School of Nursing
Please direct all questions about the flag proposal process to the Center for the Skills & Experience Flags.
N 223 Genetics in Health Care
Ethical Reasoning as Course Content: Courses that carry the Ethics Flag teach students to think ethically. Please describe course readings, assignments, and/or activities that require students to engage in ethical reasoning.
As part of the core bachelor’s of science in nursing curriculum, all students take this course, which addresses several ethical issues and related considerations through readings, reflections, group assignments, individual assignments and quizzes. Though too numerous to list in this application, select examples will be provided below. Each unit will include at least one reading assignment covering relevant ethical, legal, social, and financial issues related to genetics in health care. Readings will include peer-reviewed publications and news articles covering important historical and contemporary topics, such as: eugenics, genetic testing; genotyping for sex in the Olympics (which has resulted in medals being revoked), issues related to in-vitro fertilization (e.g. sex selection; “designer babies”); the near eradication of Down syndrome in Iceland via selective termination; genetically modified organisms; gene editing with Crispr/Cas9. Readings related to important genomic laws and policy (e.g. Genetic Information Nondisclosure Act; etc.) will also be included. Multimedia content incorporated into in-person and online lectures will reinforce diverse perspectives on ethical considerations related to genomics in health care (e.g. a video featuring a disability advocate with an inherited disorder; a video where a family finds out their new daughter-in-law has an autosomal dominant disorder she could pass on to her children). Students will complete individual and group assignments where they respond to the readings and videos to ensure they are grasping the ethical concepts and learning approaches to evaluating and navigating ethical issues in health care; assignments will cover basic concepts (e.g. vocabulary; ethical reasoning skills; ethical frameworks; nursing roles related to ethical conduct in the genomic area). Students will also work in small groups to complete case studies that outline ethically challenging issues nurses may face; groups will identify all relevant stakeholders (e.g. patient, family, physician, nurse, insurance provider, etc.) and consider the perspectives/values of all relevant parties. Students will also have an opportunity to practice responding to ethical dilemmas in a way that is professional and consistent with the expectations for nurses (according to professional guidelines). The students, who will have been in the clinical setting at this point in their studies, will be encouraged to examine ethical issues they have already encountered or may encounter in their intended practice area and will be evaluated using formal graded reflection assignments. Student discussions and assignments will allow them to demonstrate their ability to tailor genetic/genomic information to clients based on their culture/religion/knowledge etc. and to advocate for clients to make autonomous decisions related to genomic health care (as consistent with the curricular guidelines published by the American Nurses Association and International Society for Nurses in Genetics). Students will be divided into two groups (pro- and anti- genetic modifications/editing) and several subgroups who are instructed to research particular aspects of the ethical issues at stake; following at-home preparation, a class-wide graded debate will occur.
Ethics as an Explicit Component of the Course: The Ethics Flag indicates that students will learn practical ethics, so the connection between ethical content and real-life choices should be made concrete. Please describe how this course gives students the opportunity to apply ethical reasoning to issues relevant to their adult and professional lives.
In nursing, ethics and practice are intrinsically interconnected to the point that they are inseparable. The next generation of nurses need to be equipped to navigate ethical, legal, social, and financial issues related to genomics in order to provide the best possible care to our patients. One of the pivotal and persistent responsibilities for all registered nurses is a recognition of one’s own attitudes and opinions on ethical, moral, and related (e.g. legal, social, financial) issues that nurses encounter in the genomic era. This is a critical first step toward understanding the implications our individual perspectives may have for delivering nursing care. Indeed, the need to understand one’s own biases is so fundamental for nurses, it is included as part of the “Essentials of Genetic & Genomic Nursing: Competencies, Curricular Guidelines & Outcome Indicators, Ed.2” published in 2008 by the American Nurses Association and International Society of Nurses in Genetics. This is the guiding document and first required reading for the course. Throughout this course, there will be several activities designed to help students recognize their own attitudes, opinions, and values as well as those of their patients and other stakeholders (e.g. physician; insurer). At the start and end of the course, students will complete an anonymous graded survey and associated reflection assignment covering key ethical issues related to genetics in health care (e.g. genetic testing; pregnancy termination under various circumstances; gene editing; genetically modified organisms). Small group discussions will be structured to provide students with opportunities to explore ethical issues from the perspectives of many stakeholders, and to consider how they would respond to real life clinical ethical dilemmas in a way that is consistent with professional standards while communicating therapeutically, in a calm, non-judgmental manner.
Graded Content Based on Ethical Reasoning: To satisfy the requirements of the Ethics Flag, at least one-third of the course grade must be based on work in practical ethics. Please describe the course grading scheme, indicating how one-third of the course is based on ethical reasoning.
At least 50% of the graded content will focus on ethical and related (e.g. legal, social, financial) issues germane to genetics in health care. The anonymous graded surveys with associated reflections administered at the start and end of the course and scattered reflections will cover ethical content, amounting to 10% of the total grade. The genetic modification/editing debate will be worth 10% of the total grade. Group assignments on content specific to ethical, legal, social, and financial issues in health care genetics will represent 15% of the total grade (2 assignments at 7.5% each). Ethical, legal, and social considerations will also be on the individual quizzes and represent 10% of the total grade. Finally, students will report on a current topic on genetics in the popular media/news and will describe relevant ethical, legal, social, and financial issues related to their chosen article (5% of the total grade).