Biomedical Ethics - Spring 2011

Embodiment: The Experience of

Autonomy and Suffering

Instructor: Eric Lambert Location:

Email: elambert@kzoo.edu Times: 1:15 – 2:30 pm

Office: HH 202 Office hrs: TBA

Texts

Ethical Issues in Modern Medicine, 7^th edition, edited by Arras, Steinbock, and London

The Body in Bioethics, Alastair V. Campbell

Course description

We will critically assess ethical issues that arise in health care, including the nature of the health professional-patient relationship; end-of-life decision-making and assisted death; abortion, assisted reproduction and genetics; experimentation on human subjects; and justice in health care. These topics raise difficult questions that resist simple answers. The aim of the course is to provide students with an overview of biomedical ethics so that they become familiar with the range of issues addressed, learn some of the methods used by professionals in the field, and develop the knowledge and skills needed to analyze and assess normative positions taken on these issues. Thus we will identify ethical problems and discuss them in thoughtful, informed, and respectful ways. This requires identifying assumptions, objections and unresolved questions in the readings, as well as developing the ability clearly to articulate viewpoints and arguments concerning the relevant ethical problems.

Grading

45% two essays: one short essay and a final essay

· Short essay (5-6 pages), worth 15% of final grade

· Final essay (8-10 pages), worth 25% of final grade

· Peer review of rough draft of final paper (typed, min. 3-5 pp.), 5%

40% four short papers (target length: 2-3 carefully written pages), worth 10% each

15% participation

Attendance

Attendance is required. Since there are only ten weeks per quarter, each class session is important. Thus three or more unexcused absences will result in 0.5 points being immediately deducted from a student’s final grade (so if your final grade is 2.7 and you have three unexcused absences, you will receive a 2.3). Lateness should also be avoided. Since tardiness is usually disruptive, excessive lateness (three or more times late) will count as an unexcused absence.

Late papers

Unless prior arrangements are made, late papers will be marked down 0.25 points each day the paper is late. Late papers will not be penalized only if prior arrangements are made, appropriate documentation is provided, and the reasons are consistent with Kalamazoo College policy.

Academic Integrity

Per the Kalamazoo College Honor System: “The term "plagiarism" includes, but is not limited to, the use, by paraphrase or direct quotation, of the published or unpublished work of another person without full and clear acknowledgment. It also includes the unacknowledged use of materials prepared by another person or agency engaged in the selling of term papers or other academic materials.” Simply put, do not plagiarize. If you are not sure what plagiarism consists of, talk to me. Plagiarized work will result (at a minimum) in a failing grade for that assignment, and possibly a failing grade for the course.

Schedule of readings

Week 1

Mon, Mar 28: Course introduction and overview

Wed, Mar 30: “Moral Reasoning in the Medical Context,” 1-12, 14-20, 23-26

Fri, Apr 01: “Modes of Moral Reasoning: The Principles Approach,” 35-41

“Autonomy, Paternalism, and Medical Models,” 43-46 (first column p. 46)

“The Hippocratic Oath,” 61

Week 2

Mon, Apr 04: Goldman, “The Refutation of Medical Paternalism,” 62-70

“Beneficence Today, or Autonomy (Maybe) Tomorrow,” 70-72

Commentaries by Elger and Chevrolet, 71-73

Wed, Apr 06: “Informed Consent and Truth-Telling,” 48-52

Katz, “Informed Consent: Must it Remain a Fairy Tale?” 89-96

Fri, Apr 08: Baylis, “Errors in Medicine: Nurturing Truthfulness,” 97-100

Week 3

Mon, Apr 11: “Conflicting Roles and Responsibilities,” 52-56 (top of first column)

“Tarasoff V. Regents of the University of California,” 117-122

“Please Don’t Tell!” 123

Commentaries by Fleck and Angell, 123-125

Wed, Apr 13: Cantor and Baum, “The Limits to Conscientious Objection,” 145-149

Fri, Apr 15: “Conflicting Roles and Responsibilities,” 59 (second column)-60

“Dialysis for a Prisoner of War,” 166

Commentary by Zupan, Solis and Schoonhoven, 166-167

Week 4

Mon, Apr 18: “Experimentation on Human Subjects,” 727-731

“The Nuremburg Code,” 739-740

Brandt, “Racism and Research: The Case of the Tuskegee Syphilis Study,”

753-762

Wed, Apr 20: “Randomized Clinical Trials,” 731-733

Hellman, “Of Mice but not Men: Problems of Randomized Clinical

Trials,” 774-778

Freedman, “A Response to a Purported Ethical Difficulty with

Randomized Clinical Trials Involving Cancer Patients,” 779-782

Fri, Apr 22: London, “Children and ‘Minimal Risk’ Research: The Kennedy-Kreiger

Lead Paint Study,” 811-815

Week 5

Mon, Apr 25: Crouch and Arras, “AZT Trials and Tribulations,” 788-792

Glantz, et al, “Research in Developing Countries: Taking ‘Benefit’

Seriously,” 803-807

Wed, Apr 27: Daniels, “Equal Opportunity and Health Care,” 200-202

Sreenivasan, “Opportunity is Not the Key,” 235-236

Kawachi, “Why the U.S. Is Not Number One in Health,” 222-230

Fri, Apr 29: Pogge, “Responsibilities for Poverty-Related Diseases,” 309-313

Week 6

Mon, May 02: Alastair V. Campbell, “My body: property, commodity, or gift?” 11-26

Wed, May 04: Alastair V. Campbell, “Body futures,” 27-54

Fri, May 06: Alastair V. Campbell, “The branded body,” 75-93

Week 7

Mon, May 09: Alastair V. Campbell, “Why the body matters,” 1-10

Drew Leder, “The ecstatic body,” 11-35 (handout)

Wed, May 11: Drew Leder, “The Dys-appearing body,” 69-92

Fri, May 13: Drew Leder, “The Dys-appearing body,” 69-92

Eric Cassell, “The Nature of Suffering” (handout)

Week 8

Mon, May 16: Buchanan and Brock, “Deciding for Others: Competency,” 368-378

Wed, May 18: Burton, “A Chronicle: Dax’s Case As It Happened,” 379-383

Commentaries by White and Engelhardt, 383-385

Fri, May 20: “State of Tennessee Dept. of Human Services v. Mary C. Northern,”

361-365

“Transcript of Proceedings: Testimony of Mary C. Northern,” 365-368

Week 9

Mon, May 23: Steinbock, “Why Most Abortions Are Not Wrong,” 555-566

Little, “The Morality of Abortion,” 576-584

Wed, May 25: “Assisted Reproductive Technologies,” 541-544

Robertson, “The Presumptive Primacy of Procreative Liberty,” 599-609

Fri, May 27: Asch, “Prenatal Diagnosis and Selective Abortion…” 675-685

Steinbock, “Disability, Prenatal Testing, and Selective Abortion,” 686-694

Week 10

Mon, May 30: MEMORIAL DAY

Wed, Jun 01: “Euthanasia and Physician-Assisted Suicide,” 334-337

Quill, “Death and Dignity: A Case of Individualized Decision Making,”

473-476

Dworkin, “Assisted Suicide: The Philosophers’ Brief,” 484-487

Fri, Jun 03: Exchange rough drafts/peer review

Due dates for papers:

April 11 the first short paper is due.

April 18 the second short paper is due.

April 25 the third short paper is due.

May 02 the fourth short paper is due.

May 16 the short essay (5-6 pp.) is due.

NOTE: The final paper will be due [June 6-9]. Students are to deliver the final paper to

Humphrey House 202, no later than 4:00 pm.