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Table 2 An example of one of the teaching tools

From: ELS (Ethical Life Support): a new teaching tool for medical ethics

The final part of the course is a challenging three-step clinical case, with different sequential ethical dilemmas.
A young girl is in need of an urgent liver transplant following a voluntary alcohol and paracetamol intoxication. Her advanced directives and her parents’ will must be taken into account, while caring for her from admittance to the emergency department, through the general ward, to a long stay in the ICU.
Each step is analyzed through small group discussions, following the ABCD approach; at the end of each step, participants are asked not only to argue their own choices, but also to defend the opposite positions. Regardless of individual participants’ values, the focus is on the importance of end-of-life shared decision-making, taking into account the best available scientific evidence as well as the best reconstruction of the patient’s preferences [8].