Seminar in Bioethics



Seminar in Bioethics

(Tentative Skeletal Syllabus for Topics in Philosophy, Winter 2008)

Course Description

An exploration of recent work in bioethics and of topics not covered or only briefly discussed in the basic Medical Ethics course (Philosophy and HPS 442/542). In addition to areas explored by the class in common, students will choose an area of research to be presented to the class. Topics include psychiatric ethics and neuroethics (e.g., criteria for involuntary commitment, rights of mental health patients, neurological intervention to control a predisposition to violence in children; ethics of enhancing memory); research ethics (informed consent, ethics of randomized clinical trials, experimentation on animals); global inequalities in health care; the global AIDS crisis; race, gender, and multiculturalism in medicine; intergenerational issues (e.g., age-based rationing); narrative ethics and virtue ethics; ethics and medical professionalism (e.g., the extent to which health care workers can conscientiously object to participation in particular procedures; dilemmas in dealing with impaired health care workers, dealing with medical mistakes); the bioethics “culture wars” and the influence of religion in bioethical thinking.

Learning Outcomes

As a result of taking this course, students should be able to demonstrate:

• an understanding of major issues in psychiatric ethics and the emerging area of neuroethics

• an understanding of major issues in the ethics of biomedical research

• an understanding of recent work in the ethics of genetics and reproductive technologies

• an understanding of global issues of bioethics; in particular disparities in health care between developed and developing countries.

• the ability to write clearly and critically about recent issues in bioethics

• the ability to do research in a selected area of bioethics

• the ability to discuss recent bioethical issues orally and to do oral presentations on some of these issues.

Course Readings (probably a course pack)

Selections from Munson, Intervention and Reflection, 8th Edition, Wadsworth, 2008.

Selections from Monagle and Thomasma, Health Care Ethics: Critical Issues for the 21st Century, Aspen, 1998.

Selections from Atul Gawande, Complications: A Surgeon’s Notes on an Imperfect Science

Selected readings from (e.g., section on neuroethics and new developments in stem cell research) and (which includes American Journal of Bioethics)

Selections from journals including Hastings Center Report, Bioethics, and Cambridge Quarterly of Health Care Ethics.

Selections from Howard Brody, Stories of Sickness, Yale University Press.

Selections from Paul Farmer, Pathologies of Power: Health, Human Rights, and the New War on the Poor, University of California Press, 2005.

Course Requirements

The course requirements reflect three different levels of concern: (1) familiarity with timely bioethical issues in the news and the ability to understand these in a larger context in relation to bioethical concepts and theories; (2) shared class exploration of scholarly work in particular areas of bioethics not covered in the basic Medical Ethics course; (3) individual, in-depth research in a chosen area of bioethics.

• Regular attendance and active participation in class and web discussion. This will include brief presentations (in class or on the web) about “bioethics in the news”

• Weekly written statements on the topics discussed

• A semester-long research project on a particular area of bioethics, chosen in consultation with instructor, resulting in a written term paper and an oral presentation to the class.

Each of these three areas will count for approximately 1/3 of course grade.

A Tentative Schedule of Topics and Readings

Note: of the 3 areas indicated above under “course requirements,” the schedule reflects mainly #2. Throughout the semester, #1, timely bioethical issues in the news, will be brought up and briefly considered (in class and in web-based discussion) and a good part of the second half of the semester will be devoted to #3, discussion of individual student research projects.

Weeks 1 and 2: Psychiatric Ethics and Neuroethics

Szasz, “Involuntary Mental Hospitalization: A Crime Against Humanity”

Chodoff, “The Case for Involuntary Hospitalization of the Mentally Ill”

Mark, “The Case for Psychosurgery”

Chorover, “Psychosurgery: A Neuropsychological Perspective”

Issues in neuroethics,

Glannon, “Neuroethics,” Bioethics, volume 20 (2006), pp. 37-52.

Weeks 3 and 4: Research Ethics

Munson, pp. 3-44 and, from Munson volume:

Goldby, et al, “The Willowbrook Letters: Criticism and Defense”

Ramsey, “Judgment on Willowbrook

Principles of the Nuremberg Code

Singer, “Animal Experimentation”

Cohen, “The Case for the Use of Animals in Biomedical Research”

Week 5: Race and Gender Issues in American Health Care

Munson, pp. 212-238 and, from Munson volume:

King, “The Dangers of Difference: The Legacy of the Tuskeegee Syphilis Study”

Khan, “‘Ethnic’ Drugs”

Sherwin, “Gender, Race, and Class in the Delivery of Health Care”

Dula, “Bioethics: The need for a Dialogue with African Americans”

Week 6-7: Global Inequalities in Health Care and Obligations to Developed Countries

Singer, “Famine, Affluence, and Morality”

Farmer and Campos, “Rethinking Medical Ethics: A View from Below,” Developing World Bioethics, Volume 4, 2004.

Selgelic, “Ethics and Infectious Disease,” Bioethics, Volume 19, 2005.

Paul Farmer, “New Malaise: Medical Ethics and Social Rights in the Global Era,” in Pathologies of Power: Health, Human Rights, and the New War on the Poor

Film: The Constant Gardener

HIV/AIDS. Munson, pp. 174-194.

Week 8: The Bioethics “Culture Wars”

Callahan, “Bioethics and the Culture Wars,” Cambridge Quarterly of Health Care Ethics, volume 14 (2005), pp. 424-431.

Dworkin, Life’s Dominion: An Argument About Abortion, Euthanasia, and Individual Freedom, chapter 3: “What Is Sacred?”

Baumgarten, “Is Nothing Sacred?” and accompanying grand rounds presentation

Week 9: Religion and Bioethics

Daar and Khitamy, “Islamic Bioethics”

Markwell and Brown, “Catholic Bioethics,”

Pauls and Hutchinson, “Protestant Bioethics,”

Goldsand, et. al,, “Jewish Bioethics,”

Rachels, “Ethics and Religion,” Appendix II in Howard Brody, Ethical Decisions in Medicine, second edition, Little Brown, 1981, 359-62.

Much of remaining weeks devoted to individual student reports

Week 10: Contribution of Narrative and Virtue Ethics

Selections from Howard Brody, Stories of Sickness

Articles on virtue ethics TBA

Week 11: Issues of Medical Professionalism: Medical Mistakes, Conscientious Objection, Coping with Incompetent or Impaired Health Care Workers

Gawande, “When Doctors Make Mistakes,” in Complications, pp. 47-74

Gawande, “When Good Doctors Go Bad,” in Complications, pp. 88-106.

Participation of physicians in death penalty, interrogation of terrorist suspects, etc.

Others TBA

Week 12: Recent Perspectives on Death and End-of-Life Care.

DVD. Beckett, Rockaby

Articles on palliative care, TBA

Weeks 13-14: Latest Developments in Genetics, Stem Cell Research, and Reproductive Technologies

Selections from recent articles on latest developments.

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