Fourth-year Medical School Electives

For medical students—including those in the Area of Concentration in Humanities, Ethics and Palliative care—the affiliated faculty of the Center for Bioethics & Health Law offer medical school electives in bioethics and the medical humanities. In recent years, these have included:

Ethical Issues in Clinical Practice
Mark Wicclair

This elective offers students an opportunity to explore several important ethical issues in clinical practice, including informed consent, competency, surrogate decision-making, advance directives, forgoing life-sustaining treatment, futility, physician assisted suicide, euthanasia, confidentiality, reproductive ethics, managed care, access to care, and rationing. The elective has two components:

  • Seminar Sessions, which explore important current medical ethics literature and related cases. There are required reading assignments for each session.
  • Case Discussion Sessions, at which students will present cases. Students may need to spend time in the clinical setting gathering data for these presentations. There will be 4-6 case discussion sessions, depending on the number of students enrolled. Each student will be expected to present at least one case. Case discussion sessions will be scheduled at times that are mutually agreeable to students and faculty.

Whenever feasible, students will be given an opportunity to participate in ethics consultations by the CME Ethics Consultation Service at PUH, MUH, or CHP. Students may also have an opportunity to attend faculty seminars and meet with CME visiting professors.

History of Medicine
John Erlen

This four-week elective provides the student with the opportunity to examine various aspects of the history of medicine, from the beginnings of medical practice into the 21st Century. Students will read a selected group of monographs and journal literature and participate in in-depth discussions with Dr. Erlen and members of a group of interested clinical faculty. Students research and write a five- to ten-page research paper on the history of medicine topic, using both primary and secondary resources. Through the assigned readings, videotapes, and discussion sessions the student will be able to gain a historical perspective on the evolution of the Western medical profession as a whole, as well as major historical issues within health care. A variety of key ethical concerns are addressed, including: impact of technology on medical practice, influence of religion on the practice of medicine, origins and current status of alternative forms of medical care, AIDS impact on the medical profession and American society, growing government role in American health care, and managed care.

Narrative, Literature, and the Experience of Illness
Various faculty

This elective provides the senior medical student with a rare opportunity to experience and examine the culture and practice of medicine from the perspective of an outside observer. Through the use of various types of medical literature (poetry, fiction, non-fiction, and essays) and through clinical experiences that are traditionally thought to lie outside of the physician's role, we will explore the perceptions that patients have of doctors and hospitals as well examine the culture of traditional biomedicine. Through experiencing, reflecting, discussing, and writing about how differently doctors and patients often view illness, disease, treatment, and death, we may gain greater insight into our own beliefs, biases, and potential strengths to provide healing. Anne Fadiman writes in The Spirit Catches You and You Fall Down, "I have always felt that the action most worth watching is not at the center of things, but where the edges meet. I like shorelines, weather fronts, international borders. There are interesting frictions and incongruities in these places, and often if you stand at the point of tangency you can see both sides better than if you are in the middle of either one. This is especially true, I think, when the apposition is cultural." It is the apposition of the culture of biomedicine and individual, personal experiences of illness that this course will help the student of medicine to examine more closely.