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Biomedical Ethics

Philosophy 221: Biomedical Ethics

Summer 2013

M-F 9:30-11:30 AM, 1:30-3:30 PM

Morse-Ingersoll 110

Professor: Matt Tedesco

            E-mail: tedescom@beloit.edu

            Phone: 363-2146

Office Hours: By appointment

            Office: Morse-Ingersoll 210

Textbook: Bioethics: An Anthology (2nd ed.), edited by Helga Kuhse and Peter Singer (Blackwell, 2006)

The Class:

The purpose of this course is to critically examine a range of philosophical questions in the areas of bioethics and medical ethics. From abortion to cloning, from euthanasia to human and animal experimentation, issues in biomedical ethics are topics of consistently intense debate. As a philosophy class, our emphasis will be on the analysis of concepts and the critical evaluation of arguments. Beyond gaining a familiarity with some of the core literature in biomedical ethics, students should expect to develop their analytic and evaluative skills through in-class discussion, debates, presentations, and a range of writing assignments.

Evaluation:

Your grade in the class will be determined as follows:

I. TWO EXAMS (2/6)

There will be two in-class written exams in this class, each worth 1/6 of your overall class grade. The first exam will be administered on May 24th; the second exam will be administered on May 30th. On the exams, anything discussed in class or assigned as class reading is fair game for a question topic. Note that these two will largely, but not entirely, overlap.

II. TWO PHILOSOPHICAL DEBATES (2/6)

Throughout the block, we will engage in five philosophical debates as outlined in the class schedule (below). Early in the block, each of you will be assigned to a team of three students that will participate in two of the debates. Each debate will concern a specific question or case connected with the topic of the debate, where the two teams will be asked to defend opposing positions. Your debate grade will be generated by both the overall performance of your team, as well as your own individual performance, in the debate. In addition to participating in the debate, you will also be responsible for writing a 2-3 page self-evaluation of your own team’s debates, as well as writing a 2-3 page evaluation of any two of the other three debates, to be turned in at the start of our next meeting. These four evaluations are required; failing to satisfactorily complete them will result in a letter-grade penalty on your debate grade for each missed evaluation.

Each debate will begin with the two teams being allotted 15-20 minutes each to present their main argument(s). After a 15-minute break, we will have a 20-minute period of open philosophical exchange, where the two teams will be expected to raise objections to their opponent’s arguments, and to respond to objections posed to them. This period will be moderated by the professor. The remaining time will be devoted to questions from the class, directed to either team, as well as an open discussion after the debate of the philosophical issues raised during the debate if time allows.

The readings assigned for each of the debates deal directly with the debate topics, and so the teams will be expected to be familiar with this material; each team, however, should go beyond these readings at their discretion to bring in any other considerations that they deem appropriate, including (but certainly not limited to) other readings from the syllabus. While every student is required to participate in the debate, and the expectation is that the members of each team will participate roughly equally, it is up to each team to decide how to divide their efforts. Please remember that these are philosophical debates; ad hominem attacks, straw man arguments, and other informal logical fallacies that may score points in popular debates will be penalized, rather than rewarded, here. Also remember that the goal is not to “win” the debate; the goal is to do as good a job as possible defending the position you have been assigned.

III. “BIOETHICS IN THE NEWS” PRESENTATION (1/6)

While our class readings and discussions are sometimes quite dense and conceptual, biomedical issues are constantly in the news, and this assignment is meant to help connect our class with these developments. We will devote a part of most of out class meetings this block to looking at bioethics in the world around us. Early in the block, each student will be assigned a presentation date; on that date, you will be expected to bring to the class some philosophically interesting biomedical news story for a 15-20 minute discussion. For those 15-20 minutes, you should be prepared to summarize the story and explain the key philosophical issues that the story raises. Additionally, you should be prepared to raise philosophically interesting questions connected with the philosophical issues raised in the story. These stories should be reasonably current—while there is no sharp cutoff here, stories should be no more than a few years old. Because stories may not be repeated, they will be allotted first come, first serve—to claim a story, simply email me with a link and a brief description. You are required to email me your story at least 48 hours prior to your assigned date, but you certainly may email me to claim a story earlier.

IV. DISCUSSION HAIKU (1/6)

One of the most effective strategies for reading critically is composing a brief summary highlighting the key elements of the reading selection in question; one of the most concise and elegant forms of writing is the classical Japanese poetry form, the haiku. This assignment combines these two distinct considerations, in an assignment aimed at helping to jumpstart our discussions through your reading of our texts. For every reading assignment on our syllabus, you are expected to compose and bring to class in writing a haiku to be shared and read aloud in class. For each reading, you will pass your haiku around, and several will be selected to be read aloud. Your haiku should reflect what you take to be one or more important or interesting elements of the assigned reading selection. You will be allowed considerable creative flexibility in composing your haikus—this assignment should be fun, not stressful—but be aware that you will be expected to explain your haiku, and the elements of the reading that it captures. I will collect your haiku after we’ve discussed them.

Every student begins with an A on this portion of the class grade. If you are prepared with a haiku for every reading, you will receive an A on this part of your grade. If you miss a haiku because you are absent from class and within your allotted two absences (described below, in section V), you will not be penalized; if you miss a haiku either because you are unprepared or because you are absent and you have already exceeded the absence limit, your grade here will decrease by a full letter grade.

V. CLASS ACTIVITY (variable)

The final component of your overall class grade encompasses several different elements, including (but not limited to) class participation and classroom behavior in general. This component is unique in that, unlike the other components, it is subjective. Attendance, first of all, is mandatory, and students with excessive absences will be penalized, where excessive absences are understood as those over and above the equivalent of one semester week’s worth of class time—in our block, that is the equivalent of two two-hour sessions. In accordance with Beloit College policy, I expect everyone to come to class, and I furthermore expect everyone who comes to class to be alert and ready to participate. Participation also is mandatory. This means that I expect every student to contribute to our ongoing class discussion throughout the block. I recognize that class participation comes more naturally to some students than others. If you expect this requirement to be difficult for you, then plan accordingly—no one is exempt from this expectation. Elements of class activity that may negatively impact your grade include disruptive behavior (e.g., engaging in side-conversations with others, ringing cell phones) or visibly obvious detachment from the class (e.g., reading outside material such as work for other classes, sleeping). Exceptionally strong class activity may raise your overall grade by one-third (e.g., if your final grade is a B, it may be raised to a B-plus), while poor class activity may lower your overall grade by at least one-third (e.g., from B to B-minus or lower). As a rule of thumb, expect to have your class grade lowered by one-third for each class missed beyond one week of absence.

As a matter of class policy, laptop computers and tablets may not be used in class. The reason for this is straightforward: the classroom is a place for community conversation, and for a variety of reasons, laptops and tablets hinder conversation. If you believe you have a compelling reason to be exempt from this policy, please see me to discuss the matter.

If a situation of prolonged absence is unavoidable, please make sure to contact me about it. Be aware that I will normally request proper documentation should such a circumstance arise.

Schedule:

 What follows is the plan for the block as I see it now. Reading assignments should be completed before the class that they’re assigned. Note that this schedule is tentative; we may deviate from it as the block progresses and class discussion takes on a life of its own. If changes are required, they will be announced in class.

If you have specific physical, psychiatric, or learning disabilities and require accommodations, please provide the appropriate documentation to me from the Learning Enrichment and Disability Services office early in the block so that your learning needs may be effectively met. Be aware that I cannot make special accommodations without direction from the LEDS office.

Introductions

5/16 am:           Class introductions

5/16 pm:           Glover, “The Sanctity of Life” (266-275)

Abortion

5/17 am:           Tooley, “Abortion and Infanticide” (25-39)

5/17 pm:           Marquis, “Why Abortion is Immoral” (51-62)

5/20 am:           Guest speaker: ethical questions in medical practice

5/20 pm:           Thomson, “A Defense of Abortion” (40-50)

                        BIN 1

Reproduction

5/21 am:           Pence,” The McCaughey Septuplets: God’s Will or Human Choice?” (87-89)

                        Purdy, “Genetics and Reproductive Risk: Can Having Children Be Immoral?” (115-121)

                        BIN 2

5/21 pm:           Parfit, “Rights, Interests, and Possible People” (108-112)

                        BIN 3

5/22 am:           Glover, “Questions About Some Uses of Genetic Engineering” (187-197)

                        Davis, “Genetic Dilemmas and the Childs Right to an Open Future” (246-256)

                        BIN 4

Euthanasia

5/22 pm:           Rachels, “Active and Passive Euthanasia” (288-291)

                        Nesbitt, “Is Killing No Worse Than Letting Die?” (292-296)

                        Kuhse, “Why Killing is Not Always Worse, and Sometimes Better, Than Letting Die” (297-300)

                        BIN 5

5/23 am:           Guest speaker: ethical questions in medical practice

5/23 pm:           Kuhse,” A Modern Myth: That Letting Die is Not the Intentional Causation of Death” (315-328)

                        BIN 6

Autonomy

5/24 am:           Dworkin, “Life Past Reason” (357-364)

                        BIN 7

5/24 pm:           Exam 1

5/27 am:           Dresser, “Dworkin on Dementia: Elegant Theory, Questionable Policy” (365-373)

                        BIN 8

5/27 pm:           Savulescu, “Rational Desires and the Limitation of Life-Sustaining Treatment” (646-663)

                        BIN 9

5/28 am:           Veatch, “Abandoning Informed Consent” (636-645)

                        BIN 10

Experimentation

5/28 pm:           Freedman, “Equipoise and the Ethics of Clinical Research” (513-519)

                        Hellman, “The Patient and the Public Good” (520-524)

                        BIN 11

5/29 am:           Singer, “All Animals are Equal” (568-577)

                        BIN 12

5/29 pm:           Debate 1: Using Future Children

Robertson, Kahn, and Wagner, “Conception to Obtain Hematopoietic Stem Cells” (150-157)

King, “Why We Should Not Permit Embryos to Be Selected as Tissue Donors” (158-161)

5/30 am:           Exam 2

5/30 pm:           Debate 2: Doctors, Euthanasia, and Assisted Suicide

                                    Callahan, “When Self-Determination Runs Amok” (381-385)

                                    Lachs, “When Abstract Moralizing Runs Amok” (386-390)

                                    Admiral, “Listening and Helping to Die: The Dutch Way” (391-397)

Resources

5/31 am:           Harris, “The Value of Life” (428-436)

                        Lockwood, “Quality of Life and Resource Allocation” (451-464)

                        BIN 13

5/31 pm:           Debate 3: Truth-telling in Medical Practice

                                    Collins, “Should Doctors Tell the Truth?” (605-610)

                                    Higgs, “On Telling Patients the Truth” (611-617)

6/3 am:             Daniels, “A Lifespan Approach to Health Care” (465-474)

                        BIN 14

6/3 pm:             Debate 4: Seriously Handicapped Infants

                                    [Readings to be sent by e-mail]

6/4 am:             Veatch, “How Age Should Matter: Justice as the Basis for Limiting Care to the Elderly” (437-447)

                        BIN 15

6/4 pm:             Debate 5: Priorities in Organ Transplantation

                                    Rescher, “The Allocation of Exotic Medical Lifesaving Therapy” (410-420)

Moss and Siegler, “Should Alcoholics Compete Equally for Liver Transplantation?” (421-427)

6/5 am:             Class conclusions