Health Law & Ethics PHMS-635
Course Data
Number: PHMS-635 Title: Health Law and Ethics Credit-hours: 3 Department: Health Management and Systems Sciences School/College: School of Public Health and Information Sciences Type: Lecture
Catalog Description
This course provides an overview of major contemporary legal and ethical issues related to administrative decision making in health care and population health.
Course Description
In today’s rapidly changing health environment health administrators confront a variety of legal and ethical challenges. This course provides an overview of major contemporary legal and ethical issues related to administrative decision making in health care and population health. The course is designed to form a foundation of knowledge and skills related to law and ethics to enable students to manage health entities in an era of change and to foster personal growth and promote ethical behavior within the organization and community. Legal and ethical issues discussed will include topics such as professional and institutional liability, health care organization structure and management, anti-trust, tax exemption, health care fraud, access and health reform, emergency care and preparedness, health information management, and medical decision making including issues related to reproductive health and end of life decisions.
Course Objectives
At the conclusion of the course students will be able to:
Demonstrate a basic understanding of the American legal system, legal process, and principles of legal analysis
Identify, analyze, apply, and evaluate the role of legal principles and legal analysis in health administration
Recognize ethical dilemmas in health administration and use ethical analysis and principles of general and professional ethics in health administration decision making and in the development of strategies to promote ethical behavior within an organization.
Develop strategies for and ways of communicating effectively with attorneys
Develop a critical awareness of one’s own ethical values and underlying ethical Concepts
Page 1 of 25 Health Law & Ethics PHMS-635
Prerequisites
The course assumes a basic understanding of the United States Health Care System and the concepts presented in the first year of the MPH Population Health Management Program.
Course Instructors
Name Office Phone Email Martha Jean Schecter, [email protected] Course Director
The course instructor welcomes conversations with students outside of class. Students may correspond with instructor by email or set up appointments by contacting Martha Jean Schecter at [email protected]
Students should also contact Martha Jean Schecter with questions they might have regarding the mechanics or operation of the course.
How This Course Relates to the MHA Program Competency Model and Blooms Taxonomy. The MHA curriculum is linked to the National Center for Healthcare Leadership Competency model. The course is linked to the model and Blooms Taxonomy as follows (Blooms Taxonomy is in Parentheses):
Learning Objectives Competency Assessment All Objectives L6 Communication Skills- L6.1 Uses Class discussion, Generally Accepted English Case analyses, Grammar Uses subject-verb agreement reflective papers, and parallel structure; Uses rules of debate, working with punctuation and sentence and paragraph attorneys exercise, construction; Uses concise thematic ethics committee construction deliberation
L6 Communication Skills- L6.2 Class discussion, Prepare Effective Written Business Case analyses, Cases or Presentations Uses accurate reflective papers, and complete presentation of facts; Uses debate, working with logical presentation of arguments pro attorneys exercise, and con; Develops well-reasoned ethics committee recommendations; Prepares concise deliberation executive summary
L6 Communication Skills- L6.3 Class discussion, Makes Persuasive Oral Presentations Case analyses,
Page 2 of 25 Health Law & Ethics PHMS-635
Uses clear and understandable voice reflective papers, that is free of extraneous phrases (i.e, debate, working with “uhm” and “you know”); Uses effective attorneys exercise, audiovisual media (presentation ethics committee software, exhibits, etc.) Stays on the deliberation topic; Engages in on-defensive Q&A; Stays within time allotment
Objectives 2, 3, and 4 L3 Analytical Thinking- L3.4 Class discussion, Develops Complex Plans or Analyses Case analyses, Identifies multiple elements of a reflective papers, problem and breaks down each of those debate, ethics elements in detail, showing casual committee relationships between them. Peels back deliberation, working multiple layers of a problem. Uses with attorneys several analytical techniques to identify exercise, Examination potential solutions and weigh the value of each
L11 Information Seeking- L11.3 Class Discussion, Delves Deeper Asks a series of probing Case analyses, questions to get at the root of a reflective papers, situation, a problem, or a potential Debate, working with opportunity below service issues attorneys exercise, presented. Calls on others who are not ethics committee personally involved to get their deliberation perspective, background information, experience, etc. Does not stop with the first answer. Finds out why something happened. Seeks comprehensive information including expecting complexity
L14 Innovative Thinking- L14.4 Class Discussion, Clarifies Complex Ideas or Situations case analyses, Makes complex ideas or situation clear, working simple, and/or understandable (e.g. re- with attorneys framing the problem, use of analogy) exercise, debate, Assembles ideas, issues and ethical committee observations into a clear and useful deliberation, explanation; Restates existing reflective paper observations or knowledge in a simpler fashion. Takes intricate data and puts it into lay terms: boils down “information 1.Demonstrate a basic L6 Communication Skills- L6.1 Uses See above understanding of the Generally Accepted English
Page 3 of 25 Health Law & Ethics PHMS-635
American legal system, legal Grammar outlined above process, and principles of legal analysis L6 Communication Skills- L6.2 See above Prepare Effective Written Business ( Comprehension) Cases or Presentations outlined above
L6 Communication Skills- L6.3 See above Makes Persuasive Oral Presentations outlined above
L24 Strategic Orientation- L24.1 Class Discussion, Conducts Environmental Scanning Case analyses, Performs analyses that identify the Working with competitive/market governmental and Attorneys Exercise. regulatory forces that currently and will Examination shape the organization; identifies the strengths and challenges of the organization vis-vis the forces of today and into the future. Identifies the requires social and economic position of the organization in light of the environmental scan 2.Identify, analyze, apply, L6 Communication Skills- L6.1 Uses See above and evaluate the role of Generally Accepted English legal principles and legal Grammar outlined above analysis in health administration L6 Communication Skills- L6.2 See above Prepare Effective Written Business (Comprehension, Application, Cases or Presentations outlined above Analysis, Synthesis, Evaluation) L6 Communication Skills- L6.3 See above Makes Persuasive Oral Presentations outlined above
L3 Analytical Thinking- L3.4 See above Develops Complex Plans or Analyses outlined above
L11 Information Seeking- L11.3 See above Delves Deeper outlined above
L14 Innovative Thinking- L14.4 See above Clarifies Complex Ideas or Situations outlined above
L24 Strategic Orientation- L24.3 Class Discussion,
Page 4 of 25 Health Law & Ethics PHMS-635
Aligns Organization to Address Long Case analysis, –term Environment Understands working with forces that are shaping health over the attorneys, debate next 5-10 years. Aligns strategy, structure or people with the long term environment. Develops a long term strategy to position the organization for success.
L16 Organizational Awareness- Class discussion. L16.1Uses Formal Structure Uses the Case analyses. formal structure or hierarchy of an Examination organization to get things done. Understands chain of command, positional power, rules and regulations, policies and procedures
L18 Process Management and Organizational Design- L18.4 Class Discussion. Understands the Basics of Case Organization Governance Analysis Understands governance practices including board relations, committee structure, ethics and clinical review responsibilities; Uses key governing and regulatory organizations such as state, county, and city governments. Uses organization governance to enhance quality, customer satisfaction and performance
L10 Impact and Influence- L10.4 Calculates Impact of Actions or Class Discussion. Words Analyzes the needs, interests Case Analysis, and expectations of key stakeholders. Working with Anticipates the effect of an action or Attorneys, Debate other detail on people’s image of the speaker. Prepares for others reactions. Tailors messages to interests and needs of an audience, aligns persuasion actions for targeted effects or impact, takes a well throughout dramatic or unusual action in order to have a specific impact
Page 5 of 25 Health Law & Ethics PHMS-635
L7 Community Orientation- L7.5 Provides Services to the Community Class discussion. Takes deliberate action to support the Case Analyses, local and regional community’s health Debate values and needs; Initiates or develops a new service or array of services to address the specific needs of the population and how it wants to receive health, recognizing ethnic and cultural differences; Works with other regional health organization and constituencies to create a comprehensive and integrated health system to promote long-term wellness and serve community needs; Advocates for community health needs and priorities.
L7 Community Orientation- L7.6 Class discussion. Advocates for the broader Health Case Analyses, Environment Engages in meaningful Debate actions at the national level to move recognized priorities forward; Partners across health constituencies to create a coordinated and dynamic health system on a national basis that meets long-term health and wellness needs; Understands needs of health stakeholders nationally and pushes their agenda forward
L4 Change Leadership- 4.2 Expresses Class Discussion. Vision for Change Defines an explicit Case analyses, vision for Change (i.e. what should be Reflective Paper different and how); Modifies or redefines a previous vision in specific terms; Outlines strategies for change
3.Recognize ethical L6 Communication Skills- L6.1 Uses See Above dilemmas in health Generally Accepted English administration and use Grammar outlined above ethical analysis and principles of general and L6 Communication Skills- L6.2 See Above professional ethics in health Prepare Effective Written Business administration decision Cases or Presentations outlined above making and in developing
Page 6 of 25 Health Law & Ethics PHMS-635 strategies to promote ethical L6 Communication Skills- L6.3 See Above behavior within an Makes Persuasive Oral Presentations organization outlined above
(comprehension, application, L3 Analytical Thinking- L3.4 See above analysis) Develops Complex Plans or Analyses outlined above
L11 Information Seeking- L11.3 See above Delves Deeper outlined above
L14 Innovative Thinking- L14.4 See above Clarifies Complex Ideas or Situations outlined above
L19 Professionalism- L19.4 Promotes Community Stewardship Develops Class Discussion, professional roles/values compatible case analyses, debate, with improving population and reflective paper individual health; commits to addressing the health and wellness needs of the total population, including adapting new approaches that address cultural attitudes about health. Ensures organizational stewardship and accountability for honesty and fair dealing with all constituencies
L1 Accountability- L1.5 Creates a Culture of Accountability Creates a Class Discussion, culture of strong accountability Case Analyses, ethics throughout the organization. Holds committee others accountable for demanding high deliberation, performance and enforcing Reflective paper consequences of non-[performance and taking action. Accepts responsibility for results of own work and that delegated to others
L15 Interpersonal Understanding- 15.4 Displays Sensitivity to Cultural, Class discussion. Ethnic and Social Issues Is sensitive to Case Analyses, the cultural, ethnic, and social Debate, ethics backgrounds of individuals and groups; committee Understands their differences with an deliberation
Page 7 of 25 Health Law & Ethics PHMS-635
eye toward accommodating or appreciating them; Displays an in-depth understanding of the ongoing reasons for a person’s behavior or responses
L10 Impact and Influence- L10.4 Calculates Impact of Actions or Class Discussion, Words Analyzes the needs, interests Case Analyses, and expectations of key stakeholders. Working with Anticipates the effect of an action or Attorneys, Debate other detail on people’s image of the speaker. Prepares for others reactions. Tailors messages to interests and needs of an audience, aligns persuasion actions for targeted effects or impact, takes a well thought out dramatic or unusual action in order to have a specific impact
L16 Organizational Awareness- L16.4 Considers Priorities and Values of Class Discussion, Multiple Constituencies Takes time to Case analysis become familiar with the expectations, priorities and values of the many stakeholders (e.g. physicians, nurses, patients, staff, professionals families, community leaders. Uses this understanding to build coalitions and consensus around the organizations visions, priorities and national health and wellness agendas. Recognizes and/or uses ongoing power and political relationships within the constituencies(alliances, rivalries)with a clear sense of organizational impact
L4 Change Leadership- 4.2 Expresses Vision for Change Defines an explicit Class Discussion, vision for Change (i.e. what should be Case Analysis different and how) Modifies or redefines a previous vision in specific terms. Outlines strategies for change
L5 Collaboration- L5.5 Builds Team Commitment Encourages or facilitates Class Discussion, a beneficial resolution to conflict Case Analysis,
Page 8 of 25 Health Law & Ethics PHMS-635
Reflective paper L7 Community Orientation- L7.5 Provides Services to the Community Class discussion. Takes deliberate action to support the Case Analyses, local and regional community’s health Debate values and needs; Initiates or develops a new service or array of services to address the specific needs of the population and how it wants to receive health, recognizing ethnic and cultural differences; Works with other regional health organization and constituencies to create a comprehensive and integrated health system to promote long-term wellness and serve community needs; Advocates for community health needs and priorities.
L7 Community Orientation- L7.6 Advocates for the broader Health Environment Engages in meaningful Class discussion. actions at the national level to move Case Analyses, recognized priorities forward; Partners Debate across health constituencies to create a coordinated and dynamic health system on a national basis that meets long-term health and wellness needs; Understands needs of health stakeholders nationally and pushes their agenda forward
4.Develop strategies for and L6 Communication Skills- L6.1 Uses See above ways of communicating Generally Accepted English effectively with attorneys Grammar outlined above (Comprehension, Application See above and Analysis) L6 Communication Skills- L6.2 Prepare Effective Written Business Cases or Presentations outlined above See above
L6 Communication Skills- L6.3 Makes Persuasive Oral Presentations See above outlined above
L3 Analytical Thinking- L3.4 See above Develops Complex Plans or Analyses outlined above
Page 9 of 25 Health Law & Ethics PHMS-635
L11 Information Seeking- L11.3 See above Delves Deeper outlined above
L14 Innovative Thinking- L14.4 See above Clarifies Complex Ideas or Situations outlined above
L5 Collaboration- L5.3 Solicits Input Working with Genuinely values others input and Attorneys Exercise expertise; Actively seeks the input of others to increase the quality of solutions developed. Displays willingness to learn from others, including subordinates and peers. Solicits ideas and opinions to help form specific decisions or plans. Works to create common mindset
L10 Impact and Influence- L10.4 Working with Calculates Impact of Actions or Attorneys Exercise Words Analyzes the needs, interests and expectations of key stakeholders. Anticipates the effect of an action or other detail on people’s image of the speaker. Prepares for others reactions. Tailors messages to interests and needs of an audience, aligns persuasion actions for targeted effects or impact, takes a well thought out dramatic or unusual action in order to have a specific impact
5.Develop a critical L6 Communication Skills- L6.1 Uses See above awareness of one’s own Generally Accepted English ethical values and Grammar outlined above underlying ethical concepts L6 Communication Skills- L6.2 See above (Comprehension, Prepare Effective Written Business Application) Cases or Presentations outlined above
L6 Communication Skills- L6.3 See above Makes Persuasive Oral Presentations outlined above
L11 Information Seeking- L11.3 See above Delves Deeper outlined above
Page 10 of 25 Health Law & Ethics PHMS-635
L23 Self-Development- L23.2 Ethical Self- Improves Own Performance Reflects Assessment on own performance; Learns from less Reflective Paper successful step
L22 Self-Confidence- L22.2 Acts Ethical Self- Confidently at the Limits or Slightly Assessment Beyond the Limits of Job or Role Reflective Paper Makes decisions without asking others. Makes decisions even when others disagree. Acts outside formal role or authority. Acts in uncertain circumstances
Course Topics and Schedule
IMPORTANT NOTE: The schedule and topics may change as the course unfolds. Changes are posted on Blackboard. Topic Assignment Wee k Introduction to the American Legal System Wee and Legal k 1 Reasoning(Lecture, Pozgar 15-28,147-164,174-179 Discussion) Kerr OS How to Read a Legal Opinion 11 Green Bag 51-63 (2007) Sources of Law, Handout: How to Read Statutes and Regulations Federalism, Separation Powers,Terminology, Civil Procedure. Administrative Agencies and procedure
Introduction to Ethical decision Making in the Health Pozgar Chapter 2 ManagementContext. Professional Ethics: ACHE Code of Ethics;GMA-ACMPE Code of Ethics (Lecture, Discussion, ACHE Code of Ethics Policy Statement #11 Ethics Self Assessment) “Medical Ethical Decisions” Health Care Executive July/Aug 2015p:45 Distinguishing law and “Strengthening Ethical Decision making” ethics. Principles of Complete Ethical Self Assessment Medical decision making https://www.ache.org/abt_ache/YourCareer_CEO_Sp05.pdf and Organizational ethics
Introduction: Health Wee Reform and Access to k 2 Care.( Case Study with Pozgar 528-531
Page 11 of 25 Health Law & Ethics PHMS-635
Legal and Ethical Kaiser Foundation:Health reformhttp://kff.org/health-reform/(check Particularly consumer Analysis. Team resources) Presentation) Case Study: National Federation of Independent Business v. Sebelius
Liability Overview : Contracts and Intentional torts as bases for liability. ( Lecture, Discussion) Elements of a contract. Pozgar 126-128,142-144,82-96 Physician-Patient Harvey v. Strickland 566 S.E.2d 529 (2002) Relations. Liability for breach of contract breach of warranty, Intentional Torts, Strict Liability and Products Liability.
Liability Overview: Wee Negligence and Medical k Malpractice. (Lecture. Pozgar Chapter 4, Chapter 25, 226-257, 164-169,352-355 3 Discussion): Basic “Disclosing Harmful Medical Error to Patients”356 NEJM 2713 (2007) Elements: Duty, Breach of Hastings Center Report Medical Error and Malpractice Duty, Causation, Injury http://www.thehastingscenter.org/Issues/Default.aspx?v=250 and Damages. Tort Reform. Legal and Ethical Issues surrounding Risk Management
Liability Overview: .Negligence and Medical Malpractice. (Case Study with Legal and Ethical Thompson v. Baylor University Medical Center 1995WL81321 Analysis. Team Presentation)
The Business of Health I: Structure and Wee Management of the k 4 Health Care Organization. (Lecture and Discussion): Forms of Pozgar 183-190,219,531-542 Business Organizations; 42 CFR 425 Medicare Shared Savings Plan Nature of “ Why ACOs are not 1990 Managed Care”307 JAMA 2263 Corporations; Volume 15 AMA Journal of Ethics (February 2013) (skim articles. Responsibilities of Read M. Camp,” Ethics and the Accountable Care Organization” Governing boards and http://journalofethics.ama-assn.org/2013/02/toc-1302.html Officers; Sarbanes Oxley Kosair’s Children’s Hospital: Is Norton v. U of L having an Impact Insider Louisville June
Page 12 of 25 Health Law & Ethics PHMS-635
Ethics of 2014 http://insiderlouisville.com/business/kosair-childrens-hospital-norton-v-u-l-impact/ Management.Multi- Institutional systems and Corporate reorganization. Alternate Corporate Strategies, ACO, CON
The Business of Health I: Structure and Radiation Therapy Oncology v. Providence Hospital S. Ct. Alabama 2006 Management:( Case http://caselaw.findlaw.com/al-supreme-court/1105368.html Studies with Legal and In the Matter of Manhattan Eye, Ear and Throat Hospital v. Spitzer 715 NYS 2d 575 (NY Ethical Analysis. Team Supp Ct 1999) Presentation
The Business of Health I: Institutional Liability Wee (Lecture and Discussion): Pozgar pages 128-129, 190-212, 453-469, 583-542 k 5 Theories of liability Harvey HB and Cohen IF “The Looking Threat of Liability for (respondeat superior, Accountable Care Organization and What to do about It 310 JAMA agency and apparent pp:141-142 ( 2013.) agency, corporate liability. Optional: McCoy et al “Is Ethics for Sale: Juggling Law and Ethics in Managed Care Managed Care” 8 DePaul Journal of Health Care Law 558 (Spring 2005) Organizations and ERISA http://via.library.depaul.edu/cgi/viewcontent.cgi?article=1169&context=jhcl
The Business of Health I: Institutional Liability( Case Studies Darling v. Charleston Community Memorial Hospital 211 NE2d 253 (Ill with Legal and Ethical 1966) Analysis. Team Pagarian v. Aetna US Healthcare of California 2005 WL 2742807 (Cal. Ct. Presentation) Of Appeals
Credentialing , Licensure, and Wee Accreditation (Lecture Pozgar pages 194-200, 202-213, 352-356, 549 k 6 and Discussion) 42 CFR 482subparts A,B, and C Oversight of Medical Staff 902 KAR Chapter 20 (skim) and peer review including HQIA 42 USC 11101-11151 (skim) Organization and Azmat v. Shalala 186 F.Supp 744(W.D. Ky 2001) appointment, due process, Watson v. Ky Board of Nursing 37 SW 3d 788 equal protection and peer review.Licensing and Administrative oversight
Class Exercise: Working Review and prepare simulation exercise (instructor handout with Attorneys: Preparing TAKE HOME MIDTERM EXERCISE WILL BE PROVIDED AT to defend and Prevent a THE END OF THIS SESSION
Page 13 of 25 Health Law & Ethics PHMS-635
Medical Malpractice Claim
MID TERM DUE Mid Term Review and Complete midterm take home exercise provided at the end of Week 6 Wee Reflections k 7 The Business of Health II: Competition and Compliance. Competition Pozgar pp: 136-140,540-541 and Anti-Trust: (Lecture Singer, “Anti-Trust Implications of the Affordable Care Act”, 6 Journal and Discussion) The Of Health and Life Sciences Law 57 Sherman Act, The Optional Havighurst Antitrust Enforcement in the Medical Services Clayton Act. FTC. Industry: What does it all mean? 58 Milbank Memorial Fund Jurisdiction ,exemption and Quarterly 89 (Dec 2005) immunity, sanctions and enforcement, rule of reason analysis and per se violations
The Business of Health Wee II:Competition and Anti- k 8 Trust (Case Study with Saint Alphonsus Medical Center v. Saint Lukes Health System , Legal and Ethical 778 F. 3d 775 (9th Circuit 2015) Analysis. Team Presentation)
The Business of Health II. Fraud Laws and Pozgar 103-109 Corporate Compliance OIG Advisory Opinion 12-06 (Lecture and Discussion) Humana Compliance and Fraud Prevention Guidehttp://www.humana- False Claims. Anti- military.com/library/pdf/compliance-fraud-prevention-guide.pdf Kickback Statute. Stark Self-Referral Law, Foreign Corrupt Practice Act. Corporate Compliance
The Business of health II.Fraud Laws and Corporate Compliance Wee (Case Study with Legal U.S. ex rel Drakeford v. Toumey 792 F.3d. 364 (4th Cir.2015) k And Ethical Analysis. Optional: U.S. v. Raithatha 385 F3d 1013 (6th Cir.2004 9 Team Presentation)
The Business of Health II.
Page 14 of 25 Health Law & Ethics PHMS-635
Tax Exemption (Lecture and Discussion): The Non- Pozgar 213-218 Profit organization Studdert et all, “Regulatory and Judicial Oversight of Organization. Federal and Nonprofit hospitals 356 NEJM 625-631(2007) https://cdn1.sph.harvard.edu/wp- Local Tax Exemptions for content/uploads/sites/487/2012/10/Charity_Care_PDF.pdf Not for Profit New Requirements for 501C(3) Hospital Organizations Organizations. Tax Under the ACA https://www.irs.gov/Charities-&-Non-Profits/Charitable- exemption in a Organizations/New-Requirements-for-501%28c%29%283%29-Hospitals-Under-the- Competitive Health Care Affordable-Care-Act Market Rosenbaum, “Hospitals as Community Hubs” 5 Economic Studies at the Brookings (March 2016) http://www.brookings.edu/~/media/research/files/papers/2016/03/09-hospitals-as- community-hubs-rosenbaum/rosenbaum-pdf-layout-final.pdf
The Business of Health II.Tax Exemption(Case Wee Study with Legal and Provena Covenant Medical Center v. Department of Revenue k 10 Ethical Analysis. Team Presentation)
Clinical Care: Emergency Care, EMTALA. (Lecture and Discussion) Pozgar pp 168-169, 292-301, 453-469 Common law related to Aacharya et al. “Emergency Department Triage:An Ethical Analysis” emergency care. Good 11 MMC Emergency Medicine16 Samaritan Statutes. (2011)011http://bmcemergmed.biomedcentral.com/articles/10.1186/1471-227X-11-16 EMTALA and access to Thomas v. St. Joseph’s Healthcare 335 SW2d 460(2011) care for vulnerable Optional Moses v.Providence Hospital 07-2111 (6th Cir. 2009 populations
Clinical Care: Health Wee Information k 11 Management: (Lecture . Pozgar pp: 359-380,345-358 Case Study HIPAAAhttp://www.hhs.gov/hipaa/ With Legal and Ethical Caldwell v. Chauvin _SW3d_ (2015) Analysis)Privacy/HIPAA. KRS 209,620,902 Form and Tarasoff v. Board of Regents content of Medical Optional: Annas, Doctors, Drugs and Driving –Tort Liability Records. The right to For Patient Caused Accidents 359 NEJM521-525 (2008) privacy. HIPAA and HITECH Legal Requirements. Exceptions. The use of health Records in legal proceedings
Page 15 of 25 Health Law & Ethics PHMS-635
Clinical Care: Decisionmaking:Informe d Consent . Patients Pozgar Chapter 13, 445-446, Chapter 19 Rights(Lecture. KRS 304.40 Discussion) Types of Sargeant v Shaffer sc-00011 (Ky S.Ct. 2015) Consent. Elements of KRS 214.185 Informed Consent. Minors Optional Denise Niemera, “Ethical Conflicts in Rural and Incompetent Adults. Communities:Shared Decision making “ in Nelson, Handbook for Role of Institution Rural Health Care Ethics Dartmouth College Presshttps://geiselmed.dartmouth.edu/cfm/resources/ethics/chapter-08.pdf
Clinical Care: Reproduction and Birth (Lecture, Class Debate) Wee Sterilization,Wrongful birth Pozgar Chapter 16 k and wrongful life. Abortion. Whole Women’s Health v. Hellerstedt (S Ct. Feb 2016) 12 Child Burwell v. Hobby Lobby Stores 134 S.Ct. 2751 Birth Options .Conscientious objection. Institutional Role in (Full opinion of above cases optional.Syllabi acceptable) Reproductive Issues Access to Fertility Services for Transgendered Persons: An Ethics Committee Opinion(American Society of Reproductive Medicine https://www.asrm.org/uploadedFiles/ASRM_Content/News_and_Publications/Ethics_Comm ittee_Reports_and_Statements/Access_to_care_for_transgender_persons.pdf Debate: Topic TBA (May focus on Ethical Responsibility of Health Care institutions with respect to honoring patient’s Decisions regarding reproductive choice )
Clinical Care: Decision- making at the End of Life: (Lecture. Discussion) Ethics Committees. Patient Pozgar Chapter 18 Determination Act. DK Movant v. Commonwealth Cabinet of Health and Family DNR .Withholding Services 221 SW3d 382 Treatment. Patient Assisted Read Belkin :First Do No Harm Suicide. Futility
Clinical Care: Ethics Complete Reading of Belkin. Prepare brief (no more than Wee Committee Deliberation 5 pages) report to be submitted to team members and the k Instructor before in class, in preparation for deliberation 13
Study Session for Final Prepare for Final Examination Exercise Exercise. Work on Reflective Paper
Wee k FINAL EXAMINATION 14 EXERCISE
Page 16 of 25 Health Law & Ethics PHMS-635
Review of Final Exercise Course Wrap Up REFLECTIVE PAPER DUE FIRST DAY OF EXAM WEEK
Course Materials
Blackboard
The primary mechanism for communication in this course, other than class meetings, is UofL’s Blackboard system at http://ulink.louisville.edu/ or http://blackboard.louisville.edu/. Instructors use Blackboard to make assignments, provide materials, communicate changes or additions to the course materials or course schedule, and to communicate with students other aspects of the course. It is imperative that students familiarize themselves with Blackboard, check Blackboard frequently for possible announcements, and make sure that their e-mail account in Blackboard is correct, active, and checked frequently.
Required Texts
The required text for this course in Pozgar Legal Aspects of Health Care Administration 12th edition. For the ethics committee deliberation students will be required to read First Do No Harm by Lisa Belkin
Other Required Reading
The text is supplemented by additional required reading of cases and articles as indicated the syllabus and as may be assigned by the instructor during the course.. Each student is expected to read the required materials and come to class prepared. At times there will be discussion of sensitive and controversial issues. Please be respectful of the opinions of others and engage in debate which is civil and constructive. Throughout the course students will be expected to follow current events relevant to the course material in the media
Additional Suggested Reading
Optional reading for select class sessions is indicated in the syllabus. The instructor will also provide a bibliography of suggested reading for supplemental and continuing learning at the beginning of the course. Students are encouraged to visit the Jefferson County Court House and view a judicial proceeding. Extra credit will be provided for students who provide a brief reflective report of their court observations. For extra credit students may also prepare and submit a brief reflective report of a reading from the suggested reading list and a reflective journal of relevant current events followed during the course .
Page 17 of 25 Health Law & Ethics PHMS-635
Prepared Materials Used by Instructors
Materials used by instructors in class are available to students via Blackboard no later than 24 hours following the class. These may include outlines, citations, slide presentations, and other materials. There is no assurance that the materials include everything discussed in the class.
Other Materials
None.
Course Policies
Attendance and Class Participation
Attendance at all class sessions is strongly encouraged. Students are advised that much of the course content is not in texts or literature. Concepts will be interactively discussed and developed during class time. As such, active class participation is expected.
Student Evaluation
The components of Student Evaluation are as follows:
1. Attendance and Class Participation. (10%) Students are expected to come to class prepared and to participate in class discussion and exercises. Students should notify the instructor if they will be absent. Students who do not attend class without excuse are not participating.
2. Team Presentations (Legal and Ethical Case Analyses) (25%). Participation of all students is encouraged each week. To facilitate discussion and encourage team work, the instructor will designate one team of students on a rotating basis to “present the case”. Teams presenting the case for the designated session will be expected to 1. Read the case closely 2. Prepare a brief written analysis of the case for submission to instructor and to guide discussion. The analysis of the legal issues should s following the format of the legal case brief provided at the beginning of the course . The analysis should also identify the ethical dilemmas presented for the administrative decision maker and raise at least three questions for class discussion.. 3. Present and lead the class discussion. Discussion should focus on understanding not only the issues but also on the relevance of the case for decision making in the context of health administration. More explicit instructions for the team presentation will be provided.
3. In Class Participatory Exercises (15%) (Working with Attorneys, Debate, Ethics Committee Deliberation)These three exercises are designed to provide alternate ways to engage the material. The Ethics Committee deliberation and Working with Attorneys will involve simulations of a hospital ethics committee deliberation and hospital administrator/in house counsel consultation.
4. Mid Term Examination. (15%) (Objective. Take Home )
Page 18 of 25 Health Law & Ethics PHMS-635
5. Final Examination . (15%) (Objective In Class)
6. Reflective Paper (20%) (No page limit is set for the Reflective Paper). The paper must be long enough for complete discussion. A paper less than 5 pages is generally too short.
Grading The components of student evaluation are weighted as follows: 1. Class Participation 10% 2 Team Presentation Case Analyses 25% 3. In-Class Participatory Exercises 15% 4. Mid-term Exercise 15% 5. Final Examination 15% 6. Reflective Paper 20%
The course and components will be graded with the +/- letter grades A, B, C, D and F in accordance with the university-wide grading policy. However, students in the program are expected to perform at or above a C level. Performance below that level will require students to repeat the course. A+ 97-100% A 93-96% A- 90-92% B+ 87-89% B 83-86% B- 82-80% C+ 77-79% C 73-76% C- 72-70% D+ 67-69% D 63-66% D- 62-60 F < 60%
Grade Item A Criterion B Criterion C Criterion F Criterion Class Participation Attends regularly. Attends regularly. Attends regularly. Consistently 10% Demonstrates Demonstrates Preparation is absent .Does not outstanding satisfactory minimal but participate in preparation. Asks preparation for adequate. discussion in any advanced questions class. Asks good Contribution meaningful way to promote analysis. questions. minimal and often Integrates new non-responsive knowledge and information. Stimulates others to participate Team Presentation Superior Solid Adequate Presentation not Case Analyses Presentation. Presentation. Presentation timely without 25% Clearly identifies Identifies most Recognizes some adequate excuse.
Page 19 of 25 Health Law & Ethics PHMS-635
relevant facts and relevant facts and relevant facts and Presentation significant legal and significant legal legal and ethical demonstrates no ethical issues. and ethical issues. issues , but many effort or Provides complete, Provides analysis are missing . comprehension of well developed that demonstrates Analysis the material or analysis that good grasp of demonstrates assignment demonstrates mastery course content, minimally of content and discusses adequate grasp of discusses significance of content. Generally significance of relevant principles cursory relevant principles of of law and ethics discussion . law and ethics for for administrative Argument usually administrative decision making not fully decision making. with some developed or Persuasive Analysis, example and supported with well supported with illustration. example and evidence and Recognizes illustration.. example. Recognizes, alternate points of Several, if not the acknowledges, view. Raises majority, of respects and relevant questions. questions are seriously engages Oral and written irrelevant or off alternate points of Expression point. Oral and view. Understands generally clear, written expression and responds to well organized, lacks clarity and audience. Provides and grammatical. needs significant original insight. Tone consistent attention to Raises questions that and attentive to organization, stimulate deeper impact grammar, word analysis. Presents choice, and tone. complex ideas simply Minimal or no without sacrificing recognition of appreciation for opposing points of complexity and view nuance. Oral and written expression is clear, logical , well organized, and grammatical. Tone consistent and attentive to impact.
In Class Superior Solid Adequate Did not participate Participatory Participation. Participation Participation in exercise without Exercises 15% Outstanding, well Good, organized Preparation is excuse. organized preparation. Shows adequate but Participated but preparation. Shows engagement with incomplete. Shows demonstrated no strong engagement and solid mastery engagement and comprehension of with and mastery of of the substantive minimum mastery the issues and no the substantive issues issues . of the substantive meaningful effort Shows depth analysis Reasonably issues. Weak to engage and understanding of sophisticated analysis of the the problems analysis of the problem.
Page 20 of 25 Health Law & Ethics PHMS-635
involved .Asks problems involved. Questions are probing questions. Asks meaningful raised but not Oral and Written questions. Oral and always relevant. Expression is written Expression Expression lacks organized, clear and is clear and clarity. grammatical. Tone grammatical. Demonstrates consistent and .Tone generally minimum attentive to impact. attentive impact. understanding of Argument well Argument the way in which supported,clarifies reasonably words and action complex ideas, and developed, impact others. demonstrates supported with Makes some effort appreciation for ways example and to identify the in which both words illustration, and interests of others, and action can impact demonstrates engage others in others. Identifies general discussion, and interests of others understanding of respect and learn and effectively and the way in from other points sensitively engages which words and of view others in discussion. action impact Respects and learns others.Recognizes from other points of the interests of view. others and makes reasonable effort to engage others in discussion. Respects and learns from other points of view. Mid term Outstanding Solid Adequate Inadequate Examination 15% comprehension of the Comprehension of Comprehension of Comprehension material presented (a the material the material Of the material score of 90% or presented (a score presented ( a score presented (a score above) of 80% or above) of 70% or above below 70%) Final Examination Same as mid-term Same as midterm Same for midterm Same as midterm 15% Reflective Papers Well written paper, Generally well Written expression Did not complete 20% well organized, written paper. is adequate but paper in a timely clearly articulated, Thoughtful needs fashion without and grammatical. In analysis of select strengthening. excuse. Paper, if depth synthesis, aspects of ideas or Synthesizes submitted in a ,analysis and issues from class aspects of some timely fashion, evaluation of select assignments and ideas from class shows no aspects of ideas or discussion Makes discussion and comprehension of issues from the class clear connections assignments and material or assignments and between learning makes general assignment discussion. Integrates and past connections concepts experience. Open between learning thoughtfully and but somewhat less an past experience. effectively with past thorough and Some what experience. probing cautious and more Thoughtful, open, examination and superficial and non-defensive appraisal of the examination and self appraisal of the learning appraisal of the learning experience. Raises experience. Some
Page 21 of 25 Health Law & Ethics PHMS-635
experience,discussing thoughtful, questioning but both growth and relevant questions questions are also frustrations related to more general and understanding not superficial and are only the materials but not always also to self- relevant. understanding and ethical consciousness . Raises probing questions
Other Policies
Expected Student Effort Out of Class
Students are expected to spend an average at least 2-1/2 hours per week per credit hour on the course exclusive of class time. This time includes but is not limited to reading, research, preparations for class, team or group meetings (electronic or otherwise), and course deliverables.
Syllabus Revision
The course director reserves the right to modify any portion of this syllabus. A best effort is made to provide an opportunity for students to comment on a proposed change before the change takes place.
Inclement Weather
This course adheres to the University’s policy and decisions regarding cancellation or delayed class schedules. Adjustments are made to the class schedule as necessary to take into account any delays or cancellations of this class. Local television and radio stations broadcast University delays or closings. The UofL web site (www.louisville.edu) and telephone information line (502- 852-5555) also broadcast delays or closings.
Grievances
A student who has grievances regarding the course should seek to have the matter resolved through informal discussion and through administrative channels, such as the course director, chair of the course’s department, associate dean for student affairs, and university grievance officer. If the issue remains unresolved, the student may file a formal grievance. More information is located at Summary of SPHIS Student Academic Grievance Procedure in Student Academic Grievance Committee (https://sharepoint.louisville.edu/sites/sphis/cbg/sagc/).
Disabilities
In accordance with the Americans with Disabilities Act, students with bona fide disabilities are afforded reasonable accommodation. The Disability Resource Center certifies a disability and
Page 22 of 25 Health Law & Ethics PHMS-635 advises faculty members of reasonable accommodations. More information is located at http://louisville.edu/disability.
Academic Honesty
Students are required to comply with the academic honesty policies of the university and School of Public Health and Information Sciences. These policies prohibit plagiarism, cheating, and other violations of academic honesty. More information is located at https://sharepoint.louisville.edu/sites/sphis/policies.
Course instructors use a range of strategies (including plagiarism-prevention software provided by the university) to compare student works with private and public information resources in order to identify possible plagiarism and academic dishonesty. Comparisons of student works require students to submit electronic copies of their final works to the plagiarism-prevention service. The service delivers the works to instructors along with originality reports detailing the presence or lack of possible problems. The service retains copies of final works and may request students’ permission to share copies with other universities for the sole and limited purpose of plagiarism prevention and detection.
In addition instructors provide the opportunity for students to submit preliminary drafts of their works to the service to receive reports of possible problems. Such reports are available only to the submitting student. Copies of preliminary drafts are not retained by the service.
Title IX/Clery Act Notification
Sexual misconduct (including sexual harassment, sexual assault, and any other nonconsensual behavior of a sexual nature) and sex discrimination violate University policies. Students experiencing such behavior may obtain confidential support from the PEACC Program (852- 2663), Counseling Center (852-6585), and Campus Health Services (852-6479). To report sexual misconduct or sex discrimination, contact the Dean of Students (852-5787) or University of Louisville Police (852-6111).
Disclosure to University faculty or instructors of sexual misconduct, domestic violence, dating violence, or sex discrimination occurring on campus, in a University-sponsored program, or involving a campus visitor or University student or employee (whether current or former) is not confidential under Title IX. Faculty and instructors must forward such reports, including names and circumstances, to the University’s Title IX officer.
For more information, see the Sexual Misconduct Resource Guide.
Continuity of Instruction Plan
A plan for continuity of instruction for this course has been developed and published. All plans are available at https://sharepoint.louisville.edu/sites/sphis/do/aa/coip. Continuity of instruction plans provide guidance for how instruction may be modified to lessen disruption by events that affect transportation, communication, or personal interaction. Such events may be
Page 23 of 25 Health Law & Ethics PHMS-635 weather-related (e.g., floods, blizzards, tornados), health-related (e.g., epidemics), or other widespread occurrences or threats.
Additional Policy Information
Additional policy information is available in the following: SPHIS Catalog (https://sharepoint.louisville.edu/sites/sphis/do/aa) SPHIS Policies and Procedures (https://sharepoint.louisville.edu/sites/sphis/policies) UofL Graduate Catalog (http://louisville.edu/graduatecatalog) v2016.06.06
Page 24 of 25 Health Law & Ethics PHMS-635
Version 2016.06.06
Course History Version Submitte Approved Change Summary Author(s) d 2016.06.06 7/11/16
Page 25 of 25