Study-Unit Description

Study-Unit Description


TITLE Bioethics and the Law

LEVEL 03 - Years 2, 3, 4 in Modular Undergraduate Course


DEPARTMENT Media, Communications & Technology Law

DESCRIPTION This study-unit consists of 14 lectures:

1. Fundamentals of Bioethics
A discussion of the fundamental rules and principles of bioethics. In particular the principles of beneficence, justice and respect for autonomy are covered; plus a discussion of the rules of veracity, fidelity and confidentiality.

2. Research Ethics
A discussion of the modern view of research ethics in health care and technology that involve the participation of human subjects. The question of research is put into the historical perspective of the Nuremberg trial and code.

3. Patient Rights
The objective of this lecture is to give students a modern perspective of patient rights, charters and code of ethics and a full discussion of the Maltese perspective. It also addresses patient rights in special circumstances, namely, young adults, elderly, disabled people and rights of parents to take medical decisions for their children.

4. ‘Sanctity’ vs. ‘Quality’ of Life issues
The aim of this lecture is to put the student into a modern perspective of what we mean by ‘sanctity’ as against ‘quality’ of life issues relating to selective abortion of genetically or congenitally malformed fetuses, selective non-treatment of malformed newborns, terminally ill patients who consider themselves as having a life not worth living, such as paraplegics and the severely disabled/ill.

5. End of Life issues
This lecture addresses problems of the ending of human life from abortion to euthanasia; a distinction between ordinary and extraordinary treatment; and Advance Directives and power of Attorney for people unable to make competent choices. The student should be able to understand clearly the definition of abortion and the distinction between abortion, discard and infanticide.

6. Justice and Allocation of Resources
The objective of this lecture is to allow the student to think in terms of the resources a country or health care system has as opposed to all the theoretically available technology and medications. The problem also addresses choices made health care teams in selecting patients for organs. It thus addresses the utilitarian versus the deontological modes of making such choices.

7. Organ Donation
The lecture addresses organs as a scarce resource; methods of obtaining organs (the opt-in and opt-out systems, and the mandated choice); allowing young people and children to donate to family members; and finally the ethics involved of health care teams (that of the donor and that of the recipient). Also the student is made aware of what is an organ (e.g. Bone Marrow; Blood).

8. Management of Medical Information
This is an important lecture tailored for the law student. It tackles the question of ‘Ownership” of Information, Confidentiality, Truth Telling, Informed Consent, Self Determination, Advance Directive etc. Although some of the topics would have been introduced in previous lectures, the aim of this lecture is to focus on the use, protection and ownership of medical information.

9. Eugenics and Human Genetics
The objective of this lecture is to discuss clearly the real threats of genetic technology in modern society, with a focus on Malta. The question of legislation, data banks, use of genetic information by insurance companies and employers, and the possibility of selective discard of fertilized ova in the quest for the ‘perfect baby’ are discussed. The student should have a clear idea of the dangers Malta stands with foreign companies who failed to operate in countries where legislature exists, who attempt to succeed here.

10. Reproductive Technology and Surrogate Parenting
The aim is to discuss the ethics of surrogate parents, and to acquire a working knowledge of existing reproductive technologies, with respect to discard of unused embryos.

11. Public Health
The question of public interest and confidentiality; allocation of resources; quarantine; the global AIDS epidemic and epidemiological studies. The student should have a clear vision of what the responsibilities of government and Departments of Health have towards society. Also occupational health, the armed forces and police.

12. Health Care Systems
The concept of Managed Care; Private vs. State Health care system, National Health Schemes and the problem of Insurance. The Student should have a clear idea between the different health care systems, which exist in libertarian, and welfare states so as to put Malta in this perspective.

13. Death and Definitions of Death
The importance of the concept of death in various situations, what do we understand by death, evolution of ‘Brain Dead’ criteria and ‘Non-Heart Beating Cadavers. Why do we need definitions of death? Is death a process? The Pittsburgh Protocol (Advantages and Disadvantages) is debated.

14. Professional Ethics
The Hippocratic Oath has been around for thousands of years; the Nuremberg Code and the Declaration of Helsinki reflect its spirit in modern language. Is the Oath outdated? The question of professional ethics and their changeability is discussed; the telos of the doctor-patient relationship. This is contrasted to other kinds of professionally relationships; in particular the lawyer, Insurance and Journalistic.

Learning Outcomes:

By the end of the study unit the student should be able to report on the following:

- The concepts and application of informed consent and refusal of treatment;
- Clinical relationships including practice of specific virtues and of building trust and good communication; and the law regulating confidentiality issues;
- The ethical and legal tensions in medical research, including the use of animals;
- The ethical and legal issues in abortion and assisted human reproduction, including the status of the embryo / fetus and prenatal screening;
- New concepts in clinical genetics with debates about the ethical and legal boundaries and the need for regulation;
- The ethical and legal issues in treating patients and their families in relation to children and patients with mental disorders and disabilities;
- The duty of care and ethical and legal justification in end of life decisions, including organ transplantation;
- The vulnerability of doctors and medical students in virtue of their clinical responsibilities;
- The fair and just distribution of scarce health care resources;
- What rights are, and their links with legal and professional duties.

Reading material:

- Principles of Biomedical Ethics, Beauchamp and Childress, 2004, Oxford: ISBN 0-19-514332-9.
- You and Your Doctor, Pierre Mallia, Agenda Publishers, 2006.
- Health, Bioethics and the Law, Maurice Cauchi, Kevin Aquilina and Bridget Ellul, Malta University Press, 2006.

ADDITIONAL NOTES Students taking this study-unit need to have a background in law.


Assessment Component/s Resit Availability Weighting
Assignment Yes 100%

LECTURER/S Pierre Mallia

The University makes every effort to ensure that the published Courses Plans, Programmes of Study and Study-Unit information are complete and up-to-date at the time of publication. The University reserves the right to make changes in case errors are detected after publication.
The availability of optional units may be subject to timetabling constraints.
Units not attracting a sufficient number of registrations may be withdrawn without notice.
It should be noted that all the information in the description above applies to study-units available during the academic year 2020/1. It may be subject to change in subsequent years.