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Cases

Section I — Medical Decision-Making

This section discusses the ethics of making medical decisions for patients incapable of such decisions, when there is disagreement about treatment. For instance, should a physician override the decision made by a substitute decision-maker not to administer pain-reducing drugs to the patient who is clearly in pain? Should a 10 year old be allowed to override her parents’ decision for corrective burn surgery because she knows it’s going to hurt? Click to Continue »

 

Section II — Communication

Ethical issues are studied with regard to: disclosing or withholding information that has potential negative impact on the patient; what happens when a patient seems to waive consent but may not be truly informed; cultural sensitivity in health care delivery; how to manage the conflict between parents who disagree about discontinuing life support for their dying infant.

The two accredited self-assessment programs are based on Disclosure of Adverse Events and Respect for Difference: Aboriginal Health cases. Click to Continue »

 

Section III — Professionalism

Key ethical issues are studied in four areas: professional competence, confidentiality, conflict of interest, and physicians and job action. What obligation do individuals or groups have for the competence of a professional who works with or for them? What constitutes a conflict of interest? Should a physician report a colleague who has a blood borne pathogen or an addiction? Does patient confidentiality override safety when the patient threatens self-harm or the public? Even the topic of whether physicians should be allowed to go on strike is discussed.

The two accredited self-assessment programs are based on Competent Practice: Obligations of Individuals, Teams and Institutions to Provide Competent Care and Relationships between Physicians and Industry. Click to Continue »

 

Section IV — Reproductive Health

This section considers the following ethical issues: abortion for an adult woman with intellectual disabilities and a teenaged girl; whether physicians should meet the requests of patients simply because technology makes new reproductive options available; what is required in the harvesting, creating and storing of gametes in the course of assisted reproduction. Click to Continue »

 

Section V — End of Life Care

This section reviews the ethics of withholding and withdrawing life-sustaining treatment; provides an appropriate clinical response to patients or families who express interest in euthanasia or assisted suicide; discusses the concept of brain death as it is used to diagnose death.

The case entitled Appropriate Use of Life-Sustaining Treatment is an accredited self-assessment program that will earn credits under section 3 of the Maintenance of Certification Program. Click to Continue »

 

Section VI — Novel Genetic Technologies

This section discusses the ethics of including children in clinical studies on gene therapy, predictive testing for genetic disorders in children, human cloning research, and research ethics in a pharmacogenomics research context. Click to Continue »

 

Section VII — Physicians, Patients and the Health Care System

This section covers three areas. Health Care Resources studies the challenge of waiting lists, transplant tourism, and withdrawal of life support to allow organ transplantation. Public Health studies the conflict between compassionate care for end-of-life patients and the demand for life-sustaining treatment; how much personal risk a physician should accept as part of the job in the wake of new infections; the role physicians play in quarantine or isolation. Research Ethics case studies include research on children and in third world countries, whether research results should be communicated to the research subjects, and why research comparing the use of two currently accepted drugs must be approved by the research ethics committee before proceeding.

The case on Waiting Times is an accredited self-assessment program that will earn credits under section 3 of the Maintenance of Certification Program framework. Click to Continue »

 

Section VIII — Global Health

This section covers 4 areas: sustainable development (resource allocation and infrastructure); research in low and middle income countries; standards of care and clinical care; and teaching the teachers. Click to Continue »