Health Ethics Video Guide

Reviews from E to H

Title:Economics of Health Care

Length: 35 min.

Produced: Concept Media

Date: 1996

Location(s): ·The Bioethics Centre, U of A

Description: This video presents a dramatized tutorial on the economics of health care in the context of the U.S. health care system. It includes discussions on factors creating rising costs, Medicare, Medicaid, prospective payment systems, roles of the participants in health care, and managed care systems.

Ethical Issues: ·health care environment as a market place

·expectations of health care system

·culture of medicine as guided by technological imperative

·role of malpractice concerns in behaviour of physicians

·hospital as money making enterprise

·moral hazard in health care insurance

·access to insurance of high risk patients

·ethics of managed care

Perspective: A balanced view is presented.

Watchability: The video is a well made information video quality program.

Comments: Although in the U.S. context, this program is a very good introduction to the economics of health care. It is, however, very dense - perhaps too much so. A great deal of information is packed into this brief presentation. It is recommended for personal viewing and especially for a group setting where time is spent afterwards explaining the concepts in greater detail and their relevance to the Canadian context.

Topics: ·Resource Allocation

·An Analysis of the Values of Canadian Health Care

Title: Emotional Fitness

Length: 29 min.

Produced: Spectrum Films

Date: 1987

Location(s): ·Medicine Hat College Library RA790 B58

Description: Not Reviewed.

Title: An Epidemic Of Fear: AIDS In The Workplace

Length: 23 min.

Produced: Pacific-Bell Corporation

Date: 1987

Location(s): ·Educational Media Services, University Extension Centre, U of A V05036

Description: Not Reviewed. (catalogue description: "Educates managers and employees how to handle AIDS in the workplace. Focuses on the wide range of medical, ethical, legal and human resource issues faced by decision makers. Includes interviews with medical experts, corporate managers, employees with AIDS, and their co-workers. STUDY GUIDE")

Title: The Ethical Challenge - 1

Length: 17 min.

Produced: Science and Mankind, Inc.

Date: 1975

Location(s): ·Grant MacEwan Community College LRC R724 .E8

Description: There are two videos in this series which aims to present four case studies of issues in biomedical ethics. This program, part one of the series, includes two cases. The first case follows a young patient who needs a kidney transplant and is on a two year waiting list to receive one. The second case is about a young woman who is a mother, wife and art teacher. The woman suffers from a mental disorder that causes her to have infrequent but violent rages. After one episode she is arrested for causing some public disturbance and is sent to a psychiatric hospital/correctional facility. She then faces the decision to consent to experimental brain surgery with uncertain results and be allowed to go home, or not to consent and to remain incarcerated.

Medical Issues: ·kidney transplant

·hemodialysis

·Ritalin to calm hyperactive kids

·Apomorphine to calm prison inmates

Ethical Issues: Case One

·micro resource allocation of scarce resources

·lifestyle/age as relevant to receiving scarce resources

·ethics of waiting lists

·living wills

·methods of allocation - first come first serve as opposed to 'God' committees

Case Two

·ethics of behaviour control mechanisms (e.g. use of psychotropic drugs to alter or control behaviour)

·relative ease of controlling individual behaviour over affecting social conditions that cause these behaviours

·mind control through brain implants

Perspective: The video is in the U.S. context and fairly balanced views are given. The second case highlights a very paternalistic social context with respect to the lower social classes.

Watchability: This is not really a video as in 'moving picture'. Rather, it is a series of photographs with voice added over top. It's still watchable but definitely very old looking (and perhaps a little annoying visually after awhile).

Comments: The program is quite old so the statistical numbers it mentions and the examples it sites are certainly out of date. The first case is pretty good at framing the questions in microallocation issues. The second case is also quite good at talking about behaviour control and ethics, and mental health in general. The advantage of this program series is that the cases are fairly well presented in a very short time (about five minutes) and the basic issues are still relevant. The disadvantage is the method of presentation. The slide format, while watchable, quickly becomes annoying. For the purposes of introducing a subject in a group setting the video is not bad if something short is needed or one can't find anything else to show.

Topics: ·Resource Allocation

·Ethics and Mental Health

·Ethical Issues in Transplantation

Title: The Ethical Challenge - 2

Length: 15 min.

Produced: Science and Mankind, Inc.

Date: 1975

Location(s): ·Grant MacEwan Community College LRC R724 .E8

Description: There are two videos in this series which aims to present four case studies in issues in biomedical ethics. This program, part two of the series, includes two cases. The first case follows a young couple about to get married and waiting for the results of some genetic testing. They find out that both of them are carriers of a gene for a fatal disease that their children could inherit. They need to decide whether to continue the relationship and how to deal with the issue of having children. The second case discusses the situation of an 85 year old woman who is paralyzed and unconscious. The family must then decide whether to consent to the use of a new medical technology to extend her life or to refuse treatment and allow her to die.

Medical Issues: ·Mongolism/Down Syndrome

·Tay-Sachs Disease where when both parents are carriers results in a 25% chance that children will have disease

·amniocentesis to detect Tay-Sachs Disease

·stroke causing non-competency

·senility and paralysis

·need for a pacemaker to regulate heartbeat

Ethical Issues: Case One

·limits to personal autonomy when carrying a gene linked to a fatal disorder

·society's obligation to identify carriers of genes for various diseases

·counselling of genetic screening patients

·aborting babies with undesirable genes/carriers of fatal diseases

·rights of the unborn child

Case Two

·allowing to die - dignity in death

·evolution of medicine's role from care to cure

·when is it appropriate to die

·autonomy and the non-competent patient

·substituted judgment

·personal directives

·how to reconcile differing opinions in developing a substituted judgment

·the role of technology in caring for the dying

Perspective: A fairly balanced view is given. The vignettes take place in a U.S. context.

Watchability: This is not really a video as in 'moving picture'. Rather, it is a series of photographs with voice added over top. It's still watchable but definitely very old looking (and perhaps a little visually annoying after awhile).

Comments: The program is quite old so the statistical numbers it mentions and the examples it sites are certainly out of date. The first case is pretty good at framing the questions in genetic testing issues. The second case is also quite good at talking about issues at the end of life and personal directives. The advantage of this program series is that the cases are fairly well presented in a very short time (about five minutes) and the basic issues are still relevant. The disadvantage is the method of presentation. The slide format, while watchable, quickly becomes annoying. For the purposes of introducing a subject in a group setting the video is not bad if something short is needed or one can't find anything else to show.

Topics: ·Ethical Issues at the End of Life

·Informed Consent

·Ethical Issues in Genetics

·Personal Directives

Title: Ethical Choices

Length: 1 hr. 30 min.

Produced: Alberta Health: Home Care/Community Long Term Care Branch

Date: 1991

Location(s): ·Education Resource Centre for Community Care V- 666A

Description: In this video Dr. J. Dossetor presents a lecture introducing bioethics at a home care and rehabilitation symposium. Later, a case is presented an discussed in the group (though this portion of the program gets cut off).

Medical Issues: ·stroke

Ethical Issues: ·universal ethical principles - Georgetown mantra

·autonomy vs. paternalism

·rights vs. responsibilities and duty

Perspective: The video offers a modern 'ethical' perspective.

Watchability: This is a home video quality program. The lighting and the video are fairly poor and the slides used are difficult to see.

Comments: The content of this video is quite good and provides a reasonable introduction to bioethics. The problem with the video is that it is difficult to watch. The video is, therefore, not recommended for use in a group setting but may be alright for personal use.

Topics: ·An Analysis of the Values in Canadian Health Care

·Introduction to Bioethics

Title: Ethical Issues in Aging

Length: 45 min.

Produced: Medical Education Associates

Date: 1990

Location(s): ·Education Resource Centre for Continuing Care V575H

Description: This video features a lecture by an American ethicist, Dr. Lo, on ethical issues faced in geriatric facilities. Through the lecture Dr. Lo discusses the case of a 77 year old woman suffering from dementia. She is institutionalized after being cared for at home. She has a DNR order in place. After awhile she develops aspiration pneumonia and is treated at an acute care hospital but her mental condition deteriorates drastically and she needs a feeding tube for nourishment. Her daughter refuses the intervention.

Medical Issues: ·aspiration pneumonia in geriatric patient suffering dementia

Ethical Issues: ·futile treatment

·appropriate vs. inappropriate treatment

·personal directives - how deal with situation where directives don't exactly match situation encountered

·patient autonomy vs. paternalism

·assessing patient competency in the elderly

·ordinary vs. extraordinary care

·ethics of withholding/withdrawing treatment

Perspective: The video offers a 'modern day' ethical perspective in the context of the U.S. health care system. A legal perspective is also offered.

Watchability: The video is a well made home video quality production. However, it is in lecture format and gets a little dry after awhile.

Comments: The video is very good at going through the ethical issues that arise in a geriatric setting and explaining the associated philosophical issues. The only setback is that it is a little boring to watch. Still, it is recommended for personal use and as background preparation for presenters of this topic. It is not recommended for use in a group setting.

Topics: ·Ethics and the Elderly

·Ethical Issues at the End of Life

·Legal Issues in Health Care

·Personal Directives

·Ethics and Long Term Care

Title: Ethical Issues in the Management of Elderly Clients - General Discussions in Medical Ethics

Length: 11 min.

Produced: University of British Columbia

Date: 1991

Location(s): ·Education Resource Centre for Continuing Care V- 769N

Description: This information video looks at several cases of elderly patients in situations where their personal autonomy comes into conflict with what appears to be their best interests.

Medical Issues: ·multi infarct dementia

·bleeding cancer of the rectum

Ethical Issues: ·autonomy vs. paternalism

·competence of the elderly patient

·'talking' patients into accepting treatment/coercion

·informed consent

·personal directives

·beneficence, justice and respect for persons as the three principles of bioethics

Perspective: The video offers a balanced set of views.

Watchability: This is an old looking but reasonably well made information video quality program.

Comments: This video provides a good introduction to the basic principles of bioethics in the context of the elderly. It is particularly appropriate for a bioethics discussion with health care professionals in long term care. It is alright for personal viewing, but there are a number of videos which introduce bioethical principles to the private viewer better.

Topics: ·Ethics and the Elderly

·Personal Directives

·Introduction to Bioethics

·Ethics and Long Term care

Title: Ethical Issues in the Management of Elderly Clients

Length: 1 hr. 2 min.

Produced: University of British Columbia Biomedical Communications

Date: 1990

Location(s): ·Mount Royal College Library RT85.E83

Description: Not Reviewed.

Title: Ethical Issues in Technologies Transfer

Length: 1 hr. 10 min.

Produced: Health Sciences Media Services - University of Alberta

Date: 1990

Location(s): ·JW Scott Health Sciences Media Desk, U of A VC115

Description: This is a series of lectures on the development of new drugs and complex clinical trials of new surgical techniques and equipment in the context of newborn heart transplantation and the history of ECMO.

Medical Issues: ·perinatal asphyxia

·congenital heart defects in newborns

·heart transplantation in newborns

·ECMO coronary bypass surgery

Ethical Issues: ·resource allocation

·prevention of illness vs. heroic treatment

·how to give proper information and get informed consent for life saving treatments without exerting pressure to accept treatment due to a vested interest in the new technology (conflict of interest)

·ethics of introducing new technologies in control trials with respect to risk management (beneficence vs. non- maleficence)

·how and when to terminate treatment in the application of new technologies

Perspective: The perspective in favour of the use of new technologies is presented.

Watchability: The video is in lecture format so it is a little dry. It is a reasonably well produced home video quality program.

Comments: The lectures are highly concerned with the medical issues involved. Some of the ethical issues involved are mentioned, but not really engaged. There is some interesting discussion of resource allocation at the end with regard to the interests of the family versus that of society in decision- making for infants.

Topics: ·Though not very well suited to be part of any kind of presentation, this video may be relevant to modules for Health Care and Technology and Ethical Issues at the beginning of life

Title: Ethical Perceptions of Men and Women: Are They Different?

Reviewed By: Al-Noor Nathoo

Length: 11 min.

Produced: Centre for Healthcare Ethics, St. Joseph's Health System

Date: Not Available

Location(s): ·P.H.E.N.

·St. Joseph's College Ethics Centre

Description: Describes the theory that women and men tend to make ethical decisions in importantly different ways, and the implications of this in the health care setting. Features John Golenski.

Ethical Issues: ·interprofessional (Physician-Nurse) differences in ethical decision-making

·ethical decision-making

·autonomy (limits of)

·gender differences in ethics

Watchability: Fairly good

Comments: Provides a simple and easy-to-understand explanation of the justice vs. care tension.

Topics: ·Introduction to Bioethics

·Ethical Decision-Making

·Ethics Committees

·Resource Allocation

Title: Ethics Committee Case Consultation

Reviewed By: Rachel Lynch

Length: 20 min.

Produced: Centre for Healthcare Ethics, St. Joseph's Health System

Date: Not Available

Location(s): ·P.H.E.N.

·St. Joseph's College Ethics Centre

Description: A discussion by Judith Wilson Ross, MA, and Sr. Corrine Bayley, MA, on case consultation by an Ethics Committee and some of the broader aspects of the Ethics Committee's role. Gave a clear explanation of the process of case consultation and raised some issues and problems that can arise without careful, advance planning.

Ethical Issues: ·Role of an Ethics Committee within an institution and at the individual case level.

Watchability: Good.

Comments: Excellent. Gave concrete troubleshooting, problem- solving ideas. A sound base from which a new ethics committee could begin developing. Video discusses role of ethics committees, setting up an ethics committee and case consultation by ethics committees.

Topics: ·Ethics Committees

Title: Ethics Committees - Allies in Long Term Care

Length: 33 min.

Produced: American Association of Retired Persons

Date: 1991

Location(s): ·St. Joseph's College Ethics Centre

·Education Resource Centre For Continuing Care V-652

Description: This video reviews the basic ethical issues that arise in long term care and the role of ethics committees in exploring/resolving ethical dilemmas. The video takes up several case studies and demonstrates how ethics committees were able to assist in them.

Ethical Issues: ·tube feeding in long term care patients

·DNR orders

·Right to refuse treatment

·patient autonomy vs. paternalistic institutional policies

·ethics committees

·competency

·physician - nurse relations

·importance of clarity in communicating with patient and family

Perspective: The perspectives of the long term care patient and institution are presented.

Watchability: This is a very well made information video quality program.

Comments: This video is very good at outlining the role of, the possibilities for and the value of ethics committees in both general and long term care settings. The video is well recommended for personal viewing and for use in a workshop or seminar setting.

Topics: ·Ethics Committees

·Ethics and Long Term Care

·Ethical decision Making

·Team Decision Making

·Personal Directives

·Ethical Issues at the End of Life

·Ethics and the Elderly

Title: Ethics of Human Experimentation and Care (Canada, the World and the Future Series)

Length: 2 hrs.

Produced: U of A Health Science Media Services

Date: 1988

Location(s): ·JW Scott Health Sciences Media Desk, U of A VC071

Description: The video features three lectures on the general subject of human experimentation: Dr. W. Bartholomew talks on children as research subjects; Dr. Marshall talks about experimentation on the incompetent elderly population without consent or any therapeutic advantage; and Dr. A. Lynch discusses the policy implications of philosophical discussions.

Ethical Issues: ·free and informed consent with respect to children

·utilitarianism

·autonomy and individual dignity

·using one group in society to benefit another

·Kant's categorical imperative

·autonomy vs. paternalism

·society's interest in human research

·central vs. decentral authority in ethics boards

·individual's right to take risks vs. society's interest in protecting against harm

Perspective: Various perspectives are offered in this program.

Watchability: This is a home video quality program that tends to be a little dry throughout.

Comments: The first speaker is good but takes a long time to make his points and is not always clear. The second lecture may be of use in a discussion on the rights of the incompetent. The context may seem a little dated but this may actually highlight certain issues. Nevertheless, a case study would probably still be better to introduce such a discussion. The third lecture provides a good grounding of the public's interest in setting research standards.

Topics: ·Informed Consent

·Health Care and Technology

·Ethics and the Elderly

·Ethics Committees

Title: Ethics, Law and Nursing

Length: 45 min.

Produced: Nursing Management Films

Date: 1983

Location(s): ·Education Resource Centre for Continuing Care V- 238

·Grande Prairie Regional College Library RT 85 .E83

Description: This video review the problems, issues and conflicts in the daily routine of nurses. The video begins with a basic introduction to ethics and then considers the ethics of a nurses day to day actions.

Ethical Issues: ·'ownership' of ethical problems

·role of principles in ethical analysis

·role of duty vs. role of consequences in ethical analysis

·professional ethics

·negligence

·autonomy vs. paternalism

·impact of fear of litigation in making decisions

Perspective: The video offers a legal perspective for nurses in the context of the U.S. health care system.

Watchability: The video is in lecture format interspersed with short vignettes of cases. It is a little dry and older looking information video quality program.

Comments: The video is good at looking at the ethical aspects of a nurses day to day work. It may be worthwhile personal viewing with a caffienated beverage, but is not recommended for use in a group setting.

Topics: ·Legal Issues in Health Care

·Introduction to Bioethics

·Ethical decision Making

Title: Euthanasia - The Nature of Things

Length: 47 min.

Produced: Canadian Broadcasting Corporation

Date: 1989

Location(s): ·Grant MacEwan Community College LRC R726 .G55

·Lethbridge Community College Library V.T. R 726 E962

Description: This documentary reviews the issues in euthanasia relating actual cases through a narrative and interviews with individuals involved. It then introduces the Dutch experience and examines it with an eye to looking at how it can inform the debate in the Canadian context.

Ethical Issues: ·the role of technology in saving life

·death as a frontier for medicine to conquer

·the technological imperative - ought we use technology to save life just because we can?

·when is it alright to withdraw treatment or assist death?

·right to die - dignity and comfort in death

·personal autonomy vs. paternalism

·value of the quality of life at its end stages

·definition of suffering

·slippery slope: voluntary euthanasia as a step closer to involuntary and the possibility of sufficient safeguards to prevent this

·importance of discussing ethical problems

·personal directives - living wills

·paternalistic nature of the medial establishment

·legal aspects of euthanasia and physician assisted killing

·withholding and with drawing life sustaining treatment

·honesty - the wording of documentation or falsifying of records to hide instances of euthanasia

·the Dutch experience

Perspective: Generally, a balanced view is offered. Increased public debate of such issues and increased individual choice are emphasized.

Watchability: Though a little old looking, this is a very well made private television quality program.

Comments: This video offers a very good review of end of life decision making. It is also valuable for examining the Dutch experience from a Canadian perspective. The video is well recommended for personal viewing. However, due to its length, there may be better resources available for introducing discussion on the topic.

Topics: ·Legal Issues in Health Care

·Health Care and Technology

·Ethical Issues at the End of Life

·An Analysis of the Values in Canadian Health Care

·Personal Directives

·Introduction to Bioethics

Title: Exceptions To Confidentiality: Secrets No Longer

Length: 17 min.

Produced: Viacom

Date: 1991

Location(s): ·Medicine Hat College Library R724 E89

·Lethbridge Community College Library V.T. R 725.5 E923

·NAIT VTC 2220

Description: Not Reviewed.

Title: Experimentation (Medical Legal Issues Series)

Length: 30 min.

Produced: Access Alberta

Date: 1983

Location(s): ·Grant MacEwan Community College LRC R724 .M43

·Education Resource Centre For Continuing Care V-045F

Description: This report examines issues surrounding ethical scientific experimentation and its coherence with the Nuremberg Code.

Ethical Issues: ·sufficiency of the Nuremberg Code in today's research environment

·beneficence and non-maleficence in research

·value and importance of experimentation and research on humans

·power of the technological imperative

·distinction between research, experimentation and therapy

·research ethics committees

·patient/subject dignity and autonomy

Perspective: Balanced views are offered in the video. A legal perspective is also given.

Watchability: This is a very well made public television quality program.

Comments: The program is good at reviewing the basic issues of experimentation with humans. It is quite amenable to being cut down and having only portions shown to introduce a discussion. Because the video is old, one would need to confirm that the legal opinions expressed are still relevant.

Topics: ·Legal Issues in Health Care

·Informed Consent

·Health Care and Technology

·An Analysis of the Values of Canadian Health Care

Title: Extraordinary Measures

Length: 5 min.

Produced: Canadian Filmmakers Distributor West

Date: 1991

Location(s): ·Education Resource Centre for Community Care V- 561

Description: This is a narrated cartoon about an elderly man with a weak heart. He finds himself in a hospital on life support and being resuscitated. His condition deteriorates in hospital.

Ethical Issues: ·informed consent

·resuscitation

·ordinary vs. extraordinary treatments

·DNR orders

Perspective: A definite sentiment in favour of individual autonomy is presented in this video.

Watchability: This is a very well made public television quality animated program.

Comments: This is a terrific video for introducing the topic to a group in a workshop, lecture or seminar setting. It is not very worthwhile for personal viewing but captures the essence of the issue perfectly for group settings.

Topics: ·Ethics and the Elderly

·Ethical Issues at the End Of Life

·Personal Directives

·Health Care and Technology

·Introduction to Bioethics

Title: A Fair Share of What Little We Have

Length: 45 min.

Produced: Horizon - BBC Education and Training Series

Date: 1976

Location(s): ·JW Scott Health Sciences Media Desk, U of A VC040

Description: This video reviews the development of primary health care in the developing world using the example of Tanzania and the use of village health worker and other solutions to rural health problems.

Medical Issues: ·hookworm

·malaria

Ethical Issues: ·the responsibility of a local and the global society in enabling people to care for themselves

Perspective: A balanced view is provided in this video.

Watchability: This is a public television quality program.

Comments: The video is interesting but relatively unhelpful in terms of direct ethical insights. It is also quite out of date and not even particularly good at looking at health care in a global context.

Topics: ·No Topic Suggested

Title: Family Caring

Length: 29 min.

Produced: Cross Point Communications

Date: 1985

Location(s): ·Medicine Hat College Library RT86.5 F3

Description: Not Reviewed.

Title: Family Stress in Critical Illness

Length: 21 min.

Produced: Robert J. Brady

Date: 1979

Location(s): ·Medicine Hat College Library RT120 I4 F3

Description: Not Reviewed.

Title: Family Tree (Discussions in Bioethics Series)

Length: 14 min.

Produced: National Film Board and Centre for Bioethical Clinical Research Institute Montreal

Date: 1985

Location(s): ·P.H.E.N.

·St. Joseph's College Ethics Centre

·The Bioethics Centre, U of A

·JW Scott Health Sciences Media Desk, U of A VC022

·Grant MacEwan Community College LRC R724 .D57

·University of Lethbridge Library R 724 D56

·Mount Royal College Library R724.F35

·Education Resource Centre For Continuing Care V-105A

·Educational Media Services, University Extension Centre, U of A V06332

·Lethbridge Community College Library V.T. R 724 D57

·NAIT VTC 241

Description: In this vignette an abusive mother of 3 comes into an acute care with what is diagnosed as an ectopic pregnancy. She is a 'repeat customer' and the attending physician wants to sterilize the woman while operating on the Fallopian tubes without consulting the woman.

Medical Issues: ·ectopic pregnancy - abortion assumed necessary - tube must be removed

Ethical Issues: ·rights of non-compliant patient

·patient autonomy vs. paternalism

·rights of a repeatedly abusive parent to bear children

·feminist ethics - objectification of women by medical establishment

·role of the physician in health management

Perspective: The video provides a fairly well balanced look at the issue.

Watchability: This is a little old looking public television quality program.

Comments: This is not a bad video to introduce questions of non-compliance and the responsibility of a health care system to patients who might be seen to abuse care. It might also prove interesting for a discussion on the rights and responsibilities of parents regarding their children and of society towards the parents that are members thereof. The video portrays a somewhat dated view of the autonomy vs. paternalism debate and so is not helpful for that discussion at an advanced level (though it perhaps may be a suitable demonstration for groups less familiar with bioethics).

Topics: ·Ethics and Mental Health

·Informed Consent

·Ethics and Women's Health Issues

·Introduction to Bioethics

Title: The Famine Within

Length: 1 hr.

Produced: Kandor

Date: 1990

Location(s): ·Educational Media Services, University Extension Centre, U of A V05897

Description: Not Reviewed. (catalogue description: "Explores the contemporary obsession with body size and shape among North American women. Under the coercive powers of consumerism and the mass media, women have come to view their bodies as marketable objects and to judge them according to the unrealistic standards of the beauty ideal. Combines the views of leading experts with the direct testimony of women of all ages and backgrounds, including those who have experienced the severest eating disorders, anorexia and Bulimia.")

Title: Fat Chance

Length: 1 hr. 12 min.

Produced: NFB Canada

Date: 1994

Location(s): ·Medicine Hat College Library RA645 O23 F3

Description: Not Reviewed.

Title: A Fate Worse Than Death

Length: 50 min.

Produced: KGW-TV

Date: 1990

Location(s): ·Grant MacEwan Community College LRC BJ1469 .H6

Description: This is an Oregon television documentary about the ethical issues surrounding comas, Persistent Vegetative States (PVS) and other conditions where individual's lives are being maintained by technological interventions. The program looks at the issues from various perspectives including families deciding how care for such individuals should be maintained.

Medical Issues: ·PVS

·coma

·feeding tubes

Ethical Issues: ·nutrition/hydration as treatment

·living wills and personal directives

·withholding/withdrawing treatment

·resuscitation orders

·futile treatment

·euthanasia - physician assisted killing

·palliative care

·dignity in death

·surrogate decision-making

·economic costs of caring for patients in PVS/comas

Perspective: The program takes place in the context of the Oregon Medical Association. It is very dollar cost oriented, but still provides a number of perspectives and is generally well balanced.

Watchability: This is a very well made private television quality program.

Comments: This is a very good video but a little long. It reviews the issues very well. The first 13 minutes could be used effectively to introduce the topic and situate a discussion. The middle section of the video is good at looking at both sides of the nutrition and hydration as treatment issue. The program is worthwhile in whole for personal viewing. The video is also quite good at explaining the condition known as PVS.

Topics: ·Legal Issues in Health care

·Health Care and Technology

·Ethical Issues at the End of Life

·Resource Allocation

·Personal directives

·Introduction to Bioethics

Title: Focus On Family Caregivers I

Length: 30 min.

Produced: Suncoast Gerontology Centre

Date: 1987

Location(s): ·Mount Royal College Library RC108.F6

Description: Not Reviewed.

Title: Focus On Family Caregivers II

Length: 30 min.

Produced: Suncoast Gerontology Centre

Date: 1987

Location(s): ·Mount Royal College Library RC108.F62

Description: Not Reviewed.

Title: For All The Good Intentions

Length: 60 min.

Produced: CBC TV

Date: 1984

Location(s): ·The Bioethics Centre, U of A

Description: This is a documentary on neonatal life support. It examines such issues as under what conditions ought treatment be given to neonates and the euthanasia question.

Medical Issues: (various conditions peripherally mentioned)

·premature babies

·digestive abnormalities

·respirator support for neonates

·cerebral palsy

Ethical Issues: ·life vs. non life issue - when does one become more valuable than the other?

·rights of the handicapped/disabled

·autonomy vs. paternalism

·the possibility of a "baby's" autonomy or own choice

·importance of how physician frames question to patient in decision making

·truth telling - information rights of patient/family

·active vs. passive euthanasia

·interest of society in maintaining life

·impact of fear of legal prosecution in decision making

·resource allocation

Perspective: A view against the rampant use and development of technology and the need to question the medical establishment is presented.

Watchability: This is a very old looking public television quality documentary.

Comments: The program is very old so in one sense this video is easy to dismiss. However, the age of the video highlights the attitudes of the times - then and now. The video succeeds in reviewing the issues quite poignantly. The aggressive therapy of neonate issues at the beginning is somewhat better than the later sections on euthanasia.

Topics: ·Ethical Issues at the Beginning of Life

·Health Care and Technology

·Ethical Issues at the End of Life Issues

·Introduction to Bioethics

·Resource Allocation

·Ethics and the Disabled

Title: Futile Treatment

Length: Not Available

Produced: L. Schneiderman, M.D.

Date: Not Available

Location(s): ·St. Joseph's College Ethics Centre

Description: Not Reviewed.

Title: The Future of Our Health and Health System

Length: 30 min.

Produced: Cinefocus Canada for National Forum on Health

Date: 1996

Location(s): ·The Bioethics Centre, U of A

Description: This video presents five scenarios, each followed by a set of discussion questions. The video is meant to encourage discussion and debate on the kinds of values important for Canadians to be manifested in the national health care system.

Ethical Issues: ·effect of health promotion and illness care activities covered in the same budget

·ethics of discrepancies in available health services between regions/provinces

·health care as a commodity

·illness care vs. health promotion and disease prevention

·ethics vs. efficiency

·resource allocation's place at the bedside

·waste/inefficiency as sole problem in rising health care costs

·health care as the expression of values of Canadian Society

·acute care vs. community care

·defining medically necessary care

·shifting the cost burden from the institution to the individual

·ethics of two-tiered health care system

·the right to health care as a right to basic service/good quality service/the best possible service

Perspective: A balanced, liberal perspective is offered.

Watchability: This is a very well made instruction video quality program

Comments: The video elucidates the issues of resource allocation in a cost cutting environment quite well. It is well recommended for personal viewing in its entirety. One or two of the vignettes may provide a useful introduction to a workshop on resource allocation for health care system administrators at different levels.

Topics: ·An Analysis of the Values in Canadian Health Care

·Resource Allocation

Title: Gender Discrimination: In The Medical Community

Length: Not Available

Produced: Loma Linda University, School of Medicine

Date: 1994

Location(s): ·St. Joseph's College Ethics Centre

Description: Not Reviewed.

Title: Genetic Engineering

Length: 28 min.

Produced: University Of Notre Dame

Date: 1990

Location(s): ·Grant MacEwan Community College LRC QH438.7 .B58

Description: Not Reviewed.

Title: Genetic Engineering: Prospects For The Future

Produced: Human Relations Media

Date: 1985

Location(s): ·Grande Prairie Regional College Library QH/442/.G46

Description: Not Reviewed.

Title: Genetic Prophecy

Length: 26 min.

Produced: Films for the Humanities and Sciences

Date: 1995

Location(s): ·Mount Royal College Library RB155 G4 1989

Description: This is an information video that introduces the human genome project and discusses some of the social, economic and ethical implications of this research.

Medical Issues: ·Dushen Muscular Dystrophy as progressive and leaving someone wheelchair bound

Ethical Issues: ·discrimination/social stigma as a possible result of positive testing

·guilt issues for the carrier of the gene

·importance of counselling for individual tested

·value of knowledge that one is carrying the gene for a given disease

·pressure to have the perfect baby and possibility of eugenics

·implications of testing for the value of the lives of the disabled

·fetal (pre-natal) testing

·value of ability to diagnose disease without having available treatment

Perspective: The video presents a balanced perspective that tends to be cautious of the human genome project.

Watchability: This is a well made information video quality program.

Comments: This is a very good introduction to some of the ethical concerns surrounding genetic research. It is recommended for personal viewing and is well suited for introducing the issue to a group in a workshop setting. The video is amenable to having one half or a portion shown.

Topics: ·Ethical Issues in Genetics

·Health Care and Technology

·Resource Allocation

·Ethics and the Disabled

Title: Genetics

Length: 30 min.

Produced: Dartmouth-Hitchcock Medical Centre

Date: 1992

Location(s): ·Grant MacEwan Community College LRC RB155 .G8

Description: This video presents a review of the ethical issues that surround genetic research and the impact of sharing of information about genetic testing on patients and their families.

Medical Issues: ·Menke's Disease

·Huntington's Disease

·Li-Fraumeni Syndrome

Ethical Issues: ·the value of information about one's genetic predisposition to illness

·value and nature of genetic counselling

·social implications and possible stigmatization with positive testing

·benefits of knowledge when disease testing for is terminal, late-onset and untreatable

·potential for eugenics in prenatal testing

·implications for family of having testing available

·benefits of planning for those diagnosed with terminal disease in early stages

·emotional issues (guilt, blame) for those in family testing negative

Perspective: A balanced perspective is given.

Watchability: This is a very well produced public television quality program.

Comments: The video raises issues very well and in a sensitive manner. It is quite appropriate for the topic and well suited for group viewing. It is highly recommended.

Topics: ·Ethical Issues at the beginning of life

·Health Care and Technology

·Ethics and the Elderly

·Ethical Issues in Genetics

·Ethics and the Disabled

Title: Genetics

Length: 30 min.

Produced: Films For The Humanities And Sciences

Date: 1992

Location(s): ·Mount Royal College Library QH430.G4

Description: Not Reviewed.

Title: Genetics And Disease Prevention

Length: 17 min.

Produced: Films For The Humanities And Sciences

Date: 1991

Location(s): ·Grant MacEwan Community College LRC QH431 .G46

Description: Not Reviewed.

Title: The Gift of Life - Your Questions Answered (Medical - Legal Issues Series)

Length: 13 min.

Produced: Viacom for U of A Hospital

Date: 1989

Location(s): ·JW Scott Health Sciences Media Desk, U of A NVC259

·Education Resource Centre For Continuing Care V-V-496

·University of Calgary Medical Library VT 349

Description: This is an information video program intended for the general public regarding organ donation.

Medical Issues: ·organ donation and transplantation

Ethical Issues: ·informed consent

Perspective: A view favouring organ donation is given. A legal perspective is also offered.

Watchability: This is a very well made information video quality program.

Comments: The video is not exceedingly helpful for use in discussing health care ethics. It is intended primarily for patients.

Topics: ·Informed Consent

·Ethical Issues in Transplantation

Title: Government Health Policies

Length: 2 hrs.

Produced: U of A Health Sciences Media Services

Date: 1988

Location(s): ·JW Scott Health Sciences Media Desk, U of A VC067

Description: Three speakers give lectures on the general topic: Mr. Ian Green talks of the federal government's role in national health care; Mrs. Ginette Rogers talks on ethics vs. efficiency in health care; and Dr. Malcolm Brown talks on health care economics.

Ethical Issues: ·macro resource allocation

·models of health - biomedical vs. population health

·importance of efficacy and efficiency in health care delivery

Perspective: A conservative Canadian perspective is presented.

Watchability: Although this is a home video quality presentation in lecture format, it is still not too bad and quite watchable.

Comments: The video is a little hard to follow at the beginning as there is no introduction. However a reasonable review of the Canadian health care system is offered at the beginning. The video is informative, but not very good at encapsulating Bioethical issues for presentation purposes. Still, it is not bad for personal viewing.

Topics: ·An Analysis of the Values in Canadian Health Care

·Resource Allocation

Title: Happy Birthday (Discussions in Bioethics Series)

Length: 12 min.

Produced: NFB

Date: 1985

Location(s): ·P.H.E.N.

·The Bioethics Centre, U of A

·JW Scott Health Sciences Media Desk, U of A VC022

·St. Joseph's College Ethics Centre

·Grant MacEwan Community College LRC R724 .D57

·Mount Royal College Library R724.F35

·Education Resource Centre For Continuing Care V-105B

·Educational Media Services, University Extension Centre, U of A V06332

·University of Lethbridge Library R 724 D56

·Lethbridge Community College Library V.T. R 724 D57

·NAIT VTC 241

Description: In this vignette, the father of lower-middle income family is offered a job in a chemical company to develop chemical weapons. He must decide whether the money is worth taking the position.

Ethical Issues: ·ethics of developing weaponry

·greater justice issues

·development/global community issues

Perspective: A liberal/anti war perspective is presented.

Watchability: This is an old looking, public television quality program.

Comments: The video deals more with a social issue than directly with health care. However, its inclusion in workshop or seminar would be effective in highlighting the wider global framework within which the work of health care operates. It is recommended for personal viewing.

Topics: ·Resource Allocation

·An Analysis of the Values in Canadian Health Care

Title: Healing Entertainers And Entertaining Healers

Length: 1 hr. 30 min.

Produced: Steve Allen

Date: 1988

Location(s): ·Educational Media Services, University Extension Centre, U of A V05746

Description: Not Reviewed. (catalogue description: "Presents an evening with Steve Allen, Steve Allen, Jr. M.D., Sid Caesar, Rick Caesar, M.D., and moderator Erin Sommerville. These two world famous comedians join their physician sons in a touching, lighthearted look at humour, health, and their families' gift of laughter. They tickle their own funny bones, as they playfully explore how the healing power of laughter has enriched their personal lives and the lives of millions of others.")

Title: Healing Presence: Pastoral Care in the Hospital Setting

Length: 24 min.

Produced: Foothills Hospital Education Resource Department

Date: 1988

Location(s): ·Foothills Hospital Library (no call numbers)

Description: Not Reviewed.

Title: Health Care: Bleeding From the Bottom Line

Length: 38 min.

Produced: ITV Eyewitness News Special Report

Date: 1994

Location(s): ·JW Scott Health Sciences Media Desk, U of A VC181

Description: This video involves a panel discussion about where the health care system is going with the reforms in Alberta. It is a news program that also reviews some of the horror stories resulting from changes. Panelists include Richard Plain, a health economist, and Brian Lemmon, a former CEO of the Capital Health Authority.

Ethical Issues: ·health care reform in Alberta

·instrumental ethical questions of the implications of instituting a plan without the details in place when making massive cuts to funding

·economics and efficiency vs. equality and ethics

·the role of the public and health care professions in making decisions about health care economics

Perspective: An anti-cutback bias is presented.

Watchability: This is a good quality private television program.

Comments: The program represents more a sensationalistic local news show than a sincere examination of the ethical issues in local health reform. There is scattered discussion on the method, value and goals of health care restructuring. The moderator does a fairly poor job at raising issues and is often subtly rude. The video is not bad for the general public (not too good either). It presents a reasonable description of what's going on currently in the health system in Alberta.

Topics: ·An Analysis of the Values in Canadian Health Care

Title: Health Care Practitioners - A Role For Nurses (Issues in Nursing Series)

Length: 60 min.

Produced: Not Available

Date: 1991

Location(s): ·JW Scott Health Sciences Media Desk, U of A VC147

·Red Deer College Library RT 41 I889

·Grant MacEwan Community College LRC RT6 .A1 P37

Description: This program is a panel discussion/talk show with guests taking open line telephone questions about the professional role of nurses in health care. There is a brief introduction reviewing the Canadian health care system and various areas that might benefit with an increased or different role for nurses.

Ethical Issues: ·medical gatekeeping

·nurses as health care practitioners

·health promotion and maintenance vs. illness care

·problems with fee for service schedule

Perspective: The nursing perspective is mainly focused on.

Watchability: This is a well made public television quality program.

Comments: The video provides a good basic review of the Canadian health care system and the role of nurses in Alberta health.

Topics: ·An Analysis of the Values of Canadian Health Care

Title: Help Me Die

Length: 1 hr.

Produced: Fanlight Productions

Date: 1992

Location(s): ·Education Research Centre for Continuing Care V- 741

Description: This is an investigative news report looking at patients requesting assistance in death. The program follows the cases of several patients in exploring the topic.

Medical Issues: ·Parkinson's Disease

·Alzheimer's Disease

·bone/prostate cancer

Ethical Issues: ·voluntary vs. involuntary euthanasia

·physician assisted death

·medicine as prolonging death - maleficence and beneficence

·personal directives

·personal autonomy

·competence

·dignity in life, in sickness and in death

·impact of having to face legal action on family making decision respecting personal directives of dying patient

·resource allocation in caring for dying patient

Perspective: The video offers, in general, a balanced set of views in the context of the U.S. health care system. However, it does seem to favour the legalization of physician assisted death.

Watchability: This is a well made private television quality program.

Comments: This video captures the ethical issues surrounding euthanasia well. It is recommended for personal viewing. It is too long for use in a group setting but is amenable to having just one case shown to introduce a topic/begin a discussion.

Topics: ·Ethical Issues at the End of Life

·Personal Directives

·Introduction to Bioethics

Title: Hidden Healers

Length: 29 min.

Produced: CBC

Date: 1987

Location(s): ·Medicine Hat College Library RT41 H5

Description: Not Reviewed.

Title: Hidden Epidemic

Length: 10 min.

Produced: CTV

Date: 1983

Location(s): ·Medicine Hat College Library RC523 H5

Description: Not Reviewed.

Title: The Home Visit

Length: 34 min.

Produced: Mosby Yearbook Inc.

Date: 1995

Location(s): ·Mount Royal College Library RT98.H6

Description: Not Reviewed.

Title: How Can I Help? = Como Puedo Yo Ayudarla A Usted?

Length: 22 min.

Produced: University of Lethbridge School of Nursing

Date: 1994

Location(s): ·University of Lethbridge Library RT 86.54 H68

·Medicine Hat College Library RT86.54 H68

Description: Not Reviewed. (catalogue description: " This program illustrates two instances of a gap that sometimes exists between health care professionals and clients due to a lack of awareness of the differences in the variety of ethnic, cultural and social backgrounds of clients. The first dramatization is set in an emergency room where a breakdown in communication takes place between a Spanish-speaking female patient and a nurse; the second is set in a public health centre where the community health nurse does not recognize a different cultural definition of illness held by a Spanish-speaking mother whose young son requires an immunization treatment. Both scenarios are re- enacted to show how the various cultural and language barriers can be overcome.")

Title: The Human Heart Machine (Managing Our Miracles - Health Care in America Series)

Length: 1 hr.

Produced: Columbia University Seminars on Media and Society

Date: 1986

Location(s): ·The Bioethics Centre, U of A

Description: This program features a moderated round table discussion with prominent American politicians, health care professionals and others about heart transplantation and the use of artificial hearts and organs.

Medical Issues: ·heart transplantation

·the use of artificial hearts

Ethical Issues: ·microallocation issues - how to decide who gets beyond using strictly medically relevant criteria

·discrimination and social values underpinning medically relevant criteria

·equity and fairness

·rationing by ability to pay

·privacy

·how to encourage organ donation

·treatment vs. experimentation and informed consent

Perspective: A view in favour of transplantation is presented. The view is a little paternalistic.

Watchability: This is a well made public television quality program.

Comments: The video provides a good introduction to transplantation issues. It is somewhat long but is amenable to having just portions of the show shown. It is recommended for personal viewing.

Topics: ·Resource Allocation

·Health Care and Technology

·Informed Consent

·Ethical Issues in Transplantation

Title: Human Rights In Canada

Length: 1 hr. 3 min.

Produced: The Board

Date: 1987

Location(s): ·Educational Media Services, University Extension Centre, U of A V06307

Description: Not Reviewed. (catalogue description: "This series of four video recordings provides a comprehensive overview of human rights, in a Canadian context. It covers political, legal, and ethical considerations, especially in a Canadian setting but within an explicit global context. As a unit, it employs historical, sociological, philosophical, legal and political approaches to the issue of human rights.")

Title: The Hunger Inside - 20/20 Television Program

Length: 45 min.

Produced: ABC News Productions - ABC Inc.

Date: Not Available

Location(s):