GEN 021: Science, Technology and Society for Allied Health
Module #6 Student Activity Sheet
Name: _________________________________________________________________ Class number: _______
Section: ____________ Schedule: ________________________________________ Date: ________________
Lesson title: Ethical Issues in Healthcare Part 1 Materials:
Student Activity Sheet
Learning Targets:
At the end of the module, students will be able to: References:
[Link] the ethical dilemmas faced by healthcare Beauchamp, T. L., & Childress, J. F.
professionals in various healthcare settings as discussed in (2019). Principles of Biomedical Ethics.
the article. Oxford University Press.
2. Propose potential solutions or approaches to address the Emanuel, E. J., Onwuteaka-Philipsen, B.
ethical challenges outlined in the article. D., Urwin, J. W., & Cohen, J. (2016).
Attitudes and practices of euthanasia and
physician-assisted suicide in the United
States, Canada, and Europe. JAMA,
316(1), 79-90.
Braveman, P., & Gottlieb, L. (2014). The
social determinants of health: It's time to
consider the causes of the causes. Public
Health Reports, 129(Suppl 2), 19-31.
A. CONNECT
A.1 Lesson Preview/Review
Welcome, students, to Periodical 2 of our course! I hope you all are excited and ready to dive into today's
important and thought-provoking topic: Ethical Issues in Healthcare Part 1. This topic is critical for anyone
entering the healthcare field as it helps us understand the complex moral landscape we navigate daily.
Before we start our lesson, let's begin with an engaging activity designed to get you thinking critically and
collaboratively about ethics in healthcare.
● You will be divided into small groups of 4-5 students.
● The group will receive an ethical dilemma scenario.
● Ensure that within your group, you consider different perspectives – those of the patient, the healthcare
provider, the patient's family, and the broader healthcare system.
● Spend 10-15 minutes discussing your assigned scenario. Consider the following questions:
1. What are the ethical principles involved (e.g., autonomy, beneficence, non-maleficence,
justice)?
2. What are the potential consequences of different decisions?
3. How would you resolve this dilemma if you were the healthcare provider?
Learning Modules by PHINMA Education is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0
International License.
GEN 021: Science, Technology and Society for Allied Health
Module #6 Student Activity Sheet
Name: _________________________________________________________________ Class number: _______
Section: ____________ Schedule: ________________________________________ Date: ________________
● After the discussion time, each group will present their scenario to the class along with their proposed
solution.
● Be prepared to explain your reasoning and answer questions from your classmates.
● After all groups have presented, we will have a class-wide reflection.
● By engaging in this activity, you'll develop a deeper understanding of the ethical challenges in
healthcare and learn to navigate these complex situations with empathy and professional integrity.
● Let's get started and see what solutions you can come up with!
The Unconscious Patient
A patient arrives at the emergency room unconscious and in critical condition. They have no identification,
and no family or friends are available to provide medical history. The doctors discover the patient needs an
immediate blood transfusion to survive, but also find a tattoo on the patient's chest that reads "Do Not
Resuscitate." There is no accompanying paperwork or further information. What should the healthcare team
do?
B. COACH
B.1. Content Notes
In this lesson, you are going to read to learn about “Ethical Issues in HealthCare”. To help us understand what
we read, we will use the comprehension strategy of Summarizing and Generalization. Since this is your first
time employing this strategy to this course I will show you how to do it. You will notice some highlighted
phrases or sentences. Those phrases or sentences are the salient information that can be used in
summarizing the whole text or content of the lesson.
Ethical Issues in Healthcare:
Ethical issues refer to dilemmas or concerns related to moral principles and values that arise in various
contexts, such as professional settings, personal interactions, or societal issues.
Ethical issues are everywhere in healthcare. They affect how decisions are made, how patients are cared
for, and how professionals behave. Whether it's letting patients make their own choices or figuring out how to
share limited resources fairly, healthcare workers face tricky moral questions every day. To handle these
challenges well, they need to stick to important principles like doing good, avoiding harm, being fair, and
respecting people's independence. These principles are like the building blocks of good healthcare.
Learning Modules by PHINMA Education is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0
International License.
GEN 021: Science, Technology and Society for Allied Health
Module #6 Student Activity Sheet
Name: _________________________________________________________________ Class number: _______
Section: ____________ Schedule: ________________________________________ Date: ________________
Patient Autonomy:
Patient autonomy is a big idea in healthcare that says people have the right to make decisions about their
own health. Think of it like being the captain of your own ship! This means you get to choose what happens
to your body and your health.
When you go to the doctor, they should explain things to you in a way you can understand. They'll tell you
about your options for treatment, like taking medicine or having surgery. Then, it's up to you to decide what
you want to do. It's like picking which path to take on a journey!
One important thing about patient autonomy is that you should have all the information you need to make a
good decision. That's why doctors and nurses talk to you about what's going on and what your choices are.
They want to make sure you understand everything before you decide.
A long time ago in the United States, there was a big court case called Canterbury v. Spence. This case
helped show how important it is for doctors to talk to patients about their treatment options. It's like saying
everyone should have a say in what happens to their own body.
End-of-Life Care:
When someone is very sick and nearing the end of their life, it's a time when important decisions need to be
made about their care. This is called end-of-life care. It's about making sure the person is as comfortable
and pain-free as possible.
Sometimes, a person might not be able to make decisions about their care because they are too sick. In
these cases, they may have talked about their wishes beforehand and written them down in something
called an advance directive. This helps their doctors and family know what they would want.
In the United States, there was a court case called Cruzan v. Director, Missouri Department of Health in
1990. It showed how important it is for people to plan ahead and talk about their wishes for medical care at
the end of their life.
Doctors and nurses also play a big role in end-of-life care. They focus on keeping the person comfortable
and helping them and their family with emotional support. This type of care is called palliative care, and it's
about making sure the person's quality of life is as good as possible.
Learning Modules by PHINMA Education is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0
International License.
GEN 021: Science, Technology and Society for Allied Health
Module #6 Student Activity Sheet
Name: _________________________________________________________________ Class number: _______
Section: ____________ Schedule: ________________________________________ Date: ________________
Health Equity: Health equity is about making sure everyone has a fair chance to be healthy. It means that
no matter who you are or where you live, you should have the same opportunities to be as healthy as
possible. Imagine if everyone had the same chance to play on a level playing field!
Sometimes, people don't have the same chances to be healthy. This can happen because of things like
where they live, how much money they have, or the color of their skin. For example, some neighborhoods
might not have good schools or places to buy healthy food. This isn't fair!
Health equity is important because everyone deserves to have a chance to be healthy. It's like making sure
everyone gets a fair shot at winning the race!
To help achieve health equity, people work to make sure everyone has access to things like good healthcare,
healthy food, and safe places to play and exercise. This way, everyone can have the best chance to live a
long and healthy life.
Let's go through the process for Step 2: Organize your thoughts then summarize the text you have read.
Again, I’ll show you how to do it since you are a first-timer. I will now review what I underlined. I will ask myself
- “What is the most important thing here? I will identify group related key points and organize them and
summarize the text that I have read. Look at what I summarized below.
Learning Modules by PHINMA Education is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0
International License.
GEN 021: Science, Technology and Society for Allied Health
Module #6 Student Activity Sheet
Name: _________________________________________________________________ Class number: _______
Section: ____________ Schedule: ________________________________________ Date: ________________
SUMMARIZE AND GENERALIZE
Ethical issues in healthcare encompass dilemmas related to moral principles and values that arise in
professional settings, personal interactions, and societal contexts. In healthcare, these issues influence
decision-making, patient care, and professional conduct. Central to ethical healthcare practice are principles
such as beneficence, non-maleficence, justice, and respect for patient autonomy.
Patient autonomy is a fundamental concept, affirming individuals' rights to make decisions about their health.
Informed consent, as exemplified by the Canterbury v. Spence case, underscores the importance of patients
having comprehensive information to make informed choices about their treatment.
End-of-life care involves crucial decisions regarding the comfort and well-being of terminally ill patients.
Advance directives, as highlighted in the Cruzan v. Director case, enable individuals to articulate their
preferences for medical care in advance, ensuring their wishes are honored.
Health equity, another significant ethical consideration, aims to ensure equal opportunities for health
regardless of socioeconomic status, geography, or other factors. It emphasizes addressing disparities in
access to healthcare, resources, and environmental factors to promote equitable health outcomes for all.
Congratulations! We are done summarizing and generalization of key ideas. This comprehension strategy is
very useful to understand the lesson better. It takes practice to do this well. Keep trying! The more you practice
summarizing and generalizing, the better you'll get at it.
B.2 Strategy Review
Now, let’s check again what reading strategy we have applied in understanding today’s lesson by answering
the questions below.
1. What is the title of the text we read? ______________________________
2. What reading comprehension strategy did we use? ______________________________
B.3 Skill Building Activity: Article Review
Instructions:
1. The objective of this activity is to critically analyze and summarize an academic article titled "Mapping
the Ethical Aspects in End-of-Life Care for Persons with a Severe and Persistent Mental Illness: A
Scoping Review of the Literature.
Learning Modules by PHINMA Education is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0
International License.
GEN 021: Science, Technology and Society for Allied Health
Module #6 Student Activity Sheet
Name: _________________________________________________________________ Class number: _______
Section: ____________ Schedule: ________________________________________ Date: ________________
2. For 30 minutes, Create a group with at least 4-5 members. Assign roles to each group member,
including roles such as facilitator, note-taker, visual creator, evidence gatherer, and presenter. Rotate
roles if necessary to ensure equal participation.
3. As a group, read the article carefully, discussing key points, arguments, and findings as you progress.
4. Collaboratively write a comprehensive summary of the article, ensuring that all group members
contribute to capturing the main objectives, methodologies, key findings, and conclusions.
5. Compile all components of your group's work (article summary, visual summary, cited evidence,
conclusions) into a single document or presentation. You may use the format below or create your own.
6. Ensure that the document or presentation is well-organized, cohesive, and clearly presents the group's
collective analysis and findings.
7. Present the ideas from your group in class after the designated time has elapsed.
8. Let’s get started
Mapping the Ethical Aspects in End-of-Life Care for Persons with a Severe and
Persistent Mental Illness: A scoping Review of the Literature
Introduction
The concept of "severe and persistent mental illness" (SPMI) lacks a consensus definition in scientific
literature. However, Zumstein and Riese identify three common characteristics in published works:
individuals suffer from one or more psychiatric disorders as defined by DSM-5, the disorder is chronic, and it
results in serious limitations in psychosocial functioning .
Vulnerability and Lower Life Expectancy
Research indicates that individuals with SPMI have a significantly lower life expectancy, often by 10-20 years
compared to the general population . Factors contributing to this reduced life span include a higher risk of
suicide, long-term use of psychotropic medication, unhealthy lifestyle choices (such as obesity and smoking),
late detection of serious conditions like cancer, and care-avoiding behavior. Additionally, individuals with
SPMI often face a limited social network, serious illness, drug abuse, risk of homelessness, and stigma,
which further exacerbate their vulnerability .
Complexity of End-of-Life Care
The complex care needs and lower life expectancy of persons with SPMI suggest that their end-of-life (EOL)
care also involves significant complexity. This complexity often brings ethical dilemmas and requires
balancing various ethical values. An ethical approach to care focuses on achieving the "best possible care"
and ensuring dignity for all parties involved. This study explores the main ethical dilemmas, values, and
actors in the EOL care for individuals with SPMI. Due to the novelty of this topic within a broad research field,
a scoping-review method was chosen to outline the key themes and challenges .
Learning Modules by PHINMA Education is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0
International License.
GEN 021: Science, Technology and Society for Allied Health
Module #6 Student Activity Sheet
Name: _________________________________________________________________ Class number: _______
Section: ____________ Schedule: ________________________________________ Date: ________________
Comparison with Related Studies
This review is related to, but distinct from, studies on the ethical aspects of medically assisted dying in
severe psychiatric suffering , and studies on life-sustaining and palliative care for persons with SPMI . It uses
a broader definition of EOL care and focuses specifically on ethical aspects, making it a comprehensive
examination of the subject.
Addressing ethical dilemmas and enhancing access to quality care demands a comprehensive strategy that
accounts for various factors. Firstly, autonomy, the cornerstone of healthcare decision-making, presents
unique challenges in cases involving Severe Persistent Mental Illness (SPMI). Factors like the authenticity of
choices, communication barriers, and the perceptions of care providers contribute to a delicate balance
between respecting autonomy and ensuring optimal care, particularly in end-of-life scenarios.
Secondly, achieving equity in healthcare access is crucial. Individuals with SPMI often encounter barriers to
receiving quality end-of-life care, including fragmented healthcare systems, societal stigma, communication
difficulties, and behavioral challenges. These barriers compound existing inequalities, necessitating efforts to
address systemic issues and ensure fair access to care for all, irrespective of mental health status.
Furthermore, there is a growing recognition of the need for a palliative care approach in psychiatry. This
approach prioritizes enhancing quality of life and alleviating suffering, moving away from solely focusing on
aggressive treatments. Emphasizing holistic care, including addressing psychological, social, and spiritual
needs, is seen as essential for providing meaningful end-of-life care for individuals with SPMI.
Lastly, beyond ethical principles, the literature emphasizes the significance of virtues and attitudes in
delivering valuable end-of-life care. Traits like respect, compassion, trust, and perseverance are foundational
in fostering a supportive and empathetic healthcare environment. Healthcare professionals play a pivotal role
in recognizing and addressing the unique challenges faced by individuals with SPMI, ensuring dignified and
respectful care throughout their journey.
In summary, a multifaceted approach encompassing considerations of autonomy, equity, palliative care
principles, and positive attitudes is necessary to address ethical challenges and improve access to quality
end-of-life care for individuals with SPMI.
Reference: Zumstein, N., & Riese, F. (2023). Ethical Aspects of End-of-Life Care for Persons with Severe
and Persistent Mental Illness: A Scoping Review. Frontiers in Psychiatry, 14, 1094038.
[Link]
Learning Modules by PHINMA Education is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0
International License.
GEN 021: Science, Technology and Society for Allied Health
Module #6 Student Activity Sheet
Name: _________________________________________________________________ Class number: _______
Section: ____________ Schedule: ________________________________________ Date: ________________
Learning Modules by PHINMA Education is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0
International License.
GEN 021: Science, Technology and Society for Allied Health
Module #6 Student Activity Sheet
Name: _________________________________________________________________ Class number: _______
Section: ____________ Schedule: ________________________________________ Date: ________________
Learning Modules by PHINMA Education is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0
International License.
GEN 021: Science, Technology and Society for Allied Health
Module #6 Student Activity Sheet
Name: _________________________________________________________________ Class number: _______
Section: ____________ Schedule: ________________________________________ Date: ________________
C. CHECK
C.1 Check for Understanding
Instructions: Read each question [Link] the best answer from the options [Link] your
answer on the answer sheet. After answering all questions, review your answers before submitting.
[Link] is patient autonomy in healthcare?
A) The right of patients to make decisions about their own health
B) The responsibility of doctors to make decisions for their patients
C) The ability of hospitals to control patients' treatment options
D) The requirement for patients to follow doctors' orders
[Link] is advance directive important in end-of-life care?
A) It allows doctors to decide treatment options
B) It ensures patients have control over their medical care preferences
C) It limits patients' choices in their end-of-life care
D) It allows family members to make all medical decisions
[Link] is the goal of health equity?
A) To provide everyone with the same healthcare
B) To ensure everyone has equal opportunities for good health
C) To prioritize the health of certain groups over others
D) To limit access to healthcare resources
[Link] is the role of doctors and nurses in end-of-life care?
A) To prolong life at all costs
B) To focus on keeping the person comfortable and providing emotional support
C) To make all medical decisions without consulting the patient or family
D) To prioritize treatment over comfort
[Link] does confidentiality protect patients in healthcare?
A) By allowing doctors to share patients' information freely
B) By keeping patients' personal information private and safe
C) By allowing hospitals to sell patients' information to third parties
D) By limiting patients' access to their own medical records
Learning Modules by PHINMA Education is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0
International License.
GEN 021: Science, Technology and Society for Allied Health
Module #6 Student Activity Sheet
Name: _________________________________________________________________ Class number: _______
Section: ____________ Schedule: ________________________________________ Date: ________________
D. CONCLUDE
D.1 Summary / Frequently Asked Questions
1. What are ethical issues in healthcare?
● Ethical issues in healthcare encompass dilemmas or concerns related to moral principles and values
that arise in professional, personal, or societal contexts. These issues impact decision-making, patient
care, and professional behavior.
2. What is patient autonomy and why is it important?
● Patient autonomy refers to the right of individuals to make decisions about their own health and medical
treatment. It is crucial because it empowers patients to participate in their healthcare decisions,
ensuring that their preferences and values are respected.
3. What is end-of-life care and why is it significant?
● End-of-life care involves making decisions about the medical treatment and comfort of individuals
nearing the end of their life. It is important as it focuses on ensuring patients' comfort, managing
symptoms, and providing emotional support during this sensitive time.
4. What is health equity and why is it necessary in healthcare?
● Health equity is about ensuring that everyone has a fair opportunity to be healthy, regardless of
socio-economic status, geographic location, or other factors. It is necessary in healthcare to address
disparities in access to healthcare services and social determinants of health, promoting fairness and
social justice in health outcomes.
D.2 Thinking about Learning
What are the challenges/difficulties you encountered in learning this lesson? If none, which part of
the topic did you find interesting that helped you understand the concept.
1.
2.
Question/s I want to ask my teacher about this module is/are:
1.
2.
Learning Modules by PHINMA Education is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0
International License.
GEN 021: Science, Technology and Society for Allied Health
Module #6 Student Activity Sheet
Name: _________________________________________________________________ Class number: _______
Section: ____________ Schedule: ________________________________________ Date: ________________
D.3. Glossary of Terms
Hello learners please check on the words you need to know from our lesson today.
1. Ethical Issues in Healthcare- Challenges in healthcare that involve making decisions about patient
care, resource allocation, and professional behavior based on moral principles.
2. Patient Autonomy- The right of patients to make their own decisions regarding their health and
medical treatments.
3. End-of-Life Care- Care provided to individuals who are in the final stages of life, focusing on comfort,
pain relief, and emotional support.
4. Health Equity- The principle of ensuring that everyone has an equal opportunity to achieve optimal
health, regardless of their socio-economic status, race, or location.
5. Advance Directive- A legal document in which a person outlines their preferences for medical
treatment in case they become unable to communicate their decisions.
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International License.
