Educational objectives
To introduce the field of neuroethics to neurology residents, encompassing the more general field of bioethics as it applies to neurology[Office1] . The curriculum will serve to familiarize residents with the basic principles and applications of neuroethics to both clinical neurology and neuroscience research. The educational objectives will be approached through a combination of lectures, monthly case-based presentation to illustrate core topics, and discussion sessions facilitated by center for bioethics (CFB) faculty. A formal elective with the ethics consultation service is also available for residents. Principles of neuro-ethics are reinforced throughout the core rotations each resident performs.
I. Goals and Objectives
Medical Knowledge
To develop a foundation in neuroethics with special emphasis on clinically relevant material.
To provide the resident with a sufficient background in principles of medical ethics to support and enhance the care of patients with neurological disorders.
To familiarize residents with up-to-date concepts in neuroethics applicable to research.
Patient Care
To educate residents about fundamental issues in medical ethics that have direct implication in daily practice for neurologists including: DNR/DNI; New York State laws regarding withdrawal of care; Surrogate hierarchy; Living wills; Heath care proxy forms; Advanced directives; Sensitivity to religious and moral issues; medical futility
Systems-Based Practice
To improve resident understanding of the intersection between medical ethicists and neurologists, and educate them about the role of the ethics team in assisting health care providers with decision making.
Practice-Based Learning and Improvement
To give residents the skills to continuously improve patient care based on application of ethical principles, facilitated by ongoing case presentation conferences.
Participate in end of life, goals of care, and prognosis discussions with families in the intensive care and consultation services with supervision from the NICU and consult service
Interpersonal and Communication Skills
To use ethical principles to improve communication with patients and their families, and foster better understanding.
Professionalism
To show compassion and respect for patients, families and colleagues involved with patient care.
To demonstrate respect and sensitivity for different cultural, religious, and socioeconomic perspectives when discussing goals and methods of treatment.
To demonstrate respect for privacy and autonomy, two fundamental ethical principles.
II. Conferences: Department of Neurology
-Grand rounds: previous topics include fundamentals of ethics for the neurologists, and introduction to palliative care in neurological diseases
Noon Neuroethics Resident Case Conference. Interactive case presentation / discussion with residents, facilitated by bioethics faculty. At these small group conferences, residents will present cases of interest that highlight ethical issues and dilemmas, in a setting similar to morbidity and mortality conference. Occurs monthly.
III. Conferences: Interdepartmental
Center for Bioethics: Bioethics of Disability, Memory and the emergence of a new science of mind
Ethics for Lunch Series: difficult cases from the NYPH ethics committee
Organ Donation tutorial (Annual)
Meeting with Staff from the transplant program & ICU Attendings/fellows to discuss ethical management of organ donation from brain dead patients, interactions with family, and protocols.
IV. Web based resources
Privacy/Confidentiality: http://ccnmtl.columbia.edu/projects/cire/pac/
Conflicts of interest: http://ccnmtl.columbia.edu/projects/cire/coi/
Neuroethics: http://ccnmtl.columbia.edu/projects/neuroethics/index.html
Resident Roles
Participation in monthly/bimonthly conferences, independent reading via syllabus, involvement in interdepartmental conferences