FACULTY OF HEALTH SCIENCES
HSCI/PHIL 319W – Applied Health Ethics
D01.00 FALL 2008
Lectures:
Instructor:
Office:
Phone number:
E-mail:
Office hours:
TAs:
Fridays 1:30 – 4:20, Blusson 9011
Dr. Jeremy Snyder
Blusson 9510
778-782-3258
jeremycsnyder@sfu.ca
Thursdays, 10-12
Ashley White (afw2), Dimitry Noel-Bently (dna14), and Kiera Ishmail (ksi1)
COURSE DESCRIPTION:
In this course, we will explore ethical issues in health sciences, emphasizing population and public health.
Fruitful discussion of ethical issues requires a background in ethical theory, and so we will begin the class
by considering historical writings within ethics. We will then apply these theories to ethical controversies
within public health, including the conflict between public health and individual autonomy, the just
distribution of health resources, and responsibility for health outcomes. The aim of this course is to
provide students with tools to discuss and assess ethical arguments and to form their own views on
controversies within population and public health. Students will be expected to write position papers,
engage in critical analysis, and participate actively in classroom discussions of these topics. This course
is cross-listed with PHIL 319.
TOPICS TO BE COVERED:
o Ethical Theory
o Defining Public Health Ethics
o Regulation and Oversight
o Human Subject Research
o Health and Environmental Justice
o Distribution and Fairness in Public Health Emergencies
o Autonomy, Responsibility, and Paternalism
o Justice, Inequality, and Health
o Coercion, Privacy, and Infectious Disease
o Genetics and Health
OBJECTIVES: The field of public health ethics demands that practitioners are able to write clear
overviews of the ethical dimensions of applications of public health policy. In addition, practitioners should
be able to produce arguments for specific ethical positions and defend these positions against critique.
Writing assignments will help develop these skills by requiring both the clear presentation of and support
for responses to ethical dilemmas in public health. In all assignments, students will be encouraged and
directed in the use of charitable language and argumentation where others’ arguments are interpreted
generously. The goal of this charitable interpretation is to further the project of reasonable dialogue and
consensus rather than the destructive process of solely refuting others’ arguments.
REQUIRED TEXTS:
Stephen Holland, Public Health Ethics (Cambridge, UK: Polity Press, 2007). [PHE]
Ronald Bayer, Lawrence Gostin, Bruce Jennings, and Bonnie Steinbock (eds.), Public Health Ethics:
Theory, Policy, and Practice (New York: Oxford UP, 2007). [TPP]
ASSESSMENT STRATEGIES: Students will receive feedback on the final wiki assignment, both formal
papers, and the midterm examination. Feedback on a preliminary draft of the mid-term and the first draft
of the final paper will be given by student peers. Students will also peer-edit the Wiki assignment in
keeping with the collaborative nature of Wikis. These students will be directed to give feedback on only
one facet of the paper or post at the direction of the instructor. Elements for revision by students will
include clarity of arguments, strength of critique, clarity of the case, use of sources, and use of updated
materials (specifically for the wiki assignment).
EVALUATION:
Midterm Exam
First Paper First Draft
First Paper Final Draft
Wiki Article
Wiki Revisions
Final Paper First Draft
Final Paper Final Draft
Participation and Attendance
(6pp.)
(6pp.)
(8pp.)
(8pp.)
20 marks
5 marks
15 marks
10 marks
5 marks
10 marks
20 marks
15 marks
10/3 In Class
10/17 In Class
10/31 In Class
11/7
11/14
11/21
Final Exam Time
GRADING SCALE:
Score
Letter Grade
A+
96
A
91
A86
B+
81
B
76
B71
C+
66
C
61
C56
D
51
F
0
PREREQUISITE:
30 credit hours of completed course work.
EXPECTATIONS / IMPORTANT NOTES:
The professor may make changes to the syllabus if necessary, within Faculty / University regulations.
PHIL 319 is identical to HSCI 319, and students cannot receive credit for both courses.
All written assignments will be presented to students well in advance of the due date in order to ensure
sufficient time to complete the assignment. Out of an interest in fairness to all students, no except as
excused ahead of the due date for the paper, in accordance with SFU guidelines. Late papers will be
docked a five percentage points per day late (ex: from 80% to 75%).
Students found to have engaged in plagiarism: 1) may receive a zero grade on the relevant assignment;
2) may fail the course at the discretion of the instructor and the Associate Dean, Academic; and 3) will be
reported to the university:
“Academic Honesty plays a key role in our efforts to maintain a high standard of academic
excellence and integrity. Students are advised that ALL acts of intellectual dishonesty are subject to
disciplinary action by the University; serious infractions are dealt with in accordance with the Code
of Academic Honesty (T10.02) (http://www.sfu.ca/policies/teaching/t10-02.htm). Students are
strongly encouraged to read the policy and inform themselves of the definitions and consequences.”
If you have any questions or concerns about plagiarism, please ask the instructor in advance of turning in
any assignments.
Schedule of Readings:
Ethical Theories:
9/5: Introduction, Overview, and Utilitarianism:
Jeremy Bentham, An Introduction to the Principles of Morals and Legislation, Chs. 1 and 4; John
Stuart Mill, Utilitarianism, Ch. 2; PHE 7-17.
9/12: Deontological Ethics:
Immanuel Kant, Groundwork for a Metaphysics of Morals, Sections 1 and 2; PHE 18-32.
9/19: Virtue Theory:
Aristotle, Nicomachean Ethics, 1.1-2, 1.4-5, 1.7, 2.1, 2.6-7, 4.2; Douglas Weed and Robert
McKeown, “Epidemiology and Virtue Ethics,” International Journal of Epidemiology, 27 (1998)
343-9; Stuart Horner, “For Debate: The Virtuous Public Health Physician,” Journal of Public
Health Medicine, 22.1, (2000) 48-53; PHE 33-35.
9/26: Political Philosophy:
John Stuart Mill, On Liberty, Chs. 1 and 4; PHE 37-56.
Approaches to Public Health Ethics:
10/3: The Terrain of PHE:
Lawrence Gostin, “Public Health, Ethics, and Human Rights: A Tribute to the Late Jonathan
Mann,” Journal of Law, Medicine & Ethics, 29.1, (2001) 121-130; James Childress, et. al.,
“Public Health Ethics: Mapping the Terrain,” Journal of Law, Medicine, and Ethics, 30.2, (2002)
170-8. TPP 27-9; 33-56.
10/10: Codes of Conduct:
Nancy Kass, “Public Health Ethics: From Foundations and Frameworks to Justice and Global
Public Health,” Journal of Law, Medicine and Ethics, 32.2, (2004) 232-42; James Thomas,
Michael Sage, Jack Dillenberg, and V. James Guillory, “A Code of Ethics for Public Health,”
American Journal of Public Health, 92.7, (2002) 1057-9; Ross Upshur, “Principles for the
Justification of Public Health Intervention,” Canadian Journal of Public Health, 93.2, (2002)
101-3. TPP 57-81
Issues:
10/17: Autonomy, Responsibility, and Paternalism:
TPP 89-133; PHE 111-134.
10/24: Coercion, Privacy, and Infectious Disease I (SARS and the Duty to Treat):
TPP 249-78; Michael Selgelid, “Ethics and Infectious Disease,” Bioethics, 19.3, (2005) 272-89;
Charles Smith, et al. “Are There Characteristics of Infectious Disease that Raise Special Ethical
Issues?” Developing World Bioethics, 4.1, (2004) 1-16; Peter A. Singer, et al., “Ethics and
SARS: Lessons from Toronto,” BMJ, 327.7427, (2003) 1342-4.
10/31: Coercion, Privacy, and Infectious Disease II (Vaccination):
John Harris and Soren Holm, “Is There a Moral Obligation Not to Infect Others?” BMJ,
311.7014, (1995) 1215-7; James Colgrove, “The Ethics and Politics of Compulsory HPV
Vaccination,” NEJM, 355.23, (2006) 2389-91; Douglas Diekema, “Responding to Parental
Refusals of Immunization of Children,” Pediatrics, 115.5, (2005) 1428-31; TPP 279-88; PHE
135-159.
11/7: Justice, Inequality, and Health I:
Sudhir Anand, “The Concern for Equity in Health, Journal of Epidemiology and Community
Health, 56.7 (2002) 485-7; Amartya Sen, “Why Health Equity?” Health Economics, 11.8 (2002)
659-66;
11/14: Justice, Inequality, and Health II:
TPP 167-86; 205-30.
11/21: Screening:
PHE 160-187; TPP 377-90.
11/28: Enhancements:
Nick Bostrom, “In Defense of Posthuman Dignity,” Bioethics, 19.3, (2005) 202-14; Arthur
Caplan and Carl Elliot, “Is it Ethical to Use Enhancement Technologies to Make Us Better than
Well?” PLoS Medicine, 1.3, (2004) 172-5; Michael Sandel, “The Case Against Perfection,” The
Atlantic Monthly, 293.3, (2004) 51-62.