Dr. Atterton
SDSU Fall Semester 2011
Sched # 22364
Sec 1
Tel: (619) 594-4997
Room: AL-431
Office Hours: TTH 1130-1230
Email: atterton@mail.sdsu.edu
PHIL 330: Medical Ethics
Course Description: Tremendous advances in the biomedical sciences—from stem cell research
to cloning—are not only pushing the limits of science, but also pushing us to think about the
ethics behind the use of that science. This survey course is designed to encourage students to use
basic forms of ethical reasoning in order to begin to analyze such controversial issues as the
moral status of the embryo/fetus, the purpose of medicine, medical multiculturalism, cosmetic
surgery, cosmetic psychopharmacology, pain relief, mercy killing, assisted reproduction, prenatal
diagnosis and screening, cloning, somatic cell and nuclear transfer research, the use of human
and nonhuman animals in scientific experiments, and justice and the health-care system. At the
end of the course, students should be qualified to make an informed contribution to current moral
and political debates surrounding biology and medicine, and have an appreciation of the ways in
which scientific advances have made our moral lives more complex. The emphasis will be on
understanding the underlying philosophical issues of biomedical ethics. No familiarity with the
current state of medical practice is presupposed, though a rudimentary knowledge of biology and
evolution is assumed. The course should be of interest to all students from all disciplines at
SDSU, but should be especially appealing to students who are considering a career in
medicine and/or the biological sciences.
Course Objectives
This course fulfills the Humanities portion of the Explorations section of the General Education
(GE) Requirements. Among the “seven essential capacities” that the GE program emphasizes,
this course develops in the student the following in particular:
1. Construct, analyze, and communicate arguments.
2. Apply theoretical models to the real world.
3. Contextualize phenomena.
4. Negotiate differences.
Among the “Goals” for GE Courses in the Humanities and Fine Arts, this course aims to fulfill
three of them:
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: Argue from multiple perspectives about issues in the humanities that have
personal and global relevance.
Goal 3: Demonstrate the ability to approach complex problems and ask complex
questions drawing upon knowledge of the humanities.
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Student Learning Outcomes
The course is designed to give students the opportunity to
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learn basic ethical reasoning, as well as widen their knowledge of the philosophical
tradition.
study systematically the works of significant figures in the field of biomedical ethics.
see clearly the connection between philosophical thought and life’s questions
analyze some controversial contemporary issues in the debate between
multiculturalism, religion and science, and discuss the prospects for settling those
issues
develop the ability to reflect critically, independently, and effectively on the basic
questions of biomedical ethics.
gain a better understanding of one’s own philosophical or pre-philosophical views.
learn how to identity arguments and their main components.
learn to discuss critically arguments and theories effectively.
learn to construct arguments for a variety of philosophical positions.
gain practice thinking and writing in a clear, logically rigorous fashion.
make a valid contribution to various current highly-charged moral and political
debates.
develop proficiency in written and oral argumentation.
Required Course Materials:
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Biomedical Ethics, ed(s). Thomas A. Mappes, David DeGrazia, Jeffrey Brand-Ballard
(McGraw-Hill, 2011) 7th Edition, available at Aztec Shops.
Blackboard: https://blackboard.sdsu.edu
It is a requirement for this course that you watch Michael Moore’s 2007 documentary
film Sicko (2007).
Organization:
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Classes will be held from 1230-1345 TTH in SH-258.
There will be a reading assignment for every class, except those during which you
have a scheduled exam.
Please read the assigned texts before the class session for which they are assigned.
Class time will focus on analyzing the reading for that day and developing skills vital
to successful completion of the course.
Please bring you textbook to each class.
Course Requirements:
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Participation 10%
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25% Midterm (Thursday, September 29)
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25% Midterm (Tuesday, November 3)
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40% Final Exam (2 hours) (Tuesday, Dec 13, 1030-1230)
Your final exam, which is non-cumulative, will include both a multiple choice and an essay
component.
Note: You must sit the midterms and the final at the scheduled time. Make-ups will only be
allowed for compelling reasons (illness, bereavement, etc.). I must be notified in advance of an
intended absence, and I will be the judge of whether your reasons are compelling. (A student
missing a scheduled examination must document a visit to Student Health or a private physician
in order to qualify for an excused absence.)
Student Excused Absence Policy: Successful completion of this course depends directly upon
student participation in classroom discussions and completion of all course requirements. You
are reminded that attendance is mandatory—and that cumulative absence is the best recipe for
academic disaster. However, it is understood that on occasion students may be required to be
absent from a scheduled class for excusable reasons, e.g., illness. (Whenever possible, students
should schedule preventive appointments at times which are minimally disruptive to their class
schedule.) I will be the judge of whether your absence is excusable. A written register of
attendance will be maintained, which you are asked to sign at the beginning of each class. In all
cases, any missed work must be made up. An immediate excused absence for a student is
typically granted in the following circumstances.
a. Personal illness or illness of a close family member when the attention of the student
is required. (In the case of illness, a medical note will be required.)
b. Death of an immediate family member.
c. Accident or other unforeseen circumstances making it impossible for a student to
attend a scheduled class.
Two unexcused absences are allowed with no penalty. Thereafter, every unexcused absence will
lower the student’s final grade by 2%. In case of 6 or more unexcused absences, the instructor
reserves the right summarily to assign you a failing grade for the course.
Criteria for Evaluation of Essays: Your essays will be evaluated in light of the four criteria
below. Essays that fulfill these criteria in an exceptional way will be awarded As; essays that do
so in an excellent way, Bs; and essays that meet the criteria at a satisfactory level, Cs. Essays that
do not fulfill the criteria at a satisfactory level will be awarded Ds and Fs, depending on the
severity of the problems.
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Organization: The essay is well organized. It contains a clear thesis statement that
focuses the essay and each and every paragraph logically contributes to the
development and defense of that thesis. The paper is succinct, to the point, and avoids
needless words.
Understanding: The essay exhibits a thorough understanding of the work being
criticized and accurately explicates its author’s argument where relevant to the
development of its critical thesis.
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Criticism: The essay takes a critical stance toward the material under examination,
clearly articulating reasons for its critical evaluation. The criticisms are based on firm
reasoning that is well supported with relevant evidence.
Format: The essay is flawlessly presented, with no spelling or grammar errors.
SDSU Grading Guidelines:
A – Outstanding achievement; available only for the highest accomplishment.
B – Praiseworthy performance; definitely above average.
C – Average; awarded for satisfactory performance; the most common grade.
D – Minimally passing; less than average achievement for undergraduate students.
F – Failing.
I – An incomplete grade will only be granted for extenuating circumstances.
93 – 100% = A
90 – 92% = A87 – 89 % = B+
83 – 86% = B
80 – 82% = B77 – 79% = C+
73 – 76% = C
70 – 72% = C67 – 69% = D+
63 – 66% = D
60 – 62% = D0 – 59% = F
Work Habits: This class will require a considerable amount of difficult reading each week. Your
decision to take this course constitutes a tacit agreement that you are prepared to put in the time
required to do the reading properly. Students are expected to come to class having done the
reading carefully for that day and should be prepared to participate in classroom discussions. The
quality of their contribution will affect their final grade in borderline cases. You are required to
bring the relevant course text to class each lecture.
Administrative: September 21 is the last day to drop classes. (11:59 p.m. deadline.)
Students with Special Needs: Any student with special needs due to a documented medical
condition should avail themselves of the resources of the Student Disability Services, Suite 3101,
Capulli Center (across the street from the Gateway Center), 594-6243. Students who have such
concerns that might prevent them from otherwise doing well in this course should discuss the
matter with the instructor so that proper arrangements may be made to accommodate their
condition.
Academic Misconduct: All students are expected to follow the administrative rules and standards
of conduct detailed in the San Diego State University catalog. Students are expected to submit
only their own work on papers and examinations. While you may discuss the assignments with
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others in the class, collaboration on the preparation of a paper is not permitted. Unless the
assignment specifically directs otherwise, papers should be based entirely on your own study of
the assigned material and not on secondary sources of any kind.
Turning in someone else’s work, whether from printed sources or material available
electronically, as if it were your own constitutes plagiarism. Plagiarism is an act of intellectual
dishonesty. The academic consequences of plagiarism range from failure for the tainted
assignment to failure for the course, depending on the seriousness of the offense. All such
offenses are reported to the college dean, who will impose additional administrative
consequences, which can include suspension or expulsion from the university.
Examples of plagiarism include, but are not limited to the following: turning in another student’s
paper as if it were your own; collaboration with another student in writing the paper; quoting,
paraphrasing, or borrowing ideas from published or unpublished material written by someone
other than yourself, without specific acknowledgment of the source.
It is your responsibility to know and observe all the SDSU rules concerning academic integrity
and plagiarism. You should familiarize yourself with SDSU Academic Senate Policy on
Plagiarism (http://its.sdsu.edu/turnitin/pdf/Plagiarism_AcadSen.pdf). If you have any questions
about what constitutes plagiarism, how to credit the work and ideas of others properly, how to
evaluate sources for quality and reliability, or any other related issues, please feel free to see me
to discuss the matter.
Classroom Etiquette
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So as not to distract other students, you are asked NOT to have your laptops or other
electronic devices (cell phones, iPads, cameras, etc.) open during class. Students caught
checking their phone or texting during class will be asked to leave. Please turn off
your cell phones and pagers before class begins. Please do not use recording equipment of
any kind during classroom lectures, unless you have a disability, and have cleared it with
me first.
When you attend class, you are expected to observe the rudiments of classroom etiquette
and civil behavior. Do NOT chat with friends during class. Do NOT sleep, eat, or drink in
the class; each of these is an annoyance and a distraction to your peers. If you are caught
chatting, the instructor will inquire as to what the “problem” is. If you are caught
sleeping, the instructor will ask the person sitting next to you to wake you. If you persist
in engaging in disruptive behavior the instructor will ask you to leave.
Do NOT consistently arrive late to class. Late comers will not be admitted after 5
minutes. Do NOT leave in the middle of class. If you have a legitimate reason to exit the
classroom early, speak to me before class begins. In short, observe good manners and be
considerate of your instructor and your peers. Please respond to the instructor and the
other students in a respectful and civil manner. Please inform me about any consistently
aggravating classroom disruptions.
Blackboard: Periodically I may send important course announcements to the class via SDSU’s
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Blackboard service. Only officially registered students can access the Blackboard website. If you
are registered, go to http://blackboard.sdsu.edu and log into the system for further course
information.
Email: Please use e-mail only for scheduling and other very brief communications. Otherwise,
come to speak with me in person in office hours or by setting up a separate meeting with me if
you can’t make those times.
Schedule
Week 1
GENERAL INTRODUCTION
Tue 8/30
Introduction to Medical Ethics
Biomedical Ethics, 1-32
Thu 9/1
Traditional Ethical Theories: Consequentialism, Deontology, and Virtue Ethics
Biomedical Ethics, (continued)
Week 2
ABORTION
Tue 9/6
Introduction
Biomedical Ethics, 456-463
Pope John Paul II, “The Unspeakable Crime of Abortion”
Biomedical Ethics, 466-468
Mary Anne Warren, “On the Moral and Legal Status of Abortion”
Biomedical Ethics, 468-475
Thu 9/8
Don Marquis, “Why Abortion Is Immoral”
Biomedical Ethics, 475-479
Week 3
Tue 9/13
Judith Jarvis Thomson, “A Defense of Abortion”
Biomedical Ethics, 479-487
EMBRYONIC STEM-CELL RESEARCH
Thu 9/15
Introduction
Biomedical Ethics, 463-465
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NIH, “Stem Cell Basics”
Biomedical Ethics, 501-508
Jeff McMahan, “Killing Embryos for Stem Cell Research”
Biomedical Ethics, 508-513
Week 4
EUTHANASIA
Tue 9/20
Introduction:
Biomedical Ethics, 376-384
James Rachels, “Active and Passive Euthanasia”
Biomedical Ethics, 395-399
Thu 9/22
Daniel Callahan, “Killing and Allowing to Die”
Biomedical Ethics, 399-402
Dan W. Brock, “Voluntary Active Euthanasia”
Biomedical Ethics, 402-404
Week 5
PHYSICIAN-ASSISTED SUICIDE
Tue 9/27
Timothy E. Quill, et al, “Care of the Hopelessly Ill: Proposed Clinical Criteria for
Physician-Assisted Suicide”
Biomedical Ethics, 418-421
The Oregon Death with Dignity Act
Biomedical Ethics, 421-426
John D. Arras, “On the Slippery Slope in the Empire State: The New York State
Task Force on Physician-Assisted Death
Biomedical Ethics, 432-438
Thu 9/29
MIDTERM 1
Week 6
THE PROFESSIONAL-PATIENT RELATIONSHIP
Tue 10/4
Introduction
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Biomedical Ethics, 41-51; 58-61
Hippocrates, “The Hippocratic Oath”
Biomedical Ethics, 69-70
Edmund D. Pellegrino, “The Virtuous Physician and the Ethics of Medicine”
Biomedical Ethics, 70-73
James F.Childress and Mark Siegler, “Metaphors and Models of Doctor-Patient
Relations: Their Implications for Autonomy”
Biomedical Ethics, 74-82
Terrence F. Ackerman, “Why Doctors Should Intervene”
Biomedical Ethics, 83-87
TRUTH-TELLING AND CONFIDENTIALITY
Thu 10/6
Introduction
Biomedical Ethics, 63-66
Roger Higgs, “On Telling Patients the Truth”
Biomedical Ethics, 103-109
Leonard Fleck and Marcia Angel, “Please Don’t Tell!: A Case about HIV and
Confidentiality”
Biomedical Ethics, 116-125
Week 7
MULTICULTURALISM
Tue 10/11
Introduction
Biomedical Ethics, 38-40; 68
Ruth Macklin, “Ethical Relativism in a Multicultural Society”
Biomedical Ethics, 132-141.
COSMETIC SURGERY
Thu 10/14
Introduction
Biomedical Ethics, 150-152
Franklin G. Miller, Howard Brody, and Kevin C. Chung, “Cosmetic Surgery and
the Internal Morality of Medicine”
Biomedical Ethics, 187-196
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Margaret Olivia Little, “Cosmetic Surgery, Suspect Norms, and the Ethics of
Complicity”
Biomedical Ethics, 196-204
Week 8
COSMETIC PSYCHOPHARMACOLOGY
Tue 10/18
Introduction
Biomedical Ethics, 152-154
Peter Kramer, “Makeover”
Biomedical Ethics, 205-213
Carol Freedman, “Aspirin for the Mind? Some Ethical Worries about
Psychopharmacology”
Biomedical Ethics, 213-222
David DeGrazia, “Prozac, Enhancement, and Self-Creation”
Biomedical Ethics, 222-230
Thu 10/20
Claudia Mills, “One Pill Makes You Smarter: An Ethical Appraisal of the Rise of
Ritalin”
Biomedical Ethics, 230-234
Martha J. Farah and Paul Root Wolpe, “Monitoring and Manipulating Brain
Function: New Neuroscience Technologies and Their Ethical Implications”
Biomedical Ethics, 235-240
Week 9
PRENATAL DIAGNOSIS AND SCREENING
Tue 10/25
Introduction
Biomedical Ethics, 523-526
Leon R. Kass, “Implications of Prenatal Diagnosis for the Human Right to Life”
Biomedical Ethics, 533-537
Laura M. Purdy, “Genetics and Reproductive Risk: Can Having Children Be
Immoral?”
Biomedical Ethics, 538-544
INFERTILITY AND ASSISTED REPRODUCTION (IVF)
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Thu 10/27
Introduction
Biomedical Ethics, 526-529
Peter Singer, “IVF: The Simple Case”
Biomedical Ethics, 544-548
Susan Sherwin, “Feminist Ethics and In Vitro Fertilization”
Biomedical Ethics, 548-553
New York State Task Force on Life and the Law, “Ethical Debates about
Infertility and Its Treatment”
Biomedical Ethics, 553-559
Week 10
Tue 11/1
Thomas H. Murray, “Families, the Marketplace, and Values: New Ways of
Making Babies”
Biomedical Ethics, 565-572
Bonnie Steinbock, “Surrogate Motherhood as Prenatal Adoption”
Biomedical Ethics, 573-577
Thu 11/3
MIDTERM 2
Week 11
HUMAN CLONING
Tue 11/8
Introduction
Biomedical Ethics, 529-532
Leon R. Kass, “Cloning of Human Beings”
Biomedical Ethics, 577-580
Thomas H. Murray, “Even If It Worked, Cloning Wouldn’t Bring Her Back”
Biomedical Ethics, 560-583
Thu 11/10
Robert Wachbroit, “Genetic Encores: The Ethics of Human Cloning”
Biomedical Ethics, 583-589
Week 12
PREIMPLANTATION GENETIC DIAGNOSIS AND GENETIC ENHANCEMENT
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Tue 11/15
Introduction
Biomedical Ethics, 519-521
John A. Robertson, “Extending Preimplantation Genetic Diagnosis: Medical and
Non-medical Uses”
Biomedical Ethics, 589-595
President’s Council on Bioethics, “Selecting Embryos for Desired Traits”
Biomedical Ethics, 595-598
Thu 11/27
Michael J. Sandel, “Mastery and Gift”
Biomedical Ethics, 610-614
Dan W. Brock, “Genetic Engineering”
Biomedical Ethics, 615-620
Week 13
HUMAN RESEARCH
Tue 11/22
Introduction
Biomedical Ethics, 243-251
“The Nuremberg Code”
Biomedical Ethics, 253-254
“The Declaration of Helsinki”
Biomedical Ethics, 254-258
Samuel Hellman and Deborah S. Hellman, “Of Mice but Not Men: Problems of
the Randomized Clinical Trial”
Biomedical Ethics, 259-264
Don Marquis, “How to Resolve an Ethical Dilemma Concerning Randomized
Clinical Trials”
Biomedical Ethics, 264-267
Thu 11/24
THANKSGIVING—NO CLASS
Week 14
NONHUMAN ANIMAL RESEARCH
Tue 11/29
Introduction
Biomedical Ethics, 251-252
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“International Guiding Principles for Biomedical Research Involving Animals”
Biomedical Ethics, 258-259
Carl Cohen, “The Case for Use of Animals in Biomedical Research”
Biomedical Ethics, 292-298
Edwin Converse Hettinger, “The Responsible Use of Animals in Biomedical
Research”
Biomedical Ethics, 299-305
Thu 12/1
David DeGrazia, “On the Ethics of Animal Research”
Biomedical Ethics, 305-298
Week 15
JUSTICE AND HEALTH-CARE
Tue 12/6
Introduction
Biomedical Ethics, 623-638
Alan Buchanan, “Justice: A Philosophical Review”
Biomedical Ethics, 638-649
Thu 12/8
Kai Nielsen
“Autonomy, Equality and a Just Health Care System”
Biomedical Ethics, 649-655
Final Exam
TUESDAY, DECEMBER 13, 1030-1230
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