3L03 Outline 2021 Updated PDF

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Course Number: Course title: Instructor: Times: Room:

BHSc 3L03 January 11 - April 14, 2021 Health Ethics Lisa Schwartz ([email protected]) Monday & Wednesday 1:30-2:20pm Online – see Avenue to Learn document for details

Course Description: This course is an introduction to the fundamental ethical concepts that inform Canadian health care and policy. We also cover globally relevant issues in bioethics. Informative and interactive sessions will outline approaches for analyzing issues and cases using ethical theories. Students will then research an area or issue in the field and present their findings in a class presentation. Topics will cover a diverse field of issues such as Informed Consent, Justice and Equity in Health Care, Global Health Ethics, Genetics, End of Life Issues and Ethics in Human Reproduction to name a few. The theory based approach will involve a philosophical analysis of key concepts with emphasis on student self-directed learning. Sessions will be held online on zoom. Most sessions will be recorded and available for future viewing. Tutorials will be held throughout the term. You will be assigned to a group led by a Teaching Assistant. See the Session Calendar for more details. Assessment: Mini analysis (1000 word) Simulation – roundtable participation Simulation – stakeholder analysis Final paper (2500 words) based on simulation Tutorial participation

Due date February 3 March 22 – Apr 7 March 29 April 14 All year

Weight 20% 20% 15% 35% 10%

We reserve the right to adjust marks +/– 5%. If students tackle especially difficult or challenging subjects of inquiry, or alternatively, choose a particularly easy route, it will be taken into account. Written Work and Late Submissions: All written work will be marked on grammar, clarity of writing, and organization, as well as content and analysis. More details about the marking scheme for each assignment will be provided in the assignment outlines. All work must be properly referenced, with footnotes and a bibliography. Use the Turabian (Chicago) style for referencing or any other style as long as you are consistent; examples can be found at https://library.mcmaster.ca/research/citing Students are encouraged to visit the Student Success Centre to improve their essay skills. For information about the Undergrad Writing Centre and other services, visit the Centre’s website: http://csd.mcmaster.ca All written work must be submitted at the end of day (11:59pm), on the due date. Students wishing to hand papers in at an alternate time should contact their tutorial leader before the due date to make arrangements. Do not slide them under the instructor’s door; do not submit them at the Health Studies office. An electronic version of the assignment must be emailed to your TA as a time-stamp to stop late marks from further accruing.

UPDATED 10.02.2021

Lisa Schwartz

email: [email protected]

REQUESTS FOR RELIEF FOR MISSED ACADEMIC TERM WORK (MSAF): In the event of an absence for medical or other reasons, students should review and follow the Academic Regulation in the Undergraduate Calendar “Requests for Relief for Missed Academic Term Work”. Please contact both the course leader and your TA to inform us of your absence, or need for an extension. Late assignments without MSAF or permission from the instructor will be penalized 1% a day (weekends will count as one day). Late penalties will not be waived except by particular arrangement prior to the due date OR unless your Faculty/Program Office advises the instructor that you have submitted to that office the appropriate documentation to support your inability to submit the work by the due date. Contacting the Instructor or Teaching Assistants: All communication outside of lecture, tutorial, and individual consultations will take place via email or Teams. Students are expected to check their McMaster email account regularly. Students can expect that emails sent to the instructor or the TA will be responded to during email office hours. Office Hours: Office hours will be held by appointment. Please contact Lisa Schwartz ([email protected]). The University reserves the right to change dates and/or deadlines etc. for any or all courses in the case of an emergency situation or labour disruption or civil unrest/disobedience, etc. Texts: • B&W: Boetzkes, E & Waluchow, W.J. eds. Readings in Health Care Ethics. Broadview Press 2012. • TBA: Web based papers, podcasts and videos to be announced • Optional: Downie, J. Caulfield, T., Flood, C (ed) Canadian Health Law and Policy (3rd ed.) Butterworths 2007. ACADEMIC INTEGRITY: You are expected to exhibit honesty and use ethical behaviour in all aspects of the learning process. The academic credentials that you earn are rooted in the principles of honesty and academic integrity. It is your responsibility to understand what constitutes academic dishonesty. Academic dishonesty is to knowingly act or fail to act in a way that results or could result in unearned academic credit or advantage. This behaviour can result in serious consequences, e.g. the grade of zero on an assignment, loss of credit with a notation on the transcript (notation reads: “Grade of F assigned for academic dishonesty”), and/or suspension or expulsion from the university. It is your responsibility to understand what constitutes academic dishonesty. For information on the various types of academic dishonesty please refer to the Academic Integrity Policy. Important and helpful information can be found here. The following illustrates only three forms of academic dishonesty: • plagiarism, e.g. the submission of work that is not one’s own or for which other credit has been obtained. • improper collaboration in group work. • copying or using unauthorized aids in tests and examinations. AUTHENTICITY/PLAGIARISM DETECTION: Some courses may use a web-based service (Turnitin.com) to reveal authenticity and ownership of student submitted work. For courses using such software, students will be expected to submit their work electronically either directly to Turnitin.com or via an online learning platform (e.g. A2L, etc.) using plagiarism detection (a service supported by Turnitin.com) so it can be checked for academic dishonesty.

UPDATED 10.02.2021

Lisa Schwartz

email: [email protected]

Students who do not wish to submit their work through the plagiarism detection software must inform the Instructor before the assignment is due. No penalty will be assigned to a student who does not submit work to the plagiarism detection software. All submitted work is subject to normal verification that standards of academic integrity have been upheld (e.g., on-line search, other software, etc.). For more details about McMaster’s use of Turnitin.com please go to www.mcmaster.ca/academicintegrity ACADEMIC ACCOMMODATION OF STUDENTS WITH DISABILITIES: Students with disabilities who require academic accommodation must contact Student Accessibility Services (SAS) at 905-525-9140 ext. 28652 or [email protected] to make arrangements with a Program Coordinator. For further information, consult McMaster University’s Academic Accommodation of Students with Disabilities policy. ACADEMIC ACCOMMODATION FOR RELIGIOUS, INDIGENOUS OR SPIRITUAL OBSERVANCES (RISO): Students requiring academic accommodation based on religious, indigenous or spiritual observances should follow the procedures set out in the RISO policy. Students requiring a RISO accommodation should submit their request to their Faculty/Program Office normally within 10 working days of the beginning of term in which they anticipate a need for accommodation or to the Registrar’s Office prior to their examinations. Students should also contact their instructor/coordinator as soon as possible to make alternative arrangements for classes, assignments, and tests. COURSES WITH AN ONLINE ELEMENT: Some courses may use online elements and platforms. Students should be aware that, when they make use of these platforms, information such as first and last names, usernames for the McMaster email accounts, and program affiliation may become apparent to all other students in the same course. The available information is dependent on the technology used. Continuation in a course that uses on-line elements will be deemed consent to this disclosure. If you have any questions or concerns about such disclosure please discuss this with the course instructor. COPYRIGHT AND RECORDING: Students are advised that lectures, demonstrations, performances, and any other course material provided by an instructor include copyright protected works. The Copyright Act and copyright law protect every original literary, dramatic, musical and artistic work, including lectures by University instructors. Students must not disseminate these materials to others not registered in the course, or post to third-party websites. The recording of lectures, tutorials, or other methods of instruction may occur during a course, either by the instructor for instructional purposes; students may make recordings for the purpose of personal study, but must not be disseminated in any form. Students should be aware that their voice and/or image may be recorded by others during the class. Please speak with the instructor if this is a concern for you. EXTREME CIRCUMSTANCES: The University reserves the right to change the dates and deadlines for any or all courses in extreme circumstances (severe weather, labour disruptions, etc). Changes will be communicated through regular McMaster communication channels, such as McMaster Daily News, A2L, Microsoft Teams and/or McMaster email. HEALTH AND WELLNESS RESOURCES FOR STUDENTS: As a signatory on the Okanagan Charter, McMaster University is committed to enhancing mental health and wellness and provides various resources for students to manage their well-being. Students are encouraged to seek support as necessary; the following are several campus- and community-based UPDATED 10.02.2021

Lisa Schwartz

email: [email protected]

resources that you may find helpful. For more resources and additional information, please visit https://wellness.mcmaster.ca/resources/ ON-CAMPUS RESOURCES: Student Wellness Centre: Provides counselling, medical services, wellness education, guided self-help, and other relevant resources. PGCLL 210; 905-525-9140, x27700; https://wellness.mcmaster.ca Sexual Violence Support: An on-campus resource where students, staff, and faculty of all backgrounds and social identities can find support and information about sexual, intimate partnership or family violence. UH 104; 905-525-9140 x20909; https://svpro.mcmaster.ca Faculty/Program Office: Feel free to contact an Academic Advisor in your Faculty/Program Office who can connect with academic advising and connect you with other resources. OFF-CAMPUS RESOURCES: Good2Talk: Free, confidential helpline providing professional counselling and information and referrals for mental health, addictions and well-being to post-secondary students in Ontario, 24/7/365; 1-866-925-5454; https://good2talk.ca Big White Wall: Online peer-to-peer chat-based service that provides mental health and wellbeing support, 24/7/365. https://www.bigwhitewall.com SACHA (Sexual Assault Centre - Hamilton Area): Confidential, anonymous 24-hour nonjudgmental telephone support for adults who have experienced sexual violence. 905-525-4162; http://sacha.ca If you have immediate safety concerns for yourself or others, call Campus Security who will respond with the MSU Emergency First Response Team (EFRT) at 905-522-4135 or call 911 if you are off campus. COURSE MODIFICATION: At certain points in the course it may make good sense to modify the schedule, deadlines, evaluation, or other elements. If such changes become necessary, students will be notified accordingly. GRADING SCALE: Conversion from percentages to letter grades will follow the standard McMaster procedure (please see the Table below). All percentage grades within 0.5% of the next letter grade will be reviewed (rounding not guaranteed). !

% 90-100 85-89 80-84

Letter A+ A A-

% 77-79 73-76 70-72

Letter B+ B B-

% 67-69 63-66 60-62

Letter C+ C C-

% 57-59 53-56 50-52

Letter D+ D D-

%

Letter

0-49

F

!

EMAIL COMMUNICATION: All emails sent to the instructor must originate from your official McMaster University email accounts. LAND ACKNOWLEDGEMENT: McMaster University recognizes and acknowledges that it is located on the traditional territories of the Mississauga and Haudenosaunee nations, and within the lands protected by the Dish with One Spoon wampum agreement.

UPDATED 10.02.2021

Lisa Schwartz

email: [email protected]

DRAFT Schedule of Readings and Lectures 3L03 2021 Week 1 Jan 11 & 13 2 Jan 18 & 20

Topic Intro & theory of ethics

Tutorial case No tutorial session this week

Justice and other principles Stakeholder analysis

Ol’Joe Woman with brain tumour

Resources 1. 2. 3. 1. 2.

3. 4.

3 Jan 25 & 27

Resource allocation

4 Feb 1 & 3

Reproduction, rights and antiracism Mini paper due

5 Feb 8 & 10

Coin theory & allyship

Flu vaccine US secures world stock of key Covid-19 drug remdesivir https://www.theguardian.com/u s-news/2020/jun/30/us-buysup-world-stock-of-key-covid-19drug?CMP=Share_iOSApp_Ot her https://www.nytimes.com/2018/ 05/27/world/europe/savitahalappanavar-irelandabortion.html

1.

https://www.cbc.ca/radio/thecur rent/the-current-for-november13-2018-1.4902679/indigenouswomen-kept-from-seeing-theirnewborn-babies-until-agreeingto-sterilization-says-lawyer1.4902693 The story of Joyce Echaquan https://www.cbc.ca/news/canad a/montreal/quebec-atikamekwjoliette-1.5743449

B&W xi-xlv The Trolley Problem https://www.youtube.com/watch?v=bOpf6KcWYyw https://www.youtube.com/watch?v=yg16u_bzjPE B&W xi-xlv Elias, A., & Paradies, Y. The Costs of Institutional Racism and its Ethical Implications for Healthcare. Journal of Bioethical Inquiry, 1-14 https://link.springer.com/article/10.1007/s11673020-10073-0 Mary’s room https://www.youtube.com/watch?v=mGYmiQkah4o https://www.cbc.ca/parents/learning/view/thepolitics-and-privilege-of-wearing-a-mask Lisa Schwartz’s recorded talk

2.

https://www.bbc.com/future/article/20200428coronavirus-how-doctors-choose-who-lives-anddies

1.

https://chepa.mcmaster.ca/news-events/labellelectureship

2.

B&W 213-224 Marquis;

3.

238-2248 Sherwin

4.

OPTIONAL reading: Lentin, R. (2013). A woman died: abortion and the politics of birth in Ireland. feminist review, 105(1), 130-136.

1. 2.

https://youtu.be/yiWZK2AxF7M Nixon, S. A. (2019). The coin model of privilege and critical allyship: implications for health. BMC Public Health, 19(1), 1-13 link https://bmcpublichealth.biomedcentral.com/articles/ 10.1186/s12889-019-7884-9

3.

Wednesdays Lisa Schwartz

Lisa Schwartz

Lisa Schwartz

Rochelle Maurice

Stephanie Nixon

6 Feb 15 & 17 7 Feb 22 & 24

Reading week

AI in healthcare

Lifelabs https://www.cbc.ca/news/lifelab s-data-breech-security-ehealth1.5400817

Podcast: a16z Podcast: AI and Your Doctor, Today and Tomorrow with Eric Topol & Vijay Pande (2019) https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkc y5zaW1wbGVjYXN0LmNvbS9KR0UzeUMwVg/episode/d GFnOnNvdW5kY2xvdWQsMjAxMDp0cmFja3MvNjM2Mz A3NDAx?hl=enCA&ved=2ahUKEwjXgbmh7ozuAhURGFkFHZz5CJsQjrk EegQICRAL&ep=6 Cathy O'Neil (2017) The era of blind faith in big data must end https://www.youtube.com/watch?v=_2u_eHHzRto Want T (2017) The human insights missing from big data https://www.youtube.com/watch?v=pk35J2u8KqY

Gali Katznelson

8 Mar 1 & 3

Pediatrics

Sunitha

1) Podcast from the CPS on pediatric consent and capacity: https://www.pedscases.com/medical-decision-

James Mellett

making-cps-podcast

3) Noiseux, J., Rich, H., Bouchard, N., Noronha, C., & Carnevale, F. A. (2019). Children need privacy too: Respecting confidentiality in paediatric practice. Paediatrics & child health, 24(1), e8-e12. 4) Optional: Franco A. Carnevale PhD, Gail Teachman & Aline Bogossian (2017) A

UPDATED 10.02.2021

Lisa Schwartz

email: [email protected]

Relational Ethics Framework for Advancing Practice with Children with Complex Health Care Needs and Their Parents, Comprehensive Child and Adolescent Nursing, 40:4, 268-284, https://doi.org/10.1080/24694193.2017.1373162

9 Mar 8 & 10

Clinical bioethics End of life care

24 & ready to die https://www.youtube.com/watch ?v=SWWkUzkfJ4M

https://www.cbc.ca/news/health/town-hall-assisted-dyingmaid-legislation-1.5491824

Paula Chidwick

10 Mar 15 & 17

Rights Disability rights

Typhoid Mary

- Osgoode Hall Law School talk from Nov 2020 https://www.youtube.com/watch?v=MxpHXUYNP4A&featu re=youtu.be - De Wolfe C, Downie J (2020) It’s time for Canada to follow Ontario’s critical care triage protocols. Policy Options - Shanouda M, De Marinis J (2020) Proceed with caution with Ontario’s critical care triage protocol. Policy Options -!Nixon S & Forman L (2008) Exploring synergies between human rights and public health ethics: A whole greater than the sum of its parts. BMC International Health and Human Rights; 8:2 https://bmcinthealthhumrights.biomedcentral.com/articles/ 10.1186/1472-698X-8-2

David Lepofsky

11 Mar 22 & 24 12 Mar 29 & 31 13 Apr 5 & 7 14 Apr 12 & 14

Simulations

Intro to topics Stakeholder analysis - start

Gautham, Sam & Lisa

Stakeholder analysis - due

Stakeholder analysis - completed Assign stakeholder roles Explore resources Explore resources Present to groups

Gautham, Sam & Lisa

Papers will be based on the simulation topic and stakeholder analysis

Lisa Schwartz

Research ethics Paper due

Challenge trials https://www.bbc.com/news/heal th-53862413

Gautham, Sam & Lisa

NB: Subject to change at the discretion of the course leader. Schedule will be updated as more details arise.

UPDATED 10.02.2021

Lisa Schwartz

email: [email protected]

Tutorials: TUTORIALS BEGIN THE WEEK OF JANUARY 11, 2019 Students are expected to attend every tutorial and to be prepared to discuss the assigned weekly readings. Students must participate regularly to receive a good grade in this section of the course; attendance alone will not be enough. You will be assigned a group at the beginning of term. If you have a conflict with the assigned time you are responsible for organizing a different session if space is available. A case(s) will be provided for the tutorial discussions. Below are some questions to help guide the discussions: o What is the core issue? o What is at stake and for whome? o Who are the stakeholders in this situation? (think beyond patient/family and direct caregivers). o What is the relationship like between them? Who is most vulnerable and who is most powerful? o What are the patient’s (or family's) wishes? How do you know this? What principles do these express? o What are the goals of care? What principles guided this choice? o Do the goals as expressed by the professional caregivers coincide with the wishes of the patient? If not, can something be done to harmonize the two sets of desires? o What is the professional duty here and to whom is this obligation owed? o What potential options are open (consider more than the obvi...