Bioethics (BETH)

BETH 210. Perspectives on Health: Introduction to Medical Humanities and Social Medicine. 3 Units.

This survey course is designed to give students a broad overview of medical humanities and medical social sciences. Students will engage materials from a wide range of disciplines and learn how to analyze which perspectives afford and obscure which types of knowledge relevant to health, illness and clinical practice. Students will learn how to identify epistemology, methodology, theory and data from various disciplinary perspectives. This course is relevant for students engaged in pre-clinical education as well as those interested in medical humanities and medical social sciences.

BETH 271. Bioethics: Dilemmas. 3 Units.

We have the genetic technology to change nature and human nature, but should we? We have the medical technology to extend almost any human life, but is this always good? Should we clone humans? Should we allow doctor-assisted suicide for the terminally ill? This course invites students from all academic disciplines and fields to examine current and future issues in bioethics--e.g., theory and methods in bioethics; death and dying; organ transplantation; genetics; aging and dementia; fertility and reproduction; distributive justice in health care access. The course will include guest lecturers from nationally-known Bioethics faculty. Offered as BETH 271 and PHIL 271.

BETH 302. Independent Studies in Bioethics. 1 - 3 Units.

This course is for students with Bioethics-related special interests not adequately addressed in regular courses, and who wish to work independently in consultation with faculty.

BETH 309. Aging, Ageism, and Embodiment. 3 Units.

What is the experience of "growing old" in America, and how does it differ based on one's sex, gender, sexuality, race or ethnicity, and socioeconomic or disability status? What lies behind America's anti-aging culture and the growth of anti-aging medicine? How does ageism manifest, and how does it affect our aging and our health? In this course, we will consider the social, cultural, scientific, medical, and personal meanings of aging, and how these meanings, as well as the embodied experience of aging in America, are influenced by multiple forms of ageism. We will interrogate the assumptions and stereotypes about age that circulate through mainstream American culture and medicine and how these shape interpersonal and institutional practices. How might we begin to recognize, respond to, and change ageism, and thus our own inevitable experiences of aging? The course requires participation and attendance, papers, and for graduate students an additional presentation. No prerequisites are required. Offered as BETH 309 and BETH 409. Counts as a CAS Global & Cultural Diversity course.

BETH 315. International Bioethics: Policy and Practice. 3 Units.

Taught by Case and international faculty, this course will include 7-10 days of intensive didactic and experiential learning in one of several "host" countries. Examples of sites include: Free University of Amsterdam and University of Utrecht in the Netherlands; University of Paris in France; and Ben Gurion University in Israel. It will afford a unique opportunity to gain perspective on important bioethics issues in different societies, i.e., euthanasia, public health policies, access to healthcare, and stem cell research. At the international site, students will spend 6 hours per day (5 days) in seminar (involving didactics, discussion, and guided-observation clinical experience). There will be two 3-hour preparatory sessions, required reading, and two 3-hour post trip sessions. Requirements: preparation, attendance, and class participation, a 12-15 page paper (undergraduate credit) and a 15-20 page paper (graduate credit). Graduate credit will also require students to prepare a presentation for a post-intensive session. Enrollment will be capped at 25. This course has an additional fee to cover costs of travel and lodging. Limited scholarships are available. Offered as BETH 315 and BETH 415.

BETH 315A. International Bioethics Policy and Practice: Women's Health in the Netherlands. 3 Units.

This 3-credit course allows students to familiarize themselves with social policies and practices related to women's health in the United States and the Netherlands. Issues covered in the course include birth control and family planning, abortion, prenatal testing, childbirth, health care disparities, cosmetic surgery, prostitution and trafficking in women. This course also addresses the US and Dutch national policies regarding the public provision of health care for women. The course places an emphasis on the ways in which social norms shape policies over time, which political actors are involved in shaping women's health policy, and the balance between women's health as a matter of the public good or individual responsibility. This course substantively explores gender-specific cultural values and practices in relation to women's health in the United States and the Netherlands and will help students develop the analytical skills necessary for evaluating social policy and ethical issues related to women's health. Offered as BETH 315A, BETH 415A and WGST 315A. Counts as a CAS Global & Cultural Diversity course.

BETH 315B. International Bioethics Policy and Practice: Public Health in the Netherlands. 3 Units.

This one week 3-credit intensive course will be held in Amsterdam, The Netherlands. Taught by faculty from Case and Utrecht University, this course offers students a cross-cultural perspective on ethical dilemmas raised by the practice of public health in the United States and Northern Europe. Additionally, this course examines policies related to prostitution, drug use, sex education, infectious disease prevention, and access to health care and how they differ in the cultural and political settings of U.S. and the Netherlands. We will examine both the rationales and outcomes of Dutch and American policies, stimulating course participants to consider their own views on these often controversial issues. Prior to the trip, students will attend lectures at Case, which will acquaint them with the theoretical approaches to public health ethics and major issues raised in the practice of public health. In these pre-trip sessions, students will also analyze and report on a case study designed to stimulate critical thinking on comparative public health ethics. In Amsterdam, students will attend lectures that will be supplemented by site visits and discussion sessions aimed at exploring the ethics of public health policy and practice in the Netherlands. Following the intensive week in Amsterdam, students will meet with instructors at Case for two hours to discuss their experiences and compare policies and practices in the U.S. and the Netherlands. Offered as BETH 315B and BETH 415B. Counts as a CAS Global & Cultural Diversity course.

BETH 315C. International Bioethics Policy and Practice: Health Care Costa Rica. 3 Units.

This 3-credit course gives students the unique opportunity to observe patients and practitioners encounter in a radically different health care system. Costa Rica has one of the most comprehensive health care systems in the Western hemisphere, featuring the innovative use of mid-level health care workers organized in basic comprehensive health care teams. This has resulted in a longer life expectancy than the United States, despite a per capita GDP of only $10,000 per person. Students will gain first-hand experience of Costa Rican health care through field experiences at sites including a national hospital in the capital city, San Jose; a peripheral treatment clinic in a smaller town; and observation of the work of an integrated basic health care team in an indigenous reserve. Following each visit, students will discuss the practical and ethical dilemmas that practitioners face in the context of the Costa Rican health care system. Specific topics include: health inequalities within and between nations; the ethics of transplantation, medical research, and end-of-life care; and health care in rural environments and with indigenous populations. Offered as BETH 315C and BETH 415C. Counts as a CAS Global & Cultural Diversity course.

BETH 315D. French Connections, A Cross-Cultural Comparison of Medical Ethics. 3 Units.

This 3-credit course is collaboration between Case Western Reserve University and the University of Paris. The course includes a ten-day trip to Paris, France over Spring Break. This course offers a cross-cultural comparison of the French and American medical systems. Students will have the unique opportunity to learn first-hand how the French medical education system is structured and how the social, cultural and political contexts in France shape medical and ethical issues. The trip includes guided field experiences in French clinical settings as well as opportunities to engage with French faculty members and physicians about contemporary issues in bioethics. Ethical issues that may be considered may include reproductive rights, decision-making involving severely impaired newborns, withholding/withdrawing life-sustaining treatment and issues in organ donation and transplant. The course also will also emphasize the role of French culture and history while in Paris with museum and site visits designed to complement seminar content and offer real-life illustrations of course content. Prior to the trip, students attend six hours of lectures, either at Case Western Reserve University or via a web-based tutorial. They are expected to become familiar with the representative articles assigned for the course, and be prepared to integrate those readings into pre-trip class participation and active participation while in France. Following the trip, students meet with the instructor for an additional four hours to discuss and synthesize their experiences. Offered as BETH 315D and BETH 415D. Counts as a CAS Global & Cultural Diversity course.

BETH 315F. Comparison in Bioethics, Spanish and American Perspectives on Health, Medicine, and Culture. 3 Units.

This 3-credit intensive course will include several day long sessions at CWRU and two weeks of classes and activities in the city of Granada, Spain. Taught by faculty from CWRU and UPV/EHU, this course offers students a cross-cultural perspective on bioethics in the United States and Spain. It uses the medium of film, complemented by readings in bioethics, film criticism, and medical research, to introduce students to a number of compelling bioethics issues, including end-of-life, reproductive ethics, biomedical research and organ transplantation. Offered as BETH 315F and BETH 415F. Counts as a CAS Global & Cultural Diversity course.

BETH 315G. Death, Dying & Euthanasia: Netherlands & the USA. 3 Units.

Is it ever permissible for physicians to kill their patients? In the Netherlands, the answer is yes. In the United States, it is no. Are the Dutch sliding down a moral slippery slope? Are the Americans compromising the rights and dignity of dying patients? This 3-credit course is a unique opportunity to examine a range of Dutch and American end-of-life policies and practices with special focus on the unique ethical, cultural, religious, and legal contexts in which they developed. This course will compare how two liberal democracies, the United States and the Netherlands, have handled difficult end-of-life issues, including: The Dutch regulation of euthanasia; Regulation of physician-assisted suicide in the state of Oregon; Terminal sedation; End-of-life decisions in newborns; Withholding and withdrawing of artificially-provided fluids and nutrition; The legal basis for end-of-life decision making in the USA; Palliative care and hospice; Public trust in medicine and physicians. In the United States, teaching methods will include lectures, case discussion, and exposure to how some of the course's themes are reflected in popular culture such as movies. Offered as BETH 315G and BETH 415G. Counts as a CAS Global & Cultural Diversity course.

BETH 315H. Water Security and Social Justice in Brazil. 3 Units.

CWRU, through the Center for Global Health and Diseases, has had projects, student exchanges and courses with institutions in Brazil and especially with the state of Bahia for over 30 years. In that time, personal and professional relationships have been developed with branches of the Ministry of Health (Oswaldo Cruz Foundation, the Municipal and State Health Departments), the Federal University of Bahia, and the Bahiana School of Medicine and Public Health. Brazil is the second largest country in the Western Hemisphere and the 7th or 8th largest economy in the world. There are more people who speak Portuguese in South America than Spanish. Despite newly discovered oil, enormous natural and human resources, development in Brazil has been uneven with the Northeast remaining the least developed. The Northeastern state of Bahia ranked 22nd out of 27 states on the UN's Index of Human Development (http://www.pnud.org.br/IDH/DH.aspx# and http://www.atlasbrasil.org.br/2013/pt/home/). The State capital, Salvador, ranks 14th out of 20 major metropolitan regions and is one site for this study abroad program. The second site, the rural town of Ubaíra, is ranked 4590 out of 5565 municipalities. Even with large social inequities and health care disparities, the Brazilian government and society have produced remarkable social policies, have shown a willingness to implement these policies and have the resources to significantly improve the lives of its most impoverished citizens. Critical basic infrastructure for health and development is water. Its consumption is essential; it is a mechanism for waste disposal, industry and agriculture are dependent on its supply. The problem of water quantity and quality are common all human societies (witness the drought in California and the burning Cuyahoga). Individuals from all walks of life will need to assess issues of water at some time, from doctors, engineers, urban planners, lawyers and politicians. In Brazil the issues of water are more exposed and easier to examine on different scales than in the U.S. The problem also resides within a social, health care, and political context that compares well and at the same time contrasts sharply with that of the USA. As a student in this course, you will gain first-hand knowledge of the social and public health challenges regarding water security in Brazil. Through field experiences in the capital city of Salvador and the rural town of Ubaíra, you will immerse yourself in interdisciplinary perspectives on the public health, scientific, political, and bioethical dimensions of water security in Brazil. This immersive experience will be facilitated by faculty from the CWRU Dept. of Bioethics and the Center for Global Health and Diseases, the Brazilian Ministry of Health, the Federal University of Bahia, the Bahiana School of Medicine and Public Health, and Brazilian graduate student participants. Offered as: INTH 315, INTH 415, BETH 315H, and BETH 415H. Counts as a CAS Global & Cultural Diversity course.

BETH 315J. Dutch Perspectives: Drugs, Decriminalization and Detention. 3 Units.

This course will offer students the opportunity to compare and contrast the ways in which the Netherlands and the United States approach drug use. In particular, students will be asked to carefully examine the ethical dimensions of harm reduction programs, policies regarding the availability and the decriminalization of drugs, and the critical role of detention and correctional medical care in addressing drug use. The course will include an introduction to the Dutch and U.S. health care and health insurance systems and will consider how the construction of the patient-physician relationship impacts the prevalence and treatment of drug use in each country. In addition, students will explore the ethics of public health initiatives and social programs aimed at drug users in both settings, including those designed for particular populations such as immigrants and older users. The course will pay special attention to the unique challenges and ethics of the opioid crisis in the U.S. Offered as BETH 315J and BETH 415J. Counts as a CAS Global & Cultural Diversity course.

BETH 315Y. Conservation, Compassion and Awe in Yellowstone National Park: Environmental Ethics and Human Health. 3 Units.

This class brings together the study of conservation, ethics and human well-being in a hands-on investigation at Yellowstone National Park. The course returns to the original meaning of the term bioethics as including the biome. It covers conservation ethics and human relationships with the environment and other species as they impact human health across multiple levels. The course draws on theories, models, and methods from psychological anthropology and political ecology to frame the complex dynamics of interaction. The evolution and psychology of compassion and awe are engaged in processual models of human interaction with the natural world and other species. Both have important implications for human health in everyday behavioral practice and in clinical settings. The course involves pre-departure study and then will integrate the materials in the field in Yellowstone National Park looking at contemporary and historical issues in partnership with Yellowstone Forever Institute instructors. In particular, the case of the conservation of the American bison will be used to understand multi-level issues over time in culture, politics, environment, human behavior, and health. The course requires papers, participation, attendance and a field journal. Offered as BETH 315Y and BETH 415Y.

BETH 316. Death, Dying, and Modern Medicine. 3 Units.

Despite death's inevitability, we consciously and unconsciously disguise or resist its reality in dreams, fairy tales, allegories, and even jokes. In his book, How We Die: Reflections on Life's Final Chapter, Sherwin Nuland describes how we have turned increasingly to modern medicine as one more means of denying the reality of death. As a surgeon with more than forty years of experience in a major metropolitan hospital, Nuland admits to actively participating in this denial. Modern medicine, he argues, influences how we as individuals and as a culture not only view but also experience death. "Modern dying," he contends, "takes place in the modern hospital, where it can be hidden, cleansed of its organic blight, and finally packaged for modern burial." This course uses literature, history, and personal and critical accounts related to death as points of reference for examining the role modern medicine has come to play in how we die. The course requires out-of-class service learning, reading quizzes, papers, participation, and attendance. For graduate students, there are additional paper and presentation requirements. No prerequisites required. Offered as BETH 316 and BETH 416.

BETH 319. Medical Science and Technology in Society. 3 Units.

Science, Technology, and Society (STS) is an interdisciplinary field of scholarship that examines how social, cultural, historical, ethical, and political forces impact scientific research and technological development: and, in turn, how our beliefs, values, and perspectives change in response to scientific and technological innovation. This course will take an STS approach to the study of human health and medicine. We will explore how advances in contemporary biomedicine have affected society and culture, and in turn, how society and culture influence medical science, technology, and clinical practice. Topics we will explore include reproductive technologies, genetics, disability, cyborgs and human enhancement, pharmaceuticals, medical practice, and end-of-life care. The course will prepare students to think critically about scientific and medical knowledge, to thoughtfully examine the relationships between science, technology and culture at large, and to consider the ways that new medical technologies shape and re-shape our understandings of illness, health, and the human body. Weekly course meetings will implement a blend of lectures, discussions, and in-class exercises. Offered as BETH 319 and BETH 419.

BETH 329. Mental Health Ethics. 3 Units.

Mental health ethics is the study of value-laden issues and moral dilemmas around psychological health, illness, and medical treatment. Ethics are crucial to effective clinical practice in both inpatient and outpatient mental health settings and to mental health research, while also shaping how people with mental health conditions navigate daily life. In this class, we will review key issues in the field of mental health ethics including involuntary treatment, deinstitutionalization, boundaries and dual relationships, peer support, user/survivor movements, and the impact of medical technologies on mental health, amongst others. The course will introduce both normative and empirical approaches to mental health ethics, while exploring patient as well as provider perspectives on mental health and illness, utilizing a combination of interactive lectures, guest presentations, and discussions. Students will learn about mental health ethics through the lenses of clinical ethics, disability bioethics, health humanities, social science, and other neighboring disciplines. By the end of this course, students will have a robust and interdisciplinary understanding of a range of ethical issues in mental health practice, research, and advocacy. Offered as BETH 329 and BETH 429.

BETH 339. Disability in Society. 3 Units.

"Disability" refers to health conditions that fundamentally alter how someone engages in the world around them, including physical, psychological, and developmental illnesses. Everyone will experience disability in their lives, whether temporary or chronic, making it especially important to consider how disability shapes, and is shaped by, society at large. In this course, students will learn about the multifaceted relationships between disability and society, including the impact of ethical, cultural, political, and technological factors on the wellbeing of people with disabilities. We will critically examine representations of people with disabilities in literature, the arts, and popular media in order to interrogate the assumptions and stereotypes about disability that circulate through mainstream culture and how they shape interpersonal and institutional practices. Throughout these topics, students will reflect on the intersections of race, gender, and age with disability through a multi-disciplinary lens, drawing on bioethics, anthropology, sociology, literary studies, and the arts. The course sessions will blend lecture and discussion, and assessments will include written responses and exams. Offered as BETH 339 and BETH 439.

BETH 350. Bioethics in Environmental and Occupational Health. 1.5 Unit.

Environmental health threats affect every person and every living thing on this planet. The ethical issues and decisions confronting not only governments, but also public health departments, healthcare providers, and every one of us are countless. Occupational health is a subset of environmental health. Occupational health professionals care for workers with work-related injuries and illnesses and consult on safety and health issues with employers. In occupational health practice, ethical issues arise daily. The types of questions this course will address are: How should states that depend on the Colorado River for water apportion rapidly falling water supplies? How do public health departments plan for extreme weather and natural disasters? How do healthcare providers decide to triage patients in overflowing emergency departments and intensive care units during pandemics? How do community health care providers advise their patients when the community experiences an environmental disaster, such as the East Palestine train derailment? How do health care providers who work for a company manage their loyalty to their company and to their patients, the company's workforce? Do these providers have the same obligations to their patients that other health care providers have? What rules and regulations do and should apply to onsite work clinics? What ethical obligations do companies have to environmental health, to those who live in proximity to their plants, and to the health of their workers? Offered as BETH 350 and BETH 450. Prereq: BETH 271.

BETH 357. Christian Bioethics. 3 Units.

Bioethics is concerned with both clinical and population level healthcare issues. Christian Bioethics aims to integrate the discipline of theology with the field of bioethics to critically evaluate the goals of healthcare and the practices associated with these goals. This course examines the theological sources used to evaluate contemporary clinical and population level healthcare issues. We will examine issues including abortion, end-of-life care, genetic enhancement, the concept of disability, health inequalities and justice, and personal and social responsibility for health, especially as these relate to political and social justice. We will also become familiar with religious moral reasoning and the relationship between religious ethics and nonreligious moral and political philosophy. In doing so, students will learn about the foundations for religion, medicine, and ethics as they intersect with care for individuals and communities. Offered as BETH 357, BETH 457, PHIL 357, PHIL 457, RLGN 357 and RLGN 457.

BETH 360. Science and Society. 3 Units.

This course examines the complex ethical and other value relationships that exist between science and society. Students will be encouraged to question the simplistic view that science proceeds independently of societal values and contentious ethical commitments. A range of other social factors, such as ethical belief systems, political forces, and large-scale financial interests all influence new scientific and technological developments. In order to illuminate each of these larger themes, this course focuses on three exciting areas of scientific inquiry: stem cell research; synthetic biology; and nanotechnology. Each of these contentious scientific fields provides an excellent view into the challenging ethical, cultural, social, political, and economic issues that will face students, both as scholars and as citizens. No prior technical knowledge is necessary for any of these scientific areas. All relevant scientific information will be provided during the course by the professor. Offered as BETH 360, BETH 460 and PHIL 360.

BETH 371. Advanced Bioethics. 3 Units.

This course offers upper-level instruction on many key bioethical issues introduced in BETH/PHIL 271. The class follows a discussion-intensive seminar format. Students begin with an in-depth analysis of ethical issues surrounding the conduct of clinical trials, both within the U.S. and through U.S.-sponsored research abroad. Next students examine the philosophical and practical challenges involved in medical decision making for adults and pediatric patients. This course concludes by addressing the broader ethical problem of what duties we owe to future generations in terms of our reproductive choices and the allocation of health-related public expenditures. Each of these general topic areas - clinical trials, medical decision making, and future generations - is of crucial importance for all students whether one plans to enter a career in biomedical research, the healthcare professions, or some other career path. Everyone is a potential patient or the family member of a potential patient. The topics covered in Advanced Bioethics will help prepare students to become responsible participants in an increasingly complex biomedical world. Offered as BETH 371 and PHIL 371. Prereq: BETH 271 or PHIL 271.

BETH 371C. Advanced Bioethics: Clinical Observation. 1 Unit.

This course is a one credit class intended to supplement BETH 371: Advanced Bioethics. In this course students will become familiar with the clinical, psychological, social, professional, and institutional context in which bioethical problems arise. Students are exposed to clinical cases as they arise, to hospital ethics committees and ethics consultation programs, to institutional review boards (IRB), and to hospital policies covering "do not resuscitate" orders (DNR), advance directives, withdrawal of artificial feeding, and medical futility. The clinical rotation will consist of 20 hours of supervised observation where students attend structured clinical activities such as ICU rounds, case conferences as well as shadow clinicians that work with the Department of Bioethics and are used to having students at various levels of observers. The purpose of the clinical rotation will be to give students first hand observational experience in the health care system and how the key bioethical issues discussed in BETH 371 manifest in the clinical setting. The primary locations for this course are MetroHealth Medical Center and Louis Stokes Cleveland VA Medical Center. Prereq: BETH 271 or PHIL 271. Coreq: BETH 371 or PHIL 371.

BETH 401. Foundations in Bioethics and Medical Humanities I. 6 Units.

The first of the two required seminar courses, this course covers four basic topic areas in bioethics and medical humanities: fundmental concepts and approaches; reproduction, sexual health, and family-making; babies, children, and adolescents; and adults and end-of-life. The course meets twice weekly and is taught in seminar format by Department faculty members who are experts on specific topics. Preentry.

BETH 402. Foundations in Bioethics and Medical Humanities II. 6 Units.

This course completes the required seminar core and covers the basic bioethics and medical humanities topic areas: research ethics and community engagement; public and global health ethics; neurodiversity, mental health, and disability; and ethics in novel biotechnology (genetics, stem cells, AI, FES, etc). The course meets twice weekly and is taught in seminar format by Department faculty members who are experts on specific topics. Recommended preparation: BETH 401.

BETH 402C. Bioethics and Medical Humanities Capstone. 1.5 Unit.

The Capstone paper is an opportunity for the student to demonstrate mastery in an area of Bioethics and Medical Humanities. It is intended to show engagement with interdisciplinary literature in Bioethics and Medical Humanities and also an ability to construct and support an argument. The specific topic in Bioethics and Medical Humanities is chosen by the student in consultation with faculty advisers. Prereq: BETH 401 and student in MA Bioethics and Medical Humanities program. Coreq: BETH 402.

BETH 403. Mental Illness and Bioethics in Film and Literature. 1.5 Unit.

This course examines bioethical issues that arise in the representation of mental illness and its treatment in film and literature. Course requirements include viewing 3 films and reading 3 or more books during the course of the semester, in-class discussion, and assigned writing. The films and works of literature will be rotated each year, with some possible repetitions. Prereq: Graduate Bioethics student or Requisites Not Met permission.

BETH 404. Poetry Boot Camp Workshop: Bioethical Poetry Topics Human, Mental Illness and Animal Welfare. 3 Units.

In this introductory poetry writing workshop and study of bioethical issues in poetry, you will write poems each day and read a wide variety of poems that are organized according to either bioethical themes or demonstrations of types of poem or craft. Participants will undertake in-class study of the following poets: James Wright, John Keats, Sylvia Plath, Robert Lowell, Theodore Roethke, and Langston Hughes, among others. As the week proceeds, we will consider how to read and review poetry with special attention to tone, theme, structure, and response to specific words and lines from poems.

BETH 405. Clinical Ethics Rotation. 1.5 - 3 Units.

In this course students will become familiar with the clinical, psychological, social, professional, and institutional context in which ethical problems arise. This course exposes students to clinical cases, to hospital ethics committees and ethics consultation programs, to institutional review boards (IRB), and to hospital policies covering the "do not resuscitate" orders (DNR), advance directives, withdrawal of artificial feeding, organ procurement and transplantation, and medical futility. Requires minimum of 8 total hours of rotation experience per week during two semester 10-week rotations. Locations for this course include: MetroHealth Medical Center, University Hospitals of Cleveland, and the Hospice of the Western Reserve. Recommended preparation: BETH 401 or concurrent enrollment.

BETH 406. Society, Religion, and Bioethics. 3 Units.

Focus and Scope of Course: The course examines the interplay of politics, governmental structures, culture and religion and their impact on ethics questions that arise in the health arena. The course provides a broad overview of the basic tenets of several major faith traditions and examines how and why the interpretation of such tenets and their impact on bioethics issues varies across different societies. The specific domains in which we explore such issues, e.g., reproductive health, regenerative medicine, end-of-life issues, infectious disease, may be rotated each year. Objectives: Students will be able to *Describe how religious views and interests affect policymaking with respect to a variety of health-related issues *Enunciate strategies for the reconciliation of bioethics perspectives stemming from diverse religious interests in a pluralistic society *Compare and contrast the perspective of various world religions with respect to specific bioethics issues Prereq: Open to Graduate Students and Seniors only.

BETH 409. Aging, Ageism, and Embodiment. 3 Units.

What is the experience of "growing old" in America, and how does it differ based on one's sex, gender, sexuality, race or ethnicity, and socioeconomic or disability status? What lies behind America's anti-aging culture and the growth of anti-aging medicine? How does ageism manifest, and how does it affect our aging and our health? In this course, we will consider the social, cultural, scientific, medical, and personal meanings of aging, and how these meanings, as well as the embodied experience of aging in America, are influenced by multiple forms of ageism. We will interrogate the assumptions and stereotypes about age that circulate through mainstream American culture and medicine and how these shape interpersonal and institutional practices. How might we begin to recognize, respond to, and change ageism, and thus our own inevitable experiences of aging? The course requires participation and attendance, papers, and for graduate students an additional presentation. No prerequisites are required. Offered as BETH 309 and BETH 409. Counts as a CAS Global & Cultural Diversity course.

BETH 410. Foundations of Medicine, Society and Culture. 3 Units.

Topics will include comparative medical systems and concepts of health, medical history, illness narratives and narrative ethics, social determinants of health and health inequalities, analysis of representations of illness and medicine in literature and the arts, and medical rhetoric. Students who complete the course should develop a command of the basic problems, approaches, and literatures in the social and cultural contexts of health sickness, and medicine. Students will be able to identify epistemology, theory, methodology and data from neighboring disciplines and understand affordances and costs in each.

BETH 411. Narrative Medicine: Methodology in Patient-Centered Medical Education. 3 Units.

Narrative Medicine, or medicine practiced with narrative skills (as defined by Rita Charon, MD, PhD), is a methodology in patient-centered medical education. Narrative medicine is informed by the theory and practice of reading, writing, telling, and receiving of stories as a clinically empowering practice for anyone engaged (or planning to engage) in the field of healthcare. This course will employ various methods of learning and experiencing narrative, including fundamental skills of close reading and reflective writing and other forms of self-representation. Narrative competence is an important skill that enables a person to "recognize, absorb, interpret, represent, and be moved by the stories of illness". Major themes throughout the course will include caregivers' and patients' empowerment, empathy, narrative ethics, testimony, reflexive writing, and illness and medical stories. The course will be conducted in a seminar-type format. Each session will have readings that relate to the theory of narrative (primarily from the Charon textbook but also from other sources in the Ethics and Humanities professional literature) and related health humanities. Many of the sessions will also include the application of reflective practice/close reading. Additional elements will be writing workshops and use of film and visual art as narrative. The class will meet once weekly for a 3 hour session. This class is open to graduate students in any humanities or healthcare field, and will be especially useful to those who intend to have a future career in which direct care of patients/clients is a part of their work.

BETH 412. Ethical Issues in Genetics/Genomics. 3 Units.

This course is designed to familiarize graduate students with the major controversies over the generation and use of new human genetic information. Topics will include the spread of predictive genetic testing, prenatal diagnosis, genetic discrimination, human genetic variation research, eugenics, genetic counseling, and the limits of human gene therapy. The course will be conducted as a seminar, involving discussions of readings, guest speakers, and student presentations.

BETH 413. A Social Justice Perspective on Digital Medicine and the Digital Divide. 1.5 Unit.

This course begins by exploring bioethical and social justice perspectives related to the digital divide and to efforts to address gaps. We will then consider the risks and benefits to individuals and to populations from the proliferating use of health-relevant data from smartphone apps, wearable devices, data generated from our google searches, etc. We will apply a social justice lens to evaluating how the FDA regulates consumer digital health technology and consider the potential risks and harms that an IRB might consider in evaluating proposals for using devices in clinical research. Finally, we will apply our learning about the digital divide and digital devices to assess individual and societal risks and benefits associated with apps intended to mitigate the risk of COVID-19.

BETH 415. International Bioethics: Policy and Practice. 3 Units.

Taught by Case and international faculty, this course will include 7-10 days of intensive didactic and experiential learning in one of several "host" countries. Examples of sites include: Free University of Amsterdam and University of Utrecht in the Netherlands; University of Paris in France; and Ben Gurion University in Israel. It will afford a unique opportunity to gain perspective on important bioethics issues in different societies, i.e., euthanasia, public health policies, access to healthcare, and stem cell research. At the international site, students will spend 6 hours per day (5 days) in seminar (involving didactics, discussion, and guided-observation clinical experience). There will be two 3-hour preparatory sessions, required reading, and two 3-hour post trip sessions. Requirements: preparation, attendance, and class participation, a 12-15 page paper (undergraduate credit) and a 15-20 page paper (graduate credit). Graduate credit will also require students to prepare a presentation for a post-intensive session. Enrollment will be capped at 25. This course has an additional fee to cover costs of travel and lodging. Limited scholarships are available. Offered as BETH 315 and BETH 415.

BETH 415A. International Bioethics Policy and Practice: Women's Health in the Netherlands. 3 Units.

This 3-credit course allows students to familiarize themselves with social policies and practices related to women's health in the United States and the Netherlands. Issues covered in the course include birth control and family planning, abortion, prenatal testing, childbirth, health care disparities, cosmetic surgery, prostitution and trafficking in women. This course also addresses the US and Dutch national policies regarding the public provision of health care for women. The course places an emphasis on the ways in which social norms shape policies over time, which political actors are involved in shaping women's health policy, and the balance between women's health as a matter of the public good or individual responsibility. This course substantively explores gender-specific cultural values and practices in relation to women's health in the United States and the Netherlands and will help students develop the analytical skills necessary for evaluating social policy and ethical issues related to women's health. Offered as BETH 315A, BETH 415A and WGST 315A. Counts as a CAS Global & Cultural Diversity course.

BETH 415B. International Bioethics Policy and Practice: Public Health in the Netherlands. 3 Units.

This one week 3-credit intensive course will be held in Amsterdam, The Netherlands. Taught by faculty from Case and Utrecht University, this course offers students a cross-cultural perspective on ethical dilemmas raised by the practice of public health in the United States and Northern Europe. Additionally, this course examines policies related to prostitution, drug use, sex education, infectious disease prevention, and access to health care and how they differ in the cultural and political settings of U.S. and the Netherlands. We will examine both the rationales and outcomes of Dutch and American policies, stimulating course participants to consider their own views on these often controversial issues. Prior to the trip, students will attend lectures at Case, which will acquaint them with the theoretical approaches to public health ethics and major issues raised in the practice of public health. In these pre-trip sessions, students will also analyze and report on a case study designed to stimulate critical thinking on comparative public health ethics. In Amsterdam, students will attend lectures that will be supplemented by site visits and discussion sessions aimed at exploring the ethics of public health policy and practice in the Netherlands. Following the intensive week in Amsterdam, students will meet with instructors at Case for two hours to discuss their experiences and compare policies and practices in the U.S. and the Netherlands. Offered as BETH 315B and BETH 415B. Counts as a CAS Global & Cultural Diversity course.

BETH 415C. International Bioethics Policy and Practice: Health Care Costa Rica. 3 Units.

This 3-credit course gives students the unique opportunity to observe patients and practitioners encounter in a radically different health care system. Costa Rica has one of the most comprehensive health care systems in the Western hemisphere, featuring the innovative use of mid-level health care workers organized in basic comprehensive health care teams. This has resulted in a longer life expectancy than the United States, despite a per capita GDP of only $10,000 per person. Students will gain first-hand experience of Costa Rican health care through field experiences at sites including a national hospital in the capital city, San Jose; a peripheral treatment clinic in a smaller town; and observation of the work of an integrated basic health care team in an indigenous reserve. Following each visit, students will discuss the practical and ethical dilemmas that practitioners face in the context of the Costa Rican health care system. Specific topics include: health inequalities within and between nations; the ethics of transplantation, medical research, and end-of-life care; and health care in rural environments and with indigenous populations. Offered as BETH 315C and BETH 415C. Counts as a CAS Global & Cultural Diversity course.

BETH 415D. French Connections, A Cross-Cultural Comparison of Medical Ethics. 3 Units.

This 3-credit course is collaboration between Case Western Reserve University and the University of Paris. The course includes a ten-day trip to Paris, France over Spring Break. This course offers a cross-cultural comparison of the French and American medical systems. Students will have the unique opportunity to learn first-hand how the French medical education system is structured and how the social, cultural and political contexts in France shape medical and ethical issues. The trip includes guided field experiences in French clinical settings as well as opportunities to engage with French faculty members and physicians about contemporary issues in bioethics. Ethical issues that may be considered may include reproductive rights, decision-making involving severely impaired newborns, withholding/withdrawing life-sustaining treatment and issues in organ donation and transplant. The course also will also emphasize the role of French culture and history while in Paris with museum and site visits designed to complement seminar content and offer real-life illustrations of course content. Prior to the trip, students attend six hours of lectures, either at Case Western Reserve University or via a web-based tutorial. They are expected to become familiar with the representative articles assigned for the course, and be prepared to integrate those readings into pre-trip class participation and active participation while in France. Following the trip, students meet with the instructor for an additional four hours to discuss and synthesize their experiences. Offered as BETH 315D and BETH 415D. Counts as a CAS Global & Cultural Diversity course.

BETH 415F. Comparison in Bioethics, Spanish and American Perspectives on Health, Medicine, and Culture. 3 Units.

This 3-credit intensive course will include several day long sessions at CWRU and two weeks of classes and activities in the city of Granada, Spain. Taught by faculty from CWRU and UPV/EHU, this course offers students a cross-cultural perspective on bioethics in the United States and Spain. It uses the medium of film, complemented by readings in bioethics, film criticism, and medical research, to introduce students to a number of compelling bioethics issues, including end-of-life, reproductive ethics, biomedical research and organ transplantation. Offered as BETH 315F and BETH 415F. Counts as a CAS Global & Cultural Diversity course.

BETH 415G. Death, Dying & Euthanasia: Netherlands & the USA. 3 Units.

Is it ever permissible for physicians to kill their patients? In the Netherlands, the answer is yes. In the United States, it is no. Are the Dutch sliding down a moral slippery slope? Are the Americans compromising the rights and dignity of dying patients? This 3-credit course is a unique opportunity to examine a range of Dutch and American end-of-life policies and practices with special focus on the unique ethical, cultural, religious, and legal contexts in which they developed. This course will compare how two liberal democracies, the United States and the Netherlands, have handled difficult end-of-life issues, including: The Dutch regulation of euthanasia; Regulation of physician-assisted suicide in the state of Oregon; Terminal sedation; End-of-life decisions in newborns; Withholding and withdrawing of artificially-provided fluids and nutrition; The legal basis for end-of-life decision making in the USA; Palliative care and hospice; Public trust in medicine and physicians. In the United States, teaching methods will include lectures, case discussion, and exposure to how some of the course's themes are reflected in popular culture such as movies. Offered as BETH 315G and BETH 415G. Counts as a CAS Global & Cultural Diversity course.

BETH 415H. Water Security and Social Justice in Brazil. 3 Units.

CWRU, through the Center for Global Health and Diseases, has had projects, student exchanges and courses with institutions in Brazil and especially with the state of Bahia for over 30 years. In that time, personal and professional relationships have been developed with branches of the Ministry of Health (Oswaldo Cruz Foundation, the Municipal and State Health Departments), the Federal University of Bahia, and the Bahiana School of Medicine and Public Health. Brazil is the second largest country in the Western Hemisphere and the 7th or 8th largest economy in the world. There are more people who speak Portuguese in South America than Spanish. Despite newly discovered oil, enormous natural and human resources, development in Brazil has been uneven with the Northeast remaining the least developed. The Northeastern state of Bahia ranked 22nd out of 27 states on the UN's Index of Human Development (http://www.pnud.org.br/IDH/DH.aspx# and http://www.atlasbrasil.org.br/2013/pt/home/). The State capital, Salvador, ranks 14th out of 20 major metropolitan regions and is one site for this study abroad program. The second site, the rural town of Ubaíra, is ranked 4590 out of 5565 municipalities. Even with large social inequities and health care disparities, the Brazilian government and society have produced remarkable social policies, have shown a willingness to implement these policies and have the resources to significantly improve the lives of its most impoverished citizens. Critical basic infrastructure for health and development is water. Its consumption is essential; it is a mechanism for waste disposal, industry and agriculture are dependent on its supply. The problem of water quantity and quality are common all human societies (witness the drought in California and the burning Cuyahoga). Individuals from all walks of life will need to assess issues of water at some time, from doctors, engineers, urban planners, lawyers and politicians. In Brazil the issues of water are more exposed and easier to examine on different scales than in the U.S. The problem also resides within a social, health care, and political context that compares well and at the same time contrasts sharply with that of the USA. As a student in this course, you will gain first-hand knowledge of the social and public health challenges regarding water security in Brazil. Through field experiences in the capital city of Salvador and the rural town of Ubaíra, you will immerse yourself in interdisciplinary perspectives on the public health, scientific, political, and bioethical dimensions of water security in Brazil. This immersive experience will be facilitated by faculty from the CWRU Dept. of Bioethics and the Center for Global Health and Diseases, the Brazilian Ministry of Health, the Federal University of Bahia, the Bahiana School of Medicine and Public Health, and Brazilian graduate student participants. Offered as: INTH 315, INTH 415, BETH 315H, and BETH 415H. Counts as a CAS Global & Cultural Diversity course.

BETH 415J. Dutch Perspectives: Drugs, Decriminalization and Detention. 3 Units.

This course will offer students the opportunity to compare and contrast the ways in which the Netherlands and the United States approach drug use. In particular, students will be asked to carefully examine the ethical dimensions of harm reduction programs, policies regarding the availability and the decriminalization of drugs, and the critical role of detention and correctional medical care in addressing drug use. The course will include an introduction to the Dutch and U.S. health care and health insurance systems and will consider how the construction of the patient-physician relationship impacts the prevalence and treatment of drug use in each country. In addition, students will explore the ethics of public health initiatives and social programs aimed at drug users in both settings, including those designed for particular populations such as immigrants and older users. The course will pay special attention to the unique challenges and ethics of the opioid crisis in the U.S. Offered as BETH 315J and BETH 415J. Counts as a CAS Global & Cultural Diversity course.

BETH 415Y. Conservation, Compassion and Awe in Yellowstone National Park: Environmental Ethics and Human Health. 3 Units.

This class brings together the study of conservation, ethics and human well-being in a hands-on investigation at Yellowstone National Park. The course returns to the original meaning of the term bioethics as including the biome. It covers conservation ethics and human relationships with the environment and other species as they impact human health across multiple levels. The course draws on theories, models, and methods from psychological anthropology and political ecology to frame the complex dynamics of interaction. The evolution and psychology of compassion and awe are engaged in processual models of human interaction with the natural world and other species. Both have important implications for human health in everyday behavioral practice and in clinical settings. The course involves pre-departure study and then will integrate the materials in the field in Yellowstone National Park looking at contemporary and historical issues in partnership with Yellowstone Forever Institute instructors. In particular, the case of the conservation of the American bison will be used to understand multi-level issues over time in culture, politics, environment, human behavior, and health. The course requires papers, participation, attendance and a field journal. Offered as BETH 315Y and BETH 415Y.

BETH 416. Death, Dying, and Modern Medicine. 3 Units.

Despite death's inevitability, we consciously and unconsciously disguise or resist its reality in dreams, fairy tales, allegories, and even jokes. In his book, How We Die: Reflections on Life's Final Chapter, Sherwin Nuland describes how we have turned increasingly to modern medicine as one more means of denying the reality of death. As a surgeon with more than forty years of experience in a major metropolitan hospital, Nuland admits to actively participating in this denial. Modern medicine, he argues, influences how we as individuals and as a culture not only view but also experience death. "Modern dying," he contends, "takes place in the modern hospital, where it can be hidden, cleansed of its organic blight, and finally packaged for modern burial." This course uses literature, history, and personal and critical accounts related to death as points of reference for examining the role modern medicine has come to play in how we die. The course requires out-of-class service learning, reading quizzes, papers, participation, and attendance. For graduate students, there are additional paper and presentation requirements. No prerequisites required. Offered as BETH 316 and BETH 416.

BETH 417. Introduction to Public Health Ethics. 3 Units.

The course will introduce students to theoretical and practical aspects of ethics and public health. This course will help students develop the analytical skills necessary for evaluating of ethical issues in public health policy and public health prevention, treatment, and research. Will include intensive reading and case-based discussions. Evaluation based on class participation, a written exercise and a case analysis. Open to graduate students with permission from instructors.

BETH 418. Seminar in Medicine, Society, and Culture. 1.5 Unit.

This course is designed to facilitate independent intellectual engagement with medical humanities educational programming occurring within the CWRU School of Medicine, the larger campus community, the surrounding medical, cultural and community institutions, as well as nationally and internationally. CWRU and Cleveland are a major national hub for medical humanities and related programming. Students will design and choose a series of medical humanities events to attend. With permission of the instructor(s), students will attend 10 events and write a reflection paper on each event. At the conclusion of the course, students will have interacted with multiple disciplines, scholars, institutions and approaches in medical humanities. Prereq: MA in Bioethics & Med Humanities students only.

BETH 419. Medical Science and Technology in Society. 3 Units.

Science, Technology, and Society (STS) is an interdisciplinary field of scholarship that examines how social, cultural, historical, ethical, and political forces impact scientific research and technological development: and, in turn, how our beliefs, values, and perspectives change in response to scientific and technological innovation. This course will take an STS approach to the study of human health and medicine. We will explore how advances in contemporary biomedicine have affected society and culture, and in turn, how society and culture influence medical science, technology, and clinical practice. Topics we will explore include reproductive technologies, genetics, disability, cyborgs and human enhancement, pharmaceuticals, medical practice, and end-of-life care. The course will prepare students to think critically about scientific and medical knowledge, to thoughtfully examine the relationships between science, technology and culture at large, and to consider the ways that new medical technologies shape and re-shape our understandings of illness, health, and the human body. Weekly course meetings will implement a blend of lectures, discussions, and in-class exercises. Offered as BETH 319 and BETH 419.

BETH 421. Research Ethics Practicum. 1.5 Unit.

The Research Ethics Practicum (80 hours,1.5 CREDITS) is designed to complement the theoretical and conceptual training received in the course, Critical Issues in Research Ethics. By way of a series of campus-wide rotations, students learn about the practical, everyday side of research administration, compliance, and scientific review. Students will work with key staff in research ethics centers, and observe their day-to-day operations, as well as attend institutional review board (IRB) and Institutional Animal Care and Use Committee (IACUC) meetings. They will become familiar with human subjects, animal, and tissue research regulations and policies as these are applied in an institutional/academic research context. Students will also spend time in a clinical trials unit and tour animal care facilities. The practicum has the following overall objectives: (1) students will be able to identify, analyze, and understand research ethics issues as they develop in the context of actual institutional research governance (2) students will gain an understanding of methods of ethical research design and implementation.

BETH 422. Clinical Ethics: Theory & Practice. 3 Units.

This course will focus on both theoretical and practical issues in clinical ethics. Clinical ethics will be distinguished from other areas of bioethics by highlighting distinctive features of the clinical context which must be taken into account in clinical ethics policy and practice. Fundamental moral and political foundations of clinical ethics will be examined, as will the role of bioethical theory and method in the clinical context. Topical issues to be considered may include informed consent; decision capacity; end of life decision making; confidentiality and privacy; the role and function of ethics committees; ethics consultation; the role of the clinical ethicist; decision making in various pediatric settings (from neonatal through adolescent); the role of personal values in professional life (e.g., rights of conscience issues, self disclosure and boundary issues); dealing with the chronically non-adherent patient; ethical issues in organ donation and transplant; health professional-patient communication; medical mistakes; and other ethical issues that emerge in clinical settings.

BETH 423. Neuroethics. 3 Units.

This course is designed to provide an overview of ethical issues related to current and future neurotechnologies as they are applied clinical and research settings. We will cover many topics related to medical care for patients with neurological disorders, including cognitive vulnerability, neurodiversity, stigma and biases in mental health, brain implants, consciousness, selfhood in neurodegenerative disease, and enhancement. Classroom activities will primarily consist of discussion of selected readings related to a topic in neuroethics, moderated by the instructor. In addition, experts will be invited to visit the classroom to assist in the dialogue. Students will actively participate in discussion, debate, written scholarship and presentation to peers. Evaluation will be based on classroom participation, short writing assignments, and an independent project that will be designed in collaboration with the instructor culminate in both a written and oral presentation.

BETH 426. Ethics of Pain Management in Vulnerable Populations. 3 Units.

This course will explore the multidimensional qualities of the human experience of pain, including its moral dimensions. Vulnerable populations across the lifespan most subject to unethical pain care will be described (e.g., marginalized populations, those with substance use disorder, chronic pain, mental health comorbidities, cognitive disabilities, and others). Historic and current views of the moral obligation of healthcare providers to treat people with pain will be discussed. Select codes of ethics and pain management policies will be critiqued. Ethical theories will be reviewed for their utility in providing frameworks for determining how ethical, empathetic, effective, and safe pain care can be achieved in the most vulnerable populations. Offered as NURS 326, BETH 426 and NURS 426. Counts as a Moral & Ethical Reasoning course. Prereq: Graduate student standing.

BETH 428. Clinical Ethics Consultation Simulation Course. 1.5 Unit.

This course will expose students to the complex world of clinical ethics by challenging them to assume the role of a healthcare ethics consultant in an immersive simulated training environment. Frequently used in medical education, simulation is an educational strategy that emphasizes experiential learning. Using medical simulation teaching methods to create various scenarios and situations commonly experienced by professional clinical ethicists, students will learn the core competencies of clinical ethics consultation and how various concepts, laws, policies, and documents impact medical decision making. Given the immersive nature of the course, students will be expected to carry a simulated `on-call pager' as well as to attend in- person simulation sessions in order to simulate the professional role and responsibilities of a clinical ethicist. Prereq: BETH 422 and BETH 405.

BETH 429. Mental Health Ethics. 3 Units.

Mental health ethics is the study of value-laden issues and moral dilemmas around psychological health, illness, and medical treatment. Ethics are crucial to effective clinical practice in both inpatient and outpatient mental health settings and to mental health research, while also shaping how people with mental health conditions navigate daily life. In this class, we will review key issues in the field of mental health ethics including involuntary treatment, deinstitutionalization, boundaries and dual relationships, peer support, user/survivor movements, and the impact of medical technologies on mental health, amongst others. The course will introduce both normative and empirical approaches to mental health ethics, while exploring patient as well as provider perspectives on mental health and illness, utilizing a combination of interactive lectures, guest presentations, and discussions. Students will learn about mental health ethics through the lenses of clinical ethics, disability bioethics, health humanities, social science, and other neighboring disciplines. By the end of this course, students will have a robust and interdisciplinary understanding of a range of ethical issues in mental health practice, research, and advocacy. Offered as BETH 329 and BETH 429.

BETH 436. Reproductive Ethics and Justice. 3 Units.

Reproductive ethics deals not only with pregnancy and birth, but also with the broader social, biological, and ethical contexts in which reproductive health lives. Principles of autonomy and justice will guide this course as we examine the ways that people have children, avoid having them, and make parenting decisions, and the contexts in which these actions and decisions happen. We will meet weekly for seminar-style discussion

BETH 439. Disability in Society. 3 Units.

"Disability" refers to health conditions that fundamentally alter how someone engages in the world around them, including physical, psychological, and developmental illnesses. Everyone will experience disability in their lives, whether temporary or chronic, making it especially important to consider how disability shapes, and is shaped by, society at large. In this course, students will learn about the multifaceted relationships between disability and society, including the impact of ethical, cultural, political, and technological factors on the wellbeing of people with disabilities. We will critically examine representations of people with disabilities in literature, the arts, and popular media in order to interrogate the assumptions and stereotypes about disability that circulate through mainstream culture and how they shape interpersonal and institutional practices. Throughout these topics, students will reflect on the intersections of race, gender, and age with disability through a multi-disciplinary lens, drawing on bioethics, anthropology, sociology, literary studies, and the arts. The course sessions will blend lecture and discussion, and assessments will include written responses and exams. Offered as BETH 339 and BETH 439.

BETH 441. Seminar in Medical and Health Humanities. 1.5 Unit.

This course is designed to facilitate independent intellectual engagement with medical/health humanities educational programming occurring within the CWRU School of Medicine, the larger campus community, the surrounding medical, cultural and community institutions, as well as nationally and internationally. CWRU and Cleveland are a major national hub for medical/health humanities and related programming. Students will design and choose a series of medical/health humanities events to attend. With permission of the instructor, students will attend multiple events and write a reflection paper on each event. Students will additionally complete readings and respond in discussion forums, conduct further research on a topic and present to their peers, and prepare a project for an external audience such as a written piece submitted for publication. At the conclusion of the course, students will have interacted with multiple disciplines, scholars, institutions and approaches in medical/health humanities.

BETH 442. Animal Ethics in Theory and Practice. 1.5 Unit.

The course aims to provoke a critical evaluation of the relationship between people and other animals by starting from a solid foundation in factual information about animal cognition and capabilities, about animals as research subjects, as food, as targets of conservation, as objects for human entertainment, and in complex, often paradoxical relationships with humans. We will survey philosophical thought and principle-based theory about animal ethics, before turning to practical and applied animal ethics. The course will use art and culture as a way to understand the relationship between human and non-human life. Prereq: Students in the MA in Bioethics and Medical Humanities program.

BETH 450. Bioethics in Environmental and Occupational Health. 1.5 Unit.

Environmental health threats affect every person and every living thing on this planet. The ethical issues and decisions confronting not only governments, but also public health departments, healthcare providers, and every one of us are countless. Occupational health is a subset of environmental health. Occupational health professionals care for workers with work-related injuries and illnesses and consult on safety and health issues with employers. In occupational health practice, ethical issues arise daily. The types of questions this course will address are: How should states that depend on the Colorado River for water apportion rapidly falling water supplies? How do public health departments plan for extreme weather and natural disasters? How do healthcare providers decide to triage patients in overflowing emergency departments and intensive care units during pandemics? How do community health care providers advise their patients when the community experiences an environmental disaster, such as the East Palestine train derailment? How do health care providers who work for a company manage their loyalty to their company and to their patients, the company's workforce? Do these providers have the same obligations to their patients that other health care providers have? What rules and regulations do and should apply to onsite work clinics? What ethical obligations do companies have to environmental health, to those who live in proximity to their plants, and to the health of their workers? Offered as BETH 350 and BETH 450.

BETH 455. Research Ethics Journal Club. 1 Unit.

This seminar course will discuss current topics in biomedical research ethics via recently published articles in both the scholarly literature and the popular science press. For each session, students will choose articles with instructor's guidance, prepare discussion questions, and lead discussion. Prereq: Enrolled in the M.A. in Bioethics and Medical Humanities program.

BETH 456. Research Ethics Journal Club. .5 Unit.

This in-person seminar course will discuss current topics in biomedical research ethics via recently published articles in both the scholarly literature and the popular science press. For each session, students will choose articles with Dr. Michie's guidance, prepare discussion questions, and lead discussion.

BETH 457. Christian Bioethics. 3 Units.

Bioethics is concerned with both clinical and population level healthcare issues. Christian Bioethics aims to integrate the discipline of theology with the field of bioethics to critically evaluate the goals of healthcare and the practices associated with these goals. This course examines the theological sources used to evaluate contemporary clinical and population level healthcare issues. We will examine issues including abortion, end-of-life care, genetic enhancement, the concept of disability, health inequalities and justice, and personal and social responsibility for health, especially as these relate to political and social justice. We will also become familiar with religious moral reasoning and the relationship between religious ethics and nonreligious moral and political philosophy. In doing so, students will learn about the foundations for religion, medicine, and ethics as they intersect with care for individuals and communities. Offered as BETH 357, BETH 457, PHIL 357, PHIL 457, RLGN 357 and RLGN 457.

BETH 460. Science and Society. 3 Units.

This course examines the complex ethical and other value relationships that exist between science and society. Students will be encouraged to question the simplistic view that science proceeds independently of societal values and contentious ethical commitments. A range of other social factors, such as ethical belief systems, political forces, and large-scale financial interests all influence new scientific and technological developments. In order to illuminate each of these larger themes, this course focuses on three exciting areas of scientific inquiry: stem cell research; synthetic biology; and nanotechnology. Each of these contentious scientific fields provides an excellent view into the challenging ethical, cultural, social, political, and economic issues that will face students, both as scholars and as citizens. No prior technical knowledge is necessary for any of these scientific areas. All relevant scientific information will be provided during the course by the professor. Offered as BETH 360, BETH 460 and PHIL 360.

BETH 466. Promoting Health Across Boundaries. 3 Units.

This course examines the concepts of health and boundary spanning and how the synergy of the two can produce new, effective approaches to promoting health. Students will explore and analyze examples of individuals and organizations boundary spanning for health to identify practice features affecting health, compare and contrast practices and approaches, and evaluate features and context that promote or inhibit boundary spanning and promoting health. Offered as MPHP 466, PQHS 466, SOCI 466, NURS 466 and BETH 466. Prereq: Graduate student status or instructor consent.

BETH 501. Advanced Study in Bioethics. 1.5 Unit.

The focus and content of this course rotates each semester that it is offered. The course provides students with an opportunity to examine in greater depth a particular issue or dimension of bioethics and/or a particular event with significant bioethical implications. Prereq: Graduate Standing.

BETH 503. Research Ethics and Regulation. 1.5 - 3 Units.

This course will introduce students to key ethical requirements and issues that arise in the design and implementation of scientific research. Historical developments leading to the establishment of national and international guidelines for ethical conduct in research with human subjects will be addressed. Specific international and national guidelines for ethically responsible research will be explored with attention to their merits and limitations in the conduct of research. Informed consent, a fundamental requirement for ethical research will be examined. The function and role of institutional review boards (IRBs) will be described with attention to challenges faced by investigators in adhering to regulatory requirements. Ethical issues associated with risk assessment and recruitment strategies will be examined. Ethical issues that arise in the implementation of biobanks and stem cell research will be discussed. Challenges associated with the development and production of pharmaceuticals will be assessed. The importance of scientific integrity in the conduct of research will be examined with special attention to conflicts of interest and scientific misconduct such as research fraud. The role of advocacy in promoting research will be addressed. Research ethics and human rights will be explored. The course will end with a discussion of emerging issues in research ethics. Case examples will be used to illustrate ethical complexities surrounding the topics discussed. Offered as BETH 503, CRSP 603 and LAWS 5225.

BETH 504. Critical Readings in Bioethics. 3 Units.

This course will focus on both normative (traditional) and descriptive (empirical) approaches to bioethics. It will be co-directed by two faculty members, one with a specialization in normative bioethics and one with a specialization in descriptive bioethics.

BETH 505. Philosophical Bioethics. 3 Units.

The purpose of this seminar is to learn methods and develop skills necessary to do high-quality philosophical bioethics. Bioethics is, of course, an irreducibly multi-disciplinary endeavor. But to the extent that the defining task of bioethics is to ask and answer normative questions that arise in the course of biomedical practice and research, philosophy is an indispensable element. To do philosophical bioethics is to put front and center conceptual and normative issues in bioethics. And to productively address such issues requires certain tools. In this course, we'll identify, develop, and sharpen those tools, and then put them to use by critically engaging with contemporary work in philosophical bioethics.

BETH 507. Research Design in Bioethics I. 3 Units.

The first of two empirical research courses will introduce students to theoretical and methodological approaches in the design and implementation of empirical research on topics in biomedical ethics. Students will be provided with a comprehensive and robust exploration of empirical models for the development of bioethics research and the skills for critically assessing the optimal methods for designing studies relevant to ethical issues in biomedicine.

BETH 508. Research Design in Bioethics II. 3 Units.

The second of two empirical research courses will introduce students to theoretical and methodological approaches in the design and implementation of empirical research on topics in biomedical ethics. Students will be provided with a comprehensive and robust exploration of empirical models for the development of bioethics research and the skills for critically assessing the optimal methods for designing studies relevant to ethical issues in biomedicine. Prereq: BETH 507.

BETH 511. Grant Writing. 3 Units.

This course will teach students the fundaments of writing a grant proposal. We will concentrate on NIH-style applications, although the principals of grant writing can be applied to any venue. In the process of working through devising a research question and study design, students will be encouraged to use this as an opportunity to think about their dissertation topic. In addition to applying theoretical and research design knowledge gained through their other core course work, the course will also teach students about how to complete application forms and to create a budget. We will also familiarize students with the peer review process. Each student will produce a draft grant application. The students will form a mock peer review section and will critique the grants.

BETH 512. Clinical Ethics Rotation - Ph.D.. 1.5 Unit.

In this course students will become familiar with the clinical, psychological, social, professional, and institutional context in which ethical problems arise. This course exposes students to clinical cases, to hospital ethics committees and ethics consultation programs, to institutional review boards (IRB), and to hospital policies covering the "do not resuscitate" orders (DNR), advance directives, withdrawal of artificial feeding, organ procurement an transplantation, and medical futility. Requires minimum of 10 total hours of rotation experience per week during two semester 10-week rotations. Locations for this course include: MetroHealth Medical Center, University Hospitals of Cleveland, and the Hospice of the Western Reserve. Recommended preparation: BETH 520/BETH 521 or concurrent enrollment.

BETH 520. Foundations in Bioethics I - Ph.D.. 3 Units.

The first of the two required seminar courses, this course covers five basic topic areas in bioethics: death and dying; health professional-patient relationship; method and theory in bioethics; organ transplantation; and ethics and children. The course meets twice weekly and is taught in seminar format by Center faculty members who are experts on specific topics.

BETH 521. Foundations in Bioethics II - Ph.D.. 3 Units.

The second of the two required seminar courses, this course covers five basic topic areas in bioethics: death and dying; health professional-patient relationship; method and theory in bioethics; organ transplantation; and ethics and children. The course meets twice weekly and is taught in seminar format by Center faculty members who are experts on specific topics.

BETH 602. Special Topics in Bioethics. 1 - 3 Units.

Students will explore particular issues and themes in biomedical ethics in depth through independent study and research under the direction of a faculty member.

BETH 701. Dissertation Ph.D.. 1 - 9 Units.

(Credit as arranged.) Prereq: Predoctoral research consent or advanced to Ph.D. candidacy milestone.