Instructor: David Squires
Office and Hours: Check homepage for location, T 1:00pm-3:00pm or by appointment
This course is a survey of medical ethics. It is helpful to know something about normative ethics before inquiring into applied ethics. We thus begin by investigating three important normative ethical theories: virtue ethics, deontology, and utilitarianism. We will read sections of the foundational texts of these systems, which, though harder to read than a textbook, will serve as a more useful groundwork should one wish to go on to further study. We will then cover a great many topics in medical ethics including but not limited to patient autonomy, informed consent, truth-telling and confidentiality in medicine, the ethics of clinical trials, access to experimental drugs, animals in medical research, genetic control, reproductive control, abortion, euthanasia, and justice in healthcare systems.
Kant, Immanuel. Groundwork of the Metaphysics of Morals. Edited by Mary Gregor and Jens Timmermann. Cambridge: Cambridge University Press, 2012
Mill, John Stuart. Utilitarianism. Edited by George Sher. Indianapolis/Cambridge: Hackett Publishing Company, Inc.
Munson, Ronald. Intervention & Reflection: Basic Issues in Bioethics, 10th Edition. United States: Cengage Learning, 2017
***Make sure to purchase this exact edition—i.e. the 10th edition. The field of medicine is changing rapidly, so it is important to have a current text that deals with the latest ethical questions/controversies.
Various other materials will be handed out via email—indicated below with a *
Assignments and Academic Policies
Assignments: there will be three paper assignments over the course of the semester. The papers are weighted equally (20% each). Papers are graded for substance (understanding the prompt, answering the prompt, producing good arguments, etc.), as well as for the quality of writing (grammar, usage, organization, style, etc.). For the sake of fairness, do not exceed the length limit. You should not need to make use of outside sources. Papers are due at the beginning of class, in hard copy, on the Thursday of the week that they are due. Late papers will be penalized.
Participation: There are two independent participation assignments each worth 20% of the final grade—viz. 1) Discussion Participation and 2) Reading Participation. Participation points are not free points, so read these two sections below carefully.
Discussion Participation: This participation assignment measures your engagement in terms of philosophical discussion. The best scores will go to students who show a sustained pattern of thoughtful contribution and questioning in class, especially if that contribution demonstrates that you have read the assigned material diligently. This can take the form of asking questions to me or other students, answering questions that I ask you by offering your interpretation of a text, producing or analyzing arguments, comparing different texts, etc. You must bring to class the text we are reading each day. If the assignment is from an electronic text that I distribute, you should print it out and bring it to class. Class attendance is an essential part of Discussion Participation. Only university required absences will be excused. Unexcused absences will result in Discussion Participation penalties.
Reading Participation: This participation assignment measures your engagement with the assigned readings. You are expected to read all of the assigned texts carefully and completely. As few as four times this semester or as many as each class period, I will give you a quiz question(s) that you must answer in a short period of time. Your Reading Participation score will be based on your answers to these quizzes, which will receive standard letter grades. If you’ve done the reading carefully and completely you should not have too difficult a time offering good answers to the questions you’ll be asked. These quizzes are not designed to test philosophical expertise, so much as whether you are doing the readings and understanding them at a basic level. In general, think of the readings and class participation as an act of citizenship, through which each individual and the collective body is responsible for the class experience.
Summary: Papers count for 60% of your grade (20% each), discussion participation for 20%, reading participation for 20%. Rubric: A: 93%, A-: 90%, B+: 87%, B: 83%, B-: 80%, C+: 77%, C: 73%, C-: 70%, D+: 67%, D: 63%, D-: 60%
Disabilities: The university’s policies regarding disabilities can be found at: https://dulac.nd.edu/academic/disabilities/ Information concerning Sara Bea Disability Services can be found at: http://sarabeadisabilityservices.nd.edu/
Academic Integrity: Don’t Cheat! This includes plagiarism of any variety, including having others do your work for you or merely syntactically or terminologically altering the work of others (e.g. plugging in a few different words into a paragraph written by someone else). Any instances of cheating discovered will be dealt with swiftly according to university policy.
Laptop and Mobile Device Policy: Laptops and Mobile devices should not be used during class. The results are in: scientific studies show that screens mean less glean. Science giveth the iPhone X and science taketh it away!
Class 1 (8/21) Introduction
Class 2 (8/23) Aristotle: Nicomachean Ethics Book 1*
Class 3 (8/28) Aristotle: Nicomachean Ethics Book 2, Book 6 Chapters 1-7*
Class 4 (8/30) Aquinas: Selected Passages on Virtue*
Class 5 (9/4) Aquinas: Selected Passages on Natural Law and the Principle of Double Effect*
Class 6 (9/6) Kant: Groundwork of the Metaphysics of Morals Preface, Section 1
Class 7 (9/11) Kant: Groundwork of the Metaphysics of Morals Section 2
Class 8 (9/13) I&R Chapter 12: Utilitarianism; Major Moral Principles;
Beyond Principlism (903-910, 932-961) 36
Class 9 (9/18) I&R Chapter 1: Patient Autonomy; Children and Informed Consent (3-20, 76-80, 85-91) 27
Class 10 (9/20) I&R Chapter 1: Paternalism in Medicine (20-49, 60-76, 80-85) 50
First Paper Due (9/20)
Class 11 (9/25) I&R Chapter 1: Truth Telling; Confidentiality (49-60, 91-109) 29
Class 12 (9/27) I&R Chapter 2: Informed Consent and Experimentation (116-120, 122-127, 132-154, 172-193) 52
Class 13 (10/2) I&R Chapter 2: Clinical Trials; Conflicts of Interest; Access to Experimental Drugs; Animals in Research (IR120-122, 127-132, 169-172, 193-225) 42
Class 14 (10/4) I&R Chapter 3: Prenatal Genetic Testing; Dilemmas of Genetic Choice; A New Eugenics? (253-262, 302-327) 34
Class 15 (10/9) I&R Chapter 3: Genetic Screening, Counseling, and Diagnosis; Genetic Research, Therapy, and Technology; Genetics and Abortion (279-302, 327-339) 33
Class 16 (10/11) I&R Chapter 3: The Human Genome Project; Gene Therapy/Editing; Stem Cells (239-253, 262-279, 339-344) 36
Class 17 (10/23) I&R Chapter 4: Case Studies in Reproductive Control; Surrogate Pregnancy (350-371, 381-384, 420-434) 39
Class 18 (10/25) I&R Chapter 4: Techniques of Assisted Reproduction; Ethical and Social Questions; Assisted Reproduction and the Limits of Autonomy; Human Reproductive Cloning (372-381, 384-394, 394-420) 45
Class 19 (10/30) I&R Chapter 5: Abortion (441-448, 455-467, 477-492) 37
Class 20 (11/1) I&R Chapter 5: Abortion Cont. (448-455, 467-477, 492-506) 31
Class 21 (11/6) I&R Chapter 6: The Dilemma of Impaired Infants (514-559) 46
Class 22 (11/8) I&R Chapter 7: Case Studies in Euthanasia; The Killing-Letting-Die Distinction (565-587, 594-602) 30
Second Paper Due (11/8)
Class 23 (11/13) I&R Chapter 7: Euthanasia Cont.: The Debate over Euthanasia and Assisted Death (587-594, 602-623) 28
Class 24 (11/15) I&R Chapter 8: Case Studies in Organ Transplantation; Who Deserves Transplant Organs? (627-649, 656-662) 28
Class 25 (11/20) I&R Chapter 8: Acquiring Transplant Organs; Allocation Principles in Medicine (549-656, 662-675) 20
Class 26 (11/27) I&R Chapter 9: Health Care and Equal Opportunity (680-712) 32
Class 27 (11/29) I&R Chapter 9/10: Health Care and the Affordable Care Act; Disability (712-729, 758-761, 781-785, 824-836 ) 38
Class 28 (12/4) I&R Chapter 10: Sex, Gender, and Medicine (734-746, 777-781, 785-795) 26
Class 29 (12/6) I&R Chapter 10: Race and Medicine (746-758, 773-777, 795-811) 32
Third Paper Due (12:00pm, last day of finals)