Issues in Bioethics


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Issues in Bioethics

  1. 1. STS 5444: Issues in Bioethics Mondays, 7:00 to 9:45 p.m., Spring, 2006 Instructor: Lee L. Zwanziger Phone: (301) 443-5362 Email: This class is an introductory graduate course. It is designed to help students become familiar with the history and some primary themes of bioethics, mostly in the U.S. We will look at both the substantive content of bioethics, including some specific issues, as well as the nature of the field overall. Course work includes weekly readings to be prepared before class and discussed in class, and papers. Students’ work will be evaluated as follows: term paper (30%), two short papers (20% each), presentation in class (15%), general class participation (10%) and completion of NIH on-line tutorial (5%). NIH Ethics Tutorial: Sometime before February 13, 2006, students should visit the website following, register, take and pass the tutorial and print out their certificate of completion. Any students who have already taken this module should see me and I’ll work out a comparable alternate assignment. Participation: Students should attend and participate in class discussions, which will be based on the assigned readings. If an illness or other unavoidable conflict prevents your attendance, please try to let me know. Presentation: each student will present the material of the week to the class on at least one occasion. Specifics will depend on class registration and will be arranged at the first meeting. Short Paper #1: Describe the field of bioethics in the U.S. --- what it is and how it has come to be what it is. My objective in assigning this is to provide you the opportunity to review and summarize the history, mainly from Jonsen though you certainly may use other works as well. The paper should be 2200 to 2600 words long (that would be about 7-8 pp if double spaced in 12 pt type, but there is no need to double space since you’ll be sending it electronically anyway) plus references as needed. This paper is due 3/13. I’d planned to have this due before the break but I realize that some students may need the breaks for writing; if you plan to travel during spring break, however, you may wish to plan to start and finish a bit early. Short Paper #2: Select a topic discussed in sessions 6-9 (genetics, organ transplants, beginning of life/reproduction, or end of life) and present a specific issue belonging to the topic, explain why it is a moral issue, and show how differing initial assumptions may lead to opposing assessments of the issue. My objective in assigning this is to provide you with an opportunity to analyze at least one standard bioethics issue and demonstrate your grasp of the arguments for the alternative positions. Length as above; due 4/10. Term Paper: Select a topic in bioethics and analyze it: describe the issue, some relevant history, alternative positions and the arguments for them. My objective in assigning this is to provide you with an opportunity to analyze a bioethics issue that particularly interests you and to demonstrate your grasp of the arguments for the alternative positions. The topic need not be one on the 1
  2. 2. syllabus, and it should be different from the topic you wrote about for paper #2 and also from the topic that you presented orally. You must clear the topic with me ahead of time. No well- formed topics are off-limits; the point of the pre-clearance is to make sure you have a feasible plan for a term paper, and to allow me to help you if needed. This paper should be about 4500 to 5000 words plus references and abstract, and will be due 5/8. All papers should be word-processed, with all quotations and other references documented in any standard format: year, author + reference list, numbered endnotes, footnotes. In general, the point of referencing is that a reader unfamiliar with this course should be able to locate the original reference you used and read it in the original author’s context, so that can be a guideline for what to provide. Please email the papers as an attachment, preferably in Word, to me by midnight of the due date. Please check your calendars now to make sure you can turn in your papers on time. If you do not have reasonably easy access to email/internet resources, or if you foresee difficulties of other sorts, please contact me so we can make other arrangements. Plans and readings below, but instructor reserves right to make changes as needed. Please note: the two books can be ordered, e.g. from Amazon or other online services, and all articles are available electronically from VA Tech’s library (often in PDF files) or on the web at the address given. The two books have been placed on reserve in the main library of Blacksburg, in case some of you did not get this syllabus ahead of time. Jonson, AR. The Birth of Bioethics. NY, NY: Oxford U. Press 1998. ISBN: 0-19-517147-0 Evans, J.H. Playing God? Human Genetic Engineering and the Rationalization of Public Bioethical Debate. Chicago, IL: University of Chicago Press. 2002. ISBN: 0-226-22262-4. Meeting 1, 1/23: Intro, overview (you may find it helpful to read the sections on normative and applied ethics in the Internet Encyclopedia of Philosophy before class: ) Meeting 2, 1/30 Some history: Jonsen, 1998, preface, ch 1-3, and the article below: Reich WT. 1994. “The Word “Bioethics”: Its Birth and the Legacies of Those Who Shaped It.” Kennedy Institute of Ethics Journal 4(4): 319-335. Meeting 3, 2/6 Historical development continued: Johnsen, 1998, Ch 4-5 Seto B. 2001. “Required Education on the Protection of Human Subjects: An NIH Initiative.” Kennedy Institute of Ethics Journal 11(1): 87-90. Meeting 4, 2/13 More of founding documents and events **Reminder: NIH Tutorial Nuremberg Code, Declaration of Helsinki, Belmont Report (all three documents available on web at ) Dresser R. 2002. “The ubiquity and utility of the therapeutic misconception.” Social Philosophy and Policy 19(2):271-94. 2
  3. 3. Eckenwiler, L.2001. “Moral Reasoning and the Review of Research Involving Human Subjects.” Kennedy Institute of Ethics Journal 11(1): 37-69. Edwards, SJL, R Ashcroft, S Kirchin. 2004. “Research Ethics Committees: Differences and Moral Judgement.” Bioethics 18(5): 408-427. Miller FG, H Brody. 2003. “A Critique of Clinical Equipoise: Therapeutic Misconception in the Ethics of Clinical Trials.” Hastings Center Report 33(3): 19-28. Miller PB, C Weijer. 2003. Rehabilitating equipoise. Kennedy Institute of Ethics Journal 13(2):93-118. (optional: see also comment same journal 13(4):347-51.) Kuczewski M, PJ McCruden. 2001. “Informed consent: does it take a village? The problem of culture and truth telling.” Cambridge Quarterly of Healthcare Ethics 10(1):34-46. Macklin, R 1998. “Ethical Relativism in a Multicultural Society.” Kennedy Institute of Ethics Journal 8(1): 1-22. Meeting 5, 2/20 Genetics, ethics, policy Jonsen 1998, Ch 6 Evans 2002, Ch 1-3 Lombardo P. 2003. “Facing Carrie Buck.” Hastings Center Report 33(2): 14-17. Meeting 6, 2/27 Genetics, ethics, policy continued Evans, 2002, Ch 4-7 Spring Break: 3/6 Meeting 7, 3/13 Organ Transplantation **Reminder: Short paper #1 Jonsen, 1998, ch 7 Etzioni A. 2003. “Organ donation: a communitarian approach.” Kennedy Institute of Ethics Journal 13(1): 1-18. Fox, MD, MR Allee. 2005. “Values, Policies, and the Public Trust.” The American Journal of Bioethics, 5(4): 1–3. Joralemon D, P Cox. 2003. “Body Values: The Case Against Compensating for Transplant Organs.” Hastings Center Report 33(1): 27-33. Kahn JP. 2003. “ Three views of organ procurement policy: moving ahead or giving up?” Kennedy Insitute of Ethics Journal 13(1): 45-50. Veatch RM. 2003. “Why liberals should accept financial incentives for organ procurement.” Kennedy Institute of Ethics Journal 13(1): 19-36. Zink, S, S. Wertlieb, J. Catalano, V. Marwin. 2005. “Examining the Potential: Exploitation of UNOS Policies.” The American Journal ofBioethics, 5(4): 6-10. Meeting 8, 3/20 End of Life, Definition of Death Jonsen, ch 8 Callahan D. 2000. “Death and the Research Imperative.” New England Journal of Medicine 342(9): 654-656. Also the responses, 343(3):223-225. (Note: I will supply this--LLZ) Chan HM.2004. “Sharing Death and Dying: Advance Directives, Autonomy and the Family.” Bioethics 18(2):87-103. Fagerlin A, CE Schneider. 2004. “Enough: The Failure of the Living Will.” Hastings Center Report 34(2):30-42. 3
  4. 4. Harris J. 2000. “Essays on science and society: Intimations of immortality.” Science 288: 59. Harris J. 2003. “Consent and end of life decisions.” Journal of Medical Ethics 29(1):10-15. Meeting 9, 3/27 Beginning of Life, Reproduction Jonsen ch 9 Callahan D. 1998. “Cloning: then and now.” Cambridge Quarterly of Healthcare Ethics 7(2):141-4 Fitzpatrick WJ. 2004. “Totipotency and the moral status of embryos: new problems for an old argument.” Journal of Social Philosophy 35(1): 108-122. Harris J. 2003. “Stem cells, sex, and procreation.” Cambridge Quarterly of Healthcare Ethics 12(4):353-71. Kass LR The Meaning of Life - In the Laboratory, reprinted in The Public Interest, available at: Savulescu J, J Harris. 2004. “The creation lottery: final lessons from natural reproduction: why those who accept natural reproduction should accept cloning and other Frankenstein reproductive technologies.” Cambridge Quarterly of Healthcare Ethics 13(1):90-5. Meeting 10, 4/3 Neuroethics Casebeer WD. 2003. “Moral cognition and its neural constituents,” Nature Reviews Neuroscience 4:841-846. Farah MJ, J Illes et al. 2004. “Neurocognitive enhancement: what can we do and what should we do?” Nature Reviews Neuroscience 5(5):421-5. Farah MJ, PR Wolpe. 2004. “Monitoring and manipulating brain function: new neuroscience technologies and their ethical implications.” Hastings Center Report 34(3):35-45 Greely HT 2004. “Prediction, Litigation, Privacy, and Property: Some Possible Legal and Social Implications of Advances in Neuroscience” text of lecture, available at website below: Illes, J. and Racine, E. (2005). Imaging or Imagining: A Neuroethics Challenge Informed by Genetics. American Journal of Bioethics, 5(2), 5-18. Kulynych J. 2002. “Legal and ethical issues in neuroimaging research: human subjects protection, medical privacy, and the public communication of research results.” Brain and Cognition 50(3): 345-57. Wolpe, P. R., Foster, K. R. and Langleben, D. D. (2005). Emerging Neurotechnologies for Lie- Detection: Promises and Perils. American Journal of Bioethics, 5(2), 39-49. Meeting 11, 4/10 Public Health and Medicalization **Reminder: Short paper #2 Bayer R, AL Fairchild. 2004. “The Genesis of Public Health Ethics.” Bioethics 18(6):473-492. Callahan D. 2003. “Individual Good and Common Good: a communitarian approach to bioethics.” Perspectives in Biology and Medicine 46(4): 496-507. Dawson A. 2004. “Vaccination and the Prevention Problem.” Bioethics 18(6):515-530. Epstein R. 2003. “Let the shoemaker stick to his last: a defense of the “old” public health.” Perspectives in Biology and Medicine 46(3): 138-159. Gostin, LO, MG Bloche. 2003. “The Politics of Public Health: A Response to Epstein.” Perspectives in Biology and Medicine 46(3): 160-175. Verweij M. 1999. “Medicalization as a Moral Problem for Preventive Medicine” Bioethics 13(2): 89-113. 4
  5. 5. Meeting 12, 4/17 Bioethics beyond health care Donnelley, S. 2002. “Natural Responsibilities: Philosophy, Biology, and Ethics in Ernst Mayr and Han Jonas.” Hastings Center Report 32(4): 36-43. Kaebnick GE. 2000. “On the Sanctity of Nature.” Hastings Center Report 30(5): 16-23. Whitehouse, P. J. 2003. The Rebirth of Bioethics: Extending the original formulations of Van Rensselaer Potter. The American Journal of Bioethics 3(4):W26-W31. Baylis F, JS Robert. 2004. “The Inevitability of Genetic Enhancement Technologies.” Bioethics 18(1): 1-26. Sandel MJ. 2004. “The case against perfection: what's wrong with designer children, bionic athletes, and genetic engineering.” Atlantic Monthly 292(3): 50-4, 56-60, 62. Kamm, FM. 2005. “Is there a problem with enhancement?” The American Journal of Bioethics 5(3):5-14. Elliott C. 2003 “Costing an Arm and a Leg: The victims of a growing mental disorder are obsessed with amputation. Slate, posted Thursday, July 10, 2003, at 10:15 AM PT see: Meeting 13, 4/24 Reflections, international Jonsen, Ch 10-12 UNESCO 2005. Universal Draft Declaration on Bioethics and Human Rights, link below: N.pdf Conference Report. 2004. “Moral Standards for Research in Developing Countries: From “Reasonable Availability” to “Fair Benefits”.” Hastings Center Report 34(3): 17-27. Macklin, R. 2001. “After Helsinki: Unresolved Issues in International Research.” Kennedy Institute of Ethics Journal 11(1):17-36. Meeting 14, 5/1 Consensus and Disinterested Action in Bioethics Turner L. 2004. “Bioethic$ Inc.” Nature Biotechnology 22(8): 947. Carl Elliott, C. 2004. “Six problems with pharma-funded bioethics.” Studies in the History and Philosophy of Biological & Biomedical Sciences 35: 125–129 Turner L. 2004. “Bioethics needs to rethink its agenda.” British Medical Journal 328: 175. Trotter G 2002. “Moral consensus in Bioethics: Illusive or Just Elusive?” Cambridge Quarterly of Healthcare Ethics 11:1-3. Englehardt HT. 2002. “Consensus Formation: The Creation of an Ideology.” Cambridge Quarterly of Healthcare Ethics 11: 7-16. Kuczewski M. 2002. “Two Models of Ethical Consensus, or What Good is a Bunch of Bioethicists?” Cambridge Quarterly of Healthcare Ethics 11: 27-36. Zoloth L. 2002. “Keeping Company: Ethics and the Talk in the Commons.” Cambridge Quarterly of Healthcare Ethics 11: 52-60. Moreno JD. 2002. Making Sense of Consensus: Responses to Englehardt, Hester, Kuczewski, Trotter, and Zoloth.” Cambridge Quarterly of Healthcare Ethics 11: 61-64. Kelly SE. 2003. “Public Bioethics and Publics: Consensus, Boundaries, and Participation in Biomedical Science Policy.” Science, Technology and Human Values 28(3): 339-364. 5