pm. Failure to meet the deadline will result in a grade of "FAIL." No exceptions will be made. A remediated "Fail" will be reported as "P*."
Email your paper in Word document format to firstname.lastname@example.org by 4pm on April 18, 2014. Please name your doc file with your LAST NAME and indicate whether your paper is the Ethics Case (ethics) or Spiritual Care (spirit) assignment (ex. Bob Johnson's ethics case paper: Johnson-ethics.doc)
BIOETHICS & PROFESSIONALISM HONORS PROGRAM
PURPOSE: The Stritch School of Medicine (SSOM), drawing on its Jesuit and Catholic heritage, encourages the development of the character & intellect of its students and has a culture of excellence in professionalism. SSOM has a large number of students who are active in a self-directed curriculum related to bioethics, health policy, service to the underserved, leadership, and professionalism. The bioethics and professionalism honors program asks the student to go one step further to document systematically and reflect upon this self-directed curriculum. Those who complete this program are recognized with departmental honors administered by the Neiswanger Institute for Bioethics. The outstanding record of achievement of these students is recognized in the following manners:
- Expected successful completion of the Honors program is appropriate to include in the Dean's letter recommending the student for residency. (Students who wish this information to be included in their letter complete the capstone project by July before his/her 4th year.)
- A listing of the successful completion of the Honors program on the student's final transcript.
- Students completing the program are recognized at graduation.
PROCEDURE: In January of the first year of medical school (M-1), students who are interested in entering the Bioethics and Professionalism Honors Program declare their intention to pursue the program by completing the application. Students are assigned an advisor from the Neiswanger institute for Bioethics who will help guide them and comment on their portfolio submissions. To be and remain eligible for the Honors Program, a student must be in good academic standing and uphold professional standards in keeping with those of the Stritch School of Medicine and Loyola University Chicago. Good academic standing is generally construed to mean that a student has not failed a course during the first or second year of medical school or needed remediation in more than one clerkship. To effectively earn honors at graduation, the student's portfolio has to include a number of required accomplishments and an adequate number of optional achievements.
TO ENROLL AND PARTICIPATE IN THE HONORS PROGRAM
Complete the APPLICATION FORM. E-mail the completed form to Katherine Wasson, PhD, MPH at email@example.com
Once in the program...
- You’ll need to enter GOALS related to bioethics & professionalism at least once per year. You will be asked to look at your goals midway through the year and revise as appropriate. In other words, goals are not etched in stone but change as some plans become unrealistic or new opportunities present themselves. You should enter such changes as they occur during the year. You should try to have goals for at least two activities per year that would sum to at least 24 hours of activity.
- REFLECTIONS: This is a key part of the program. You upload supporting materials at intervals to demonstrate progress toward goals; such material will usually be a critical reflection on this work. These reflections help you to see how you are evolving as a future member of the medical profession. While these reflections need not be long or cumbersome, they should usually bring together your observations of the people you served, your response to them, and the role of the medical profession. (See Reflection on Experience questions developed by University Ministry. Submitting a page or two of such reflections on an activity is usually suitable.)
- You need not answer the questions in list order but these may serve as prompts to guide your reflection process. Submitting a page or two of such reflections on an activity is usually suitable. Of course, reflections will vary based on the kind of activity you are describing.
- Faculty mentors enter comments at intervals (at least every six months) on goals and on progress.
- Portfolio entries including goals and reflections each year. Goals should be formulated with an eye toward enhancing one's skills, knowledge, and commitments in bioethics and professionalism.
- Twenty-four (24) hours per year of activities related to bioethics and professionalism (see list below).
- Upon completion of an activity, the student should enter evidence of completion of the activity and reflection on it.
Selective Activities: Student should consider a well-rounded program of activities that include clinical, educational, or service activities over the course of his or her three years in the honors program. However, not every area need have a goal or activity each year.
- Attendance at the Honors Research Seminar in addition to three (3) Topical Seminars in Bioethics and Professionalism offered during M1 and M2 years.
The grand rounds ethics credits are a requirement for SSOM graduation for all students and are distinct from those offered for students in the Bioethics and Professionalism Honors Program. Students in this program are required to attend 4 seminars exclusively offered within the honors program. Grand rounds ethics credits are a separate SSOM requirement and do not count toward this quota.
- Capstone Project (Must be done as MS3 or by July before 4th year for student to receive recognition in Dean's letter for residency application.) Capstone Project Proposal must be submitted and approved no later than January of MS3 year. Click here to view past Capstone Project Summaries.
Suggested sources of activities:
- Participation in activities of the Bioethics Interest Group (B.I.G.)
- Participation in Ethics Grand Rounds
- Participation in multi-profession activities
- Participation in Innovations in Leadership training
- Participation in an International Service Immersion trip or Global Health Fund
- Participation in other service activities, e.g., free clinic, volunteer work at the Community Health Center, Habitat for Humanity, Center for Service & Global Health, etc.
- Other activities approved by the student's advisor that are equivalent in substance, mission, effort to those listed.
- Students are encouraged to suggest activities to be included to Katie Wasson, PhD, MPH, and their advisors. Advisors and other SSOM faculty will also occasionally put out messages through the student portal when they are supervising current eligible activities in which students might participate.
RESEARCH SEMINAR HANDOUTS (pdf files)
- Research Seminar, Katherine Wasson, PhD, MPH
- Does My Project Need IRB Approval? Emily Anderson, PhD, MPH
- Human Subjects Research and the IRB Process, Elaine Fluder, MSN, RN
- Health Care Disparities: Ethical Responsibilities of Physicians, Emily Anderson, PhD, MPH
- Getting Started with CITI
- Protocol Outline Template (updated 2013)
- Retrospective Chart & Material Review Template (updated 2013)
DATES TO REMEMBER:
Class of 2014
- September 20, 2010 - Introduction to Honors Program: 12:30-1:30pm, SSOM 160
- November 1, 2010 - Introduction to Honors Program: 12:30-1:30pm, SSOM 170 January 15, 2011 - Deadline to submit Application Form to enter Honors Program. (Katherine Wasson, PhD, MPH)
- February 7, 2011 - Deadline to have entered entries for Statement of Purpose.
- June 2011 - Deadline for entering end of Year 1 Reflection on previous year's activities. Students should have asked advisors to mark activities as "completed."
- September 2011 - Deadline for entering Goals for Year 2
- Fall 2011 & Spring 2012 - Honors Research Seminar (required to attend during M2 year)
- June 2012 - Deadline for entering Year 2 Reflection
- September 2012 - Deadline for entering Goals for Year 3
- Fall 2011 - Spring 2013 - Topical Bioethics Seminars (required to attend THREE Topical Bioethics Seminars prior to presentation of Capstone Project: June 2013)
- January 2013 - Deadline to submit Capstone Project Proposals
- June 13 & 14, 2013 - Capstone Presentations of Honors Projects
- June 2013 - Deadline for entering final Year 3 Reflection
Class of 2015
- September 22, 2011 - Introduction to Honors Program: 12:30-1:30pm, SSOM 150
- December 1, 2011 - Introduction to Honors Program: Noon-1:00pm, SSOM 150
- January 16, 2012 - Deadline to submit Application Form to enter Honors Program. (Katherine Wasson, PhD, MPH)
- February 10, 2012 - Deadline to have entered entries for Statement of Purpose.
- June 2012 - Deadline for entering end of Year 1 Reflection on previous year's activities. Students should have asked advisors to mark activities as "completed."
- September 2012 - Deadline for entering Goals for Year 2
- Fall 2012 & Spring 2013 - Honors Research Seminar (required to attend during M2 year)
- June 2013 - Deadline for entering Year 2 Reflection
- September 2013 - Deadline for entering Goals for Year 3
- Fall 2012 - Spring 2014 - Topical Bioethics Seminars (required to attend THREE Topical Bioethics Seminars prior to presentation of Capstone Project: June 2014)
- January 17, 2014 (Friday)- Deadline to submit Capstone Project Proposals
- June 2014 - Capstone Presentations of Honors Projects
- June 2014 - Deadline for entering final Year 3 Reflection
- December 2012 - Introduction to Honors Program
- January 16, 2013 - Deadline to submit Application Form to enter Honors Program. (Katherine Wasson, PhD, MPH)
- April 2013 - Deadline to have entered entries for Statement of Purpose.
- June 2013 - Deadline for entering end of Year 1 Reflection on previous year's activities. Students should have asked advisors to mark activities as "completed."
- September 2013 - Deadline for entering Goals for Year 2
- Fall 2013 & Spring 2014 - Honors Research Seminar (required to attend by the end of M2 year)
- June 2014 - Deadline for entering Year 2 Reflection
- September 2014 - Deadline for entering Goals for Year 3
- Fall 2013 - Spring 2015 - Topical Bioethics Seminars (required to attend THREE Topical Bioethics Seminars prior to presentation of Capstone Project: June 2015)
- January 2015 - Deadline to submit Capstone Project Proposals
- June 2015 - Capstone Presentations of Honors Projects
- June 2015 - Deadline for entering final Year 3 Reflection
Joint MD/MA Program in Bioethics & Health Policy
We offer a high quality dual degree program for medical students of the Stritch School of Medicine who wish to also be trained in bioethics. This degree prepares the student for clinical ethics roles within health-care systems and enables the student to make bioethics part of their conceptual or empirical research portfolio.
Key Features of the Program:
- Enables completion of MA simultaneous with conferral of MD degree.
- Students receive course credit (two independent study courses) toward the MA degree from relevant ethics assignments in medical school classes (Patient Centered Medicine).
- Online courses provide greater flexibility for busy medical students.
- The online environment facilitates interaction and collaborative learning with experienced physicians and clinicians from across the country.
- Students have ready access to Neiswanger faculty.
- Tuition scholarships toward the MA coursework are available.
Who is Eligible: Admission to the MD/MA program is contingent upon acceptance to SSOM.
How will this joint degree help my career?
Having a formal degree in bioethics will help those physicians who wish to take on more active roles in their professional lives with regard to a variety of ethics activities: ethics committees, ethics consultation, IRBs, teaching, research and scholarship.
Will I really have time to finish this degree concurrently with my medical degree?
Although all joint degree programs require greater time management skills, our joint degree program is actually easier for medical students to pursue because of the online nature of the coursework. You can log on at any time and check into your course. There’s no need to meet at a scheduled time but assignments must be completed on a weekly basis. Moreover, some of the coursework that you’ll take in your medical school curriculum will apply toward this degree.
Do I have to write a thesis for this joint degree?
No, the MD/MA program does not require a thesis. Students are required to write a paper of publishable quality for a research capstone course near the end of their program. (This paper can also fulfill the project requirement of the medical school Honors Program in Bioethics & Professionalism)
When can I apply?
Students should apply concurrently to both SSOM and Loyola University Graduate School. Only those students accepted to SSOM will be considered for acceptance into the MD/MA program. The Graduate School online application can be found at: https://gradapp.luc.edu/gradapp/login.htm
How do the online courses work?
In some ways, they work similarly to traditional face-to-face courses - there are required books, assignments, papers and discussions. The biggest difference is how instructors and students discuss the materials in the course. Instead of meeting once a week, students and faculty discuss and exchange ideas in asynchronous discussion threads that are posted each week. This kind of exchange allows students to think and reflect about their responses before they post comments.
Can I apply transfer credit to the MA degree from relevant ethics assignments in medical school courses?
Yes, students will receive credit for two independent study courses (6 credits) towards the MA degree requirements.
Who are the other students in the program?
Students in the program are physicians, nurses, social workers, lawyers, scientists, administrators, chaplains, and researchers. Students learn a great deal from each other as well as from faculty.
Will my degree say online MA?
No, your degree will be exactly the same as a traditional master’s from Loyola University Chicago.
Who are the Neiswanger faculty?
To learn about our faculty, go here: http://hsd.luc.edu/bioethics/content/faculty-directory
How do I get more information about the MA program?
Visit our Graduate Education Programs website for complete information; degree requirements, course descriptions.
Healer's Art (BP430)
Dates/Periods: January-March 2014 (11A-11C), 1.0 week of credit
“It is the deeper meaning of our work, our shared purpose and not our science, that will sustain us.” Rufswold and Remen, 2002
Course Description: Healer’s Art is unlike any other course you’re likely to get in medical school. In its unique design that centers on a personal and interactive environment between small groups of students and faculty, the course explores and reinforces the human dimensions of medicine. In an increasingly demanding and hectic health care environment, where it may be easy to lose perspective amid the flurry of tasks we face each hour, Healer’s Art asks us to take a step away and to remember why we chose to by physicians in the first place. It asks us difficult questions about ourselves. It forces us to look inward, to address and heal ourselves before we can hope to heal others. Through the series of regular meetings and reflections, Healer’s Art helps each of us find and remember the humanness and the meaning in medicine. (more information...)
Bioethics & Professionalism: Social Justice & Underserved Minorities (BP431)
Dates/Periods: December 2012 - April 2013 (10C-12A), 2.0 weeks of credit
Course Description: This elective independent study will focus on the role of race in the United States, especially as it manifests itself in medicine. We will read two books and analyze the impact of race in terms of social justice. We will particularly focus on the issue of structural inequities that perpetuate disparities in terms of goods and services that promote quality of life, e.g., access to health care, education, and income. We will also work with the students of Christ the King Jesuit College Preparatory High School to create a health fair. We will learn about the barriers to healthy living and achieving a future in the health professions that these high school students face. And, we will help them develop strategies for meeting these challenges. (click here for course syllabus...)
Bioethics & Professionalism: Social Justice & Cultural Awareness in Health Care (BP432)
Dates/Periods: December 2013 - March 2014 (10C-11B), 2.0 weeks of credit
Course Description: This part-time elective (2 credits) will focus on the role of culture and race in the United States, especially as it manifests itself in medicine. We will read the book by Prof. Vigen and analyze the impact of race and culture in terms of social justice. We will particularly focus on the issue of hearing the voices of those whose perspectives are marginalized in mainstream cultural discourse. We will seek to develop a concept of cultural humility in order to be open to the insights of those from “minority” cultures and consider how medical and health care professionals can better serve their needs. (more information...)
Honors Program in Bioethics & Professionalism Capstone Elective (HON401)
Dates/Periods: August 2013 - April 2014 (9B-12B), 4.0 weeks of credit
Course Description: This four credit elective is available to students who have completed the Bioethics and Professionalism Honors Program. Students in the program complete a capstone project and presentation which can be empirical, pedagogical, service oriented, or conceptual. The aim of the elective is to have the student acquire the knowledge and skills to prepare and submit a paper for publication based on the student’s capstone project. Students must complete and submit for approval a proposal detailing their project and schedule for the four week elective. During the elective students will meet with their faculty advisors mid-course for feedback and be required to produce a detailed outline or draft of their paper. By the end of this elective, the student will have the final paper completed, a specific journal identified for submission and the paper will be formatted according to that journal’s specifications. Faculty will assess whether the student has fulfilled these requirements. For further information contact Dr. Katherine Wasson at firstname.lastname@example.org.