Skip to main content

Advertisement

Log in

End-of-life ethics and disability: differing perspectives on case-based teaching

  • Scientific Contribution
  • Published:
Medicine, Health Care and Philosophy Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

Notes

  1. This understanding of disability has become known as the medical or individual pathology model of disability.

  2. 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.

    Article  CAS  PubMed  Google Scholar 

  • Creswell, J.W. 2007. Qualitative inquiry and research design: Choosing among five approaches, 2nd ed. Thousand Oaks, CA: Sage Publications.

    Google Scholar 

  • Crotty, M. 1998. The foundations of social research: Meaning and perspective in the research process. London: Sage Publications.

    Google Scholar 

  • 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.

    Article  CAS  PubMed  Google Scholar 

  • Derksen, J., and H.M. Chochinov. 2006. Disability and end-of-life care. Journal of Palliative Care 22(3): 175–182.

    PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • Gill, C.J. 2006. Disability, constructed vulnerability, and socially conscious palliative care. Journal of Palliative Care 22(3): 183–189.

    PubMed  Google Scholar 

  • 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.

    Article  Google Scholar 

  • Hafferty, F.W., and F. Franks. 1994. The hidden curriculum: Ethics teaching and the structure of medical education. Academic Medicine 69(11): 861–871.

    Article  CAS  PubMed  Google Scholar 

  • Kaufert, J., and T. Koch. 2003. Disability or end-of-life? Competing narratives in bioethics. Theoretical Medicine 24: 459–469.

    Article  Google Scholar 

  • Linton, S. 1998. Claiming disability: Knowledge and identity. New York: New York University Press.

    Google Scholar 

  • Magwood, B. 2003. The Medical Humanities Program at the University of Manitoba, Winnipeg, Manitoba, Canada. Academic Medicine 78(10): 1015–1019.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • Newell, C. 2006. Disability, bioethics, and rejected knowledge. Journal of Medicine and Philosophy 31: 269–283.

    Article  PubMed  Google Scholar 

  • Oliver, M. 1998. Theories of disability in health practice and research. British Medical Journal 312: 1446–1449.

    Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • Rubin, S.B. 2007. If we think it’s futile, can’t we just say no? HEC Forum 19(1): 45–65.

    Article  PubMed  Google Scholar 

  • Shakespeare, T. 2006. Disability rights and wrongs. London: Routledge.

    Google Scholar 

  • Stienstra, D., and H.M. Chochinov. 2006. Vulnerability, disability, and palliative end-of-life care. Journal of Palliative Care 22(3): 166–174.

    PubMed  Google Scholar 

  • Von Gunten, C.F. 2007. The hidden (real) curriculum. Journal of palliative medicine 10(3): 632–633.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    Google Scholar 

Download references

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).

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Joseph Kaufert.

Rights and permissions

Reprints and permissions

About this article

Cite this article

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

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11019-009-9231-x

Keywords

Navigation