Syllabi: Medical Ethics and the Presidential Physician: Stories of Doctors Confronted with Ethical Dilemmas

INSTITUTION: Northeastern Ohio Universities College of Medicine

PRESENTER: Ludwig M. Deppisch, M.D., Department of Pathology, Western Reserve Care System, is Professor of Pathology, NEOUCOM.

PROGRAM DIRECTOR: Martin Kohn, Ph.D., Director of the Human Values in Medicine Program (email: mfk@neoucom.EDU)

ENROLLMENT: BS/MD; selective; limit: 15

SEMESTER: Spring 2000
April 17, 24, May 1, 8 (Monday mornings 8:00 a.m. - 12noon)

LEARNING GOALS: This course will employ a political and historical context within which to examine physician behavior towards patients, patient families, and other interested parties when presented with dilemmas affecting patient care. The patients in question will be the presidents of the United States. The doctor in question will be the White House physician. The issues will be examined through stories of real-life historical situation. At the conclusion of this course, the participant will be able to:

1. appreciate the centrality of patient confidentiality in the care of the patient.

2. understand the degree and extent to which extraneous non-medical circumstances might affect the patient-physician relationship.

3. appreciate the complexity of a complete and full disclosure to the patient of his medical diagnosis and prognosis.

4. examine the evolution of medical ethics from an historical perspective.

METHOD OF INSTRUCTION: This course will be taught in seminar format in four consecutive weekly four- hour sessions. The participants will pre-read stories of white house physicians in historical situations and then discuss them with the course director.

OUTLINE:

Week 1: (April 17) Patient Confidentiality and the Public's Right to Know. The Often Conflicting Goals Goals of the Inviolability of a Medical Record and an Informed and Serious Body Politic.

A. Cary Grayson and Woodrow Wilson

B. Ross McIntyre and Franklin D. Roosevelt

C. Janet Travell and John F. Kennedy

Week 2: (April 24) Full Patient Disclosure and Patient Disinterest. Affairs of State Surpass in Importance That of a Medically Informed Patient.

A. Cary Grayson and Woodrow Wilson and the first Mrs. Wilson

B. Max Jacobsen and John F. Kennedy

C. John C. Warren and Andrew Jackson

Week 3: (May 1) Is What Is Good for the Patient Good for the Politician? Do Politics Make for Good Medicine? The Acquiescence of Medical to Political Decision Making. Reversal of the Physician-Patient Relationship in the Determination of Appropriate Diagnosis and Therapy.

A. Joseph Bryant and Grover Cleveland

B. Leonard Heaton and Dwight Eisenhower

C. Burton Lee and Bill Clinton

Week 4: (May 8) The Patient as an Example, Not as an Individual. To What Extent Should the Medical Care of the President Serve as an Exemplar for the Medical Awareness of the Citizenry.

A. Burton Lee and George Bush

B. Oliver Baehrs and Ronald and Nancy Reagan

C. Dan Ruge and Ronald Reagan

REQUIREMENTS: Attendance at all sessions and active participation in discussion.

READING LIST: TBA