Clinical Skills – Ethics/Humanities/Health Law

Tutorial Notes for Sept. 25, 2002

11-11:40

This session is a follow-up to the first simulated patient session these students will have done. A copy of the case is attached, along with some notes on ethical aspects of the case that were prepared by Daryl Pullman.

The students in your groups will not all have been in the same group for the simulated patient interviews. That means there could be a fairly substantial difference amongst them in terms of how much opportunity they will have already had to discuss the ethical aspects of the case. Apparently some of the facilitators for the Clinical Skills course spend lots of them on ethics and some spend almost none. If your students seem not to have spent much time on the ethics of the case, then you can use Daryl’s notes as a guide to some of the issues you might cover (although you shouldn’t feel like you need to get through them all). If, however, the students seem to have already considered the case pretty thoroughly, I’ve attached some supplementary material you could move on to. The attached article is from a series called Bioethics for Clinicians that ran in the CMAJ a few years ago. It begins with some cases revolving around similar issues to the Clinical Skills case (and ends with some recommendations as to what a physician should do in those cases). The cases should provide plenty to discuss.

Regardless of whether you stick to the Clinical Skills case or use cases from the articles, it would be helpful if you could spend at least some of the session applying the facts, principles, concepts approach that the students have been introduced to in class. Often this will be a good way to start a discussion about the case. (Daryl’s notes for the Clinical Skills case provide a good example of this approach.)

FYI, after the small group session, the students reconvene as a full class from 11:45-12:20 for a follow-up lecture from me (lucky students!). The announced topic for the lecture is confidentialty, however, since I didn’t manage to finish giving them an introduction to ethical theory in the last lecture class I’ll be focusing more on the difference between consequentialist and deontological approaches to ethics. I’ll still be using the Clinical Skills case as the basis for the lecture, but the focus will be on how consequentialists and deontologists approach the idea of confidentiality.

Thanks for doing this. If you have any questions or concerns, you can reach me at 777-6720 or alatus@mun.ca

Andrew