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Syllabus subject to revision as circumstance warrants. Students will be apprised of such revisions.

Meeting Times & Locations

Day Time Duluth Room Twin Cities Room Wednesdays (NB: This course begins January 18, 2017) 8:30-9:55 AM LSci 160 No enrollees

Course Moodle Site: https://

Course Instructional Team

Course Director: Tim Stratton, Ph.D., BCPS, FAPhA Professor of Pharmacy Practice Department of Pharmacy Practice and Pharmaceutical Sciences Office location: 209 Life Science, UMD Phone: 218-726-6018 Email: tstratto@d.umn.edu Preferred method of contact: email Office Hours: When the office door is open or by appointment Teaching Assistants: None.

Overview of the course

Course content: Students in this elective course apply ethical principles and selected schools of ethical thought to discuss and debate ethical dilemmas in pharmacy practice, health care and biomedical research. Course format: This is a two-credit (per the University credit scale used for electives in the Pharm.D. curriculum), semester-long course. Students will meet two hours once a week in class for 15 weeks. Generally, no break is taken during these two-hour sessions. Students will predominantly spend class time applying the Ethics Problem-Solving Approach to engage each other and faculty in discussions about ethical dilemmas arising in pharmacy practice, health care and biomedical research.

Phar 6962: Ethics in Pharmacy Practice

Course Syllabus Spring 2017 2.0 Credits (Elective scale)

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In addition, students will spend approximately 23 hours outside of class: 1) Authoring a one-page ethical dilemma case scenario to be discussed in class (cases are de-identified by the Course Director prior to use in class); 2) Preparing two two-page, and one three-four page written ethics case analyses; 3) Preparing a 10-minute Multicultural Ethics oral presentation on their assigned culture to present in class; and 4) Working up the ethical dilemma case scenario authored by a classmate (see 1 above), and facilitating a 15-minute class discussion of the case. Scenarios are assigned by the instructor. To avoid duplication of themes, not all student-authored scenarios are used. Additional course requirements for Master of Arts students in the University of Minnesota Center for Bioethics program: a) Prepare and lead at least one class session on a topic jointly determined by student and Course Director b) Final case write-up must be at least 5 double-spaced type-written pages with references. Prerequisites

• Successful completion of all Ethics-related content in courses preceding this elective, including the Ethics discussions with preceptors in IPPE-I and IPPE-II.

• Standing as a PD3 student to help ensure that students have obtained enough experience in a pharmacy practice setting to meaningfully contribute to discussions about ethical dilemmas arising in these settings.

• A non-pharmacy graduate student enrolled in the Bioethics MA program (requires Course Director permission). Technology proficiency requirement:

• Students in this course must be able to create electronic documents. • Students in this course must be proficient at downloading/uploading materials from/to Moodle.

Computer/Technology Requirements The University of Minnesota computer requirements are listed here: http://www1.umn.edu/moodle/start/technical.html Course Goals & Objectives COURSE GOALS The goal of this course is to provide students with practice: 1) Systematically and thoughtfully applying ethics concepts, teachings from selected philosophers, professional codes of ethical practice, and multicultural ethical considerations to analyze ethical dilemmas that arise in pharmacy practice, health care and in biomedical research settings; 2) Proposing and critiquing possible resolutions for those dilemmas, and; 3) Recommending how a dilemma might have been prevented in the first place.

Learning Objectives After completing this course, the student should be able to:

1. Evaluate and articulate their own values and ethical beliefs.

2. Utilize critical thinking and problem-solving skills to articulate how they would apply ethics concepts, teachings from selected philosophers, professional codes of ethics and multicultural ethical considerations to analyze ethical dilemmas in pharmacy practice, health care and biomedical research scenarios.

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3. Using ethics concepts, teachings from selected philosophers and professional codes of ethics, justify their recommended courses of action for resolving an ethical dilemma.

4. Describe the ethical underpinnings which might explain the rationale for ethical opinions which differ from their own.

Attendance Policy The course consists predominantly of in-class discussions of cases and ethical issues; therefore, attendance is expected at every session. Students who anticipate having to miss a class session should contact the Course Coordinator beforehand. Ten (10) points will be deducted for each unexcused absence. Students with unexcused absences for 25% or more of class sessions during the semester will receive a failing grade in the course. Expectations for Student Behavior Students are expected to attend all class sessions and behave in a professional manner. Discussions of controversial issues should be undertaken in a respectful manner. Disagreements are permissible; however, baiting or belittling classmates will not be tolerated. Cellular phones should be set to vibrate mode or turned off completely prior to the beginning of class, and are not to be answered during class.

Course Materials

Required (or Optional) Text, eReserve, or Materials Required: 1) It is expected that students will make use of the Ethics Tool Kit on the “Ethics in Pharmacy” Moodle site. 2) Longo, et al. “Addiction: Part II. Identification and Management of the Drug-Seeking Patient.” Am Fam Physician. 2000 Apr 15;61(8):2401-2408. http://www.aafp.org/afp/2000/0415/p2401.html (link posted to the course Moodle site). 3) Avorn J. “Healing the Overwhelmed Physician.” New York Times. June 11, 2013. Posted to the course Moodle site. Optional: Students are free to use other written Ethics resources with which they are familiar (e.g., the writings of other philosophers such as John Rawls, the Bible, the Quran, etc.). Assessments and Grading Graded Assessments The following graded assessments will count towards the final grade in this course. For all written case analyses, students will identify themselves on the paper by a student-selected number only. No student name should appear on the paper. A student in class will be designated to record student names and numbers, and will provide that list to the faculty member only after papers have been graded.

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# Date Due

Title Brief description

Assessment Goal (required to link to domain)

Points % of final grade

1 1/25/17 Single-page, double-spaced student submitted pharmacy-practice, healthcare or research-based ethics case scenario for use in class discussions.

1 - 4 Zero Non-graded course requirement

2 2/8/17 Two-page, double-spaced written analysis of faculty-provided pharmacy practice, healthcare or research-based ethics case. (Student identified by number only.)

1 - 4 50 14.3%

3 3/1/17 Two-page, double-spaced written analysis of faculty-provided pharmacy practice, healthcare or research-based ethics case. (Student identified by number only.)

1 - 4 50 14.3%

4 3/8/17 Student team presentations of Multicultural Ethics (10 min.)

2, 4 50 14.3%

5 4/19/17 Student team presentation and team-facilitated discussion of student-submitted pharmacy-practice, healthcare or research-based ethics case scenario. (Students do not present the scenario they submitted in Week 1, but present another student’s scenario assigned them by the instructor.)

1 - 4 50 14.3%

6 5/10/17 Three-four page, double-spaced written analysis of faculty-provided pharmacy practice, healthcare or research-based ethics case. (Student identified by number only.) MA (Bioethics) students must submit at least a 5-page paper with references.

1 - 4 50 14.3%

Weeks 1-13 Participation in class discussions 1 – 4 50 14.3%

Weeks 14-15 Participation in student case discussions 1 – 4 50 14.3%

TOTAL 350 100%

Statement on Penalties for Late Work Assignments are due by the beginning of class on the date due. Students at remote sites must e-mail their assignment to the instructor as an attachment prior to the beginning of class on the due date.

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Assignments submitted late will have points deducted based upon the following schedule: Submitted late on due date: 10% penalty

(It behooves students NOT to wait until the last minute before class to e-mail or print their paper in case e-mail server/Internet/printer problems are encountered.)

Submitted next day after the deadline: 20% penalty Submitted two days after deadline: 30% penalty Submitted later than two days after deadline: Zero score

(Paper must still be submitted to avoid receiving an Incomplete for the course.) Exam Policy No exams will be administered in this course. Grades will be based on student participation in class discussions, student presentations and student written case analyses. Grading Information

http://www.policy.umn.edu/Policies/Education/Education/GRADINGTRANSCRIPTS.html

Course Letter Grades

Grade Percentage

A 93.0 - 100

A- 90.0 - 92.9

B+ 87.0 - 89.9

B 83.0 - 86.9

B- 80.0 - 82.9

C+ 77.0 - 79.9

C 73.0 - 76.9

C- 70.0 - 72.9

D 60.0 - 69.9

F 0 - 59.9

Statement on Extra Credit No extra credit is available in this course. Minimum Passing Level Per University and College Policy, students who receive a grade below D in this course must successfully repeat the course before academic credit will be awarded.

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Detailed Course Outline & Schedule*

Class Agenda/Topics Competency/ Learning Objective [provide link to course learning objectives]

Activities / Assignments / Assessments

1/11/2017 NO CLASS

1/18/2017 Course Introduction General discussion of ethics in pharmacy practice, healthcare and research. Review Problem-solving in ethics cases Review the jargon of ethics Aristotle, Kant, Mill

1 - 4 In-class activity: Use instructor-provided case to review Ethics jargon and practice use of Ethics Problem-Solving Framework Assignment 1: Type a one-page description from your internship/externship experience where you or the pharmacists with whom you worked faced an ethical dilemma in practice. If you have no pharmacy experience, make up a scenario which could happen in a pharmacy practice setting. Do not include how the dilemma was dealt with. Provide enough details that the class can discuss the situation you describe. Please e-mail your case write-up to your instructor. (Due 9/14, non-graded) In-class activity: In small groups and as a class, discuss and analyze Ethics case vignettes applying the writings of Aristotle, Kant and Mill.

1/25/2017

Levels of moral development (Kohlberg, Gilligan)

Code of Ethics/Oath of a Pharmacist

1 - 4 ASSIGNMENT #1 DUE (Non-graded). In-class activities: 1) In small groups and as a class, discuss and analyze the Heinz case applying Kohlberg’s Levels of Moral Development and Gilligan’s Feminist Ethics philosophy. 2) As a class, discuss the Pharmacist’s Code of Ethics and Oath of a Pharmacist. 3) In small groups, discuss instructor-provided case for Written

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Case #1.

2/1/2017

Ethics of Placebos in Clinical Practice

Multicultural Ethics assignment

1 - 4 In-class activities: In-class activities: 1) Class discussions of instructor-provided case vignettes describing the use of placebos in clinical practice. 2) Discussion of the ethics of managing pain vs. managing drug-seeking behavior. 3) Discussion of Multicultural Ethics assignment. (This assignment is much more in depth than the introduction to Cultural Competency students receive in PHAR 6716-Applied Pharmaceutical Care. Students will work on their presentations in the weeks that follow – out-of-class time in following weeks takes this work into account.)

2/8/2017 Distributive Justice

Video: Borderline Medicine Discussion of Written Case #1

1 - 4 In-class activities: 1) View and discuss the PBS Frontline video, Borderline Medicine comparing the U.S. and Canadian healthcare systems. 2) Discuss Written Case #1 in class

2/15/2017 PHARMACY LEGISLATIVE DAY NO CLASS

2/22/2017 Case: “The Case of the Romantic Pharmacist” Moral wimpism

1 - 4 In class activity: 1) Class discussion of “The Case of the Romantic Pharmacist.” 2) Class discussion: Are you a moral wimp? WRITTEN CASE #1 DUE (Graded)

3/1/2017 The Ethics of Managing Pain vs. Managing the Drug Seeker Ethics of Compassionate Drug Programs

Pre-Class activities: Read Longo, et al. article about managing drug-seeking patients @ http://www.aafp.org/afp/2000/0415/p2401.html, link also available on course Moodle site under Readings.

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Discussion of returned Written Case #1 and discussion of next written case (Written Case #2)

Visit www.NoFreeLunch.org In class activities: 1) Written Case #1 returned. 2) Written Case #2 distributed and discussed in class.

3/8/2017 Video: Welcome to Happy Valley

1 - 4 Pre-Class Activity: Read “Healing the Overwhelmed Physician” (on course Moodle site under Readings). In class activity: View and discuss the PBS Frontline video, Welcome to Happy Valley about attitudes surrounding fluoxetine use. WRITTEN CASE #2 DUE (Graded)

3/15/2017 SPRING BREAK NO CLASS

3/22/2017 Dr. Stratton out of town

NO CLASS

MEETING Students work outside of class on Multicultural Ethics presentations

3/29/2017

Multicultural Ethics (Student presentations)

1 - 4 In-class activity: Students present their multicultural ethics reports and facilitate discussion arising from their presentation. (Graded)

4/5/2017

Ethics Considerations in Research (Basic Science Guest facilitator TBA)

1 - 4 In-class discussion around research ethics facilitated by guest presenter and Ethics faculty member.

4/12/2017 Discussion of Written Case #3 1 – 4 1) Written Case #3 distributed and discussed in class. (Hours of effort writing this final paper allocated in weeks that follow.) 2) Student cases distributed.

4/19/2017

Student Ethics Case Presentations

1 - 4 In-class activity: Students present the ethics case written by a classmate and facilitate discussion arising from their presentation. (Graded)

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4/26/2017 If needed

Student Ethics Case Presentations

1 - 4 In-class activity: Students present the ethics case written by a classmate and facilitate discussion arising from their presentation. (Graded)

5/3/2017 If needed

Student Ethics Case Presentations

1 - 4 In-class activity: Students present the ethics case written by a classmate and facilitate discussion arising from their presentation. (Graded)

5/10/2017 If needed Final Exam Week

Student Ethics Case Presentations

1 - 4 In-class activities: Student teams present the ethics case written by a classmate and facilitate discussion arising from their presentation. (Graded) WRITTEN CASE #3 DUE (Graded)

* Subject to change at course instructor’s discretion. University of Minnesota and College of Pharmacy Policy Reference (Centralized Syllabus) This page includes all required UMN and CoP policies, e.g., Academic Freedom; Copyright; Course Evaluations; Disability Accommodations; FERPA, etc.