Abstract
The way in which medical professionals engage in bioethical issues ultimately reflects the type of care such patients are likely to receive. It is therefore critical for doctors and other health care professionals to have a broad understanding of disability. Our purpose in this paper is to explore ways of teaching bioethical issues to first year medical students by integrating alternative approaches. Such approaches include (a) the use of the narrative format, (b) the inclusion of a disability perspective, and (c) the presentation and facilitation of classes by people with disabilities. We consider how these new kinds of presentations are evaluated by students, faculty, people with disabilities and professional ethicists. We hope new knowledge may provide health care professionals with a greater understanding of the perspectives of patients with disabilities, who are confronted by conflicting ethical values and frameworks for decision-making in their interaction with such professionals.
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Notes
This understanding of disability has become known as the medical or individual pathology model of disability.
This understanding of disability has become known as the social model of disability.
References
Brulde, B. 2001. The goals of medicine. Towards a unified theory. Health Care Analysis 9: 1–13.
Creswell, J.W. 2007. Qualitative inquiry and research design: Choosing among five approaches, 2nd ed. Thousand Oaks, CA: Sage Publications.
Crotty, M. 1998. The foundations of social research: Meaning and perspective in the research process. London: Sage Publications.
Dammers, J., J. Spencer, and M. Thomas. 2001. Using real patients in problem-based learning: Students comments on the value of using real, as opposed to paper cases, in a problem-based learning module in general practice. Medical Education 35: 27–34.
Derksen, J., and H.M. Chochinov. 2006. Disability and end-of-life care. Journal of Palliative Care 22(3): 175–182.
Eckles, R.E., E.M. Meslin, M. Gaffney, and P.R. Helft. 2005. Medical ethics education: Where are we? Where should we be going? A review. Academic Medicine 80(12): 1143–1152.
Gill, C.J. 2006. Disability, constructed vulnerability, and socially conscious palliative care. Journal of Palliative Care 22(3): 183–189.
Goodrich, T.J., C.A. Irvine, and D. Boccher-Lattimore. 2005. Narrative ethics as collaboration: A four-session curriculum. Families, Systems & Health 23(3): 348–357.
Hafferty, F.W., and F. Franks. 1994. The hidden curriculum: Ethics teaching and the structure of medical education. Academic Medicine 69(11): 861–871.
Kaufert, J., and T. Koch. 2003. Disability or end-of-life? Competing narratives in bioethics. Theoretical Medicine 24: 459–469.
Linton, S. 1998. Claiming disability: Knowledge and identity. New York: New York University Press.
Magwood, B. 2003. The Medical Humanities Program at the University of Manitoba, Winnipeg, Manitoba, Canada. Academic Medicine 78(10): 1015–1019.
McColl, M.A., D. Stienstra, S.E. Shortt, W. Boyce, J. Kaufert, and M. Godwin. 2005. Reducing inequities in access to primary care for people with disabilities: Final report to CIHR. University of Manitoba, Winnipeg, Manitoba; Queen’s University, Kingston, Ontario.
Minihan, P.M., Y.S. Bradshaw, L.M. Long, W. Altman, S. Perduta-Fulginiti, J. Ector, K.L. Foran, L. Johnson, P. Kahn, and R. Sneirson. 2004. Teaching about disability: Involving patients with disabilities as medical educators. Disability Studies Quarterly 24(4): n.p.
Nantais, D., and M. Kuczewski. 2004. Quality of life: The contested rhetoric of resource allocation and end-of-life decision-making. Journal of Medicine and Philosophy 29: 651–664.
Newell, C. 2006. Disability, bioethics, and rejected knowledge. Journal of Medicine and Philosophy 31: 269–283.
Oliver, M. 1998. Theories of disability in health practice and research. British Medical Journal 312: 1446–1449.
Owen, C., and R.E. Reay. 2004. Consumers as tutors—Legitimate teachers? BMC Medical Education 4: n.p.
Ozolins, I., H. Hall, and R. Peterson. 2008. The student voice: Recognising the hidden and informal curriculum in medicine. Medical Teacher 30: 606–611.
Rubin, S.B. 2007. If we think it’s futile, can’t we just say no? HEC Forum 19(1): 45–65.
Shakespeare, T. 2006. Disability rights and wrongs. London: Routledge.
Stienstra, D., and H.M. Chochinov. 2006. Vulnerability, disability, and palliative end-of-life care. Journal of Palliative Care 22(3): 166–174.
Von Gunten, C.F. 2007. The hidden (real) curriculum. Journal of palliative medicine 10(3): 632–633.
Werth J.L. Jr. 2005. Concerns about decisions related to withholding/withdrawing life-sustaining treatment and futility for persons with disabilities. Journal of Disability Policy Studies 16(1): 31–37.
Wiebe, R., J. Kaufert, G. Stewart, and J. Derksen. 2009. Introducing medical students to perspectives on independent living and the experiences of persons with disabilities. Poster Session: Canadian Conference on Medical Education (Edmonton, Alberta).
Wilson, J.C. 2000. Making disability visible: How disability studies might transform the medical and science writing classroom. Technical Communication Quarterly 9(2): 149–161.
Acknowledgments
The preparation of this article was supported by the Canadian Institutes of Health Research New Emerging Team Grant on End of Life Care and Vulnerable Populations held by Harvey M. Chochinov (P.I.), Deborah Stienstra (Co-P.I.), Zana M. Lutfiyya, Co-I.), & Joseph Kaufert (Co. I).
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Kaufert, J., Wiebe, R., Schwartz, K. et al. End-of-life ethics and disability: differing perspectives on case-based teaching. Med Health Care and Philos 13, 115–126 (2010). https://doi.org/10.1007/s11019-009-9231-x
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DOI: https://doi.org/10.1007/s11019-009-9231-x