Concentration in Medical Ethics
Concentration Director:
Jay Baruch, MD
University Emergency Medicine Foundation
Director, Ethics Curriculum
Warren Alpert Medical School at Brown University
593 Eddy Street, Claverick Building, 2nd Fl.
Providence, RI 02903
Ph: 401-444-5120
Email: jay_baruch@brown.edu
Co-Director
Michael Felder, DO, MA
University Medicine Foundation
Family Medicine
Director, Quality Care and Improvement
1035 Post Rd.
Warwick, RI 02888
Ph: 401-941-2830/fax 941-6886
Email: MFelder@Lifespan.org
Overview
What is an ethical dilemma? One definition defines it as a “genuine conflict of moral belief, perspective, or position.” But how do you identify an ethical problem? Often it finds you. It churns your stomach, keeps you up at night. People often react to ethical problems with their gut, without necessarily identifying the source of their discomfort.
The goal of clinical ethics is to provide students with the ability to work around that gut instinct; to examine the deeply held moral values of all participants in the conflict; to learn to sensitively tease out the latent principles contained in the dilemma, and to provide justifications that support your opinions.
The ultimate requirement of ethical analysis is action. In the medical context, as opposed to theoretical and philosophical construct, problems demand practical solutions.
Biomedical ethics is, by its very nature, a multidisciplinary pursuit. A concentration in biomedical ethics will span many disciplines, including medicine, philosophy, the humanities, technology, industry, policy and human rights.
Medial ethics concentrators will develop moral reasoning skills to identify and clarify the ethical dilemmas that occur in both medical education and clinical practice, engage in scholarship, and belong to a community of support and mentorship.
A concentrator in medical ethics will be prepared to serve as a resource for colleagues faced with ethical dilemmas. They will also develop skills in ethics teaching, be involved in development and refinement of the ethics curriculum, and gain experience on hospital ethics committees.
Curriculum Offerings:
1) The summer elective "Comparative Medical Ethics" offered for two weeks at the end of June in Tuebingen, Germany will provide an excellent foundation for students without previous experience in medical ethics.
Course description: The goal of this intensive two-week seminar is to bring pre-medical and medical students from Brown and Tuebingen together to discuss ethical issues of medical practice in a comparative perspective. The seminar will consist of small group discussions and study periods, and will include the students preparing short presentations for the group sessions. By comparing different ethical standards and positions from the US, Germany, and selected other countries, the students will not only receive a basic training in medical ethics but also get a sense for the cultural relativity of moral reasoning, the co-existence of alternative and competing ethical frameworks, calibrated to different cultural traditions and socio-political conditions. The participants will be offered clinical cases to discuss the implications of different ethical positions. The seminar will be highly interactive to induce a stimulating exchange of ideas and arguments between the medical students from the US and Germany.
During the summer between first and second year, students will be required to participate in an intensive project that will be designed in concert with his or her mentor. This can take many forms, including, but not limited to, academic papers, community work, research, and curriculum development.
2) Law, Medicine and Ethics: The Medical-Legal Collaborative (pre-clinical elective)—an interdisciplinary course with Roger Williams Law School taught in the Fall semester, which focuses on advocacy, ethics, and legal issues facing vulnerable populations. One of the first courses in the country that unites law and medical students, this innovative elective concentrates on providing a theoretical framework for understanding the connections between social justice and health outcomes, substantive examples of medical-legal problems affecting child and family health, and interdisciplinary problems that raise ethical issues for both professions.
Instructors:
From Warren Alpert School of Medicine at Brown University
Jay Baruch, MD
Director, Medical Ethics Scholarly Concentration and Assistant Professor of Emergency Medicine
Patricia Flanagan, MD
Director of Scholarly Concentration in Advocacy and Activism and Associate Professor of Pediatrics
Roger Williams University School of Law
Liz Tobin Tyler, JD
Director of Public Service and Community Partnerships, and Lecturer in Public Interest Law
Monthly seminar series in classic cases and classic readings in medical ethics will provide the basic platform for the Concentration during the second year, with designated reading and didactics during the self-study period. Detailed examination of cases from the consult services of Brown-affiliated hospitals will also be explored in detail. These series will most likely be offered in the evenings. The afternoon times will be available for students to do readings in preparation for the sessions. Students should expect to be involved with running case discussions and participating in educational endeavors in the medical school.
Learning Objectives
Students will develop a richer understanding of core issues in medical ethics.
Students will develop tools for identifying, understanding, and analyzing ethical issues.
Students will become proficient and sensitive educators in the field of medical ethics.
Students will become skilled at ethics consultation.
Evaluation
Students are expected to have a clear, focused summer project.
Students will participate in group discussions, and are expected to be involved with ethics teaching at the medical school.
The scholarly project expectation can be satisfied by a “portfolio”—examples of portfolio work include academic papers, talks on ethical issues, curriculum development, community projects, or research.
Students will be expected to submit reports on the status of their work every six months to their faculty mentor.
Student work will be presented to the faculty during their fourth year. We expect the work to be professionally done, suitable for submission to a national meeting or scholarly journal. The work will be reviewed by the faculty as a group.
Current Student Projects:
Comfort feeding only: A proposal to bring clarity to decision making regarding feeding in the nursing home setting
Improving bioethics and biomedical journalism
Ethical issues relating to translation and communication and how it impacts healthcare for the Latino community
2009 Accepted Students & Scholarly Concentration Projects:
| Student | Project Title | Mentor |
| Bravo, Michelle | Brown Longitudinal Advanced Spanish Training for Medical Doctors (BLAST MD) | Jay Baruch, MD |
Maximum Number of Students
The concentration will be able to accommodate 2-4 students to start. There will be approximately 5 faculty members available to mentor students.
Faculty Mentors
Jay Baruch, MD, is Clinical Assistant Professor Department of Emergency Medicine. He has been teaching medical ethics at Brown since 2002. Fellowship trained in medical ethics at Harvard Medical School, he was also a visiting scholar at the Hastings Center. He founded and currently directs the Ocean State Ethics Network. Current interests include ethical issues of medical blogging, and the role of literature and writing in medical education. Other interests center on ethical considerations of pain management. He’s also doing work in medical humanities, creative writing, and curriculum development. His fiction collection, Fourteen Stories: Doctors, Patients, and Other Strangers, was published March, 2007.
Tom Bledsoe, MD is a Associate Professor of Medicine at the Warren Alpert School of Medicine and teaches medical ethics in the clinical clerkships and Internal Medicine residency and fellowship programs. He is co-chair of the Rhode Island Hospital Ethics Committee and is particularly interested in the ethics of shared decision-making and end of life care.
Michael Felder, DO, MA is a Clinical Assistant Professor of Medicine and a Fellow of the American Academy of Family Physicians. He completed his MA in Philosophy/Bioethics at Georgetown University and the Kennedy Institute of Ethics. His interests include ethics and Managed Care, outpatient ethics, the role of ethics in health policy, Jewish Medical Ethics and the moral and ethical development in the young physician. In the 1990s he was the founding chairperson of a nationally innovative corporate level HMO Ethics Committee. He has been teaching ethics at Alpert Medical School as well as leading "Ethics Rounds" at the Rhode Island and The Miriam hospitals since 1999.
Deirdre Fearon, MD, MA is an Assistant Professor in the Departments of Emergency Medicine and Pediatrics at Alpert Medical School. She is an attending physician in Pediatric Emergency Medicine at Hasbro Children's Hospital. Dr. Fearon completed a Master's Degree in Philosophy/Bioethics at Brown University in 2002, and is a member of the Rhode Island Hospital Ethics Committee and the American Academy of Pediatrics Section on Bioethics. Dr. Fearon's interests include informed consent in the setting of medical education as well as pediatric and emergency ethics.
Rosalind Ladd, PhD Lecturer in Pediatrics, Brown Med School, Visiting Scholar in Philosophy, Brown University, Professor of Philosophy Emerita, Wheaton College Special interests in Bioethics: pediatrics, women's health issues, geriatrics/end of life care. She is the co-author, Ethical Dilemmas in Pediatrics and Ethical Issues in Home Health Care; editor, Children's Rights Re-Visioned. Most recent journal articles: Rights of autistic children, Altruistic motives reconsidered. She is a member of ethics committees at Rhode Island, Bradley (co-chair), and Women and Infants hospitals.
Funding Opportunities (alternatives to Summer Assistantships)
At the moment, funding sources for student summer projects between Years I & II will be limited to Summer Assistantships SAs.