Postgraduate Taught

Major advances in medical technology, increased expectations, and changing moral attitudes have combined to generate many complex ethical and legal problems in the fields related to medical ethics and palliative care. Individuals who care for patients with life-threatening illnesses can face particularly pressing and difficult moral choices. The course provides an opportunity to gain a deeper and more systematic understanding of these issues, and to explore the moral problems health care professionals working in these areas may face.

The course is taught in Liverpool by lecturers from Keele’s Centre for Professional Ethics (PEAK) and the Learning & Teaching Department of the Marie Curie Palliative Care Institute. From time to time, law lecturers from Keele University may provide specialist input, and external expert speakers may also be invited to speak on the course. This is an exciting joint venture uniting academic and practical expertise.

We regard high levels of student participation in discussion as particularly important for teaching and learning in this area, and employ teaching techniques which encourage this wherever possible.

Students come from a wide range of backgrounds within the field of health care and many diverse geographical locations. Past and current students have reported that meeting and exchanging ideas with others who work in different fields and in different parts of the country is one of the major benefits of the course.

The Medical Ethics and Palliative Care teaching team have many years experience of teaching postgraduate applied ethics courses. We are well aware of the special problems and challenges which may face mature students and those combining study with full-time work, and therefore we do our utmost to offer a supportive and stimulating environment for learning. Each student is assigned a personal supervisor from the teaching team, whom they can contact for help or advice at any time during the course.

This course aims to deepen students’ understanding of health care ethics that are particularly relevant to the fields related to medical ethics and palliative care, and to enhance their ability to think systematically about the moral issues that health care professionals may face in the course of their work in these areas. It also aims to provide a foundation for pursuing further study at doctoral level for those interested in doing so.

The course is open to all those with either a degree in a relevant subject, or appropriate professional qualifications and/or experience. Applications are welcome from people with a professional or other serious interest in the medical ethics and palliative care, including (but not limited to) doctors, nurses, health care managers, intercalating medical students, radiographers, chaplains, charity and voluntary workers, social workers, hospice directors, medical and pharmaceutical researchers, and health care educators.

Intercalation

Students studying medicine can opt to take a year out of their undergraduate medical studies in order to study a subject area in greater depth, before returning to complete the medical course. To intercalate, students must have completed the fourth year of a medical degree. Intercalating students would take the MA in Medical Ethics and Palliative Care as full-time students to ensure that the course is completed within one year.

The MA in Medical Ethics and Palliative Care involves both taught sessions and a chance for students to write a dissertation on a topic of their choosing related to the course. Teaching occurs in four three-day modules that run between October and April. This innovative structure has proved particularly popular with health care professionals in full-time employment as it allows students to combine study with full-time work, family and other commitments. It also enables students who are based in all areas of the UK and beyond to attend. Contact between students and staff, and between students, is facilitated between modules to create a distinctive student community. The MA requires the successful completion of 180 M Level credits, made up of four 30-credit taught modules and a 60-credit dissertation. It can be taken either full-time or part-time. When taken part-time the four taught modules are completed in the first year, with the dissertation being completed in the second year. When taking this route there are no specific attendance requirements during the second year – you may meet your supervisor at mutually convenient times, keep in touch via email or phone, or use a combination of methods. If the course is being taken full-time, it can be completed within one year with the dissertation being submitted at the start of September.

Some students may not want to do the whole course. An alternative route is to leave after completing the four taught modules. Successful completion of these will lead to the award of a Postgraduate Diploma in Medical Ethics and Palliative Care.

The content of the modules is briefly outlined below with illustrations of the topics to be covered:

• Module 1: Introduction to Ethics and Palliative Care - In this block, you are introduced to the main concepts and theories used in health care ethics. This is done in a number of ways that bring out their connection with issues of practical concern in palliative care. Additionally, Module 1 normally contains topics such as: the shift from curative to palliative care; the context of care (e.g. hospital, hospice, home); the relationship between ethical and clinical considerations.

• Module 2: Autonomy, Paternalism and Advance Care Planning - Module 2 addresses issues within palliative care which relate to respect for the autonomy of patients and carers and for issues that arise over advance care planning.  Important topics normally include: truth-telling; confidentiality; decision-making for the seriously ill patient; informed consent; consent and the law; advanced directives; paternalism; challenges of non-malignant diseases; and the nature and role of hope in palliative care.

• Module 3: Ethical Issues in Care of the Dying - This module focuses on end-of-life issues and care for the dying.  It includes topics on the significance of death; the sanctity and value of life; the idea of 'quality of life'; withdrawing and withholding life-prolonging treatment; and ethical and legal issues in euthanasia.  The practical aspects of care for the dying are also addressed through a focus on the Liverpool Care Pathway.

• Module 4: Policy, Resource and Research Ethics in Palliative Care - The content of this module varies from year to year to reflect current issues of particular concern in the field. However, central to controversies in palliative care and issues of policy, resource allocation and research, which from the central core of the module.  In recent years, it has included seminars on special issues relating to the care of children; screening programmes; the role of religious belief in ethical debate; and differing conceptions of palliative care.

Dissertation

The dissertation gives students a chance to undertake a more intensive piece of work (between 15,000 and 20,000 words) on an approved topic of their choice. Students will have a supervisor to provide support and advice during the writing process. Dissertation topics are chosen by the student themselves and must relate to an issue within the broad area of the ethics of cancer and palliative care.

Some students start the course with a clear idea about what they want to write about - often an ethical issue from within their own practice - but the vast majority of students find and develop particular interests as the course progresses and they learn more about ethical theory, so don't worry if you have no clear idea what to write about at the moment.
Here is a far-from-exhaustive sample list of topics that students have written on in the past:

• "Do Not Resuscitate" orders;
• Patient autonomy and end-of-life decisions;
• Withdrawal of life-prolonging treatment;
• Futility and ethical issues;
• Truth telling and deception
• Terminal sedation;
• Euthanasia / assisting in bringing about death;
• Concepts of a good death;
• The doctrine of double effect;
• The acts/omissions doctrine;
• Screening programmes;
• Resource allocation and palliative care;
• Ethical issues in considering faith and spirituality

If there is a particular area you wish to write about, and would like to discuss this prior to applying for the diploma year, please contact us.

Each teaching block is followed by an assignment. For module one this is made up of three short written tasks, whilst for each of modules 2, 3 and 4 the assignment consists of a 4,000-word essay. All modules must be passed in order to proceed to the dissertation.

“I felt the course was constructed well, the Keele staff were very knowledgeable and supportive.  Marie Curie was an excellent centre to hold the teaching and I have thoroughly enjoyed the past year of the course”

 “Excellent combination of clinical and academic input”

 “Opportunity to develop new skills”

 “Learning to think differently about everything”