Master of Science (M.S.) in Health Care Ethics Curriculum

General Requirements
The M.S. in Health Care Ethics consists of thirty credit hours. All students complete the twenty-seven hours of Core Courses and select 3 hours of Electives that are consistent with their career interests.

Core Courses (27 hours)

MHE 601   Health Policy (3)
MHE 602   Research Ethics (3)
MHE 603   Law and Health Care Ethics (3)
MHE 604   Social and Cultural Contexts of Health Care (3)
MHE 605   Philosophical Bioethics (3)
MHE 606   Theories of Justice (3)
MHE 607   Practical Ethics in Health Care Settings (3)
MHE 608   Practicum (3)
MHE 609   Capstone Project (3)

Electives (3 hours) Choose One:

MHE 611   Advanced Bioethical Theory (3)
MHE 612   Philosophical and Theological Perspectives on End of Life Care (3)
MHE 613   Professional Ethics and the Vocation of Health Care (3)
MHE 614   Jaded and Faded: Health Care Professionals and Moral Motivation (3)
MHE 615   Ethics and the Cultural Construction of Categories, Measurement, and Time (3)
MHE 616   Quality Improvement and Institutional Ethics (3)
MHE 617   Mental Health and Medical Humanities (3)
MHE 618   Teaching and Learning Strategies in Ethics (3)
MHE 619   Dying, Death, and Transplantation in the American Hospital (3)
MHE 620   Bioethics as Practice (3)

Course Descriptions

MHE 601              Health Policy (3)
An exploration of health policy and its development, emphasizing social justice and human rights as providing the moral and ethical bases of policy.  The course considers and compares institutional, local, regional, national, and international approaches to public health, health systems, and determination of research and development priorities.  American health systems, their operations, processes, successes, and failures are extensively analyzed.  The processes and challenges for making policy at institutional, state, and federal levels are described, and past and current attempts at health systems reform, and why they succeed or fail, are analyzed.

MHE 602              Research Ethics (3)
This course will enhance students’ understanding of core ethical issues in research ethics. Vulnerable populations will be a primary organizing theme. Study of historically pivotal cases will lead into examination of ethical and policy responses. Examples are the Belmont Report, the Helsinki Declaration, IRBs (Institutional Review Boards), and roles of ethical theories, principles, and human rights. Among issues related to vulnerable populations will be research on prisoners, women, children, the poor, and residents of developing countries. A focus will be ethical issues in the emerging area of Community-Based Participatory Research. Topics in scientific research will include design (e.g., randomized or placebo-controlled trials), elements of good science, critical reflection about science (such as critiques of objectivity), and conflicts of interest. A section will address informed consent. Special topics will include collaborative and intersectoral research, cross-cultural aspects of research, social responsibility of scientists, genetics, and stem cell research. USA and global research will be considered.

MHE 603              Law and Health Care Ethics (3)
This course explores the crucial connection between health law and health care ethics. The course focuses on major ethical themes that have emerged in the law and highlights specific interconnections of doctrines that have come out of landmark cases. The course will also examine the significant and fundamental differences between health care ethics and health law.

MHE 604              Social & Cultural Contexts of Health Care (3)
This class introduces the student to the various contexts of personal and social experience that construct and interpret bioethics. Participants consider identity and autonomy as embedded in social matrices ranging from the body itself to global configurations. Various power dynamics of class, legitimacy, and ideology are considered. Participants analyze the culture of the biomedical project and the challenge of finding one’s voice within it.

MHE 605              Philosophical Bioethics (3)
This  course reviews the nature of ethical reasoning, including various epistemological challenges to moral judgment.  Second, major theories of ethics will be introduced, including virtue ethics, natural law, deontology, utilitarianism, casuistry and principlism, discourse ethics, and care ethics. Third, signature texts by protagonists of these historical theories will be compared and contrasted with contemporary critics, with specific reference to issues of vulnerability. P: MHE 601 or MHE 602.

MHE 606              Theories of Justice (3)
This course builds on the “Philosophical Bioethics” course by advancing students’ competence in ethical reasoning and familiarizing students with social justice theories in particular.  This course will introduce students to theory formation in the area of social justice, drawing on political philosophy, economics, and the social sciences. P: MHE 601 and MHE 605.

MHE 607              Practical Ethics in Health Care Settings (3)
The practical application of ethics to clinical situations is much more than following standards of practice. This course will provide the opportunity to apply foundational concepts of ethics to a variety of health care settings. Additionally, the use of deliberative methods to think through and discuss the unique features presented by different health care settings and professional conduct will be an integral component of the course. The typical charges of institutional ethics committees will be examined: consultation, education, and policy review/development. P: MHE 605.

MHE 608              Practicum (3)
This course requires synthesis of content from foundational course work as well as at least two of the following courses: “Health Policy,” “Research Ethics,” or “Practical Ethics in Health Care Settings.” Students will analyze a particular group, population, policy, or structure that raises significant concerns about vulnerability and develop a practical plan for responding to the identified ethical issue or problem in a constructive manner. Using a portfolio approach, students will integrate appropriate course content and other relevant support material into the plan. P: MHE 603, MHE 604, MHE 606 and two of the following: MHE 601, MHE 602, or MHE 607, provided that the student complete the course covering the focus area of the Practicum.

MHE 609              Capstone Project (3)
In this final required course of the degree program, students are expected to integrate insights gained and competencies acquired. Applying methods of scientific inquiry, students will synthesize their findings in a publishable commentary to an article in the scholarly literature, selected by the course director. P: MHE 601, MHE 602, MHE 603, MHE 604, MHE 605, MHE 606, MHE 607, MHE 608, and Elective.

MHE 611              Advanced Bioethical Theory (3)
Whereas MHE 605 focuses on the major ethical theories as they have been developed since Greek antiquity and that nowadays still inform bioethical thinking, this course focuses on modern variations on these historical theories and newly developed theories that have specific relevance for the field of health care ethics. The course is particularly useful for students planning to continue their education with doctoral studies and/or students who are planning to engage in bioethical research and scholarship. P: MHE 605.

MHE 612              Philosophical and Theological Perspectives on End of Life Care (3)
The possibilities of modern medicine to extend people’s lives are considerable and are generally much appreciated. But these advances have also evoked ever more ethical quandaries. Patients have begun to decline the available life-extending interventions or even request euthanasia. Medicine – and society more in general – appear unable to balance life extension gained with quality of life considerations. On top of that, the economic expenses are quickly becoming prohibitive. The biomedical sciences, philosophy, and theology struggle to address these new challenges theoretically, for extending life has been one of the most important goals of western medicine for many centuries, rarely questioned and fully supported by most major faith traditions.  This course will (1) challenge participants to reflect on and examine their own views on disabilities, aging and dying; (2) review historically, culturally and religiously significant patterns for societies’ understanding of aging and death, and medical treatments at the end of life; (3) offer analytical tools to critically examine the paradox of harmful life-extension; (4) examine the merits of legislation and policy development in the area of end of life health care; and (5) provide students with an opportunity to study and debate hallmark ethics cases in end-of-life care. P: MHE 603, MHE 605.

MHE 613 (413)  Professional Ethics and the Vocation of Health Care (3)
This course will examine what health care professionalism is or should be in light of health and health care inequalities, multiculturalism, humanistic concerns, and practical considerations. Topics will include: (1) The historical development and social configuration of health care professions and structures; (2) Proposed moral foundations such as calling, social contract, moral principles, and an ethics of care; (3) The legal status of professions; (4) The scope of professional obligations, including direct health care, public health, advocacy, elimination of health inequalities, code development, standardization, peer review, whistle-blowing, and protection of public trust; and (5) Intersectoral and interprofessional collaboration. Students will be invited to critically assess whether professional tenets and structures promote or undermine health and health care equality, humanistic care, fair treatment, openness to diversity, power equalities, and systemic analyses.

MHE 614   Jaded and Faded: Health Care Professionals and Moral Motivation (3)
High rates of turnover, suicide, and divorce among healthcare professionals suggest that healthcare careers and training can incur significant damage to practitioners’ relationships and self-conceptions. “Burnout,” “callousness,” “jaded,” “compassion fatigue,” “moral distress,” and other kindred concepts have been used to characterize some negative moral psychological dimensions of professional caregiving. With a philosophical approach toward examining relationships among healthcare professionals’ demeanors, dispositions, and motivations, this selective explores a rich, multi-disciplinary literature on personal and professional identity formation and on how healthcare professionals orient themselves affectively to their patients over time. Other topics to be explored are processes of socialization in healthcare, structural features of social hierarchies and labor in healthcare organizations and education, consequences of eroding collegiality, and consequences for vulnerable populations of patients.

MHE 615              Ethics and the Cultural Construction of Categories, Measurement, and Time (3)
Categories of measurement are culturally constructed to include certain aspects and omit others.  As health care ethics examines issues of power in US health care delivery, one crucial question involves the kinds of health care that garner reimbursement and their implications.  Who decides which categories are legitimate and how they should be ranked?  Taking an historical approach, students in this course will examine the phenomena of measurement, standards, and ranking in the delivery of health care, and consider how these categories reflect and reinforce ideological movements in the US.  Of particular interest will be the development of common coding strategies.

MHE 616              Quality Improvement and Institutional Ethics (3)
Essentially all health care institutions conduct Quality Improvement (QI) activities, generally overseen by a committee structure.  These activities rarely have input from those who are consultants or experts in bioethics.  Thus QI activities seldom give specific consideration to questions of ethics in their choice of subjects for examination, their analyses or recommendations.  This course will explore the purposes of QI, its ethical bases, barriers to considerations of bioethics in QI programs, and means to integrate ethics into QI by affecting the institutional cultural ethic.

MHE 617              Mental Health and Medical Humanities (3)
Recent policy trends in mental health, health inequalities, and intersections of health policy and social policy are focal points of study in this elective. A handful of scholarly articles complement our main study of these issues through literature and film. P: MHE 601, MHE 604, MHE 606.

MHE 618              Teaching and Learning Strategies in Ethics (3)
What sorts of knowledge do teachers of ethics need whether the instruction occurs in a classroom, online, or in a professional seminar? This course will examine the knowledge that Shulman asserts teachers need including: 1) content knowledge; 2) general pedagogical knowledge with special reference to broad principles and strategies of management and organization that transcend subject matter; 3) pedagogical content knowledge, that special form of understanding of best practices in teaching ethics; and 4) knowledge of learners and their characteristics. The course will emphasize teaching and learning methods that are most effective for ethics content. P: MHE 605.

MHE 619              The Social Constructions of Dying and Organ Transplantation in the American Hospital (3)
Students explore how CPR and the obligation to perform it have changed the social construction of dying and death in the American hospital through the mechanisms of rescue, stabilization and the ritual of intensification.  With this background students explore the assumptions and pressures that underlie the US transplant movement, including the cultural anchoring of brain death, the valorization of transplant, and the role of neurological injury in the definition of personhood.  The US transplantation experience is compared with other nations, including Japan.

MHE 620               Bioethics as Practice (3)
Prominent debates and discussions about defining bioethics and its projects are focal points of study in this selective. We will consider the merits and drawbacks of critical approaches and methods of intersectoral work in bioethics and explore different thinkers’ responses to questions about the nature, scope, and authority of the field.