Pediatric Residency Ethics Elective

Brief or more prolonged electives for trainees and students interested in clinical ethics are possible on a case by case basis. Attempts will be made to customize the experience for each individual trainee or student.

 

The one month elective in pediatric ethics was created as a collaboration between the Charles Warren Fairbanks Center for Medical Ethics at Indiana University Health and the Indiana University Pediatrics Residency Program.  The purpose of this elective rotation is to help participating residents increase their knowledge in the field of medical ethics and develop practical skills in clinical ethics consultation.  The course director is Paul R. Helft, MD, Director of the Fairbanks Center.

Participants:

The elective is open to any resident in the Indiana University Pediatrics Residency Program. The participant may take seven (7) days of vacation during this rotation, with completion of all readings and projects within seven (7) days of finishing the rotation. Med/peds residents may take the elective as a rotation in either Medicine or Pediatrics. Participants should apply for a special elective within one of these departments and will be responsible for initiating contact with the Fairbanks Center and creating their own schedules. This schedule should be documented and is subject to the approval of the assigned faculty member for the special elective. Two weeks of “on call” status for participating in ethics consultations should be expected. Exceptions for attending activities will include: vacation, clinic, and post-call status. If the participant has a Wednesday continuity clinic, it is recommended that the resident make arrangements ahead of time to change the clinic day so that he/she may participate in Fairbanks Fellowship in Clinical Ethics seminar activities.

Goals of the Elective:

  • To develop skills for ethical decision-making in the practice of medicine
  • To acquire a functional framework for addressing ethical dilemmas
  • To experience the practical application of ethics principles to cases in pediatric medicine
  • To develop leadership and teaching skills by leading fellow residents through an exercise in ethics
  • To explore personal interest topics within the area of pediatric bioethics
  • To increase personal knowledge of literature in pediatric bioethics

Rotation Activities:

  • Topical reading in ethics:
    • Jonsen, Siegler & Winslade (2006) Clinical Ethics: A Practical Approach to Ethical Decisions in Clinical Medicine, 6th ed. New York: McGraw-Hill (a copy will be available in Pediatric Housestaff Lounge)
    • Readings for seminars, ethics journal club, etc - to be determined.
  • Participation in Fairbanks Center programs and IU Health Ethics Committee activities:
    • Orientation to the Elective – Two weeks prior to the start of the elective contact the Fairbanks Center office (962-9258) to request an appointment with the Director and/or the Program Manager to discuss your goals for the elective and to receive information about ethics activities scheduled during the month of your rotation. Depending on the month, activities may include Ethics Fellowship seminars, Unit-Based Ethics Conversations, Pediatric Residents “Ethics at Lunch” discussions, and Fairbanks Ethics Lectures.
    • Attend twice-monthly meetings of the IU Health Ethics Consultation Subcommittee (2 per month, 1.5 hours each)
    • Attend the monthly meeting of the IU Health Ethics Committee (1 per month, 1.5 hours)
    • Participate in taking ethics call with the IU Health Ethics Consultation Service. Two members of the Ethics Consultation Service and an ethics fellow are on call each month for consults. Availability should be confirmed with the ethics on call team.
  • NICU fellowship ethics discussions: Contact Dr. Zeynep Salih(zsalih@iu.edu) at the beginning of the elective to determine if there are any NICU ethics curriculum activities during the month. Attend these if applicable (1-2 hours for the whole month).
  • February elective: If the elective is taken in the month of February, there are opportunities to participate in the medical students’ ethics course. This is an intensive month of lectures and readings. 
  • August elective: If the elective is taken in the month of August, the resident will participate in a series of conscience-based ethics seminars provided for psychiatry residents and medical students. This series is hosted by the IU Center for Bioethics.
  • IU Center for Bioethics Journal Club: Contact the IU Center for Bioethics on the first day of the elective to see if there is a journal club meeting during the month. Obtain readings and go to this meeting if applicable. (1 hour, once during the month)
  • Preparation of an Art of Medicine discussion topic for a future morning report session: The elective participant prepares a topic to present at the Art of Medicine morning report. The discussion may be based on an article the participant read during the month, application of ethics principles to a past case at Riley, review of a consult case from the month, etc. Contact Dr. Abby Klemsz (aklemsz@iupui.edu) and one of the pediatric chiefs to schedule the presentation.
  • Completion of one special project in ethics: The special project in pediatric ethics provides an opportunity for the resident to explore an area of special interest within bioethics. Examples of potential special projects include (but are not limited to):
    • perform a detailed literature search and create an expanded reading list on a particular topic in ethics
    • write a retrospective clinical case analysis or a web module with discussion of the ethical principles and dilemmas at hand
    • write a reflective piece suitable for publication (for example, in NEJM’s “Piece of my Mind” section)
    • create a teaching tool (lecture, power point, web module) for future use in teaching ethics to residents or medical students
    • complete additional reading (fiction, history, etc) and write a 1-2 page review of plotlines and decision making in the book using ethics frameworks
    • view two or more movies (suggestions available from the Fairbanks Center) and write a 1-2 page comparison of how the ethical issues portrayed were handled by the characters.`

Plans for the special project should be reviewed with the special elective faculty member in the first week of the elective. The special elective faculty will be responsible for helping the resident with the project and informally evaluating it at the end of the month.

For additional information contact:

Paul R. Helft, MD - phelft@iupui.edu
Director, Charles Warren Fairbanks Center for Medical Ethics
Associate Professor of Medicine
Division of Hematology/Oncology
Indiana University School of Medicine