Phil 330: BIOMEDICAL ETHICS
FALL Semester 2015
Schedule Number: 22667
INSTRUCTOR and CLASS INFORMATION
Instructor: H. Reyes
Email: hreyes@mail.sdsu.edu
Office Hours Location: AL 427
Office Hours: MW 9:30 am – 12:00 noon
COURSE OVERVIEW
Course Catalog Description
Phil 330: Biomedical Ethics (3) (GE) – has to do with value judgments upon which medicine is based and the ethical issues which medicine faces.
Course Description and Objectives:
In this course, we are going to study ethical issues in modern medicine. Biomedical ethics in particular focuses on questions about how one should act in the context of patient care and the distribution of medical resources. We will focus on addressing questions such as: What makes clinical research on humans morally justified? How can we justify human experimentation on vulnerable populations such as children and third world peoples? What obligations do doctors have toward their patients, patients’ families, and society? Is abortion, in vitro fertilization or genetic engineering morally permissible? Should a pregnant woman be punished for exposing her fetus to risk? Who has the right to life and does such a right obligate others to provide medical care? Should gene doping, stem cell research or human reproductive cloning be legal?
Are health benefits fairly distributed based on race/ethnicity, gender, or sexual orientation? How do we distribute scarce resources such as organs for transplantation? Does a person have a right, or even a duty, to die?
The following are the objectives and goals of this course:
1.
to interpret and analyze arguments from philosophical texts in biomedical ethics
2.
to understand the reasoning of others and to communicate well-formed objections
3.
to apply various ethical theories and moral principles to real life medical cases
4.
to contextualize controversies in medicine in light of historical and cultural conditions
5.
to approach medical issues with personal or global relevance from multiple perspectives
6.
to recognize the debate between competing groups (multicultural, religion vs. science, patient vs. researcher, adult vs. child) and try to negotiate a resolution
7.
to learn how to construct, communicate, and defend one’s own well-reasoned arguments about contemporary moral issues in biomedical ethics
General Education (GE) Outcomes:
Philosophy 330 is an upper division course which fulfills General Education section IV,
Explorations of Human Experience. Courses in this area must not be taken sooner than the semester in which a student achieves upper division standing (60 units passed). Upper division courses in the major department may not be used to satisfy General Education section IV,
Explorations of Human Experience. Courses in a student’s major (collaborative, cross-listed,
“Same course as”) may not be used in Section IV, Explorations of Human Experience.
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Philosophy 330 is aimed at “providing the breadth of knowledge necessary for meaningful work, life-long learning, socially responsible citizenship, and intellectual development. Through this course, “students gain intellectual and practical skills such as inquiry and analysis, creative and critical thinking, written and oral communication, etc.” Among the “seven essential capacities” emphasized by San Diego State’s General Education program, Philosophy 330 develops in students these abilities:
1.
Construct, analyze, and communicate arguments
2.
Apply theoretical models to the real world
3.
Contextualize phenomena
4.
Negotiate differences
5.
Integrate global and local perspectives
6.
Illustrate relevance of concepts across boundaries
7.
Evaluate consequences of actions.
Specific Learning Goals:
This upper division GE course fulfills the goals for GE Courses in the Humanities and Fine
Arts. In particular, Philosophy 330 will promote student’s understanding of “human problems, responsibilities and possibilities in changing historical contexts and diverse cultures.” Students will gain the ability to identify and to evaluate belief systems and values. Students will acquire
“capacities for reflection, critique, communication, [and] cultural understanding.” Upon completing this area of Foundations, students will be able to:
Goal 1 : Analyze written, visual, or performed texts in the humanities and fine arts with sensitivity to their diverse cultural contexts and historical moments.
Goal 2 : Develop a familiarity with various aesthetic and other value systems and the ways they are communicated across time and cultures.
Goal 3 : Argue from multiple perspectives about issues in the humanities that have personal and global relevance.
Goal 4 : Demonstrate the ability to approach complex problems and ask complex questions drawing upon knowledge of the humanities.
ENROLLMENT OVERVIEW
Prerequisites: Completion of the General Education requirement in Foundations of Learning
II.C., Humanities. Also, to satisfy upper division GE requirement, student should have upper division standing. Phil 101 (Intro to Ethics) is recommended, but not required. Deadline to add, drop or change grading basis: September 4, 2015 (11:59 pm)
COURSE MATERIALS
REQUIRED TEXT: Vaugh, Lewis (2013). Bioethics: Principles, Issues, and Cases (2 nd edition). Oxford University Press. (with ISBN: 978-0-19-979623-6)
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COURSE STRUCTURE and CONDUCT
Our course is a fully online class . As such, it offers the advantage of learning anyplace and anytime. However, despite this flexibility, in order to be successful in the online course students should keep in mind the following requirements:
1.
A computer - PC or Macintosh- with a stable Internet connection. Higher speed Internet connections (cable modem, DSL) are strongly recommended.
2.
Basic computer skills - email, surf the Internet, and create basic word processor files.
3.
Microsoft Office 2010, or higher (Must include Word and PowerPoint).
4.
Complete readings and assignments by the dates indicated on the syllabus. Time management is very important for online classes. Distance learning courses require as much time as traditional classroom instruction. The primary difference is that online instruction allows flexibility. Procrastinators are rarely successful in distance learning courses.
5.
Check email and Blackboard announcement page on a daily basis.
Please Note The Following:
1.
To see whether you meet the distance learning prerequisites, please take SDSU’s
“readiness survey” at https://sunspot.sdsu.edu/pls/webapp/survey.hybrid_learning.main
2.
Download Mozilla’s
Firefox is recommended (however, some students claim that Safari or Chrome work better for them).
3.
Download (for free) all necessary software , including the latest versions of: Adobe’s
Acrobat Reader and Flash Player , QuickTime Player , and Java .
4.
Have a backup plan for fulfilling course obligations when/if your computer malfunctions. For example, to find out about computers at the library; go to http://scc.sdsu.edu/home.php
.
5.
If you need to learn how to use Blackboard, go to: http://its.sdsu.edu/blackboard/student/
6.
Re: Technology -- The instructor cannot provide IT support. You are responsible for your computing needs. When problems occur on the SDSU end (blackboard crash, our clerical errors), you will not be penalized. However, when problems occur on your end, you must fix them prior to any deadlines. Student IT problems are not an acceptable excuse for non-completion of work . You can go to Student Computing Center in Love
Library for help or to use their computers; call (619) 594-3189; email scc@rohan.sdsu.edu
; or click http://scc.sdsu.edu/home.php
.
COURSE ASSESSMENT AND GRADING
COURSE REQUIREMENTS:
The following are the different types of requirements you will complete in this course:
READINGS:
You are expected to do all the assigned readings. This includes the e-lectures (posted on
Blackboard), the readings assigned from your textbook, and other materials that may be posted
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on the course document section of Blackboard for each week. Every week, there is a Blackboard announcement, and this announcement will inform you of the readings and class work that you need to do for that week. That is why you must make it a practice to login to Blackboard every
Monday to find out about the announcement for the week.
ONLINE DISCUSSION BOARD (ODB):
For each Online Discussion Board assignment you are to post your answers to the discussion board questions on the Discussion Board section of Blackboard. The average grade of all the responses to the discussion board will be 40% of your final grade.
Please remember that the Discussion Board is not a chat room. Responses and replies should be thoughtful, considerate and must use college-level language and grammar. Carefully proof-read your response to the discussion board questions for correctness in grammar, spelling, use of punctuation marks, etc. before submitting your response. Each ODB is worth 10 points.
NOTE: You must follow the specific requirements as to the due date for the posting of your discussion board response as well as for other things you will be asked to do in regard to each discussion board.
QUIZZES:
For each chapter there will be a short multiple-choice quiz. This is primarily intended to ensure that you become familiar with the critical concepts and issues covered in each chapter. Each quiz is worth 10 points.
MAJOR EXAMS:
There will be a major exam upon completion of each module. These major exams will consist of essay questions that you will need to answer as clearly and thoroughly as possible. These major exams will be based on the e-lectures and readings done for a given period of the course. Again, the specifics about these major exams will be provided in the Blackboard announcement. Each major exam is worth 100 points.
GRADING POLICY:
Your final grade will be based on the following distribution of points:
600-------------------- 6 Major Exams
100 --------------------10 Quizzes
100-------------------- 10 ODBs
800 TOTAL POINTS
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Your final letter grade will be based upon the following scale:
750 – 800 ---------- A 500 – 549----------- C+
700 --749----------- A- 450 – 499----------- C
650 – 699----------- B+ 400 – 449----------- C-
600 – 649----------- B 350 – 399----------- D+
550 – 599----------- B- 300 – 349----------- D
Anything below 300 is an F.
STUDENT DISABILITY SERVICES & RELIGIOUS OBSERVANCES
Student Disability Services
If you are a student with a disability and believe you will need accommodations for this class, it is your responsibility to contact Student Disability Services at (619) 594-6473. To avoid any delay in the receipt of your accommodations, you should contact Student Disability Services as soon as possible. Please note that accommodations are not retroactive, and that accommodations based upon disability cannot be provided until you have presented your instructor with an accommodation letter from Student Disability Services. Your cooperation is appreciated.
The CSU Office of the Chancellor defines a learning disability as “... a generic term that refers to the heterogeneous group of disorders manifested by significant difficulties in the acquisition and use of listening, speaking, reading, writing, reasoning or mathematical abilities. These disorders occur in persons of average to very superior intelligence and are presumed to be due to central nervous system dysfunction. Even though a learning disability may exist concomitantly with other handicapping conditions (e.g., sensory impairments) or environmental influences (e.g., cultural/language difficulties), it is not the direct result of these conditions or influences.” If you think something might prevent you from doing well in this course, you should discuss this with me so that proper arrangements may be made to accommodate your needs.
Religious Observances
By the end of the first week of classes, students should notify the instructor of planned absences for religious observances. They must inform faculty members within the first week in order to be excused from scheduled tasks on scheduled days.
ACADEMIC HONESTY
The University adheres to a strict policy regarding cheating and plagiarism . These activities will not be tolerated in this class. Become familiar with the policy
(http://www.sa.sdsu.edu/srr/conduct1.html). Any cheating or plagiarism will result in failing this class and a disciplinary review by Student Affairs.
Examples of Plagiarism include but are not limited to:

Using sources verbatim or paraphrasing without giving proper attribution (this can include phrases, sentences, paragraphs and/or pages of work)

Copying and pasting work from an online or offline source directly and calling it your own

Using information you find from an online or offline source without giving the author credit
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
Replacing words or phrases from another source and inserting your own words or phrases

Submitting a piece of work you did for one class to another class
If you have questions on what is plagiarism, please consult the policy
(http://www.sa.sdsu.edu/srr/conduct1.html) and this helpful guide from the Library :( http://infodome.sdsu.edu/infolit/exploratorium/Standard_5/plagiarism.pdf
)
COURSE OUTLINE/SCHEDULE
MODULE #1: Introductory Module
#1 – Week of 08/24/15: Introduction to philosophy in general
TO DO:

Read Lecture 1.1 (posted on Blackboard)

Read Lecture 1.2 (posted on Blackboard)

ODB #1 DUE: Friday, 08/28/15 (11 pm)

QUIZ #1 DUE: Sunday, 08/30/15 (11 pm)
#2 – Week of 08/31/15: Introduction to ethics and bioethics in particular
TO DO:

Read chapter 1 (pp. 3-31) and study chapter 1 power point

QUIZ #2 DUE: Sunday, 09/06/15
#3 – Week of 09/08/15: Bioethics and Moral Theories
TO DO:

Read chapter 2 (33-50) and study chapter 2 power point
 Read Mill’s Utiltarianism (pp. 52-53)
 Read Kant’s The Moral Law (pp. 54-60)
 Read Mayo’s Virtue and the Moral life (pp. 60-62)
 Read Held’s The Ethics of Care (pp. 63-68)

ODB #2 DUE: Friday, 09/11/15 (11 pm)

MAJOR EXAM #1 DUE: Sunday, 09/13/15 (11 pm)
MODULE #2: Medical Professional and Patient (part 1)
#4 – Week of 09/14/15: Paternalism and Patient Autonomy
TO DO:

Read chapter 3 (pp. 71-83) and study chapter 3 power point
 Read Dworkin’s Paternalism (pp. 84-93)
 Read Goldman’s The Refutation of Medical Paternalism (pp. 93-98)

Read Ackerman’s Why Doctors Should Intervene/ (pp. 99-103)
 Read Schwartz’s Autonomy, Futility, and the Limits of Medicine (pp. 104-108)
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
Read Bouvia v. Superior Court (pp. 109113)
 Read AMA’s Fundamental Elements of the Patient-Physician (pp. 113-114)
 Read ANA’s Code of Ethics of for Nurses (pp. 114-115)
 Read Newton’s In Defense of the Traditional Nurse (pp. 116-123)
 Read Kuhse‘s Advocacy or Subservience for the Sake of Patients? (pp. 123- 130)

ODB #3 DUE: Friday, 09/18/15 (11 pm)

QUIZ #3 DUE: Sunday, 09/20/15 (11 pm)
#5 – Week of 09/21/15 and #6 – Week of 09/28/15: TruthTelling and Confidentiality
TO DO:

Read chapter 4 (pp. 131-140) and study chapter 4 power point
 Read Thomasma’s Telling the Truth to patients: A Clinical Ethics Exploration
(pp. 141-145)

Read Lipkin’s On Telling Patient the Truth (pp. 145-147)
 Read Kant’s On a Supposed Right to Life from Altruistic Motives (pp. 147-148)
 Read Cullen and Klein’s Respect for patients, Physicians and the Truth (pp. 148-
155)
 Read Rachels’ Why Privacy is Important (pp. 156-161)
 Read Siegler’s Confidentiality in Medicine – A Decrepit Concept (pp. 161-164)

Read Macklin’s Ethical Relativism in a Multicultural Society (pp. 165-174)
 Read Supreme Court of California’s Tarasoff v. Regents of the University of
California (pp. 175-179)

ODB #4 DUE: Friday, 09/25/15 (11pm)

QUIZ #4 DUE: Sunday, 09/27/15 (11 pm)

MAJOR EXAM #2 DUE: Sunday, 10/04/15 (11 pm)
MODULE #4: Medical Professional and Patient (part 2)
#7 – Week of 10/05/15: Informed consent
TO DO:

Read chapter 5 (pp. 180-189) and study chapter 5 power point
 Read Beauchamp’s The Concept of Informed Consent (pp. 190-194
 Read Katz’s Informed Consent – Must It Remain a Fairy Tale (pp. 195-204)
 Read Brody’s Transparency: Informed Consent in Primary Care (pp. 205 -210)

Read Levine’s Informed Consent: Some Challenges to the Universal Validity of the Western Model (pp. 211-216)

Read Canterbury v. Spence (pp. 217-220)

ODB #5 DUE: Friday, 10/09/15 (11 pm)

QUIZ #5 DUE: Sunday, 10/11/15 (11 pm)
#8 – Week of 10/12/15: Human Research
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TO DO:

Read chapter 6 (pp. 221-240) and study chapter 6 power point

Read Nuremberg Code (pp. 241- 242)

Read Declaration of Helsinki: Ethical Principles for Medical Research Involving
Human Subjects (pp. 242-245)

Read The Belmont Report (pp. 245-248)

Read Final Report: Human Radiation Experiments (pp. 248-254)
 Read Hellman and Hellman’s Of Mice but Not Men: Problems of the
Randomized Clinical Trial (pp. 254-259)
 Read Freedman’s A response to a Purported Ethical Difficulty with Randomized
Clinical Trials Involving Cancer Patients (pp. 259-263)
 Read Marquis’ How to Resolve an Ethical Dilemma Concerning Randomized
Clinical Trials (pp. 263-266)
 Read Brandt’s Racism and Research: The Case of the Tuskegee (pp. 266-275)
 Read Angell’s The Ethics of Clinical Research in the Third World (pp. 279-282)
 Read Brody’s Ethical Issues in Clinical Trials in Developing Countries (pp. 283-
286)

QUIZ #6 DUE: Friday, 10/16/15 (11 pm)

MAJOR EXAM #3 DUE: Sunday, 10/18/15 (11 pm)
MODULE #5: Life and Death (part 1)
#9 – Week of 10/19/15: Abortion
TO DO:

Read chapter 7 (pp. 291-306) and study chapter 7 power point
 Read Thomson’s A Defense of Abortion (pp. 307-316)
 Read Marquis’ Why Abortion is Immoral? (pp. 317-328)
 Read Noonan’s An Almost Absolute Value in History (pp. 329-333)

Read Warren’s On the Moral and Legal Status of Abortion (pp. 333- 343)
 Read Callahan’s Abortion Decisions: Personal Morality (pp. 343-348)
 Read English’s Abortion and the Concept of a Person (pp. 348-353)

Read Tooley’s In Defense of Abortion and Infanticide (pp. 354-370)
 Read Sherwin’s Through a Feminisst Ethics Lens (pp. 371-379)

Read Roe v. Wade (pp. 380-385)

Read Planned Parenthood of Southeastern Pennsylvania v, Casey (pp. 385-391)

ODB #6 DUE: Friday, 10/23/15 (11 pm)

QUIZ #7 DUE: Sunday, 10/25/15 (11 pm)
#10 – Week of 10/26/15 and #11 – Week of 11/02/15: Reproductive Technology
TO DO:
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
Read chapter 8 (pp. 392-409) and study chapter 8 power point
 Read Singer’s IVF: The Simple Case (pp. 410-414)
 Read Warren’s IVF and Women’s Interests: An Analysis of Feminist Concerns
(pp. 414-425)
 Read Cohen’s “Give Me Children or I Shall Die!” New Reproductive
Technologies and Harm to Children (pp. 4227-436)
 Read Congregation for the Doctrine of the Faith’s Instruction on Respect for
Human Life in the Origin and on the Dignity of Procreation (pp. 438-446)
 Read Robertson’s The presumptive Primacy of Procreative Liberty (pp. 447-454)
 Read Purdy’s Surrogate Mothering: Exploitation of Empowerment (pp. 454-461)
 Read Rothman’s On “Surrogacy” (pp. 464-471)
 Read Anderson’s Is Women’s Labor a Commodity? (pp. 471-481)
 Read Kass’ The Wisdom of Repugnance (pp. 483-498)
 Read Brock’s Cloning Human Beings: An Assessment of the Ethical Issues Pro and con (pp. 499-508)

Read opinion in the Matter of Baby M (pp. 510- 517)

ODB #7 DUE: Friday, 10/30/15 (11 pm)

ODB #8 DUE: Sunday, 11/01/15 (11 pm)

MAJOR EXAM #4 DUE: SUNDAY, 11/08/15 (11 pm)
MODULE #6: Life and Death (part 2)
#12 – Week of 11/09/15: Genetic Choices
TO DO:

Read chapter 9 (pp. 518-537) and study chapter 9 power point
 Read Kass’ Implications of Prenatal Diagnosis for the Human Right to live (pp.
538- 542)
 Read Purdy’s Genetic and Reproductive Risk: Can Having Children Be Immoral?
(pp. 542-547)
 Read MacMahan ‘s The Morality of Screening for Disability (pp. 549-552)
 Read Davis’ Genetic Dilemmas and the Child’s Right to an Open Future (pp. 553-
562)
 Read Wachbroit’s Disowning Knowledge: Issues in Genetic Testing (pp. 563-
567)
 Read Brock’s The Non-identity Problem and Genetic Harms – The Case of the
Wrongful Handicaps (pp. 567- 571)

Read Harris’ Is Gene Therapy a Form of Eugenics? (pp. 571-576)
 Read Glannon’s Genetic Engineering (pp. 577-581)
 Read Walters and Palmer’s Germ-Line Gene Therapy (pp. 582-588)
 Read Steinbock’s What Does “Respect for Embryos” Mean in the Context of
Stem Cell Research? (pp. 589-592)
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 Read Pontifical Academy For Life’s Declaration on the Production and the
Scientific and Therapeutic Use of Human Embryonic Stem Cells (pp. 592-593)

ODB #9 DUE: Friday, 11/13/15 (11 pm)

QUIZ #8 DUE: Sunday, 11/15/15 (11 pm)
#13 —Week of 11/16/15: Euthanasia and Physician-Assisted Suicide
TO DO:

Read chapter 10 (pp. 594-609) and study chapter 10 power point
 Read Quill’s Death and Dignity: A Case of Individualized Decision Making (pp.
610-613)
 Read Brock’s Voluntary Active Euthanasia (pp. 614-624)
 Read Callahan’s when Self-Determination Runs Amok (pp. 625-630)
 Read Lachs’ When Abstract Moralizing Runs Amok (pp. 630-634)
 Read Arras’ Physician-Assisted Suicide: A Tragic End (pp. 634-646)
 Rachels’ Active and Passive Euthanasia (pp. 649-652)

Read The Distinction Between Refusing Medical Treatment and Suicide (pp. 653-
660)
 Read The Philosophers’ Brief (pp. 661-669)

Read Vacco v. Quill (pp. 669-672)

Read Washington v. Glucksberg (pp. 672-677)

QUIZ #9 DUE: Friday, 11/20/15 (11 pm)

MAJOR EXAM #5 DUE: Sunday, 11/22/15 (pm)
WEEK OF 11/23/15 – THANKSGIVING BREAK (NO CLASS)
MODULE #7: Justice and Health Care
#14 – Week of 11/30/15: Dividing Up Health Care Resources
TO DO:

Read chapter 11 (pp. 681-694) and study chapter 11 power point
 Read Daniels’ Is There a Right to Health Care and, If So, What Does It
Encompass? (pp. 696-702)
 Read Buchanan’s The Right to a Decent Minimum of Health Care (pp. 703-708)
 Read Engelhardt’s Rights to Health Care, Social Justice, and Fairness in Health
Care Allocations: Frustrations in the Face of Finitude (pp. 708-716)
 Read Deber’s Health Care Reform: Lessons from Canada (pp. 717-722)
 Read Daniels’ Rationing Fairly: Programmatic Consideration (pp. 724-728)
 Read Rescher’s The Allocation of Exotic Medical Lifesaving Therapy (pp. 729-
738)
 Read Harris’ QALYfying the Value of Life (pp. 738-746)

ODB #10 DUE: Friday, 12/04/15 (11 pm)

QUIZ #10 DUE: Sunday, 12/06/15 (11 pm)
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
MAJOR EXAM #6 DUE: Thursday, 12/10/15 (11 pm)
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