2013-14 General Bulletin

This is an archived copy of the 2013-14 bulletin. To access the most recent version of the bulletin, please visit http://bulletin.case.edu.

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Room TA-200, School of Medicine
http://www.case.edu/med/bioethics/bioethics.html
Phone: 216.368.8718
Stuart J. Youngner, MD, Susan E. Watson Professor of Biomedical Ethics and Chair

Marie Norris , Program Assistant

The mission of the Department of Bioethics is to improve public and professional understanding of the ethical issues involved in health sciences research, health care delivery, and health policy development through teaching, research and community dialogue.

The department has offices at the Case’s School of Medicine and at MetroHealth Medical Center and has faculty from multiple disciplines, including philosophy, religion, law, political science, anthropology, history, sociology, nursing and medicine.

Department faculty teach in both core and elective components of the medical school curriculum, undergraduate courses in ethics, and an intensive course in responsible conduct of research for PhD students in the School of Medicine. The department also has a highly successful master’s degree program in bioethics.

Department faculty have gained international prominence for research in many areas of biomedical ethics that collectively address the concerns of the School of Medicine’s spectrum of biomedical disciplines.

The Department of Bioethics publishes a newsletter, Bioethics Update. Bioethics Update contains information and articles on a variety of ethical issues of interest to both professional and lay communities. It is published three times a year and features faculty research and activities, department events, and master’s degree alumni information.

Please visit the department website , where visitors can read Bioethics Update online, obtain information about the master’s degree and PhD programs, and learn about department and faculty activities.

Master of Arts in Bioethics Degree

The Department of Bioethics offers a program leading to the Master of Arts degree in bioethics, emphasizing the interdisciplinary and inter-professional nature of the field. This graduate program is designed to provide advance training in bioethics for students and professionals who anticipate encountering ethical issues in the course of their primary careers.

The 27 credit-hour degree can be earned full-time in one year or part-time in up to three years. Core courses are taught by department faculty and are scheduled so that part-time students can continue their professional responsibilities while completing the degree.

The Master of Arts program provides students with a firm understanding of the intellectual content of the study of bioethics, of bioethical literature, and of the underlying philosophical arguments and empirical assumptions that inform it. Students are taught to understand the institutions and structures of health care and the ethical issues that arise in medical practice. They are trained to identify and analyze a range of clinical ethics issues.

All students pursuing a Master of Arts degree in bioethics are required to complete the interdisciplinary core of 12 credit hours (the equivalent of four courses) in the first two semesters of their first year of study.

The courses, BETH 401 Foundations in Bioethics I, and BETH 402 Foundations in Bioethics II, each six credits, examine 10 basic topic areas in bioethics: death and dying, the therapeutic relationship, method and theory in bioethics, organ transplantation, health care justice, defining health care needs, reproduction and fertility, families, babies and children, research ethics and genetics. Classes meet two evenings per week for seminar sessions (two hours per session).

Another required course is BETH 405 Clinical Ethics Rotation. This course requires a minimum of 8 hours of clinical experience per week during two 10-week rotations. Students spend most of their time observing rounds in relevant services (intensive care units, pediatrics, geriatrics, etc.) with leading clinicians at several area hospital sites. Students must complete rotations at two sites. At the conclusion of each rotation, students are familiar with the clinical, psychological, social, professional, and institutional contexts in which ethical problems arise. Also, they are able to identify, analyze and understand ethical issues as they develop.

In addition, all students must complete 12 credit hours of electives. Electives are selected in consultation with a faculty advisor. Electives must enhance the student’s understanding of bioethical issues and must be relevant to the student’s academic goals.

The department currently offers dual-degree programs with the School of Medicine (MD/MA), the School of Medicine’s Department of Genetics (PhD/MA), the School of Law (JD/MA), the Frances Payne Bolton School of Nursing (MSN/MA) the School of Medicine’s Public Health program (MPH/MA) and Mandel School of Applied Social Sciences (MSSA/MA) at CWRU.  Students must apply and be accepted to each program to qualify.

Commencing in the fall semester of 2007, the department will offer a new research ethics track within the MA program, designed to prepare specialists who will pursue research ethics-related work as a primary career (IRB coordinators, research administration, etc.) or who will use this specialized training to enhance their primary careers (investigators, regulators, etc.). In addition to the core seminars BETH 401 Foundations in Bioethics I and BETH 402 Foundations in Bioethics II, discussed above, the research ethics track will feature a modified clinical ethics rotation, focused on IRB work and research ethics activities, and four research ethics electives.

Admission policies conform to those of Case Western Reserve University School of Graduate Studies. In general, an applicant for admission and concurrent financial consideration must have completed application forms on file by March 1 for the fall semester.

MA Bioethics Plan of Study

First YearUnits
FallSpring
Foundations in Bioethics I (BETH 401)6  
Clinical Ethics Rotation (BETH 405)1.5 - 3  
Elective I3  
Elective II3  
Foundations in Bioethics II (BETH 402)  6
Clinical Ethics Rotation (BETH 405)  1.5 - 3
Elective I  3
Elective II  3
Year Total: 13.5-15 13.5-15
 
Total Units in Sequence:  27-30

 

PhD in Bioethics

The increasing complexity of the health care system has resulted in a growing need for investigators who can conduct research to address pressing social problems in bioethics. The objective of the bioethics doctoral program is to train scholars who will have specific expertise in the conceptualization, design and conduct of empirical research concerning bioethics questions. Graduates will:

  • obtain grounding in the philosophical basis of bioethics to conceptualize and analyze moral problems
  • develop a theoretical perspective to guide their research
  • be proficient in empirical methodologies (both qualitative and quantitative) so that they can conduct research in bioethics problems
  • become researchers who can develop and conceptualize timely and meaningful research questions in bioethics

Graduates of the program have a wide range of opportunities, including careers as independent investigators, serving as a bridge between colleagues in the traditional medical humanities and those in clinical and basic-science departments, and employment in academic bioethics centers, clinical and basic science departments in medical schools and schools of public health, government agencies, and public policy institutes.

PhD students receive a full tuition scholarship, health insurance support and a $20,000-per-year graduate assistantship.

Course of Study

Completion of the PhD requires

  • Minimum of 51 credit hours of course work for candidates with bachelor’s degrees; minimum of 42 credit hours for candidates with master’s degrees
  • 18 credit hours of dissertation course work
  • 125 research hours (supervised research experiences with Department faculty)
  • Training in research ethics
  • Comprehensive examination preceding advancement to candidacy
  • Defense of dissertation proposal
  • Completion of dissertation
  • Defense of dissertation

Core Coursework

  • Foundations in Bioethics I & II
  • Clinical Ethics Rotation
  • Advanced Seminar on Methods in Normative Bioethics I & II
  • Empirical Research Methods and Design in Bioethics I & II
  • Statistical Methods and Data Management in Bioethics I & II
  • Grant Writing
  • Critical Readings in Bioethics
  • Research hours

Additional course work: three credit hours each in advanced statistics, methods and study design, and theory from the social sciences, and six credit hours of elective courses

Enrollment in the Doctoral Program

The doctoral program is highly selective. Candidates should have a strong theoretical background in the social sciences or philosophy, preferably in the form of a master’s degree in a relevant discipline or a clinical degree. Candidates also must demonstrate an ability to work with quantitative data and demonstrate promise of integrating theory and empirical application.

Applicants must complete an interview and submit:
  • CWRU Graduate School Application
  • Transcripts (undergraduate and graduate if applicable)
  • GRE scores — verbal, analytic and quantitative sections. Scores will be considered in relation to the applicant’s other credentials. Applicants may submit scores of other standardized tests in addition to the GRE.
  • Three letters of recommendation
  • A letter to the admission committee detailing the applicant’s general interests in bioethics and the candidate’s past training and current research interests

PhD Bioethics, Plan of Study

§

  Please also see Graduate Studies Academic Requirements for Doctoral Degrees


First YearUnits
FallSpring
Foundations in Bioethics I - Ph.D. (BETH 520) (or elective if student enters with equivalent course)3  
Research Design in Bioethics I (BETH 507)3  
Methods in Normative Bioethics I (BETH 505)3  
Introductory Course in Statistical Methods3  
Foundations in Bioethics II - Ph.D. (BETH 521) (or elective if student enters with equivalent course)  3
Research Design in Bioethics II (BETH 508)  3
Methods in Normative Bioethics II (BETH 506)  3
Elective  3
Clinical Ethics Rotation - Ph.D. (BETH 512)  1.5
Year Total: 12 13.5
 
Second YearUnits
FallSpring
Grant Writing (BETH 511)3  
Elective3  
Elective3  
Elective3  
Critical Readings in Bioethics (BETH 504)  3
Elective  3
Elective  3
Elective  3
Year Total: 12 12
 
Third YearUnits
FallSpring
Dissertation Ph.D. (BETH 701)9  
Dissertation Ph.D. (BETH 701)  9
Year Total: 9 9
 
Fourth YearUnits
FallSpring
Dissertation Ph.D. (BETH 701)9  
Dissertation Ph.D. (BETH 701)  9
Year Total: 9 9
 
Total Units in Sequence:  85.5

 

 

Courses

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, PHIL 271.

BETH 314. Global Health: India. 3 Units.

Bioethics is the study of ethical controversies arising at the intersection of biology, medicine, technology, politics, law, philosophy, religion and culture. This course will discuss and analyze the issue of health in India; recognizing that health is more than the diagnosis and treatment of a disease. Using three diseases (HIV/AIDS, leprosy and tuberculosis) students will explore the relationship between culture and health care outcomes. Relevant issues addressed in the course include the history of British rule in India, Hinduism, the Caste system, poverty, access to education and public policy. Faculty will introduce readings on the history of India, medical anthropology, religion and the law. Students will then be given the opportunity to focus on a particular topic, research the existing literature, present their findings to the class and create a plan to observe the chosen topic while in India during the Summer semester. Course instructors include Nicole Deming, JD, MA Assistant Professor of Bioethics; Deepak Sarma, PhD, Associate Professor of South Asian Religions; and Gopal Yadavalli, MD Assistant Professor of Medicine and Chief of the Infectious Diseases Clinic at the Cleveland VA Medical Center. The course will also invite guest lectures from many different departments and schools to share their expertise and experience in the areas of Global Justice, Anthropology, and Human Rights.

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 and BETH 415A. Counts for CAS Global & Cultural Diversity Requirement.

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 for CAS Global & Cultural Diversity Requirement.

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 for CAS Global & Cultural Diversity Requirement.

BETH 315D. International Bioethics Policy and Practice: Issues at the Beginning and End of Life in France. 3 Units.

This 3-credit course gives students the unique opportunity to observe patients and practitioners encounter in a radically different health care system. France has one of the most comprehensive and successful health care systems in the world which covers all citizen and non-citizen residents of France. Instruction is by Case and French faculty and includes 3 classes of intensive didactic learning in the US and 5 days of intensive didactic and experiential learning in Paris, France. Students will gain first-hand experience of the French health care through lectures and readings with French bioethicists and physicians who, generally, are one and the same. Field experiences at sites include the principal medical school in Paris, as well as hospitals, clinics, assisted reproduction facilities and hospices in order to explore the ethical issues related to life and death. Specific topics include: of lectures at home and in Paris include medical education in France, the ethics of a national health care system, reduction/elimination of health care inequalities, gender issues in medical education and medical practice, genetic research, abortion, assisted reproductive technologies, end of life decision making in adult and pediatric medicine, transplantation technologies and immigrant health. Offered as BETH 315D and BETH 415D. Counts for CAS Global & Cultural Diversity Requirement.

BETH 315E. International Bioethics: Policy and Practice--US and Spanish Perspectives, Salamanca Spain. 3 Units.

This 3-credit hour course will introduce advanced undergraduate and graduate students to theoretical and practical aspects of bioethics in a European context. Continental health professionals and bioethicists work in an environment that differs from the American context in at least three important dimensions: the political structure of their health care systems, the cultural influence of their religious histories, and the theoretical perspective of continental moral philosophy. The University of Salamanca in Spain, one of the oldest universities in Europe (known as the "Oxford of Spain"), will be used in this course as a focal point for examining the interplay of these three dimensions in shaping institutional and professional approaches to specific problems in bioethics, including end of life decisions, organ procurement and allocation, reproductive ethics, health care justice, and environmental bioethics ("eco-ethics"). This course will help advanced students who are already grounded in American bioethics develop the analytical skills necessary for evaluating European bioethical scholarship and policy-making, while helping less advanced students develop a familiarity with fundamental similarities and differences between bioethics in Spain and the U.S. The course will include a one week trip to Salamanca, Spain where students will be taught by instructors and faculty from the University of Salamanca. Teaching will include some guided field experiences and regular discussion sessions with the course faculty. Prior to the trip, students will attend 4 hours of class at Case to become familiar with elements of political theory and moral philosophy relevant to the in-country discussions. Following the trip, students will meet with instructors for an additional 2 hours. Offered as BETH 315E and BETH 415E. Counts for CAS Global & Cultural Diversity Requirement.

BETH 315F. Looking at Bioethics through the Lens of Both American and Spanish Films. 3 Units.

This one week 3-credit intensive course will be held in San Sebastian, Spain. Taught by faculty from CWRU and University of the Basque Country, this course offers students a cross-cultural perspective on bioethics in the United States and Spain. This course uses the medium of film, complemented by readings in bioethics, film criticism, and medical research, to introduce students to a number of compelling bioethics problems facing physician-scientists today, including: when life begins, the nature and limits of informed consent, use of randomization without equipoise, medical imperialism (or the appearance thereof), the treatment of so-called "orphan" diseases, use of deception in research, and financial conflicts of interests caused by among other things, the involvement of the pharmaceutical industry in the drug invention process. Offered as BETH 315F and BETH 415F.

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 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 401. Foundations in Bioethics I. 6 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. Preentry.

BETH 402. Foundations in Bioethics II. 6 Units.

This course completes the required seminar core and covers the basic bioethics topic areas: health care justice; defining 'health care needs;' reproduction and fertility ethics; research ethics; and ethics in genetics. The course meets twice weekly and is taught in seminar format by Center faculty members who are experts on specific topics. Recommended preparation: BETH 401.

BETH 405. Clinical Ethics Rotation. 1.5 - 3 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 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 408. Ethics, Law and Health Research. 3 Units.

This course focuses on an examination of issues arising at the juncture of law, ethics, and health research, such as informed consent, the assessment of risks and benefits, conflict of interest, and scientific misconduct. Particular attention is placed on issues arising in the context of study design and community based research. To the extent possible, the class will utilize a case-focused approach.

BETH 409. Global Justice and Bioethics. 3 Units.

This course aims to introduce students to the problem of global distributive justice, with an emphasis on both theoretical accounts of justice, and the practical implications of those accounts for important topics in global bioethics. The first half of this course will be devoted to important contemporary works which bring out core philosophical ideas about justice and how we address concerns of justice globally. The second half of this course will focus on current global bioethics topics, such as inequality and poverty, global intellectual property rights, the allocation of healthcare resources, the setting of research priorities, exploitation & the distribution of the benefits of research, and medical tourism. In addition to familiarizing students with the contemporary literature regarding global justice and related topics in bioethics, this course also seeks to help students strengthen their skills in reading, analyzing, interpreting, and engaging with philosophy and bioethics texts. This course is a seminar and will therefore emphasize in-class discussion rather than lecture. Students are expected to prepare by reading all assigned readings before class.

BETH 410. Reproductive Ethics. 3 Units.

Reproductive ethics is a sub-discipline of bioethics that deals with moral issues related to pregnancy, reproduction, and reproductive health care. Relevant issues include procreative liberty and reproductive rights, sterilization, contraception, abortion, conscientious refusals by health care professionals to participate in abortions or in other reproductive practices, reproductive genetic testing, prenatal healthcare, birthing practices, in vitro fertilization, surrogacy, gamete and embryos donation, and research involving reproductive materials. Particular attention will be paid to why each of these issues is controversial.

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 414. International Health Research Ethics. 3 Units.

This course will introduce students in the health and social sciences to key ethical issues that arise in international health research. The course will include intensive reading and case-based discussion of current ethical and moral quandaries posed by research conducted in the international arena. Five full-day sessions are planned. Each day will be divided into a series of formal presentations and active, group-based discussions around topics that include: the historical context of international health research; current international ethics principles, standards, and declarations; key tools and concepts for unpacking ethical issues in international health research; issues in informed consent and conflict of interest; "reasonable availability" and the conduct of clinical trials; cutting-edge international genetics research; and, the responsibility of researchers to the international health community. Course evaluation is based on class participation, a written exercise, and a case analysis.

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 and BETH 415A. Counts for CAS Global & Cultural Diversity Requirement.

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 for CAS Global & Cultural Diversity Requirement.

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 for CAS Global & Cultural Diversity Requirement.

BETH 415D. International Bioethics Policy and Practice: Issues at the Beginning and End of Life in France. 3 Units.

This 3-credit course gives students the unique opportunity to observe patients and practitioners encounter in a radically different health care system. France has one of the most comprehensive and successful health care systems in the world which covers all citizen and non-citizen residents of France. Instruction is by Case and French faculty and includes 3 classes of intensive didactic learning in the US and 5 days of intensive didactic and experiential learning in Paris, France. Students will gain first-hand experience of the French health care through lectures and readings with French bioethicists and physicians who, generally, are one and the same. Field experiences at sites include the principal medical school in Paris, as well as hospitals, clinics, assisted reproduction facilities and hospices in order to explore the ethical issues related to life and death. Specific topics include: of lectures at home and in Paris include medical education in France, the ethics of a national health care system, reduction/elimination of health care inequalities, gender issues in medical education and medical practice, genetic research, abortion, assisted reproductive technologies, end of life decision making in adult and pediatric medicine, transplantation technologies and immigrant health. Offered as BETH 315D and BETH 415D. Counts for CAS Global & Cultural Diversity Requirement.

BETH 415E. International Bioethics: Policy and Practice--US and Spanish Perspectives, Salamanca Spain. 3 Units.

This 3-credit hour course will introduce advanced undergraduate and graduate students to theoretical and practical aspects of bioethics in a European context. Continental health professionals and bioethicists work in an environment that differs from the American context in at least three important dimensions: the political structure of their health care systems, the cultural influence of their religious histories, and the theoretical perspective of continental moral philosophy. The University of Salamanca in Spain, one of the oldest universities in Europe (known as the "Oxford of Spain"), will be used in this course as a focal point for examining the interplay of these three dimensions in shaping institutional and professional approaches to specific problems in bioethics, including end of life decisions, organ procurement and allocation, reproductive ethics, health care justice, and environmental bioethics ("eco-ethics"). This course will help advanced students who are already grounded in American bioethics develop the analytical skills necessary for evaluating European bioethical scholarship and policy-making, while helping less advanced students develop a familiarity with fundamental similarities and differences between bioethics in Spain and the U.S. The course will include a one week trip to Salamanca, Spain where students will be taught by instructors and faculty from the University of Salamanca. Teaching will include some guided field experiences and regular discussion sessions with the course faculty. Prior to the trip, students will attend 4 hours of class at Case to become familiar with elements of political theory and moral philosophy relevant to the in-country discussions. Following the trip, students will meet with instructors for an additional 2 hours. Offered as BETH 315E and BETH 415E. Counts for CAS Global & Cultural Diversity Requirement.

BETH 415F. Looking at Bioethics through the Lens of Both American and Spanish Films. 3 Units.

This one week 3-credit intensive course will be held in San Sebastian, Spain. Taught by faculty from CWRU and University of the Basque Country, this course offers students a cross-cultural perspective on bioethics in the United States and Spain. This course uses the medium of film, complemented by readings in bioethics, film criticism, and medical research, to introduce students to a number of compelling bioethics problems facing physician-scientists today, including: when life begins, the nature and limits of informed consent, use of randomization without equipoise, medical imperialism (or the appearance thereof), the treatment of so-called "orphan" diseases, use of deception in research, and financial conflicts of interests caused by among other things, the involvement of the pharmaceutical industry in the drug invention process. Offered as BETH 315F and BETH 415F.

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 419. Ethics and the Business of Biomedicine. 3 Units.

Central to current national discourse are concerns about ethics, costs, and profits in relation to health care. These concerns are primarily driven by major shifts in health care during the 20th century. These shifts include: the transformation of professional medical practice from a service orientation to a market orientation; the emergence of powerful pharmaceutical and health care corporations; the development of new, innovative, and expensive biomedical technologies by for-profit enterprises. This course will focus on questions about values (e.g., distributive justice, rights, human dignity, community welfare in relation to the business of medicine. Topics covered include: 1) commodification in relation to health care; 2) the just distribution of health care goods and services in market economies; 3) pharmaceutical research, development, and marketing; and 4) ethical issues in the sale of human body parts and ethically contentious services (like contract surrogacy). While course topics will be addressed primarily in reference to the United States, students will have some opportunity to analyze specific issues regarding these topics from an international perspective.

BETH 420. Critical Issues in Research Ethics. 3 Units.

This course is open to graduate students with an interest in health-related research ethics. Enrollment preference will be given to Masters-level bioethics students in the Research Ethics Track (RET). The course provides students with a comprehensive study of critical issues in research ethics, including the modern history of research ethics in science and medicine, the ethics of clinical trial design and conduct, advanced issues in informed consent, the ethics of animal experimentation, and key issues in genetics research. Coursework will include case studies and in-depth readings to highlight topic areas. Discussions of ethical and regulatory frameworks that influence decision-making, policy development, and the conduct of biomedical and social-behavioral science research will allow students to explore the nuances, gaps, challenges, and concerns present in research, particularly research involving human subjects. Topics will be addressed within the framework of integrating research ethics into the scientific process. Students are expected to lead class discussions and write a course-relevant paper. Enrollment will be limited to 15 students. Class will meet weekly for 3 hours.

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 425. Stem Cells: Ethics and Policy. 3 Units.

This graduate-level course addresses major issues in the science, ethics, and politics of stem cell research. Over the past decade, embryonic stem cell research has emerged as one of the world's most controversial areas of biomedical research. While new forms of stem cell research have emerged recently which appear to sidestep the debate over the use of human embryos, these new forms of stem cell research raise a host of problems in their own right. Furthermore, as stem cell research marches toward clinical applications for patients, the scientific and ethical issues will continue to evolve in evermore complex directions. In order to fully appreciate the ethical and policy issues at the cutting edge of stem cell science, one needs a sound grasp of the science of stem cell research. Thus this course is designed to take a science-based approach to the ethics of stem cell research. (No prior knowledge of stem cell biology is presupposed.)

BETH 430. Bioethics in Literature. 1 Unit.

This course complements the Foundation course in the MA bioethics program by introducing students to narrative literature (fiction, nonfiction and poetry) that addresses ethical issues in medicine. The material is frequently the work of physicians and patients who narrate their respective experiences. As such, narrative provides direct insights into the practice of modern medicine tested against both accepted and controversial moral norms and serves as a vehicle for discussion and analysis of ethical issues. These issues involve topics such as death and dying, reproduction, pediatrics, women as patients and clinicians, public health and medicine as a profession and its practice as a privilege. Students will sample the work, among others, of William Carlos Williams, Lewis Thomas, Toni Morrison, Margaret Atwood, John Donne, Dylan Thomas and Abraham Verghese.

BETH 440. Science and Society Through Literature. 3 Units.

This course will examine the interaction of scientific investigation and discovery with the society it occurred in. What is the effect of science on society and, as importantly, what is the effect of society on science? An introduction will consider the heliocentric controversy with focus on Galileo. Two broad areas, tuberculosis and the Frankenstein myth, will then be discussed covering the period 1800-present. With tuberculosis, fiction, art and music will be examined to understand the changing views of society towards the disease, how society's perception of tuberculosis victims changed, and how this influenced their treatments and research. With Frankenstein, the original novel in its historical context will be examined. Using fiction and film, the transformation of the original story into myth with different connotations and implications will be discussed. Most classes will be extensive discussions coupled with student presentations of assigned materials. Offered as PHRM 340, BETH 440, PHRM 440, and HSTY 440.

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, EPBI 466, SOCI 466, NURS 466 and BETH 466. Prereq: Graduate student status or instructor consent.

BETH 496. Public Policy and Aging. 3 Units.

Overview of aging and the aged. Concepts in the study of public policy. Policies on aging and conditions that they address. The politics of policies on aging. Emergent trends and issues. Offered as ANTH 498, BETH 496, EPBI 408, GERO 496, HSTY 480, MPHP 408, NURS 479, NURS 579, POSC 480, and SOCI 496.

BETH 503. Research Ethics and Regulation. 2 Units.

This course is designed to introduce students to the ethical, policy, and legal issues raised by research involving human subjects. It is intended for law students, post-doctoral trainees in health-related disciplines and other students in relevant fields. Topics include (among others): regulation and monitoring of research; research in third-world nations; research with special populations; stem cell and genetic research; research to combat bioterrorism; scientific misconduct; conflicts of interest; commercialization and intellectual property; and the use of deception and placebos. Course will meet once per week for 2 hours throughout the semester. Grades will be given based on class participation and a series of group projects and individual short writing assignments. Offered as BETH 503, CRSP 603 and LAWS 603.

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. Methods in Normative Bioethics I. 3 Units.

The first of the two required Methods seminars is designed to give graduate students an intensive introduction to the modes of moral reasoning that have been adopted and adapted by contemporary Bioethics, and the major critical perspectives that have been brought to bear upon them.

BETH 506. Methods in Normative Bioethics II. 3 Units.

The second of the two required Methods seminars is designed to give graduate students an intensive introduction to the modes of moral reasoning that have been adopted and adapted by contemporary Bioethics, and the major critical perspectives that have been brought to bear upon them.

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 520/521 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 Unit.

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 603. Bioethics Research. 6 Units.

Research leading toward the MD/MA degree is Bioethics.

BETH 604. Advanced Research Ethics Seminar. 0 Units.

This course meets for two hours each month and is focused on the following topics and the development of the stated competencies: September Introduction; How to critically analyze the literature; Facilitator critique of assigned manuscript; Designing re-entry projects Critical analysis of literature. October Trainee #1 critique of assigned manuscript; Methodological and ethical issues in designing and reviewing research; Trainee presentation of concept papers for re-entry projects Critical review of research protocols and manuscripts; Issues in designing research. November Trainee #2 critique of assigned manuscript; How to prepare and present professional presentations Critical analysis of literature; Oral presentation skills December Trainee #3 critique of assigned manuscript; Principles of adult education Critical analysis of literature; Oral presentation skills; Development of teaching skills. January Trainee #1 critique of assigned manuscript; Principles of adult education Critical analysis of literature; Oral presentation skills. February Trainee #2 critique of assigned manuscript; Developing submissions for IRB review Critical analysis of literature; Oral presentation skills; Identifying and addressing ethical issues in research; Preparation of IRB submissions. March Trainee #3 critique of assigned manuscript; Update on development of re-entry projects; Logistical issues related to re-entry projects; Manuscript preparation Critical analysis of literature; Oral presentation skills; Implementing research; Preparing work for publication; Negotiation skills. April Re-entry issued Implementing research; Readjustment. This course is only open to trainees in the Fogarty-funded Training Program in International Research Ethics.

BETH 605. Special Study: IRB Administration. 1.5 Unit.

This course is limited to Fogarty-sponsored trainees in the Training Program in International Research Ethics. The course, which meets 1.5 hours per week, focuses on issues relevant to the management and administrations of the various functions of research ethics review committees. Topics to be covered include identification and selection of appropriate community representatives for membership and/or consultation, utilization of independent experts/consultants, recordkeeping, approaches to communication with investigators, and others. Regular guest lectures will be provided by members of the various local IRBs, staff members of local IRBs, and senior investigators. The course will utilize a case-based approach

BETH 701. Dissertation Ph.D.. 1 - 18 Unit.

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