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Biomedical Ethics

Philosophy 221: Biomedical Ethics

Spring 2014

TTh 12:00-1:50 PM

Science Center 249

Professor: Matt Tedesco

            E-mail: tedescom@beloit.edu

            Phone: 363-2146

Office Hours: Wednesdays 10:45-11:45 AM, and by appointment

            Office: MI 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, and a range of writing assignments.

Evaluation:

Your grade in the class will be determined as follows:

I. THREE EXAMS (3/7)

There will be three exams in this class, each worth 1/7 of your overall class grade. The first two exams will be take-home exams, and will be due on 2/25 and 3/25, respectively. The third exam will be a closed-book in-class cumulative final exam administered on Tuesday, May 13th at 9 AM (our assigned time during finals week). I will offer an optional final exam session on Thursday, May 8th for those who wish to finish the class earlier; note that it is entirely up to you which final exam session you attend, though I will ask you to decide which time slot you prefer so that I may plan accordingly. On the exams, anything discussed in class or assigned as class reading (including the readings assigned for the debates) is fair game for a question topic. Note that these two will largely, but not entirely, overlap.

II. TWO PHILOSOPHICAL DEBATES (2/7)

Throughout the semester, we will engage in six philosophical debates as outlined in the class schedule (below), where each student will be a part of two debates (each worth 1/7 of your overall class grade). 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.

Early in the semester, each of you will be assigned to two teams of (typically) four students each. On debate day, each debate will begin with the two teams being allotted 15-20 minutes each to present their main argument(s). After a 10-minute break, we will have a 20-30 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. In preparation for your debate, you must divide your team’s roles as follows: two of the team members will present your team’s main argument(s), while the other two members will represent your team in in the open part of the debate (so, in other words, only half the team is a vocal participant in each of these two main parts of the debate). The remaining time will be devoted to questions from the class, directed to either team (where any team member can respond), 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. It is likely a poor strategy to limit your consideration of the issue to the arguments raised in the assigned readings. Every student is required to participate in the debate, and the expectation is that the members of each team will participate roughly equally. 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.

In your debates, you will be evaluated on three central criteria:

1.     Your ability to offer philosophical arguments on behalf of your assigned position

2.     The clarity with which you communicate your arguments

3.     Your full participation as a teammate in the debate (including all preparations leading up to it)

With those three criteria in mind, your debate grades will be determined as follows:

1.     A-range: forceful and compelling philosophical argumentation; clear, careful, and organized in communication; a contributing and supportive teammate at all points

2.     B-range: thoughtful philosophical argumentation, with only minor gaps or open questions; clear, careful, and organized in communication; a contributing and supportive teammate at all points

3.     C-range: some important problems in argumentation, OR unclear/disorganized at times in communication, OR some deficiencies as a teammate

4.     D-range: Any two of the following: some important problems in argumentation, unclear/disorganized at times in communication, some deficiencies as a teammate

5.     F-range: Some important problems in argumentation, AND unclear/disorganized at times in communication, AND some deficiencies as a teammate

When you are in the audience for a debate, you should be attentive and respectful of your classmates who have the floor. And remember, the last part of the debate will involve questions from the class, so you should prepare questions to be asked in that last segment.

III. DEBATE EVALUATIONS (1/7)

In addition to participating in the debate, you will also be responsible for writing a self-evaluation of your own team’s debates, as well as writing an evaluation of any three of the other four debates. These evaluations are always to be turned in at the START of our next class meeting. Your debate evaluations should be at least 750 words in length, and have the following components:

Debates evaluated as an audience member:

You should evaluate each team—and individual members of each team, wherever relevant—according to the three central criteria of the debate: were their arguments as compelling as possible? How clear and organized were they in presenting their arguments? Did they work well together as a team?

Debates evaluated as a debate participant:

You may also evaluate both your team and the other team according to the three debate criteria, but importantly, I would like you to provide for me a window into the inner workings of your team in the days and weeks leading up to the debate. One of the central criteria in the debates involves your work as a team, and while I will observe your teamwork in the context of the debate, you should use your self-evaluation as an opportunity to provide relevant information to which I would otherwise have no access. Grades for group projects are tricky things, and while each of you will receive an individual grade, that grade is certainly colored by the team’s work as a whole. A team member might be a particularly excellent leader behind the scenes in ways that are particularly helpful; or, conversely, a team member may fail in the preparation leading up to the debate, placing a heavier burden on the rest of the team. So you should see your debate self-evaluation as an opportunity to provide me with any information that gives me a clearer picture of your team’s work, which in turn will help me offer a more appropriate evaluation.

These debate evaluations will be graded on a pass/fail basis. If you turn in all five, and each meets the criteria of the assignment, you will receive an A on this portion of your grade. Each evaluation that does not satisfy these criteria lowers this portion of your grade by one full letter.

IV. TEXT RESPONSES (1/7)

You will be responsible for posting weekly text responses to me in Moodle throughout the semester. These responses should be at least two substantial paragraphs in length. The first paragraph should briefly summarize what you take to be the thesis, main point, or purpose of the reading assignment you’ve selected to discuss (presumably something on the schedule for our next meeting). The second paragraph and beyond should contain your response to the reading. Here, you should be critically evaluating some aspect of the reading: what was particularly interesting, convincing, problematic, confusing, etc.? Your text responses will not be evaluated for correctness, but they should demonstrate a serious engagement with the reading for class. In order to help ensure that you are seriously engaging the material, each text response must be a minimum of 350 words in length; the word count must be included in the text response. This word count is merely a bare minimum; response e-mails may, and frequently do, exceed this number. Text responses that fail to seriously engage the reading, including those that fail to reach the minimum word requirement, will receive no credit.

Text responses must be received before we discuss the reading in class, and you can turn in no more than one per week. If you turn in thirteen (one for each week, excluding the first, last, and mid-term break) satisfactorily, you will receive an A for this portion of your grade. For each one not turned in, this portion of your grade will decrease by one-third of a letter grade (so, turning in twelve earns an A-, eleven a B+, etc.). For our purposes, each week ends at the start of our Thursday meeting; text responses for each week will therefore close precisely at noon on Thursday.

These, then, are the key principles to keep in mind about text responses: one per week, on something we have not yet discussed in class.

These text responses serve a number of purposes. Most importantly, they help ensure your critical engagement with the text throughout the semester. You should regularly be reviewing your text responses after our class discussions, to see how your understanding of the text has developed; in this respect, they provide for you a way to track your engagement with the material. They also give me a window into your reading of the text, which in turn directly informs my teaching. I’ll have a sense of what you focused on in the reading, and what needs special attention in class. I will also draw from the content of your text responses in class, sometimes generally, but also sometimes by referencing particular text responses. I will do my best to use discretion, but please let me know in text responses if there are details in it that you would prefer not to reveal to the rest of the class.

Given the volume of text responses that I will be receiving from all of you, you should not expect regular feedback on individual text responses. I may, however, respond to individual text responses intermittently throughout the semester.

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 week’s worth of class time. 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 semester. 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.

Note a couple of things about the grading in this class. First, notice that the penalty for excessive absences is serious. This should signal to you the importance in this class of being present, and being prepared, every time. Second, notice that a full two-sevenths of your grade (between the response e-mails and debate evaluations) is entirely in your control based solely on effort. There is no good reason for anyone to receive less than an A on these parts of your grade.

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 semester as I see it now. Reading assignments should be completed before the class that they’re assigned, where the days listed signal when I expect us to begin discussing the article in question. Note that this schedule is tentative; we may deviate from it as the semester progresses and class discussion takes on a life of its own. If changes are required, they will be announced in class.

If you have a disability and need accommodations, contact the Learning Enrichment and Disability Services Office located on the 2nd floor of Pearsons Hall. The office can be reached by phone at x2572 or by email at learning@beloit.edu. For accommodations in this class, you must bring me an Accommodation Verification Letter from the Director of that office and we will then discuss how to meet your needs. Contact that office promptly; accommodations are not retroactive. Be aware that I cannot make special accommodations without direction from the LEDS office.

1/21:     Class cancelled

1/23:     Class cancelled

Abortion

1/28:     Introductions

Tooley, “Abortion and Infanticide” (25-39)

1/30:     Marquis, “Why Abortion is Immoral” (51-62)

2/4:       Thomson, “A Defense of Abortion” (40-50)

Reproduction

2/6:       Pence, ”The McCaughey Septuplets: God’s Will or Human Choice?” (87-89)

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

2/11:     Parfit, “Rights, Interests, and Possible People” (108-112)

2/13:     Glover, “Questions About Some Uses of Genetic Engineering” (187-197)

2/18:     Davis, “Genetic Dilemmas and the Childs Right to an Open Future” (246-256)

Euthanasia

2/20:     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)       

2/25:     Kuhse,” A Modern Myth: That Letting Die is Not the Intentional Causation of Death” (315-328)

            TAKE-HOME EXAM 1 DUE

2/27:     Class cancelled

Autonomy

3/4:       Dworkin, “Life Past Reason” (357-364)

3/6:       Dresser, “Dworkin on Dementia: Elegant Theory, Questionable Policy” (365-373)

Spring break

3/18:     Savulescu, “Rational Desires and the Limitation of Life-Sustaining Treatment” (646-663)

3/20:     Class cancelled

3/25:     Veatch, “Abandoning Informed Consent” (636-645)

            TAKE-HOME EXAM 2 DUE

Debate session 1

3/27:     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)

4/1:       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)

4/3:       DEBATE 3: Truth-telling in Medical Practice

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

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

Experimentation

4/8:       Freedman, “Equipoise and the Ethics of Clinical Research” (513-519)

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

4/10:     Singer, “All Animals are Equal” (568-577)

Resources

4/15:     Harris, “The Value of Life” (428-436)

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

4/17:     No class, Symposium Day

4/22:     Daniels, “A Lifespan Approach to Health Care” (465-474)

4/24:     Veatch, “How Age Should Matter: Justice as the Basis for Limiting Care to the Elderly” (437-447)

Debate session 2

4/29:     DEBATE 4: 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)

5/1:       DEBATE 5: Seriously Handicapped Infants

            [readings available on Moodle]

5/6:       DEBATE 6: Enhancement

            [readings available on Moodle]

5/8:       OPTIONAL ALTERNATE FINAL EXAM (time TBD)

5/13:     FINAL EXAM (9 AM)