BIOETICA CLINICA

Degree course: 
Corso di Long single cycle degree (6 years) in Medicine and Surgery
Academyc year when starting the degree: 
2015/2016
Year: 
4
Academyc year when helding the course: 
2018/2019
Course type: 
Compulsory subjects, characteristic of the class
Credits: 
1
Period: 
First Semester
Standard lectures hours: 
8
Detail of lecture’s hours: 
Lesson (8 hours)
Requirements: 

None

Assessment: 
Giudizio Finale

At the end of the course, students should be able to:
• demonstrate familiarity with the major concepts and theoretical perspectives in eth-ics;
• recognize and critically analyze ethical concerns in biology, medicine and public health;
• distinguish ethical questions from scientific and legal questions and from questions of personal preference, custom, or habit;
• develop and use critical thinking skills to analyze information and situations in or-der to respond and act ethically with regard to scientific research, practice, and tech-nology;
• recognize that while there can usually be several answers or approaches to an ethical question, it is important to present a strong, well-reasoned argument for one’s posi-tion. And then to develop the ability to justify an ethical position;
• Enhance respectful dialogue among individuals with diverse perspectives.
At the end of the course, students should have also the theoretical competences that will allow them to assess ethical reasoning in complex situations and ethical decision making in professional and research practice.
Students will be faced with a set of four key questions that can be used to clarify an ethical problem. In all cases, students will need to ask the following:
What is the ethical question?
What are the relevant facts?
Who or what could be affected by the way the question gets resolved?
What are the relevant ethical considerations?

About history of medicine, the purpose of course is to encourage students to a critical reading of the cultural and historical medicine.
This purpose will be achieved by providing food for thought on some fundamental issues for several specialized areas of medicine.

The frontal lessons are focused on the following topics:
1. Definition of medical deontology, medical ethics and law (1h, educational objective 1)
2. The ethics consultation in hospital (1h, educational objective 1)
3. Methods in clinical ethics (2h, educational objective 1)
4. The end of life (3h, educational objective 1)
Legal, deontological and ethical profiles. The difference between killing and letting die, active/passive euthanasia, proportionality of care, quality of life, over-treatment, palliative sedation, advance treatments directives, difference between withholding and withdrawing treatments and medical futility (when to suspend a futile treatment)
5. The genetics and different types of genetic tests, incidental findings and genetic consultation (2h, educational objective 1)
6. The organ transplants from living and corpse donor (with discussion about brain death criteria) (2h, educational objective 1)
7. The integrity in scientific research and ethics in experimentation (falsification, plagiarism, “scientific misconduct”) (1h, educational objective 1)
8. Legal, deontological and ethical issues of information and consent of medical treatments (1h, educational objective 1)
Communicating the truth to the patient, the concepts of confidentiality and professional secrecy.
9. The beginning of life (2h, educational objective 1)
Medically assisted procreation, abortion and stem cells.
10. The aim and purpose of medicine (1h, educational objective 1)
11. Discussion of clinical cases (educational objective 1)

About History of medicine, the frontal lessons are focused on the following topics:
- Definition of medicine. From medicine instinctive regular medicine.
- The basics of medicine in the classical world. The body of knowledge Hippocratic-galenical.
- Medication transmission.
- The European Medieval medicine and Universities. The medieval cookbooks.
- Large health problems from the Middle Ages to 'Modern Age. The protagonists of the cure. Places of medicine and places of science.
- The renewal in Modern science. The chapters progress of the knowledge of the human body. New knowledge of anatomy and physiology. The surgeons of the sixteenth century. The sides interpretations of doctrines iatrochemistry and iatromechanics. The optical zoom. Towards the demolition of the doctrine of spontaneous generation. The vaccination.
- The large medical systems to a new understanding of the disease. The mechanisms of social awareness and environmental factors in health and disease. The organ pathology. The victorious statements of basic sciences. The theory phone and cellular pathology.
- The scientific dimension of the nineteenth century. The clinic, hospitals and places of care. Knowledge of semeiotics. The theory phone and cellular pathology. The scene surgery. Medicine and surgery of war. The neutrality of the wounded. The experimental medicine. The identification of infectious agents. The talks between the clinic and laboratory.
- The mental illness. From structures for med men to the mental hospital.

Mario Tavani, Mario Picozzi, Gabriella Salvati, Manuale di deontologia medica, Giuffrè Editore, 2007.
Mario Picozzi, Il trapianto di organi. Realtà clinica e questioni etico deontologiche, FrancoAngeli, 2010.
Mario Picozzi, Fino a quando? La rinuncia ai trattamenti sanitari, San Paolo Editore, 2012.
Mario Picozzi, Omar Ferrario, Il diavolo è nei dettagli, Rosenberg, 2016
Mario Picozzi, Renzo Pegoraro, A.G. Spagnolo, La consulenza etica, Piccin, 2016
G. ARMOCIDA, B. ZANOBIO, Storia della medicina, Masson, Milano 2002