Philosophy 242
Smith College
Spring 2013
T Th 10:30-11:50 a.m.
Susan Levin
Dewey 203
Office Hours: T 1-2; Th 2-3; and by appointment
Phone: x3647
E-mail: slevin@smith.edu
Topics in Medical Ethics
This course will explore key philosophical issues in the field of medical ethics. Particular topics to be
treated include: prominent views of the optimal doctor-patient tie; the allocation of medical resources
and considerations of social justice; end-of-life care and euthanasia; procreative freedom and prenatal
testing. The goal is for us to reflect carefully on the issues both as individuals and as a group, bringing
philosophical rigor to the exploration of assumptions, intuitions, and theories.
Required Readings
1) Steinbock, Bonnie, John D. Arras, and Alex John London, eds. Ethical Issues in Modern Medicine.
8th edition. New York: McGraw-Hill, 2013. Available at the College Bookstore.
2) Genova, Lisa. Still Alice. New York: Pocket Books, 2009. Available at the College Bookstore.
3) Additional readings—including, but not limited to, those listed below—will be distributed in class,
available electronically, or on reserve in Neilson Library.
Schedule
Unit 1 (Jan. 29-31): Background
a) The Hippocratic Oath, Ethical Issues in Modern Medicine (hereafter, EIMM), p. 59
b) Introduction, EIMM, pp. 1-41
Unit 2 (Feb. 5-12): Approaches to the Doctor-Patient Tie and the Standing of Medicine
a) Ancient Roots of the Debate: selections from Plato’s Republic and Laws (to be distributed)
b) Overview: EIMM, pp. 43-58
c) Autonomy vs. Paternalism: EIMM, pp. 60-84
d) Medicine and Justice, A Case Study: Should Physicians Participate in Executions? EIMM, pp.
126-42
Unit 3 (Feb. 14-28): Resource Allocation and Considerations of Social Justice
a) Overview: EIMM, pp. 147-66
b) Is Access to Health Care a Moral Entitlement?
i) EIMM, pp. 174-82
ii) Excerpt from John Rawls, A Theory of Justice, revised edition (Cambridge, Mass.: Harvard
University Press, 1999)—to be distributed
iii) EIMM, pp. 182-92
c) Social Determinants of Health and the Health Care Debate:
i) selections from Richard Wilkinson and Michael Marmot, Social Determinants of Health: The
Solid Facts, 2nd edition (Copenhagen, World Health Organization, Regional Office for Europe,
2003)—book is available electronically through Neilson Library
ii) EIMM, pp. 222-31
iii) excerpts from Norman Daniels, Just Health: Meeting Health Needs Fairly (New York:
Cambridge University Press, 2008)—book is available electronically through Neilson Library
d) Considerations of Fairness and the Allocation of Particular Treatments: EIMM, pp. 233-47, 25475
e) Personal Responsibility and Health: EIMM, pp. 247-53
f) Organ Transplantation and Remuneration:
i) EIMM, pp. 277-87
ii) “Conversations with Kidney Vendors in Pakistan: An Ethnographic Study,” Farhat Moazam,
Riffat Moazam Zaman, Aamir M. Jafarey, Hastings Center Report 39/3 (2009): 29-44 (available
electronically via Neilson Library)
g) Health and Social Justice: The Relevant Moral Community: EIMM, pp. 289-94, 302-7
Unit 4 (Mar. 5-Ap. 4; Spring Break Mar. 16-24): Euthanasia and the Refusal and Withdrawal of
Life-sustaining Treatment
a) Definitions of Death:
i) selections from President’s Commission for the Study of Ethical Problems in Medicine and
Biomedical and Behavioral Research, Defining Death: A Report on the Medical, Legal and
Ethical Issues in the Determination of Death (Washington, DC: U.S. Government Printing
Office, 1981)—work accessible online (http://catalog.hathitrust.org/Record/001815034)
ii) EIMM, pp. 517-25, 530-34
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b) Overview, Euthanasia and Stances toward Life-Sustaining Treatment: EIMM, pp. 311-24
c) Incompetence: Anticipations and Realities:
i) EIMM, pp. 355-73
ii) “Terri Schiavo, Son Hudson, and ‘Nonbeneficial’ Medical Treatments,” Robert M. Veatch,
Health Affairs 24/4 (2005): 976-79 (article available electronically through Neilson Library)
iii) “Schiavo’s Legacy: The Need for an Objective Standard,” Rebecca Dresser, Hastings Center
Report 35/3 (2005): 20-22 (article available electronically through Neilson Library)
iv) EIMM, 373-90, 398-416
d) Physician-Assisted Suicide:
i) EIMM, pp. 437-61
ii) “Assisted Suicide: The Philosophers’ Brief,” Ronald Dworkin, Thomas Nagel, Robert Nozick,
John Rawls, Thomas Scanlon, and Judith Jarvis Thomson, including an introduction by Ronald
Dworkin—accessible online (http://www.nybooks.com/articles/archives/1997/mar/27/assistedsuicide-the-philosophers-brief/?pagination=false)
e) Duty to Die? EIMM, pp. 483-501
f) The novel Still Alice
Unit 5 (Ap. 9-25): Reproduction and Genetics
a) Abortion: EIMM, pp. 510-14, 543-73
b) Overview, Procreative Assistance and Genetics: EIMM, pp. 585-91
c) Procreative Assistance: EIMM, pp. 631-41, 650-68
d) Prenatal Genetic Testing: EIMM, pp. 609-29
Unit 6 (Ap. 30-May 2): The Experimental Use of Human Subjects
a) Research involving Children: EIMM, pp. 762-5, 781-6
b) Clinical Trials Involving AZT to Prevent Perinatal Transmission of HIV—Who Ought to Benefit
from International Research? EIMM, pp. 757-62, 766-80
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Course Requirements
1) Regular and spirited attendance! It is crucial that everyone come to each class meeting wellprepared to discuss and assess the readings. As the use of laptops and other electronic devices in class
can pose a distraction, I would ask that they not be employed. Participation of various forms, including
the leading of discussion, will make up 20% of the course grade.
2) In-class presentation (15%). (Date: Depends on when you sign up to give it.)
3) Two 5-page papers, due by noon in the Philosophy Department office (Dewey Hall 106) on
Monday, March 4 and Friday, April 5—20% each. Alternatively, you may submit papers via email, but
if you do so, be sure that you send them from your Smith account and that you receive email
confirmation of receipt from me.
4) One 6-8 page paper, due by noon in the Philosophy Department office (Dewey Hall 106) on Friday,
May 10—25%. Alternatively, you may submit papers via email, but if you do so, be sure that you send
them from your Smith account and that you receive email confirmation of receipt from me.
Note: Grades on late work (i.e., that turned in at any point after it is due) will be lowered one step
(e.g., from A- to B+) each day.
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