84236 - Ethics and Behavioural Sciences

Learning outcomes

Identify the main ethical issues involved in the doctor-patient/family interaction, including confidentiality, informed consent, withdrawal of treatment, chronic illness, age-related cognitive limits, death and bereavement, cultural concerns, and complementary health practices. Recognize the most frequent difficulties in doctor-patient interaction due to age-, personality- and motivation-related variations in the functioning of the cognitive processes (perception, attention, learning, memory and thinking), emotional and interpersonal processes (recognition and control of emotions, verbal and non-verbal communication skills, expectations and attitudes). Recognize the basic components of the strategies of informative and persuasive communication to improve patient’s cooperation and adherence to medical care.

Course contents

Lecture 1. Overview of the course. Patient-doctor relationship. Ethics versus morality. Bioethics and the law. Ethics in medical practice.

Lecture 2. Brief historical perspective on medical deontology from Hippocrates, to the utilitarian, deontologic ethics and the virtuous approach to the principilism. The four principles of medical ethics.

The principle of autonomy. Consent. Confidentiality. Withdrawal from treatment. The principles of beneficience; non maleficence and justice.

Lecture 3. Ethics in research. When research is not ethical: an historical perspective (Nuremberg doctors trials. Milgram study. Stanford prisoner study. Tearoom trade study. Tuskegee syphilis study). Declaration of Helsinki. Human subjects protection and regulation.

Lecture 4. Behavioral sciences: methods in neuroscience. Brief review of neuroanatomy. Methods for investigating cognitive processes. An historical perspective: from the study of brain lesions to functional magnetic resonance (fMRI). Employment of fMRI for clinical purposes: from localization of brain function before neurosurgery to the study of consciousness in patients in vegetative state.

Lecture 5. The three channels of communication. Verbal; paraverbal and non-verbal. Tools of non-verbal communications. Facial cues of non-verbal communication. Facial expressions of emotion. Perception of eye gaze.

Lecture 6. Understanding others. Emotions and their neurophysiological basis. Stress and burnout syndrome. Neurophysiological basis of empathy and emotions: mirror neurons and theory of mind.

Lecture 7. Communication in medicine. Effective doctor-patient communication. Tree separate stages in the interaction with the patient: opening; gathering information; summary and closure.

Lecture 8. Attention and effective doctor-patient interaction: preparing oneself to pay attention. Paying attention to interpersonal distance: proxemics. Body language: the meaning of touch. Body posture. First impressions.

Readings/Bibliography

A pdf of the powerpoint presentation will be available on "Virtuale" after each lecture. Pdfs of the powerpoint presentations of the lectures will be the material to be reviewed for the written exam.

The following readings are recommended if you want to explore further the topics covered in class but they will not be part of the written exam.

Books:

 

Principal of biomedical ethics by Tom Beachamp and James Childress. Oxford University Press

 

A philosophical Basis of Medical Practice: Toward a Philosophy and Ethics of the Healing Professions by Edmund D. Pellegrino and David C. Thomasma

Virtues in Medical Practice by Edmund D. Pellegrino and David C. Thomasma

Articles:

Ethics and clinical research by Beecher H. New England Journal of Medicine, 1966.

Rizzolatti G, Sinigaglia C. (2010). The functional role of the parieto-frontal mirror cicuit: interpretation and misinterpretation. Nat Rev Neurosci. 11:264-74.

Oosterhof NN, Todorov A. (2008). The functional basis of face evaluation. Proc Natl Acad Sci U S A. 105(32):11087-92.

Haxby JV, Gobbini MI. The perception of emotion and social cues in faces. (2007). Neuropsychologia, 45: 1.

Ekman P, Sorenson ER, Frisen Wv. (1969). Pan-cultural elements in facial displays of emotion. Science, 164: 86-88

Pellegrini S, Palumbo S, Iofrida C, Melissari E, Rota G, Mariotti V, Anastasio T, Manfrinati A, Rumiati R, Lotto L, Sarlo M, Pietrini P. (2017). Genetically-driven enhancement of dopaminergic transmission affects moral acceptability in females but not in males: a pilot study. Front Behav Neurosci 11: 156 (eCollection).

Teaching methods

Lectures with slides. At the end of each lecture a pdf with the powerpoint presentation will be distributed to students. Pdfs with the powerpoint presentations of the lectures will be the material to be reviewed for the written exam at the end of the course.

The minimum attendance requirement to be admitted to the final exam is 60% of lessons. For Integrated Courses (IC), the 60% attendance requirement refers to the total amount of I.C. lessons. Students who fail to meet the minimum attendance requirement will not be admitted to the final exam of the course, and will have to attend relevant classes again during the next academic year.

Absences may be authorized upon receipt of proper justifying documentation, in case of illness or serious reasons. Excused absences do not count against a student’s attendance record to determine their minimum attendance requirement.

Assessment methods

Written test (for examination dates, see almaesami.unibo.it)

The test consists of 32 4-choice questions. Only one answer is correct. There are no penalties for wrong or blank answers.

The test must be completed in 45 minutes.

Module CFU Questions

History of Medicine 1 4

Ethics and Behavioural Sciences 2 8

Medical Statistics and Epidemiology 2 8

Scientific Research Methodology 1 4

Determinant of Health and Disease 2 8

Number of right answers

Marks

31/32 30L

30 30

29 29

28 28

27 27

26 26

25 25

24 24

23 23

22 22

21 21

20 20

19 19

18 18

<18 Fail

≥18 and 0 right answers in any module: Fail

The test must be completed in 45 minutes.

Grade acceptance/refusal

Grades are published within 3 days on AlmaEsami.

The student can refuse the grade within 5 days from publication by sending an e-mail to Prof. Rucci (paola.rucci2@unibo.it) and the Program coordinator (medicine.surgery@unibo.it).

All refusals must be sent from the institutional e-mail address @studio.unibo.it

After 6 days from publication, the acceptance will be taken for granted and the exam will be recorded.

Teaching tools

Discussions among students will be encouraged through in class questions on the subject covered during each class.

The PDFs of each lecture will be available on online after class. Students will have the chance of reviewing the material and ask the instructor to go over parts of the lecture that were unclear.

Office hours

See the website of Maria Ida Gobbini