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Unethical Experiments: Synthesis

9/30/2016

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Your work for the long weekend is to complete your synthesis work from the short unit we recently completed on unethical experiments. The specific details of the assignment can be found below. In addition, if you want to look at the articles or the Nuremberg Codes, they can also be found below, or in the "Check it Out!" section of this website.
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The Nuremberg Codes

9/26/2016

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Picture
HOMEWORK DUE 9/27/16

Let’s take a deeper look at the Nuremberg Codes. Create the chart below in your notebooks and for each point, re-state the meaning in your own words (paraphrase it). The first point is already explained for you. This should be completed in your notebooks.





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Physician's Oath: Synthesis

9/23/2016

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HOMEWORK

DUE MONDAY 9/26/16!

Select ONE of the three options to show your understanding of the contrast between the two physician’s oaths you studied in class. Due Mon 9/26.

•Option 1: Write two academic TE/EA paragraphs comparing and contrasting the Hippocratic Oath with the second oath you were assigned.
-Terms/phrases that must be included are: standard of care, euthanasia, moral principles, basis of law (underline those terms when they are used).
-Focus on the Hippocratic oath in the first paragraph and the other oath in the second paragraph.
-Be sure to use TE/EA structure for each. You can use your handouts to select quotes (E/E)
-Analysis of the first paragraph should the strengths and/or weaknesses of the Hippocratic oath and why they are important for patients and doctors
-Analysis of the first paragraph should the strengths and/or weaknesses of the second  oath and why they are important for patients and doctors. It should also leave the reader thinking about the impact of these two oaths and how they affect us today

•Option 2: Write a dialogue between two doctors who believe in the two different oaths. In it, they should be arguing with each other about which oath is the most successful and why. Get creative!
-Dialogue should be 1 - 2 pages long.
-Terms/phrases that must be included are: standard of care, euthanasia, moral principles, basis of law (underline those terms when they are used).
-Feel free to place this dialogue in current-day America!
Example: Hippocrates:”Hello Dr. Mal, I was wondering if     you would like to take the Hippocratic oath?     It’s the oldest doctor’s oath around!
    Dr. Mal: “Hey Hippocrates, I’m sorry but your     oath is so outdated. We don’t have the same
    moral principles as you did back then.”
      Hippocrates: “What do you mean? Why     would you say a thing like that?”
      Dr. Mal: “Well, you see…”

•
•Option 3: Write your own physician’s oath. Combine the strongest and most successful elements of the different oaths we’ve studied in class to create the perfect example. Have fun, be creative!
-Oath should be approximately 1 page long.
-Your oath must address at least 10 of the 12 categories we studied in class (from your charts)
-You will also write a 1 page explanation for how and why you created your oath the way you did. Consider:
-Why did you include certain elements and exclude others?
-What was your thought process when considering what is most important for a doctor to believe in?
-What makes your oath the best out of the ones we studied in class? Give clear examples.

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Compare and Contrast Oaths HW

9/19/2016

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DUE TUESDAY 9/20/16

Complete your worksheet comparing/contrasting the Hippocratic Oath with the new oath you received in class today. The different oaths are listed below:

1. The Declaration of Geneva, as currently published by the World Medical Association[6] reads:
At the time of being admitted as a member of the medical profession:
  • I solemnly pledge to consecrate my life to the service of humanity;
  • I will give to my teachers the respect and gratitude that is their due;
  • I will practice my profession with conscience and dignity;
  • The health of my patient will be my first consideration;
  • I will respect the secrets that are confided in me, even after the patient has died;
  • I will maintain by all the means in my power, the honour and the noble traditions of the medical profession;
  • My colleagues will be my sisters and brothers;
  • I will not permit considerations of age, disease or disability, creed, ethnic origin, gender, nationality, political affiliation, race, sexual orientation, social standing or any other factor to intervene between my duty and my patient;
  • I will maintain the utmost respect for human life;
  • I will not use my medical knowledge to violate human rights and civil liberties, even under threat;
  • I make these promises solemnly, freely and upon my honor


Hippocratic Oath (Modern)
I swear to fulfill, to the best of my ability and judgment, this covenant:...
I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.
I will apply, for the benefit of the sick, all measures which are required, avoiding those twin traps of overtreatment and therapeutic nihilism.
I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug.
I will not be ashamed to say "I know not," nor will I fail to call in my colleagues when the skills of another are needed for a patient's recovery.
I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. Above all, I must not play at God.
I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.
I will prevent disease whenever I can, for prevention is preferable to cure.
I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.
If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.

The Nuremburg Code
  1. Required is the voluntary, well-informed, understanding consent of the human subject in a full legal capacity.
  2. The experiment should aim at positive results for society that cannot be procured in some other way.
  3. It should be based on previous knowledge (like, an expectation derived from animal experiments) that justifies the experiment.
  4. The experiment should be set up in a way that avoids unnecessary physical and mental suffering and injuries.
  5. It should not be conducted when there is any reason to believe that it implies a risk of death or disabling injury.
  6. The risks of the experiment should be in proportion to (that is, not exceed) the expected humanitarian benefits.
  7. Preparations and facilities must be provided that adequately protect the subjects against the experiment’s risks.
  8. The staff who conduct or take part in the experiment must be fully trained and scientifically qualified.
  9. The human subjects must be free to immediately quit the experiment at any point when they feel physically or mentally unable to go on.
  10. Likewise, the medical staff must stop the experiment at any point when they observe that continuation would be dangerous.


2. Solemn Oath of a Physician of Russia [1992]
In the presence of my Teachers and colleagues in the great science of doctoring, accepting with deep gratitude the rights of a physician granted to me I SOLEMNLY PROMISE:
• to regard him who has taught me the art of doctoring as equal to my parents and to help him in his affairs and if he is in need;
• to impart any precepts, oral instruction, and all other learning to my pupils who are bound by the obligation of medical law but to no one else;
• I will conduct my life and my art purely and chastely, being charitable and not causing people harm;
• I will never deny medical assistance to anyone and will render it with equal diligence and patience to a patient of any means, nationality, religion, and conviction;
• no matter what house I may enter, I will go there for the benefit of the patient, remaining free of all intentional injustice and mischief, especially sexual relations;
• to prescribe dietetic measures and medical treatment for the patient’s benefit according to my abilities and judgment, refraining from causing them any harm or injustice;
• I will never use my knowledge and skill to the detriment of anyone’s health, even my enemy’s;
• I will never give anyone a fatal drug if asked nor show ways to carry out such intentions;
• whatever I may see and hear during treatment or outside of treatment concerning a person’s life, which should not be divulged, I will keep to myself, regarding such matters as secret;
• I promise to continue my study of the art of doctoring and do everything in my power to promote its advancement, reporting all my discoveries to the scientific world;
• I promise not to engage in the manufacture or sale of secret remedies;
• I promise to be just to my fellow doctors and not to insult their persons; however, if it is required for the benefit of a patient, I will speak the truth openly and impartially;
• in important cases I promise to seek the advice of doctors who are more versed and experienced than I; when I myself am summoned for consultation, I will acknowledge their merit and efforts according to my conscience. If I fulfill this Oath without violating it, let me be given happiness in my life and art. If I transgress it and give a false Oath, let the opposite be my lot.



3. The American Medical Association (AMA)
The medical profession has long subscribed to a body of ethical statements developed primarily for the benefit of the patient. As a member of this profession, a physician must recognize responsibility to patients first and foremost, as well as to society, to other health professionals, and to self. The following Principles adopted by the American Medical Association are not laws, but standards of conduct which define the essentials of honorable behavior for the physician.
Principles of medical ethicsI. A physician shall be dedicated to providing competent medical care, with compassion and respect for human dignity and rights.
II. A physician shall uphold the standards of professionalism, be honest in all professional interactions, and strive to report physicians deficient in character or competence, or engaging in fraud or deception, to appropriate entities.
III. A physician shall respect the law and also recognize a responsibility to seek changes in those requirements which are contrary to the best interests of the patient.
IV. A physician shall respect the rights of patients, colleagues, and other health professionals, and shall safeguard patient confidences and privacy within the constraints of the law.
V. A physician shall continue to study, apply, and advance scientific knowledge, maintain a commitment to medical education, make relevant information available to patients, colleagues, and the public, obtain consultation, and use the talents of other health professionals when indicated.
VI. A physician shall, in the provision of appropriate patient care, except in emergencies, be free to choose whom to serve, with whom to associate, and the environment in which to provide medical care.
VII. A physician shall recognize a responsibility to participate in activities contributing to the improvement of the community and the betterment of public health.
VIII. A physician shall, while caring for a patient, regard responsibility to the patient as paramount.
IX. A physician shall support access to medical care for all people.


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Real Life Ethical Dilemmas

9/14/2016

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If you did not finish your classwork, here are the questions from today.
DUE TOMORROW 9/15

The New York Times has a column called “The Ethicist” where people write in with ethical dilemmas and ask for advice.

​In your groups:
•In one or two sentences, what is the dilemma, or problem, being posed here?
•What was the ethicist’s response?
•Do you agree with his response? Why or why not?
•If you were the ethicist, how would you have responded to this person?
•How do norms, morals and ethics impact your scenario?
•If there are differing answers to the last three questions within the group, record all differing opinions that arise
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Rumination Paragraph

9/9/2016

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Homework:
**DUE TUESDAY 9/13**

The ability to react to a quotation by explaining what it means, taking a stand on it, and showing its relevance and connection to other aspects of life is an important skill to have! 
Select a quote that you want to write about and write a "rumination" paragraph based on it. You can use the quote you took home from class, or choose a different one below.

RUMINATION PARAGRAPH (TE/EA structure)
To ruminate (verb) - to think deeply about something. Pick one quote to RUMINATE on.
•T - Take a stance in reaction to the quote (do you agree? Disagree? Are you surprised? Disappointed? Inspired? Angry?). Make sure you’re also interpreting the quote - saying what you believe it means.
•E/E•Explain why you had this response to the quotation/how your thinking about the quotation developed. Use at least two specific reasons or examples to show your thinking or make connections  (things you’ve read about/witnessed/experienced)
•A•What is the take-away from this quote? What is an important effect or message that this quote can have on our thinking and/or understanding?

SAMPLE PARAGRAPH:

"The good physician treats the disease; the great physician treats the patient who has the disease."
–William Osler

  This quote by William Osler inspires me because it captures what it really means to be a successful doctor. Osler states that mediocre doctors simply address the physical consequences of a disease, whereas a great doctor treats the entire person who is suffering from it. For example, a doctor who is giving a needle to a child should not just coldly administer the shot. A great doctor would calm the child, explain the procedure, and maybe even give them candy when it’s over. A doctor who is helping someone with a serious or frightening illness has to both treat their patient AND help them to move on with their lives by providing medical care and emotional counseling. Doctors have jobs that involve directly treating illness, but it is important that a doctor not forget that they also need to be caring and thoughtful about the person that they are treating. Osler is explaining that truly successful doctors should be able to deal with both the social and diagnostic aspects of their job.


QUOTES:
  1. "As a medical doctor, it is my duty to evaluate the situation with as much data as I can gather and as much expertise as I have and as much experience as I have to determine whether or not the wish of the patient is medically justified." –Jack Kevorkian
  2. "The purpose of a doctor or any human in general should not be to simply delay the death of the patient, but to increase the person's quality of life." –Patch Adams
  3. Sometimes the only choices you have are bad ones, but you still have to choose." –Doctor Who
  4. "Whenever a doctor cannot do good, he must be kept from doing harm." –Hippocrates
  5. "The purpose of medicine is to prevent significant disease, to decrease pain, and to postpone death…technology has to support these goals—if not, it may even be counterproductive." –Dr. Joel J. Nobel
  6. “We look for medicine to be an orderly field of knowledge and procedure. But it is not. It is an imperfect science, an enterprise of constantly changing knowledge, uncertain information, fallible individuals, and at the same time lives on the line. There is science in what we do, yes, but also habit, intuition, and sometimes plain old guessing. The gap between what we know and what we aim for persists. And this gap complicates everything we do.” –Atul Gawande
  7. "The purpose of science is to develop, without prejudice or preconceptions of any kind, a knowledge of the facts, the laws, and the processes of nature" –Robert A Millikan
  8. Medicine is not only a science; it is also an art. It does not consist of compounding pills and plasters; it deals with the very processes of life, which must be understood before they may be guided." –Paracelus
  9. Ethics is knowing the difference between what you have a right to do and what is right to do” -Potter Stewart (Supreme Court Justice of the United States)
  10. “Science is concerned wholly with truth, not with ethics”- Arthur Keith (Scottish anthropologist)
  11. "The current health care system is neither healthy, caring, nor a system" –Walter Cronkite


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