Syllabus
Graduate Programs in Public Health
GPH 704 Public Health Law & Ethics – Fall B 2016
Credits - 3
Description
This is an introductory course in public health law and ethics. While a goal of government is to protect and support the health of the public, implementation of health policies may infringe on the right and liberties of individuals, including businesses. This conflict is sometimes characterized as “private interest versus public good.” This course explores the inherent tension between promoting the public health and protecting the legal and ethical rights and interests of individuals. The course will focus on the legal foundations of the American public health system and resulting ethical dilemmas that must be reconciled when the interests of the larger community may be at odds with those of individuals.
We will examine key elements of the U.S. legal system that govern and influence public health, including the US Constitution, federal and state laws, administrative law and judicial decisions. Students will use the case study method approach to scrutinize ethical and legal issues in public health practice, administration and research, as well as analyze functions and interactions between courts, legislators and regulators. Class activities and assignments will provide students with opportunities to read and discuss case law, statutes and regulations, and to apply various analytical models for probing relevant legal and ethical principles in public health.
Materials
Required Texts:
Gostin LO. Public Health Law and Ethics: A Reader. Berkeley, CA: University of California Press; 2010.
Coughlin SS. Case Studies in Public Health Ethics. Washington, DC: American Public Health Association; 2009. This book is available online through the UNE Library Catalog. Access it by entering the title of the book in the Quick Search field at http://www.une.edu/library.
Learning Objectives and Outcomes
Course Objectives:
At the end of this course, students will achieve the following course learning objectives:
- Describe the framework of the U.S. legal system and the intersection of public health law and ethics.
- Discuss the relevance of ethical principles, and apply such principles in public health practice and administration.
- Describe the regulatory environment that governs and influences public health. Discuss the complex legal, economic, social and ethical considerations associated with various public health issues.
- Describe and assess conflicts between government interests in public health and individual interests in liberty.
- Identify and address existing and emerging ethical concerns in public health practice and administration.
- Interpret and present pertinent legal and ethical analysis of public health issues through written and oral communications.
Assignments
Discussion Forums
50 points (5 points each)
You will be required to participate in discussions. Initial contributions are due on Sundays of each week; responses are due on Wednesdays of each week. Please note the late policy: Due to the timely nature required for weekly peer-peer discussion, a 10% deduction will be applied to original contributions that aren’t submitted by the Sunday deadline. Posts submitted after the discussion week will not be accepted.
Ethical Case Study Analysis
10 points (5 points for Group Analysis; 5 points for Individual Written Analysis)
The Ethical Case Study Analysis will allow you to apply an ethical framework to a case study. It has two parts: (1) Group Analysis and (2) Individual Written Analysis. You will be individually assessed for both parts.
Group Analysis: In part 1, you will work in a small group of four to five class peers. In your group’s discussion board, you will participate in collectively applying one of the ethical decision making frameworks from chapter 1 of Coughlin, as well as other related course materials. Details for this assignment are provided in Week 2. Due end of Week 2 (Wednesday by 11:59 PM)
Individual Written Analysis: In part 2, you will use the results of your group’s discussion. Applying ideas generated in the discussion, in conjunction with an ethical framework, you will independently write an ethical case study analysis. Details for this assignment are provided in Week 3. Due end of Week 3 (Wednesday by 11:59 PM)
Legal Analysis Papers
40 points (20 points each)
Your topics will focus on legal issue-spotting and analysis of public health cases.
Paper 1: Benning v. Vermont
- Your first legal analysis paper is based on Benning v. Vermont http://www.publichealthlaw.net/Reader/docs/Benning.pdf. As an introduction to this paper, one of the Court’s decisions in this case was that the “Link between safety for highway users and motorcycle helmet law is rational, since it minimizes the extent of injuries for which government or individuals are financially responsible.” In this assignment, you will be placed in the role of assistant to the Attorney General of your state. In addition to the case law, you will refer to your own state’s constitution. Due end of Week 5 (Wednesday by 11:59 PM)
Paper 2: Balancing Personal Rights and Public Safety
- Your second legal analysis paper is based on a 2005-2006 case of a homeless man in Maine who was imprisoned for refusing to take medication to prevent the spread of his tuberculosis. In this paper, you will analyze the balance between personal rights and public safety. Due end of Week 7 (Wednesday by 11:59 PM)
Grading Policy
Your grade in this course will be determined by the following criteria:
Grade Breakdown
Assignment | Points |
---|
Weekly Discussion Forums | 50 points |
Ethical Case Study Analysis | 10
points |
Legal Analysis Papers | 40 points |
Total | 100 points |
Grade Scale
Grade |
Points Grade |
Point Average (GPA) |
A |
94 – 100% |
4.00 |
A- |
90 – 93% |
3.75 |
B+ |
87 – 89% |
3.50 |
B |
84 – 86% |
3.00 |
B- |
80 – 83% |
2.75 |
C+ |
77 – 79% |
2.50 |
C |
74 – 76% |
2.00 |
C- |
70 – 73% |
1.75 |
D |
64 – 69% |
1.00 |
F |
00 – 63% |
0.00 |
Schedule
Schedule
Week One: |
10/26 – 11/2 |
Week Two: |
11/2 – 11/9 |
Week Three: |
11/9 – 11/16 |
Week Four: |
11/16 – 11/23 |
Week Five: |
11/23 – 11/30 |
Week Six: |
11/30 – 12/7 |
Week Seven: |
12/7 – 12/14 |
Week Eight: |
12/14 – 12/18 |
Weekly Calendar
Week 1: Oct 26 – Nov 2
Introduction to Public Health Law and Ethics
Objective:
- Describe the framework of the U.S. legal system and the intersection of public health law and ethics.
Lecture:
- Introduction to Public Health Law and Ethics
Readings:
- Gostin: Preface and ch 1
- Wiens C. What role should government play in combating obesity? The Wall Street Journal. April 21, 2013. Accessed August 25, 2016.
- Glossary of Legal Terms
Assignment:
Introduction
- Please post a brief personal introduction on the Discussion Board. Share what you do, why you are taking this course, what you expect to get out of it, and how it may help you in your work or the work you hope to do.
Forum Discussion
- Original Contribution: Read “What role should government play in combating obesity?” and respond to the three panelists’ remarks. Due Sunday by 11:59 PM
- Response Post: Please respond to the original contribution of at least one colleague. Draw on prior learning and the insights you gleaned from your initial reading, your initial analysis, and your colleague’s comments. Due Wednesday by 11:59 PM
Week 2: Nov 2 – 9
Public Health Ethics: Introduction to ethical principles, analytic framework and case study approach
Objectives:
- Describe the relevance of ethical principles and the application of such principles in public health practice and administration.
- Identify and address existing and emerging ethical concerns in public health practice and administration.
Lecture:
Readings:
- Gostin: Ch 2
- Coughlin: Ch 1, 12, 17
- Kass NE. An ethics framework for public health. American Journal of Public Health. 2001;19(11): 1776-1782.
- Roberts MJ, Reich MR. Ethical analysis in public health. Lancet. 2002;359: 1055-1059.
- Public Health Leadership Society. Principles of the Ethical Practice of Public Health. 2002.
- Thomas SB, Quinn SC. The Tuskegee Syphilis Study, 1932 to 1972: Implications for HIV Education and AIDS risk education programs in the black community. American Journal of Public Health. 1991;81(11): 1498-1505.
- Centers for Disease Control and Prevention. The Tuskegee Timeline. http://www.cdc.gov/tuskegee/timeline.htm. Updated February 19, 2016. Accessed August 25, 2016.
Assignment:
Forum Discussion
- Original Contribution: Thomas writes about the lasting effects of the Tuskegee Syphilis Study on the credibility of public health in the black community. What public health laws and policies help or hinder this effort? Due Sunday by 11:59 PM
- Response Post: Please respond to the original contribution of at least one colleague. Draw on prior learning and the insights you gleaned from your initial reading, your initial analysis, and your colleague’s comments. Due Wednesday by 11:59 PM
Ethical Case Study Group Discussion
- You have been placed in a group to discuss a specific ethical case study presented in Coughlin’s Case Studies in Public Health Ethics. Your group will be assigned one of the following case studies (by chapter and letter): 2c (pp. 17-18), 10e (pp. 64-65), 10g (pp. 66-67), 11a (pp. 70-71), or 13a (pp. 82-83). To your assigned case study, your group will apply one of the ethical decision making frameworks presented in chapter 1 of Coughlin, as well as in the other Week 2 materials. Use the framework to assess the ethical conflict presented in your case study. Within your discussion, answer the “Questions for Discussion” listed at the end of your assigned case study. To access your group discussion, go to the “My Group” area in the left side navigational menu on Blackboard. Due Wednesday by 11:59 PM (Note: The focus of this week’s assignment is on your group discussion; individual written analyses are due at the end of Week 3.)
Week 3: Nov 9 – 16
Public Health Duties, Powers, and the Protection of Individual Rights
Objectives:
- Describe the framework of the U.S. legal system and the intersection of public health and ethics.
- Discuss the complex legal, economic, social, and ethical considerations associated with various public health issues.
- Describe and assess conflicts between government interests in public health and individual interests in liberty.
- Interpret and present a pertinent legal and ethical analysis of public health issues through written and oral communications.
Lecture:
- Public Health Law Introduction
Readings:
- Gostin: Ch 3, 4
- Greenhouse L. A second chance for Joshua. New York Times. June 17, 2010. Accessed June 30, 2016.
- Mariner, WK, Annas GJ, Glantz LH. Jacobson v. Massachusetts: It’s not your great-great-grandfather’s public health law. American Journal of Public Health. 2005;95(4):581-590.
- Parmet WE. After September 11: Rethinking public health federalism. The Journal of Law, Medicine & Ethics. 2002;30(2):201-211.
- Jacobson v. Massachusetts 197 US 11 – Supreme Court 1905. Accessed June 30, 2016.
Assignment:
Forum Discussion: Jacobson v. Massachusetts
- Original Contribution: The case of Jacobson v. Massachusetts, decided in 1905, is one of the hallmark public health law decisions. Do you think the court’s ruling remains relevant today? Why or why not? Is the court’s opinion regarding mandatory smallpox vaccination applicable to non-communicable disease public health laws? Due Sunday by 11:59 PM
- Response Post: Please respond to the original contribution of at least one colleague. Draw on prior learning and the insights you gleaned from your initial reading, your initial analysis, and your colleague’s comments. Due Wednesday by 11:59 PM
Forum Discussion: Deshaney v. Winnebago
- Original Contribution: Do you agree with the majority or the dissent in Deshaney v. Winnebago? Why? If the government acts to establish a protective agency, should citizens have a reasonable expectation that they can rely on that agency to safeguard their health and safety? Why or why not? Due Sunday by 11:59 PM
- Response Post: Please respond to the original contribution of at least one colleague. Draw on prior learning and the insights you gleaned from your initial reading, your initial analysis, and your colleague’s comments. Due Wednesday by 11:59 PM
Ethical Case Study Written Analysis
- Using the results of Week 2’s group discussion about your ethical case study, write your own individual analysis. Clearly identify both the assigned case study and the ethical framework used; briefly discuss the dilemma, stakeholders, actions, and consequences; discuss your own response to the questions associated with the case; and offer recommendations. Due Wednesday by 11:59 PM
Week 4: Nov 16 – 23
Public Health Governance/Tort Law and the Public Health
Objectives:
- Describe the framework of the U.S. legal system and the intersection of public health law and ethics.
- Discuss the regulatory environment that governs and influences public health.
- Discuss the complex legal, economic, social, and ethical considerations associated with various public health issues.
- Describe and assess conflicts between government interests in public health and individual interests in liberty.
- Interpret and present pertinent legal and ethical analysis of public health issues through written and oral communications.
Lecture:
Readings:
- Gostin: Ch 5, 6
- Mello MM, Studdert DM, Brennan TA. Obesity – The new frontier of public health law. New England Journal of Medicine. 2006; 354(24):2601-2610.
- Murtagh L, Ludwig DS. State intervention in life-threatening childhood obesity. American Medical Association. 2011;306(2):206-207.
- King, A. King renews push to curb gun violence in America [Video]. YouTube. Published October 8, 2015. Accessed June 30, 2016.
- District of Columbia et al v Heller 554 US – Supreme Court 2008. Accessed June 30, 2016.
Assignment:
Forum Discussion: Ethical Use of State Powers
- Original Contribution: As discussed in this week’s readings, some states have decided to intervene in the cases of morbidly obese children. Is this an appropriate and ethical use of state police powers? Is it good public policy? Why or why not? Due Sunday by 11:59 PM
- Response Post: Please respond to the original contribution of at least one colleague. Draw on prior learning and the insights you gleaned from your initial reading, your initial analysis, and your colleague’s comments. Due Wednesday by 11:59 PM
Forum Discussion: District of Columbia v Heller
- Original Contribution: In the case of District of Columbia v. Heller, the U.S. Supreme Court found the gun control laws enacted by the District of Columbia to be unconstitutional (see text pp. 155-160). Do you agree with the majority or the dissent(s) in this case? Why? What types of gun control legislation might be deemed to be constitutional, and what public health arguments could be made the next time this issue comes before the courts? Due Sunday by 11:59 PM
- Response Post: Please espond to the original contribution of at least one colleague. Draw on prior learning and the insights you gleaned from your initial reading, your initial analysis, and your colleague’s comments. Due Wednesday by 11:59 PM
Looking Ahead to Week 5: Legal Analysis Paper 1
- Legal Analysis Paper 1 is due at the end of Week 5. If you haven’t already, it is recommended that you read the case of Benning v. Vermont. It is also recommended that you begin reviewing the assignment this week; it can be accessed in the Week 5 folder.
Week 5: Nov 23 – 30
Surveillance and Public Health Research: Privacy and the “Right to Know”
Lecture:
- Surveillance and Public Health Research
Readings:
- Gostin: Ch 8
- Coughlin: Ch 2
- Gostin LO. Surveillance and public health research: Privacy and the “right to know.” In: Public Health Law and Ethics: A Reader. 2002. (Tarasoff v Regents of the University of California 1976)
- Mello MM, Gostin LO. Commentary: A legal perspective on diabetes surveillance – Privacy and the police power. The Milbank Quarterly. 2009;87(3):575-580.
- Chamany S, Silver LD, Bassett MT, Driver CR, Berger DK, Neuhaus CE, Kumar N, Frieden TR. Tracking diabetes: New York City’s A1C Registry. The Milbank Quarterly. 2009;87(3):547-570.
- State of Maine Confidentiality of Health Care Information Privacy Statute (MRS Title 22 1711-C)
Assignment:
Forum Discussion
- Original Contribution: What are the pros and cons of public health department surveillance techniques for non-communicable diseases like diabetes? Are the considerations different for communicable diseases? Why or why not? What are the pros and cons of the NYC diabetes monitoring program? Due Sunday by 11:59 PM
- Response Post: Respond to the original contribution of at least one colleague. Draw on prior applicable learning, if any, and the insights you gleaned from your initial reading, your initial analysis, and your colleague’s comments. Due Wednesday by 11:59 PM
Legal Analysis Paper 1 Due Wednesday by 11:59 PM
Week 6: Nov 30 – Dec 7
Public Health Strategies for Infectious Disease: Bodily Integrity, Challenges to Association, Travel and Liberty
Objectives:
- Describe the framework of the U.S. legal system and the intersection of public health law and ethics.
- Discuss the regulatory environment that governs and influences public health.
- Discuss the complex legal, economic, social, and ethical considerations associated with various public health issues.
- Describe and assess conflicts between government interests in public health and individual interests in liberty.
- Identify and address existing and emerging ethical concerns in public health practice and administration.
- Interpret and present pertinent legal and ethical analysis of public health issues through written and oral communications.
Lecture:
Readings:
- Gostin: Ch 10, 11
- Maine Department of Health and Human Services/Center for Disease Control and Prevention. Chapter 258: Rules for the Control of Notifiable Diseases and Conditions.
- Maine Department of Health and Human Services/Center for Disease Control and Prevention. Notifiable Conditions List.
Assignment:
Forum Discussion:
- Original Contribution: The widespread use of non-medical exemptions has provoked concern for the public’s health. How should we balance respect for individual beliefs against legitimate community health needs? What are some of the approaches to effectively balance those interests? How can we resolve the existing tensions between them? Due Sunday by 11:59 PM
- Response Post: Respond to the original contribution of at least one colleague. Draw on prior learning and the insights you gleaned from your initial reading, your initial analysis, and your colleague’s comments. Due Wednesday by 11:59 PM
Looking Ahead to Week 7: Legal Analysis Paper 2
- Legal Analysis Paper 2 is due at the end of Week 7. If you haven’t already, it is recommended that you begin reviewing the assignment this week; it can be accessed in the Week 7 folder.
Week 7: Dec 7 – 14
Global Health Law
Objectives:
- Describe and assess conflicts between government interests in public health and individual interests in liberty.
- Interpret and present pertinent legal and ethical analysis of public health issues through written and oral communication.
Lecture:
Readings:
- Gostin: Ch 7
- Treat all people living with HIV, offer antiretrovirals as additional prevention choice for people at “substantial” risk [news release]. World Health Organization: September 30, 2015. Accessed July 1, 2016.
- Beaubien J. World Health Organization posts ambitious new guidelines for HIV treatment. National Public Radio. October 7, 2015. Accessed July 1, 2016.
- Fact sheet to the WHO consolidated guidelines on HIV testing services [fact sheet]. World Health Organization: July 2015. Accessed July 1, 2016.
Assignment:
Forum Discussion
- Original Contribution: The World Health Organization (WHO) has issued new treatment protocols for persons who test HIV+. It is suggested that the treatments be administered as soon as possible. Some poorer countries are ill-equipped to implement these new guidelines. What are some of the issues surrounding the known inequalities of income and resources? What should be done about these inequalities, if anything? What are the ethical issues? Should anything be done about the low percentages of men being tested for HIV? Why or why not? Due Sunday by 11:59 PM
- Response Post: Respond to the original contribution of at least one colleague. Draw on prior learning and the insights you gleaned from your initial reading, your initial analysis, and your colleague’s comments. Due Wednesday by 11:59 PM
Legal Analysis Paper 2 Due Wednesday by 11:59 PM
Week 8: Dec 14 – 18
Government Speech
Objectives:
- Describe the framework of the U.S. legal system and the intersection of public health law and ethics.
- Discuss the regulatory environment that governs and influences public health.
- Discuss the complex legal, economic, social, and ethical considerations associated with various public health issues.
- Describe and assess conflicts between government interests in public health and individual interests in liberty.
- Identify and address existing and emerging ethical concerns in public health practice and administration.
- Interpret and present pertinent legal and ethical analysis of public health issues through written and oral communications.
Lecture:
- Gostin: Ch 9
- New York City Department of Health & Mental Hygiene. The Requirement to Post Calorie Counts on Menus in New York City Food Service Establishments [Brochure]. (Section 81.50 of the New York City Health Code.)
Assignment:
Forum Discussion
- Original Contribution: Public health is attempting to change the food marketing environment by such measures as the NYC ordinance requiring chain restaurants to disclose caloric information. Do you think this conforms to the law on commercial speech? Why or why not? And do you think it is effective policy? Why or why not?
- Response Post: Please respond to the original contribution of at least one colleague. Draw on prior learning and the insights you gleaned from your initial reading, your initial analysis, and your colleague’s comments.
Both original contribution and response post due Sunday by 11:59 PM
Student Resources
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Policies
AMA Writing Style Statement
The American Medical Association Manual (AMA) of Style, 11th edition is the required writing format for this course. Additional support for academic writing and AMA format is provided throughout the coursework as well as at the UNE Portal for Online Students.
Online resources: AMA Style Guide
Turnitin Originality Check and Plagiarism Detection Tool
The College of Professional Studies uses Turnitin to help deter plagiarism and to foster the proper attribution of sources. Turnitin provides comparative reports for submitted assignments that reflect similarities in other written works. This can include, but is not limited to, previously submitted assignments, internet articles, research journals, and academic databases.
Make sure to cite your sources appropriately as well as use your own words in synthesizing information from published literature. Webinars and workshops, included early in your coursework, will help guide best practices in APA citation and academic writing.
You can learn more about Turnitin in the guide on how to navigate your Similarity Report.
Technology Requirements
Please review the technical requirements for UNE Online Graduate Programs: Technical Requirements
Course Evaluation Policy
Course surveys are one of the most important tools that University of New England uses for evaluating the quality of your education, and for providing meaningful feedback to instructors on their teaching. In order to assure that the feedback is both comprehensive and precise, we need to receive it from each student for each course. Evaluation access is distributed via UNE email at the beginning of the last week of the course.
Late Policy
Students are responsible for submitting work by the date indicated in Brightspace.
Quizzes and Tests: Quizzes and tests must be completed by the due date. They will not be accepted after the due date.
Assignments: Unless otherwise specified, assignments will be accepted up to 3 days late; however, there is a 10% grade reduction (from the total points) for the late submission. After three days the assignment will not be accepted.
Discussion posts: If the initial post is submitted late, but still within the discussion board week, there will be a 10% grade reduction from the total discussion grade (e.g., a 3 point discussion will be reduced by 0.3 points). Any posts submitted after the end of the Discussion Board week will not be graded.
Please make every effort ahead of time to contact your instructor and your student support specialist if you are not able to meet an assignment deadline. Arrangements for extenuating circumstances may be considered by faculty.
Student Handbook Online - Policies and Procedures
The policies contained within this document apply to all students in the College of Graduate and Professional Studies. It is each student's responsibility to know the contents of this handbook.
Student Handbook
UNE Course Withdrawal
Please contact your student support specialist if you are considering dropping or withdrawing from a course. The last day to drop for 100% tuition refund is the 2nd day of the course. Financial Aid charges may still apply. Students using Financial Aid should contact the Financial Aid Office prior to withdrawing from a course.
Academic Integrity
The University of New England values academic integrity in all aspects of the educational experience. Academic dishonesty in any form undermines this standard and devalues the original contributions of others. It is the responsibility of all members of the University community to actively uphold the integrity of the academy; failure to act, for any reason, is not acceptable. For information about plagiarism and academic misconduct, please visit https://www.une.edu/studentlife/plagiarism.
Academic dishonesty includes, but is not limited to the following:
- Cheating, copying, or the offering or receiving of unauthorized assistance or information.
- Fabrication or falsification of data, results, or sources for papers or reports.
- Action which destroys or alters the work of another student.
- Multiple submissions of the same paper or report for assignments in more than one course without permission of each instructor.
- Plagiarism, the appropriation of records, research, materials, ideas, or the language of other persons or writers and the submission of them as one's own.
Charges of academic dishonesty will be reviewed by the Program Director. Penalties for students found responsible for violations may depend upon the seriousness and circumstances of the violation, the degree of premeditation involved, and/or the student’s previous record of violations. Appeal of a decision may be made to the Dean whose decision will be final. Student appeals will take place through the grievance process outlined in the student handbook.
Attendance Policy
8 week: Students taking online graduate courses through the College of Professional Studies will be administratively dropped for non-participation if a graded assignment/discussion post is not submitted before Sunday at 11:59 pm ET of the first week of the term. Reinstatement is at the purview of the Dean's Office.
16 week: Students taking online graduate courses through the College of Professional Studies will be administratively dropped for non-participation if a graded assignment/discussion post is not submitted before Friday at 11:59 pm ET of the second week of the term. Reinstatement is at the purview of the Dean's Office.
Student Handbook Online - Policies and Procedures
The policies contained within this document apply to all students in the College of Professional Studies. It is each student's responsibility to know the contents of this handbook.
UNE Online Student Handbook
UNE Course Withdrawal
Please contact your student support specialist if you are considering dropping or withdrawing from a course. The last day to drop for 100% tuition refund is the 2nd day of the course. Financial Aid charges may still apply. Students using Financial Aid should contact the Financial Aid Office prior to withdrawing from a course.
Academic Integrity
The University of New England values academic integrity in all aspects of the educational experience. Academic dishonesty in any form undermines this standard and devalues the original contributions of others. It is the responsibility of all members of the University community to actively uphold the integrity of the academy; failure to act, for any reason, is not acceptable. For information about plagiarism and academic misconduct, please visit UNE Plagiarism Policies.
Academic dishonesty includes, but is not limited to the following:
- Cheating, copying, or the offering or receiving of unauthorized assistance or information.
- Fabrication or falsification of data, results, or sources for papers or reports.
- Action which destroys or alters the work of another student.
- Multiple submissions of the same paper or report for assignments in more than one course without permission of each instructor.
- Plagiarism, the appropriation of records, research, materials, ideas, or the language of other persons or writers and the submission of them as one's own.
Charges of academic dishonesty will be reviewed by the Program Director. Penalties for students found responsible for violations may depend upon the seriousness and circumstances of the violation, the degree of premeditation involved, and/or the student’s previous record of violations. Appeal of a decision may be made to the Dean whose decision will be final. Student appeals will take place through the grievance process outlined in the student handbook.