Philosophy 230 – Medical Ethics
Section
02: MWF 10:00-10:50 306 Friends Hall Spring
2003
Overview: Philosophy 230 is an
examination of various ethical issues having to do with the practice of
medicine. We will begin by examining
some general principles of ethics. In
Part One of the course we will next apply these principles to some issues
regarding the physician-patient relation:
Is it ever permissible to override the wishes of the patient so long as
you act for his/her own good? Is it
ever permissible to lie to a patient for his/her own good? In Part Two of the course, we will turn to
examine issues having to do with the beginning and end of human life: How is death best defined? Is abortion morally permissible? Should euthanasia be legalized? Should cloning and stem cell research be
banned?
Professor: Craig Duncan
Email:
cduncan@ithaca.edu
Webpage:
www.ithaca.edu/faculty/cduncan
Office
hours and location: Tuesdays 12-1 and Wednesdays 2-3 in Dillingham G9B.
Office
phone: 274-3580
Course
Materials:
·
Ronald
Munson, Intervention and Reflection:
Basic Issues in Medical Ethics, Sixth Edition (Wadsworth,
2000). (required; a copy of this is
also on library reserve)
·
Peter
Singer, Rethinking Life and Death (St. Martin’s, 1994). (required)
·
A
very short coursepack, purchased from the Philosophy and Religion Department.
(required)
Course Requirements:
·
Quizzes: Over the course of the term there will be six unannounced quizzes,
each lasting 10 minutes. Your top five
scores will be averaged together to form your quiz average; this will count for
25% of your grade. There will be no
make-up quizzes given. This means
that people who must unavoidably miss class due to extracurricular activities
(e.g. athletics) will have to work hard to ensure they score well on the
quizzes they are able to take.
·
“Philosophy Court”
Debate: Five times in the term we
will devote a class period to a debate regarding a case relevant to the course. The debate will be modeled on the style of
debate that takes place in a Supreme Court hearing. Four students will serve as “advocates” for a position (two on
each side) and two as judges. A 5 page
written essay will be one component of this activity. More details will be given out shortly. This activity is worth 20% of your overall grade.
·
The Moral Conversation Project. See the
final page of the syllabus for an extended explanation of this. Your journal will be due on Friday, April
18th. It will count
for 10% of your overall grade.
·
Final exam: There will be a final exam that counts 30% toward your overall
grade. Final exam time and place to be
announced.
·
Class Discussion: Philosophy cannot be passively learned. It requires active engagement, both with the
texts and with individuals in the form of discussion. For this reason class participation counts for 15% of your
overall grade. In order to get a good
participation grade, you must have excellent attendance (I will keep track of
this), do the assigned reading for each class period, and take an active role
in class discussions.
Note: I do not permit extra
credit assignments. The difficulty of
designing and administering these assignments makes me unwilling to offer the
opportunity to all students, and it would be unfair to offer the opportunity
merely to some students.
(Tentative) Reading Schedule:
Page numbers in parentheses refer to the Munson anthology. Links to readings labeled “web” are on the Philosophy 230 coursepage, which you can get to via my webpage (www.ithaca.edu/faculty/cduncan).
Background: Principles of Ethics
1/22: “Major Moral Principles: Nonmaleficence, Beneficence, Utility” (31-37)
1/24: “Major Moral Principles: Autonomy” (40-45)
PART ONE: LIES
AND DECISIONS
Deciding for Patients
1/27: Robert M.
Veatch, “The Hippocratic Oath and Its Challengers” (coursepack)
Sample oaths (web)
Case Presentation: Donald (Dax) Cowart (378-381)
1/29: Cowart and Burt, “Confronting Death” (411-414)
Atul Gawande, “Whose Body Is It, Anyway?” (coursepack)
2/3: Drane, “Competency to Give Informed Consent” (415-418)
Lying to Patients
2/5: Lipkin, “On Telling Patients the Truth” (434-435)
Cullen and Klein, “Respect for Patients” (435-442)
2/7: [No new reading]
2/10: DEBATE #1
PART TWO: LIFE
AND DEATH
2/12: Singer,
Prologue, Chs. 1 and 2
2/14: Singer,
Ch. 3
2/17: Carl
Cohen, “The Case for Presumed Consent to Transplant Human Organs After Death” (773-779)
2/19: Embryology Fact Sheet (coursepack)
Centers for Disease Control and Prevention, Fact Sheet Abortion Surveillance (web) Gregg Easterbrook, “Abortion and Brain Waves” (web)
2/21: Pope
John Paul II, “The Unspeakable Crime of Abortion” (coursepack)
Note
on “The Adoption Option” (coursepack)
2/24: Singer,
Ch. 5
2/26: Thomson, "A Defense of Abortion" (87-96)
2/28: Marquis,
"Why Abortion is Immoral" (105-109)
3/3: Norman,
“The Wrongness of Killing” (coursepack)
3/5: Susan
Sherwin, “Abortion Through a Feminist Ethic Lens” (113-116)
3/7: DEBATE
#2
3/17: “Introduction”
(145-48)
Singer,
Ch. 6
3/19: Robertson,
"Examination of Arguments" (151-157)
3/21: Robert F. Weir, "Life-and-Death Decisions" (163-169)
3/24: [No new reading]
3/26: DEBATE #3
3/28: “Introduction”
(202-211)
Singer,
Ch. 4
3/31: James
Rachels, “Active and Passive Euthanasia” (212-215)
Thomas
D. Sullivan, “Active and Passive Euthanasia:
A Reply” (coursepack)
4/2: Singer,
Ch. 7
“Social
Context: Oregon’s Physician Assisted
Suicide Law” (192-196)
“Legal
Background on Oregon v. Ashcroft” (web)
4/4: Daniel
Brock, “Voluntary Active Euthanasia” (215-222)
4/7: Daniel
Callahan, "When Self-Determination Runs Amok" (225-230)
4/9: [No new reading]
4/11: DEBATE
#4
4/14: Singer,
Ch. 8
4/16: Singer,
Ch. 9
4/18: “Social Context: Hello,
Dolly” (647-650)
“Social Context:
Human Stem Cells—Amazing Treatments of the Future?” (569-571)
4/21: Robert P. Lanza, et. al., “The Ethical Validity of Using Nuclear
Transfer” (coursepack)
Charles Krauthammer, “Crossing Lines” (web)
4/23: The President’s Council on Bioethics, Executive Summary from Human
Cloning and Human Dignity: An Ethical Inquiry (web)
4/25: [No new reading]
4/28: Leon Kass, "The Wisdom of Repugnance" (710-715)
Philip M. Boffey, “Fearing the Worst Should Anyone
Produce a Cloned Baby” (web)
4/30: [No new reading]
5/2: DEBATE #5
Teaching
Policies:
Attendance
In my lectures I will often introduce material that
is not covered in the reading assignments.
You will be held responsible for
knowing this material. If you do
not come to class, you will not know this material, and your performance on
essays and exams will suffer. So come
to class.
Also, attendance is a significant part of your class
participation grade. Everyone is allowed
two absences, no questions asked.
Absences beyond that will begin to chip away your participation
grade. Prior to the start of each
class, there will be an attendance sheet for you to sign at my desk. After class starts, this sheet will be put
away. Hence, coming late to class will count as a "no show" for
attendance purposes. So don't be
late. (Of course, any questions or comments
you make during the class period will still count toward your participation
grade).
Finally, if you do miss class, do the assigned
reading straight away and ask your fellow students whether you can copy their
notes from lecture. After having studied these notes, you
may ask me questions about items you don't understand.
Academic Conduct
Students are expected to conform to the Standards of
Academic Conduct printed in the Student
Handbook. Please familiarize
yourself with these. Violations will be
reported to the Ithaca College Conduct Review Board. Additionally, you will receive a grade of zero on any assignment
that is not completed according to these standards.
Classroom Behavior
I care about your education, and I
put a lot of time into preparing lectures and classroom activities. Hence it is disrespectful not to give me
your attention in class. If during our
class's time period you wish to read the school newspaper, catch up on your
sleep, write a letter to a friend, finish your Spanish homework, study for a
math exam, or talk to a fellow classmate, then please do not come to class—stay
home. Your participation grade will
suffer more from such actions than it will from an absence. Talking to fellow classmates is an
especially annoying action, as this disturbs other students in addition to
being disrespectful. On that same
note, please turn off your cell phones before entering the classroom.
The Moral Conversation Project
The issues we will study in this course are extremely difficult issues. Since we have such a short time, do not expect to emerge from the course with a settled view on each of the course’s issues; in fact, you will probably emerge from the course thinking that the answers to at least some of the issues are less clear-cut than you had hitherto imagined.
Since you will not walk away with a settled view of each issue we study, the value of the course does not lie in giving you such views. Instead, the course’s value lies in sharpening your abilities to reason well about ethical issues—that is, its value lies in equipping you with the mental tools you need to begin the process of piecing together well-reasoned responses to ethical issues. Another value of the course is that it will give you practice in reasoning about these issues with other people—in particular, with other people who may not initially be inclined to view matters as you do. Being able to converse and reason with others who hold different views is an absolutely essential skill to have in a democracy like ours, composed as it is of many different types of people.
In short, the course aims to improve both your moral reasoning skills and your moral conversation skills. The Moral Conversation Project is designed to further both of these aims. As part of this project, you will on three different occasions in the term be assigned a conversation partner. On each occasion, you must contact your partner in person, by phone, or by email (email addresses will be provided) to set up an hour long meeting outside of class time. During your meeting, you will discuss questions given to you by the professor. For each conversation you will record an entry in your “Moral Conversation Journal”—a blue Ithaca College examination book that you will be provided to you. Each journal entry should have the following format:
· Pre-conversation reflection (2 pages): Record here your initial reactions to the discussion questions.
· Conversation report (3 pages): Summarize here some of the main features of your conversation—points on which you and your partner agreed or disagreed, points on which you and your partner expressed confusion or uncertainty, points on which you and your partner felt you needed further information, points your partner raised that you had never thought of before, etc.
· Post-conversation reflection (2 pages): Record here your reactions to the discussion. Did your views change in any way? (There is of course no requirement that they do change, but you may in fact find that they do some of the time.) Are you more or less optimistic that there is a best answer to the discussion questions? Did you find the conversation comfortable or uncomfortable? And so on.
It goes without saying that you should make an effort to write legibly. You will not hand in your journal until Friday, April 18th, by which time all three conversations will have taken place.