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

This course is part of the Integrated Course in Humanities and Scientific Methods. The Integrated Course aims to provide students with an initial but structured understanding of how humanistic, social, and scientific disciplines contribute to health and medical practice. Through this interdisciplinary approach, students will explore key historical milestones in medicine, fundamental ethical principles, and communication strategies in the doctor–patient relationship, as well as the psychological and cultural dimensions of health. They will also examine major determinants of health and disease — including inequalities — and acquire essential skills in medical statistics, epidemiology, and scientific research methodology. By the end of the course, students will be able to understand the role of evidence, data, context, and values in shaping healthcare practice and public health policies.

The contents of this specific course are the following:

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: Identifying the Key Stages for Effective Doctor-Patient Interaction. First impressions.

Lecture 8. Nonverbal Communication, with a focus on spatial organization and interpersonal distance (proxemics) and body language (the significance of touch.

Mechanisms of Attention.

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

The final exam is a joint written test covering all the teaching units of the Integrated Course. It consists of a paper-based, multiple-choice quiz with 32 questions (each with 4 choices, only one of which is correct). The number of questions for each unit is proportional to its number of CFU:

• History of Medicine: 4 questions
• Ethics and Behavioural Sciences: 8 questions
• Medical Statistics and Epidemiology: 8 questions
• Scientific Research Methodology: 4 questions
• Determinants of Health and Disease: 8 questions

The exam lasts 30 minutes. There are no penalties for wrong or blank answers.

The test is passed with at least 18 correct answers, provided that the student answers at least one question correctly in each module. A score of 31 or 32 correct answers is awarded with 30 cum laude (30L). Students who fail the exam can retake it on the next available date.

Grades will be sent by email to each student's institutional address (@studio.unibo.it). The student has three days to reject the grade by replying to the professor's message. After that, the grade will be considered accepted and recorded.

Reviewing the exam with the professor is possible, upon request, only in case of a failing grade. Details about the test questions or the student's incorrect answers will not be shared by email.

Students with specific learning disorders (SLD) or those with temporary or permanent disabilities are advised to contact the relevant office in advance (https://site.unibo.it/studenti-con-disabilita-e-dsa/en/for-students) to arrange appropriate compensatory measures. The request must be submitted to the professor at least 15 days before the exam date. The professor will assess the suitability of the proposed measures in relation to the course's learning objectives.

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