What is Health Science? Health Science is: - PowerPoint Presentation

1. What is Health Science?Health Science is: Big idea of this course =Website:

2. What is Health Science?Health Science is: an applied science that addresses the use of science, technology, engineering and mathematics in the delivery of healthcare.Big idea = There are many different fields of study and careers that contribute to health science. Health depends on achieving homeostasis through balancing all dimensions of holistic health.Loganpetlak.ca/Health-Science-20

3. Philosophy and EthicsHS20-HC1 Analyze how Western, Indigenous, traditional, complementary and alternative approaches to health care contribute to a holistic perspective (e.g., mental, emotional, physical and spiritual) of health.

4. Indicators!a. Identify how humanity’s beliefs about health, wellness, illness, disease, and treatment have changed over time. (STSE) b. Discuss the importance of and difficulties in defining terms such as Western, Indigenous, traditional, complementary, and alternative approaches to health care within a current global context. (K, A, S, STSE) c. Assess how health, wellness, illness, disease, and treatment (e.g., Circle of Life disharmony of body energies, being symptom free, and healthy lifestyle choices) are addressed in Western, Indigenous, traditional, complementary, and alternative approaches to health care. (K, A, STSE) d. Investigate the intended results of using natural products (e.g., herbs, vitamins, minerals, probiotics, and essential oils) and mind and body practices (e.g., acupuncture, various massage therapies, yoga, spinal manipulation, relaxation techniques, meditation, and movement therapies) and other complementary and/or alternative approaches to health care. (K, A, STSE) e. Examine the significance of rituals, place based ceremonies, plants, and traditional herbs in Indigenous and traditional approaches to health care. (K, A, STSE) f. Describe the role of clinical based studies (e.g., randomized, blind, double-blind, and placebo) in understanding Western approaches to health care. (STSE) g. Provide examples of ways in which one or more of the approaches to health care might be implemented together to support the health and wellbeing of an individual. (K, A, STSE)

5. What does it mean to be “healthy” or have good “wellness”?Identify how humanity’s beliefs about health, wellness, illness, disease, and treatment have changed over time. (STSE) Who is the healthiest person you know? What makes them healthy?Why would our answers or definitions differ?Why would this answer be different in different parts of the world or at different points in history?

6. What does it mean to be “healthy” or have good “wellness”?Identify how humanity’s beliefs about health, wellness, illness, disease, and treatment have changed over time. (STSE) Who is the healthiest person you know? What makes them healthy?Why would our answers or definitions differ?People view health differently – some may do some things “unhealthily” but other things “more healthily”Why would this answer be different in different parts of the world or at different points in history?In the past, being ”overweight” was a sign of health because you were adequately nourished. Now, it’s almost the opposite.

7. Varying Approaches to Health and “Ability”Different points in history view health differently –Let’s look at the history of “disability”.

8. Late 1800’sIn the late 1800’s, the social norm of dealing with a disabled family member was to keep them hidden away within the family homeA disabled child was seen as shameful and they were not accepted in public

9. Late 1800’s ContinuedAdministrative agencies began constructing institutions for disabled family membersThe main goal during this time was to keep them segregated from societyDisable people were often pitied, ridiculed, rejected, feared, or objects of fascination.Joseph Merrick

10. What is a disability?A disability is: a physical or mental condition that limits a person’s movement, senses, or activities.Examples include:Down syndromeMSParalysisParkinsonsLoss of limbsMuscular dystrophyBlindDeaf

11. 1900’s The institution model of dealing with disabled people became popular in the early 1900’sThis style of care was common practice until the 1960’s.In the 1960’s a paradigm shift began the acceptance of disabled people within societyTemple Grandin

12. 1970’sThe 1970’s were the start of integrating individuals with different abilities into societyInstitutions still exist today, but are structured as come of your own free will and you are allowed to leave

13. Recent HistoryIn the 1990’s came laws against discriminating based on abilityThese laws also prevented goods and services from being withheld from people with differing abilitiesContemporary portrayal of individuals with Autism/Aspergers:The Good DoctorBig Bang TheoryAtypical

14. Perspectives on what is Healthy? How do we view “disability” now? How was it different in the past?Is being on your phones too much bad for you or is it the new norm?Eugenics used to be a prevalent ideology, is it good or bad? Is Nature Deficit Disorder a thing? Should we be outside more?Importance: Our perceptions of “health” are subjective (meaning it can change from person-person)

15. What is health?

16. What is health?“physical condition of a living organism”Good health = optimal functioning of an organism

17. What is health?Functioning of the bodyVital signs - proper functioningThe state your body is inEmotional, physical, spiritual, mental - Wellbeing

18. What is wellness?“Capacity of which an organism can function at”

19. What is wellness? how you use or apply your health in your daily lifeHow you believe your health is going…

20. What is wellness?Mental, physical, emotional, and spiritualWellbeing of the body, rather than the state of the bodyStudy of the bodyMental condition

21. Health and Wellness is connectedThe World Health Organization (WHO) defines health as being “A state of complete Physical, mental, and social well-being and not merely the absence of disease or infirmity” in 1948.Where have we heard these terms before?

22. Health and Wellness is connectedThe World Health Organization (WHO) defines health as being “A state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity” in 1948.Where have we heard these terms before?The idea of balance between areas of wellbeing is not a new conceptIndigenous cultures view health as being well in all areas of life (mental, physical, social, and spiritual) and all components are equally valuedAs these approaches have become more widely held, phrases likeHolistic Health have emerged.

23. Holistic HealthShould have heard it in health before… what does it mean?Overall ___________ and _____________ between all of your different ___________ of health. _______ Socioemotional _______ SpiritualThis means… __ ____ _______, ____ ____ ________.Important to remember that this involves the most complete form of health and needs to be considered beyond simply treating a condition with a pill… this is what CAM (_________________________________) keeps in mind.

24. Holistic HealthOverall balance and well-being between all of your different dimensions of health. Physical – what are the literal/deeper meanings? Socioemotional – what are the literal/deeper meanings? Mental – what are the literal/deeper meanings? Spiritual – what are the literal/deeper meanings?This means… If one suffers, all can suffer. Example?Important to remember that this involves the most complete form of health and needs to be considered beyond simply treating a condition with a pill… this is what CAM (complimentary and alternative medicine) keeps in mind.

25. What is physical health (literal)?Wellbeing of your body - organ functionsHabitsCondition of muscles and bones (all systems)Being free of illness

26. What is physical health (deeper)?ActionSkillsSustainability

27. What is mental health (literal)?Psychological wellbeingEx. of mental health conditions: bipolar, depression, anxiety.Mindset and outlook on lifeStimulating and using the mind

28. What is mental health (deeper)?UnderstandingAwarenessPerspective Leadership

29. What is emotional health (literal)?Lack of emotional disordersStrong relationshipsFeeling and how you deal with themDo your emotions drive you?Social behaviours, feelings of inclusion

30. What is emotional health (deeper)?RelationshipsEmpowermentCooperationStruggle

31. What is spiritual health (literal)?Values and beliefsYoga and meditationIdentifying your own sense of meaning and purpose (IT’S NOT NECESSARILY BEING RELIGIOUS)

32. What is spiritual health (deeper)?DignityValuesConnectionReflection

33. Western versus Alternative Medicine (Types of Medicine)- Discuss the importance of and difficulties in defining terms such as Western, Indigenous, traditional, complementary, and alternative approaches to health care within a current global context. (K, A, S, STSE) Western (conventional) medicine - Holistic health – Complimentary medicine – Alternative medicine –

34. Western versus Alternative Medicine (Types of Medicine)- Discuss the importance of and difficulties in defining terms such as Western, Indigenous, traditional, complementary, and alternative approaches to health care within a current global context. (K, A, S, STSE)Western (conventional) medicine -The science and practice (by Health Care Providers) of the diagnosis, treatment, and prevention of disease through experimental study and testing. This is typically done through medications and surgery. What we consider conventional medicine. Historically just focused on treating the illness of the patient and didn’t look at holistic health.Holistic health – health includes not just illnesses of the body, but of the mind and soul (well-being physically, mentally, emotionally, and spiritually).Complimentary medicine – is using conventional medicine (pills, surgeries, etc.) and alternative medicine (yoga, naturopath, chiropractor).Also called CAM.Alternative medicine – a medical treatment that may not be scientifically tested, regulated or proven. Alternative medicine has become “arguably more common” in recent history (last 50 years).

35. Traditional MedicineWhat is traditional medicine?

36. Traditional MedicineWhat is traditional medicine?“Sum total of the knowledge, skills, and practices based on the theories, beliefs, and experiences indigenous to different cultures, whether explicable or not, used in the maintenance of health as well as in the prevention, diagnosis, improvement or treatment of physical and mental illness.”In other words: All the ideas and practices of a particular group as it relates to health and well-being.

37. How might all these phrases be somewhat difficult to classify?How might all these phrases be somewhat difficult to classify, relatively speaking (in a global context)?Ie. Why would it be incorrect to call some things just “traditional” or “alternative”? Some medicines that are “traditional” in one location are “alternative” in another and this may make it sound worse than other, “conventional” medicine.

38. How might all these phrases be somewhat difficult to classify?How might all these phrases be somewhat difficult to classify, relatively speaking (in a global context)?Ie. Why would it be incorrect to call some things just “traditional” or “alternative”? Health practices that are “traditional” for a particular culture are “alternative” for another.The term “traditional” is relative based on where the medicine originated and where it is practiced.

39. Complimentary and Alternative Medicine (CAM)What is CAM Allopathy – Complementary medicine – Alternative medicine – Complete the Complimentary and Alternative Medicine HandoutCorrect – hand in.

40. Complimentary and Alternative Medicine (CAM)What is CAMA group of practices and products that are not a strict part of conventional medicineAllopathy – conventional medicine or common and usual practice of medicineComplementary medicine – alternative medicine used with conventional medicineAlternative medicine – used instead of conventional medicineComplete the Complimentary and Alternative Medicine HandoutCorrect – hand in.

41. Health and WellnessPerspective towards “Illness”:Perspective towards “Wellness”:Perspective towards “Disease”:Traditional(note: there are many different cultures)WesternComplimentary and AlternativePerspective and Worldview is important – how might individuals holding a specific one of these perspectives think?

42. Health and WellnessPerspective towards “Illness”:Perspective towards “Wellness”:Perspective towards “Disease”:Traditional(note: there are many different cultures)Example: illness is a result of poor decisions or even “sin”.Example: state of mind being at peace with world.Example: could be shamefulWesternOut of balance or abnormal functioning of the body in a “sickness” sense. “Treat the sickness”Absence of illness. Good functioning of body.Curable or treatableComplimentary and AlternativeOut of balance in a holistic sense. “treat the whole person”Holistic well-beingDoesn’t just affect you – involves family.Perspective and Worldview is important – how might individuals holding a specific one of these perspectives think?

43. Health and Wellness ApproachesWhich perspective might each of these apply to?Why are these not potentially wrong? What are the implications of each (limitations, positives)?Circle of Life – HealthcareDisharmony of body energiesBeing symptom freeHealthy lifestyle choices

44. Opening Video – Medicine Men Go Wild – The Hot Zone – BayakaIndicator: compare Western medicine to other cultures’ medicine.Watch the video/documentary - https://www.youtube.com/watch?v=5KVLsiLeTN8 Note: You will see an infected monkey getting cooked and chopped up. And a baby cut with a razor to try to help with an infection.Complete the associated question-sheet.Key Questions/Takeaways – What is natural selection and how is it at work?What are the similarities and differences between Western Medicine and other forms of medicine?

45. Traditional MedicineMeditation

46. Traditional (alternative) Medicine - MeditationWhat cultures meditate? What are the benefits?

47. Traditional (alternative) Medicine - MeditationWhat cultures meditate?East Indian Religions (Hinduism, Buddhist, Judaism and Christianity) – meditation is now a global practice – not culture-specificWhat are the benefits?Decreases tension, boosts immune system, lowers blood pressure, reduce anxiety attacks.

48. Traditional Medicine - MeditationHow to:- Sit or lie comfortably.- Close your eyes.- Make no effort to control the breath; simply breathe naturally.- Focus your attention on the breath and on how the body moves with each inhalation and exhalation. Notice the movement of your body as you breathe. Observe your chest, shoulders, rib cage and belly. Make no effort to control your breath; simply focus your attention. If your mind wanders, simply return your focus back to your breath. Maintain this meditation practice for 2–3 minutes to start, and then try it for longer periods.Let’s try! There are others online! http://marc.ucla.edu/body.cfm?id=22

49. Indigenous Health PracticesTraditional/Alternative/Conventional

50. Indigenous HealthFocuses on treating the person as a whole, not just the conditionBalance and harmony

51. Sacred HerbsTobacco* - Only smoked during pipe ceremonies, not traditionally used recreationally. Used an an offering or to give thanks.Sweetgrass* - used for cleansing and produces a sweet smoke.Sage* - A traditional herbal medicine. Often used for digestive problems.Cedar - used in ceremonies

52. Methods used by Traditional HealersSweats - used for cleansingSmudging - burning of sacred herbs. A person will carry the smoke to their body with their hands, focusing it particularly on the areas that require healingHerbal Medicine* - may be in the form of teas, powders, or ointments.Traditional Diets* - Western diets are unhealthy as they are full of sugar and fat. Returning to a traditional diet can help with restoring harmony and balance.

53. Sweat LodgesThe sweat lodge ceremony both cleanses and heals, the mind is provided with clarity and the participant demonstrates strength and enduranceSweat lodges are holy places, where indigenous people can deepen or renew their connection with the universeThe ceremony removes stress from the body, improving your mental, physical, emotional, and spiritual well-being

54. Western and First Nations ScienceThere is a lot of “Western validity” to First Nation’s science and medicine.Many philosophies associated with First Nation’s culture has informed Western understandings of the complexity of health and well-being and the need for harmony in all elements of health.When considering this in a community perspective (as our communities influence our health as well), better understanding cultural perspectives informs our definition of health and allows us to provide more inclusive health care.

55. Balance TestI picked up this new tool that improves balance! I’ll show you how it works!Many elite athletes – football guys, Brett Favre swears by this stuff – use and wear this when training and performing.Results?

56. Clinical-Based Studies – What are they?Describe the role of clinical based studies (e.g., randomized, blind, double-blind, and placebo) in understanding Western approaches to health care. (STSE)New potential types of medicine are subject to testing (clinical based studies) to determine their effects. This can look into…- the effect the body has on the medicine (_______________) = how does the body process it, should it be taken with food? - the effect the medicine has on the body (_______________) = does it reduce symptoms, have side effects?Thalidomide is an example of a drug that was not thoroughly tested before being put on the market.

57. Clinical-Based Studies – What are they?Describe the role of clinical based studies (e.g., randomized, blind, double-blind, and placebo) in understanding Western approaches to health care. (STSE)New potential types of medicine are subject to testing (clinical based studies) to determine their effects. This can look into…- the effect the body has on the medicine (pharmacokinetics) = how does the body process it, should it be taken with food? - the effect the medicine has on the body (pharmacodynamics) = does it reduce symptoms, have side effects?.Thalidomide is an example of a drug that was not thoroughly tested before being put on the market.

58. Clinical-Based StudiesDifferent types of these studies exist following the scientific method, and this can be done in a combination of the following tests.Randomized Study – Blind Study–

59. Examples and Definitions for Clinical-Based StudiesRandomized Study – Individual(s) is/are chosen at random to be the participant(s) in a study.Example: everyone take a card from the deck at random… whoever draws a heart is who I will test.It’s important to note that random still has “rules”, large group sizes or having an equal distribution of certain demographics adds validity to experiment.Blind Study – A type of study in which information (ie. Whether they are a part of the test group or control group) about the test (or product) is kept from the participant(s) until after the test. –Example: “Here… take this pill” *watches and observes what happens knowing it’s supposed to increase energy*.

60. Clinical-Based StudiesDouble-Blind Study– Placebo Effect –

61. Examples and Definitions for Clinical-Based StudiesDouble-Blind Study – An experiment or clinical trial in which neither the subjects nor the researchers know which subjects are receiving the active medication, treatment, etc., and which are not.It is a technique for eliminating subjective (or confirmation) bias from the test results. Placebo Effect – A psychological phenomenon of taking a treatment that a person “believes” will treat a condition. A placebo is a harmless pill, medicine, or procedure prescribed more for the psychological benefit to the patient than for any physiological effect. Frequently used as a control group for testing new drugs. Example: ‘Here, take this pill to help with your headache’ *expects nothing to happen.* If something does, it’s not the pill!IT WAS IN SPACE JAM - https://www.youtube.com/watch?v=kbaKze622Kg

62. Clinical Based StudiesDescribe the role of clinical based studies (e.g., randomized, blind, double-blind, and placebo) in understanding Western approaches to health care. (STSE) Terms:_______________________- is the participants in a study that do not receive the active ingredient, but rather are used to compare the individuals receiving the active ingredient to._______________________ - we tend to be more accepting of information that aligns with what we believe in.Connecting it all together – https://www.youtube.com/watch?v=2xBVEM2iMns

63. Clinical Based StudiesDescribe the role of clinical based studies (e.g., randomized, blind, double-blind, and placebo) in understanding Western approaches to health care. (STSE) Terms:Control Group - is the participants in a study that do not receive the active ingredient, but rather are used to compare the individuals receiving the active ingredient to.Confirmation Bias - we tend to be more accepting of information that aligns with what we believe in.Connecting it all together – clinical-based are meant to try to test whether or not a particular medicine works regardless of opinion, belief, or bias. That doesn’t necessarily mean that placebo effects aren’t valuable. https://www.youtube.com/watch?v=2xBVEM2iMns

64. Conducting a Clinical-Based StudyWhen we are creating a Clinical-Based Study we want to try to be able to eliminate “subjectivity” or a person’s beliefs or opinions from the equation (even though those still have an effect, some companies may profit from the deceit associated with this). With this we use the scientific method.Here is a good resource for certain health supplements: https://informationisbeautiful.net/visualizations/snake-oil-scientific-evidence-for-health-supplements/

65. Scientific Method ReminderHypothesis/Prediction – Independent variable – Dependent variable – Control group – Data Collection – Model data (making a graph) – Analyze results/draw conclusion –

66. Scientific Method ReminderHypothesis/Prediction – if we do ______, then _____ should happen because of ___________. Independent variable – what you change.Dependent variable – what happens as a result of the change.Control group – group that isn’t given the drug (but may have the same environment and conditions as the other group).Data Collection – collect your dataModel data (making a graph) – Put data into a visual.Analyze results/draw conclusion – what does the data say? Did it work? Why or why not?

67. Create a Clinical Based StudyDescribe the role of clinical based studies (e.g., randomized, blind, double-blind, and placebo) in understanding Western approaches to health care. (STSE)What are you testing for and why? What is your prediction and why?Come up with a test to perform on your classmates for one of these (or a class in the school). Not drug-based, but come up with something to test in the class. Small groups (3 or less).Importance: Conventional medicine needs clinical based studies to become safely, widely used and distributed to meet the health needs of people.

68. Phase of Clinical ResearchClinical trials involving new drugs are commonly classified into four phases. Each phase of the drug approval process is treated as a separate clinical trial. The drug-development process will normally proceed through all four phases over many years. If the drug successfully passes through Phases I, II, and III, it will usually be approved by the national regulatory authority for use in the general population. Phase IV are 'post-approval' studies.

69. Phases of Clinical ResearchWhen new drugs try to become widely used as prescriptions, in hospitals, or over-the-counter, they go through phases of clinical trials.Clinical trials involving new drugs are commonly classified into four phases (but we’ll discuss six). Each phase of the drug approval process is treated as a separate clinical trial. The drug-development process will normally proceed through all four phases over many years. If the drug successfully passes through Phases I, II, and III, it will usually be approved by the national regulatory authority for use in the general population. Phase IV are 'post-approval' studies.

70. Phases of Clinical ResearchPre-ClinicalPhase 0Phase 1Phase 2Phase 3Phase 4VocabularyPharmacodynamicsPharmacokinetics

71. Phases of Clinical ResearchPre-Clinical – Phase 0 – Phase 1 – Phase 2 –

72. Phases of Clinical ResearchPre-Clinical – observe (drug) on animal or human cells in a test tube.Phase 0 – humans are given the test but in amounts below what would actually be given in order to observe results… this may also reduce the negative effects.Phase 1 – human-testing – testing safety, pharmacokinetics (what a body does to a drug), pharmacodynamics (what a drug does to the body), and how food absorption affects the drug. “Helps determine safety and dosage”Phase 2 – usually when a new drug fails – this is when it is observed if the drug actually works - how much should be given and how well it works at those doses. “Evaluate effectiveness, look for side effects”

73. Pre-Clinical

74. Phase 1!

75. Phase 3 - IF GOOD IT’S DISTRIBUTED! YAAAAAY!Phase 4 – Phases of Clinical Research

76. Phase 3 - the most expensive, time-consuming and difficult trials to design and run – Can involve up to 3000 people and different institutions (hospitals for example) done randomly. “Pre-marketing phase” – actually given to consumers and data is collected. (Can take a minimum of 3 years)IF GOOD IT’S DISTRIBUTED! YAAAAAY!Phase IV (4) – Post-marketing surveillance. Constant monitoring of the drug, if problems appear, drug production will be ceased. This can last over 10 years!Phases of Clinical Research

77. How long does it take?Approximately __ to __ years (but not always), often costing over ______________________________Some can get fast-tracked – Phase 0 helps with this.Importance –

78. How long does it take?Approximately 12 to 18 years (but not always), often costing over $1 billionSome can get fast-tracked – Phase 0 helps with this.Importance – It is important to understand the extended length of time it takes for a drug that may be very beneficial for individuals to actually make it through testing and into normal/regular consumer use.

79. Chart of Phases and Timelines

80. New medicineWhen we hear about new medicines that can save lives, why aren’t they immediately put into the market?Look up: “new way to cure/treat __________” https://www.sciencealert.com/cancer-vaccine-stanford-immunotherapy-t-cell-ox40-mouse-models-lymphoma Lots of experimental cancer treatments exist and people may share them saying “why aren’t we using this”? Now you know why!

81. Phases of Clinical ResearchImportance:It can take up to twenty years for a drug to be tested and proven safe. And close to 10 years for it simply to be put on the market. So when you hear about new drugs to cure diseases (like Cancer or HIV), it may not come into mainstream usage for awhile to ensure it’s safety.

82. Quiz FridayMatching (match term to definition) -What are the six phases of clinical testing?What are the four different ways of clinical based tests?What does pharmacokinetic and pharmacodynamic mean?

83. Scientific Studies - John Oliver (uses some foul language and inappropriate comments)… https://youtu.be/0Rnq1NpHdmw?t=15m1s What were some points that stood out (need three) –But! Good reminder for our projects at the end of the year and scientific studies.Remember – no results, are still results!

84. Bill Nye – Alternative MedicineWhen watching the video – what are things you would do different – what is important when we analyze this information to be aware of?How does it inform you understanding of what we know?

85. Cultural BeliefsRead over the cultural beliefs! Then record the following on looseleaf!Something I found interesting about __________ (culture) was… __________________ because __________________.Something I did/didn’t agree with about __________ (culture) was… __________________ because _________________.Summarize a simple way to describe one particular culture’s worldview on medicine.

86. Overall Worldviews of GroupsCutltural GroupBelief (Summarized) – interesting treatmentsSouth AfricanAsian EuropeanHispanicMiddle EasternFirst NationsDifferent parts of the world practice different means of medicine. Using parts from all of them may provide the most complete health care service to everyone.

87. Overall Worldviews of GroupsCutltural GroupBelief (Summarized) – interesting treatmentsSouth AfricanIllnesses are caused by the supernatural – can be healed by regaining harmony through herbal medicines. Balance of body, spirit and mind!AsianHarmony and balance with nature - Yin and Yang (Cold and Hot). There are medicines. Disgrace associated with sickness – supernatural forces cause it. EuropeanGood health is a personal responsibility. Cured by medications and immunizations.HispanicHealth is good luck and a reward from God. Bad luck = bad health = punishment. Express pain verbally.Middle EasternTHE EVIL EYE! Cleanliness is important to health – males are dominant in health and health care. Can’t examine female patients. Tolerating pain is a sign of strength.First NationsHealth is harmony between man and nature. Holistic health. Herbs and other means of medication.Different parts of the world practice different means of medicine. Using parts from all of them may provide the most complete health care service to everyone.

88. Natural Products – Intended UseInvestigate the intended results of using natural products (e.g., herbs, vitamins, minerals, probiotics, and essential oils) and mind and body practices (e.g., acupuncture, various massage therapies, yoga, spinal manipulation, relaxation techniques, meditation, and movement therapies) and other complementary and/or alternative approaches to health care. (K, A, STSE)What are they, what are the intended results of (pick one and look it up) – do they work? Herbs – Vitamins – Minerals – Probiotics – Essential Oils –

89. Natural Products – Intended UseInvestigate the intended results of using natural products (e.g., herbs, vitamins, minerals, probiotics, and essential oils) and mind and body practices (e.g., acupuncture, various massage therapies, yoga, spinal manipulation, relaxation techniques, meditation, and movement therapies) and other complementary and/or alternative approaches to health care. (K, A, STSE)What are the intended results of (pick one and look it up)…Herbs – any plant with leaves, seeds or flowers used for medicine, flavour or food. Example Aloe and Chamomile. Not all 100% work.Vitamins – essential for normal growth and nutrition. Organic compounds. In pill form – does it work?Minerals – solid, inorganic substance that the body needs to function.Probiotics – microorganism introduced into the body for beneficial qualities, typically aiding with digestion.Essential Oils – oils obtained from plants by distillation. They can help with sickness, moods, and other health concerns. Do they work? For some maybe.

90. Your thoughts on these treatments…immunizations, chemotherapy, radiation, vitamin supplements, physical activity, nutrition and prayerPick one of the above and answer briefly what they involve as it pertains to health.Does the evidence support this practice (does it work)? Are there guaranteed benefits? Are there side effects? Is it a western practice?Think of a culture we covered, would they accept this given their beliefs and perspectives?

91. Your thoughts on these treatments…immunizations, chemotherapy, radiation, vitamin supplements, physical activity, nutrition and prayerPick one of the above and answer briefly what they involve as it pertains to health.Immunizations – injections of a weak form of a virus to get the body to learn how to fight it.Does the evidence support this practice (does it work)? Are there guaranteed benefits? Are there side effects? Is it a western practice?Assuming no allergies – evidence supports it! Tiredness and fatigue (fighting off infection). In Western countries typically vaccine rates are high and disease rates are low.Think of another belief we covered, would they accept this given their beliefs and perspectives?Hispanic – may not agree because their methods are pain free and alternative forms of medicine.

92. Your thoughts on these treatments…immunizations, chemotherapy, radiation, vitamin supplements, physical activity, nutrition and prayerPick one of the above and answer briefly what they involve as it pertains to health.Chemotherapy – two forms: directly into blood or vein. Chemical that kills cancer cells – can prevent or reduce spreading of cancer.Does the evidence support this practice (does it work)? Are there guaranteed benefits? Are there side effects? Is it a western practice?Proven to work, will kill cancer cells. Poisons your body (every system) – lose weight, get sick. Yes to Western practice.Think of another belief we covered, would they accept this given their beliefs and perspectives?Jewish – no blood donation. “Obligation to preserve life takes precedence over a person’s decision with their body” – may not agree.European – would accept this, it is a medication to help treat the illness.Hispanic – against beliefs, but some may still use it.

93. Your thoughts on these treatments…immunizations, chemotherapy, radiation, vitamin supplements, physical activity, nutrition and prayerPick one of the above and answer briefly what they involve as it pertains to health.Physical activity – bodily movement produced by skeletal muscles requiring energy.Does the evidence support this practice (does it work)? Are there guaranteed benefits? Are there side effects? Is it a western practice?It helps, evidence supports it! Reduces blood pressure amongst other things! Side effect – possible injury. It is a western practice!Think of another belief we covered, would they accept this given their beliefs and perspectives?All beliefs would practice this.

94. Mind and Body Practices – Intended UseInvestigate the intended results of using natural products (e.g., herbs, vitamins, minerals, probiotics, and essential oils) and mind and body practices (e.g., acupuncture, various massage therapies, yoga, spinal manipulation, relaxation techniques, meditation, and movement therapies) and other complementary and/or alternative approaches to health care. (K, A, STSE)What are the intended results of…AcupunctureMassage TherapyYogaSpinal ManipulationRelaxation Techniques MeditatingMovement Therapies

95. Alternative Health in Moose JawResearch and advertise an alternative health care practice in Moose Jaw!

96. Mind and Body Practices – How much do these cost? Where are they found in MJ?Investigate the intended results of using natural products (e.g., herbs, vitamins, minerals, probiotics, and essential oils) and mind and body practices (e.g., acupuncture, various massage therapies, yoga, spinal manipulation, relaxation techniques, meditation, and movement therapies) and other complementary and/or alternative approaches to health care. (K, A, STSE)What are the intended results of…AcupunctureMassage TherapyYogaSpinal ManipulationRelaxation Techniques MeditatingMovement Therapies

97. ScenarioAn individual is experiencing back pain. They have stated that it feels like its muscular pain in the lower back.What is a Western treatment you might recommend?What is an alternative treatment you might recommend?In what way may it be beneficial to combine the two treatments?In what way may it be detrimental to combine the two treatments?

98. Philosophy and EthicsHS20-HC2 Examine how personal and societal beliefs impact ethical decisions regarding health care.

99. Indicatorsa. Pose questions about ethical dilemmas within health care. (K, S, A, STSE) b. Understand the core ethical questions to be considered when making health care decisions: What can be done for the patient? (intervention technologies) Does the patient understand the options? (informed consent) What does the patient want? (autonomy) What are the benefits? (beneficence) Will it harm the patient? (non-maleficence) Are the patient’s requests fair and able to be satisfied? (justice) Are the costs involved fair to society? (economic consequences) (K) c. Analyze a health care issue (e.g., case study, interview and current events) with respect to the core ethical questions. (K,A, S, STSE) d. Contrast how procedures to prevent illness, such as immunizations, vitamin supplements, physical activity, nutrition and prayer, might be viewed from the perspective of Western, Indigenous, traditional, complementary, and alternative approaches to health care. (K, A) e. Examine ethical considerations related to various treatments (e.g., chemotherapy, radiation, acupuncture, sweat lodge, blood transfusions, and hirudotherapy) that might be prescribed in Western, Indigenous, traditional, complementary, and alternative approaches to health care. f. Examine individual, community and cultural beliefs regarding issues related to life and death such as home birthing, blood transfusions, contraception, abortions, organ donation, autopsies, euthanasia, cremation and burials. (K, A, STSE)g. Discuss ethical considerations and perspectives related to issues such as the use of cadavers in professional studies, dissection and raising animals for the purpose of dissection, and public exhibits of plastinated organs and bodies, all of which could provide increased scientific understanding of human anatomy. (A, STSE)h. Understand a patient’s rights in Saskatchewan and in Canada with regards to health care decisions such as developing an advance care directive, refusal of treatment, informed consent, and the role of a proxy or substitute decision-maker. (K)i. Discuss ethical considerations (e.g., personal beliefs, informed consent, the roles of institutional review boards and regulatory agencies) of why an individual may choose to participate in a clinical study of a new biomedical intervention (e.g., vaccine, drug, treatment, device, or process). (STSE)j. Debate a decision related to ethics in health care from the viewpoint of individuals who hold different belief systems. (K, A, S, STSE)

100. Ethical Questions/Scenarios in Health CareWhat are some health care issues, topics, concerns?

101. Ethical Questions/Scenarios in Health CareWhat are some health care controversies, issues, topics, concerns?AbortionVaccinationsBlood transfusionsExperimental treatmentsGender therapyContraceptionEuthanasiaOrgan donation/autopsies

102. Making a Health Care DecisionSeveral core ethical questions (CEQ) guide health care providers in making decisions.In addition to these questions, there are 7 additional steps to resolving ethical dilemmas that relate to health decision making.Why? Health care providers will be faced with tough life/death decisions and it helps to have a set of guidelines to follow in making a decision of that magnitude and being confident in it.

103. Making Health Care DecisionsCORE ETHICAL QUESTIONSa. (intervention technologies) b. (informed consent) c. (autonomy) d. (beneficence) e. (non-maleficence) f. (justice) g. (economic consequences)

104. Making Health Care DecisionsCORE ETHICAL QUESTIONSa. What can be done for the patient? (intervention technologies) b. Does the patient understand the options? (informed consent) c. What does the patient want? (autonomy) d. What are the benefits? (beneficence) e. Will it harm the patient? (non-maleficence) f. Are the patient’s requests fair and able to be satisfied? (justice) g. Are the costs involved fair to society? (economic consequences)

105. Making Health Care Decisions7-Steps to Resolving Ethical DilemmasRecognize that a case raises an important ethical problem. Identify the problem that needs to be solved. Determine reasonable alternative courses of action. Consider each option in relation to the fundamental ethical principles.

106. Making Health Care Decisions7-Steps to Resolving Ethical DilemmasRecognize that a case raises an important ethical problem. Ethical problems arise when there is a conflict of values and when there are different ways of proceeding. It is important to be as knowledgeable as possible about the case.Identify the problem that needs to be solved. Once the problem is precisely identified, you will be better able to decide what resources you need to handle the problem. Determine reasonable alternative courses of action. These options don’t need to include everything, but they should be clearly distinct. Consider each option in relation to the fundamental ethical principles. None of these principles is always paramount, but in certain situations, one may trump another (benefits may outweigh the harm).

107. Making Health Care Decisions7-Steps to Resolving Ethical DilemmasDecide of a resolution to the problem. Consider your position critically. Are there circumstances under which you would advocate a different course of action? Could your decision be formulated into a general principle?Consider your emotions, conscience and the opinion of others.Would you make the same choice if your decision were made public?Do the right thing!

108. Making Health Care Decisions7-Steps to Resolving Ethical DilemmasDecide of a resolution to the problem. Your conclusion may be disputed, so you should be able to say why you think it is the best one. Consider your position critically. Are there circumstances under which you would advocate a different course of action? Could your decision be formulated into a general principle?Consider your emotions, conscience and the opinion of others.Would you make the same choice if your decision were made public?Do the right thing! But what is the “right” thing?

109. Making DecisionsWhen making these decisions, certain processes are involved in the delivery of treatment as rights for an individual (there are specific rights in Saskatchewan).Patients must be provided with informed consent, and can still refuse treatment.In the event of being unable to make a health care decision for themselves, patients must have a substitute decision-maker or identify individuals to do so with an advance care directive.

110. Rights of an SK IndividualUnderstand a patient’s rights in Saskatchewan and in Canada with regards to health care decisions such as developing an advance care directive, refusal of treatment, informed consent, and the role of a proxy or substitute decision-maker.Advance Care Directive – Refusal of Treatment –Role of a proxy or substitute decision-maker (cover more in-depth soon)Informed Consent (cover more in-depth soon)There is an associated activity for each of the following

111. Rights of an SK IndividualUnderstand a patient’s rights in Saskatchewan and in Canada with regards to health care decisions such as developing an advance care directive, refusal of treatment, informed consent, and the role of a proxy or substitute decision-maker.Advance Care Directive - is a legal document in which a person specifies what actions should be taken for their health if they are no longer able to make decisions for themselves because of illness or incapacity. (Ex. Will)Refusal of Treatment – individuals have the right to refuse treatment when they are able to make a decision to do so.Role of a proxy or substitute decision-maker Informed Consent - a process for getting permission before conducting a healthcare intervention on a person. Ex. Massage Therapy, sign here.There is an associated activity for each of the following

112. Role of Substitute Decision-Maker (SDM)http://www.hss.gov.yk.ca/pdf/substitute_dm_brochure.pdf How is it chosen – what is the order of individuals who could be responsible?Who can be one? What is the minimum criteria?

113. Role of Substitute Decision-Maker (SDM)http://www.hss.gov.yk.ca/pdf/substitute_dm_brochure.pdf How is it chosen – what is the order of individuals who could be responsible?Guardian  Proxy (Advance Directive)  Spouse  Child  Parent  Grandparent  Brother or Sister  Other relative  close friend  last resort – care providersWho can be one?Over 19 years of age… unless they are spouse or parent.Contact in last 12 months and;No court orders or conflicts preventing this.

114. Role of Substitute Decision-Maker (SDM)Things to be aware of in this role…The person’s current wishes;• Whether the person’s condition or well-being is likely to improve, worsen or stay the same if the person receives the care;• Whether the person’s condition or well-being is likely to improve, worsen or stay the same if the person does not receive the care;• Whether the benefits of the care will outweigh the risks or negative consequences;• Whether a less restrictive or less intrusive form of available care would have greater benefits or less negative consequences;

115. SDM - DutiesDuties• Consult with the person to the extent reasonable, given their condition; • Consult with any friend or relative who asks to assist if the substitute decision-maker does not know the person’s values or wishes; • Follow the wishes expressed by the person when they were still capable and after they turned 16 years of age unless: • It is impossible to follow the wish; OR • The substitute decision-maker believes that because of changes in knowledge, technology or practice, the person would no longer act on the wish; • Use the person’s wish as guidance where it does not clearly anticipate the specific circumstances that exist; • Make a decision based on the person’s values and beliefs if the substitute decisionmaker does not know the person’s wishes; • Make a decision based on what is in the person’s best interests if the substitute decision-maker does not know the person’s values and beliefs or wishes;

116. SDM - Decisions to MakeDecisions to make…• Health care (e.g. medical treatment, dental care, diagnostic procedures)• Admission to a care facility (e.g. nursing home, group home for adults with cognitive disabilities)• Personal assistance services (e.g. home care, personal care in a care facility)

117. SDM - Importance and TakeawaysSelect someone to represent you who really knows you and your wants OR select someone whose opinion you trust even if you sometimes don’t agree with it.Ultimately they are making decisions for you when you are incapable to do so… this includes “pulling the plug”.Who did you pick? Why? What are some beliefs you have about death, organ donation, etc that they should know?

118. SDM – Who would you actually pick? Mr. P’s answerI would pick my father. He is the most similar to me in terms of life-outlook (science-focused) and has similar beliefs about death.Donate organs… anything to science. Plant tree from remains.If there’s legitimate hope (>1%) for even just my brain to recover, give it a short amount of time (<month) or until it becomes a financial burden on others – if I have kids, ensure their needs are met first and foremost and financial needs for my health do not jeopardize their futures. Or if my brain can be frozen to be implanted in a robot… go for it.No funeral/memorial needed. Have a party or something! I think once I’m dead I’m dead so regardless of what you do it don’t matter, do what you got to do for you, not me… if chosen to cremate and selecting somewhere meaningful will make you feel better, spread my ashes somewhere near the Base, on the prairies or on the hockey arena.Avoid religion if memorial-based, but offer services to those who are.

119. Role PlayPick someone in our class to be your SDM. Talk with them for 5 minutes about each of your health desires should anything bad happen to you.You will read the story on the next slide, they will decide your future and write it down including their rationale.They will then share it with you and we will see if they did what you would have wished.TAKE 3 MINUTES AND FIND OUT ABOUT THE PERSON NEXT TO YOU (THOUGHTS ON DEATH, MEDICATION, TREATMENTS, WOULD THEY STRUGGLE IF THEY WERE A PARAPALEGIC – SO OPT OUT)

120. SDMWhat I would choose for myself:What I would choose for my partner(s):

121. StoryThey were in a car accident. Severe damage to the body. Permanent paralysis from the waist down, waist-above will work. Possible sight-loss but no apparent damage to vocal cords and no apparent brain damage. However, they have been in a coma for the past month. Life support has helped maintain functioning of body. Doctors say that IF they come out of a coma naturally in the next 2 months (each month of care costs $20,000) they would retain brain function… or they could induce you try to come out of a coma immediately with a 50% success/mortality rate. Decision?Keep in mind what you think the wishes of this person are.

122. In light of decision…What does our decision say about our worldviews and current health?Would we make a decision based on our beliefs or others (is there extenuating circumstances?)

123. Doctor-Assisted DyingGoogle Forms – Period 2 https://goo.gl/forms/bGS5rKdaT6RUq9yZ2 Google Forms – Period 5https://goo.gl/forms/WlJCDcOd3KlkHyBw1

124. Physician-Assisted Suicide Via Global News

125. Informed ConsentBe sure to grab the hand out!What are the three main types of informed consent?What does informed consent need to include?

126. Informed Consent to TreatmentThroughout Canada, before health care professionals may treat a client, he or she requires the informed consent of the client. The health care professional must determine whether the person is capable of giving consent to treatment. The individual’s capacity to give consent can change. One day they may be capable, the next, incapable. If a person becomes incapable (unable to understand the nature of an intervention), the issue of consent must be readdressed.Consent MUST be both Informed and Voluntary.

127. Informed ConsentInformed Consent is based on the patient understanding:1) the treatment or procedure2) the nature and purpose of the proposed treatment3) risks, side effects, benefits and expected outcomes4) implications of refusing recommended treatment5) be made aware of alternatives (if any) to the proposed treatment so they understand their choices*Health care professionals have an obligation to use language that is at an appropriate level and to discuss the information when the client is not stressed or unhappy (may require second explanations of the intervention when the client is in a calm frame of mind)

128. Voluntary Consent:Clients must NOT feel compelled to make a decision for fear of criticism, nor must they feel pressured toward any particular decision by the information provider or anyone else. *At times only a fine line exists between coercing (i.e., bullying) and making a recommendation especially when the health care professional feels strongly that the client should consent to a treatment, and the client is leaning toward refusing it.*According to the Supreme Court of Canada, it is the basic right of every capable person to decide which medical interventions he or she will accept or refuse. It shows respect for the client and the person’s right to autonomy; it also improves client compliance with treatment regimes.*Every province has its own legislation regarding informed consent. Health care providers are encouraged to obtain written consent for all medical services even minor medical services like immunizations.

129. Types of Consent:Written Consent:Major medical interventions require signed, written consent as confirmation that the appropriate process for obtaining consent was followed and that the client has agreed to the intervention.Client must understand the intervention along with the risks and benefitsMost forms must be signed by the client, dated and witnessed (the definition of a witness varies in different areas)For minor or major surgeries, physicians or a registered nurse will usually witness the consentThe witness must be sure the client understands what they are signing. If there is doubt, there must be further explanation and clarification.Most hospitals have a list of volunteer interpreters should the need arise, but interpreters who can deliver health-related information clearly and accurately are not always available. Often family members translate and what is presumed to be “informed consent” may not be.

130. Types of Consent:Oral Consent:Given by spoken word over the phone or in person and is as equally binding as written consentAt times, someone other than the client offers consent to surgeryTwo people must validate that consent has been givenWritten consent is still preferred for complex treatments

131. Types of Consent:Implied Consent:Consent assumed by the client’s actions, such as seeking out the care of a health care professional or failure to resist or protest. More and more health care professionals are requesting written consent even for treatments within a health clinic (e.g., receiving immunizations at the clinic).By allowing themselves to be admitted into a hospital, clients imply their consent to certain interventions (e.g., allowing the nurse to give them a bath or take vital signs). However, where possible oral consent should be obtained. “Is it okay if I change your dressing in a little while?” *Refusal to treatment are recorded on health records with reasons for refusal provided by the client*

132. Who Can Give ConsentThe person receiving medical care most often gives consent for treatmentIf the person is incapable of providing consent (e.g., is unconscious or not mentally competent), the person’s legal representative or next of kin assumes the responsibility. The person who has power of attorney (A legal document naming a specific person or persons to act on behalf of another in matters concerning personal care, personal estate or both) may take on this duty.If no power of attorney is present, most provinces and territories will allow a spouse (legal or common law) or another family member to legally provide consent. In some locations, there is a designated order depending on the availability of particular relatives – typically, a spouse will have control before a mother and father who have control before a sibling, then aunts and uncles and so on.

133. In most regions, there is no specific age defining a minor (a person under the age of majority in a particular province or territory) when it comes to providing independent consent to treatment or to requesting treatment without a parent’s knowledge. As long as the minor fully understands the treatment (along with risks and benefits), he or she can make an informed decision about accepting or rejecting treatment, and health care professionals MUST respect his or her wishes.When a minor’s consent is accepted, the minor is referred to as a mature minor. Frequently, a minor’s consent to treatment is made along with the parents. Emancipated minors – those married, living on their own, or showing independence from parents in some way – may also consent to medical care.When required, either parent with legal custody of the minor (or legally appointed guardian) can provide consent to treatment. **In the view of the courts, if the children are too young to hold and express beliefs or understand the consequences of receiving or not receiving treatment, courts will uphold requests made to intervene on the child’s behalf.

134. Case Studies – Making an Ethical DecisionLet’s try it out given the case studies I have for you!

135. Given your own case (whichever you’d like) – come up with a…Small groups – 3-5Summary of the case (3 sentences).How it connects to each of the “core ethical questions” - CEQs (2 marks each = 6)?What the question was? (1 mark)What your decision would have been (2 marks)?CEQsAutonomy – ability to think/decide freely for the patient. Are they in a position to make an informed decision.Beneficence and Non-Maleficence - What is best for the patient? Are these presented to them? – Act in a manner that does bring further harm.Justice – Are measures taken by Health Care provider within reason? Does it take into account scarcity of resources? (Is it a proper use of resources?)

136. Create a caseTry to create a case now including a difference of opinions on a issue we discussed earlier. (Probably will need at least 5 sentences to create a story presenting a case).Look at it with different perspectives/cultures involved.Determine a course of action following the core ethical questions to pursue in this process and justify your decision.Are their rights being respected?