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Catholic University of America
TRS 333 01 (6892) Biomed and Health Care Issues
Spring Semester, 2009.
Prof. Brian Johnstone
Office: Caldwell 505
Tel 202-319-5120
e-mail: johnstob@cua.edu
Office Caldwell 505. Hours by appointment. Please send an e-mail.
Articles will be made available on Blackboard. To enter: http://bb8.cua.edu
Under the new system, to enter, students enter their CUA user name and password.
Monday 4:10 – 6:40
Location: Marist 213
The course will include lectures and debates and, where appropriate, film discussions.
Requirements:
From the date indicated, Feb. 2, the course will include a weekly debate.
The time before these debates, that is, before Feb. 2, is available for research and writing in
preparation for the debates.
Two students, who have chosen the particular topic will present arguments for, two other
students, who have chosen the particular topic will present arguments against.
Each presentation should be 10 minutes (max).
Students are encouraged to consult the professor in preparing their arguments.
The debates will last one hour. Students are requested to choose a debate topic as listed on this
syllabus, and to choose a position to defend, that is either for or against the proposition. Each
debate will involve four persons, in two teams. One team will take the position in favor of the
proposition; the other team will take the position against. The first debater will present
arguments in favor. The first debater on the negative side will then provide contrary arguments.
The second member of the positive side will then reply to the other’s arguments. Then the
second member of the negative side will reply to the arguments of the positive side. Then the
debate will be opened to questions and criticisms from the class as a whole.
Students may well have to defend a position with which they do not agree. All recognize this; it
is not a matter of revealing your own personal views on these controversial topics. The purpose
of the exercise is to provide an experience of researching for and defending an argument.
A list of the debate topics can be found on this syllabus. A separate list will be made available
with the date, titles and spaces for names. Students are requested to sign up.
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The students who present the debates will give a written copy of their arguments to the professor
one week before the debate. Students are encouraged to review their arguments and, where
appropriate, rewrite them before the final presentation. Dead-line for the final presentation,
Friday, May 1 (last class day).
The students who do not present the arguments on this occasion of the debate will present a
written, one page (double space) response to the arguments. This should analyze the arguments; a
mere summary of the debate is not sufficient. This is to be given to the professor within two
weeks of the debate.
Thus, in summary, each student will present one (1) a written paper (the students arguments on
the debate topic, 10 pages, double spaced) and
ten (10) one page, double spaced, reaction papers.
There will also be a mid-term exam which will ask for explanations of some key concepts, for
example, “What is meant by ‘the natural law’?” “What is meant by ‘utilitarianism’?”
There will also be a final exam which will also ask for explanations of some key concepts,
namely those which have been introduced after the mid-term exam.
One hour will be allowed for these exams.
Grading:
The ten page written debate paper
The one page debate reports
The mid-term exam
The final exam.
Attendance and participation
Total for the course
30 %
30%
15%
15%
10%
100%
Bibliography
These books will be available in the reserve section of Mullen Library.
Church Documents.
*Congregation for the Doctrine of the Faith, Instruction Dignitatis Personae on Certain
Bioethical Questions, 8 September 2008. (Available on BB)
John Paul II, Pope. Gospel of Life (Evangelium Vitae) Origins 24 (42): 689-731.(BB)
John Paul II, Pope. Care for Patients in a Permanent Vegetative State, Origins 33 (43): 737-40.
(BB)
USCCB, Ethical and Religious Directives for Heath Care Services 4th. edition (2001. 2003)
ISBN 1-57455-454-9
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Books.
(Available at CUA bookstore.)
Ashley, Benedict, Jean DeBlois and Kevin D. O'Rourke, Health Care Ethics: A Catholic
Theological Analysis, 5th ed. Washington: Georgetown University Press, 2006.
ISBN-13: 978-1-58901-116-8 (pbk. : alk. Paper) .
lSBN-I0: 1-58901-116-3 (pbk. : alk. Paper)
R724 .A74 2006
Jeffrey, David. Against Physician Assisted Suicide: A Palliative and Personal Care Perspective.
Oxford New York: Radcliffe Publishing Co. 2009
ISBN-13: 978 184619 186 2
John Paul II, Pope, The Gospel of Life, March 1995. Obtainable from USCCB
BT 1902. J6213
ISBN 1-55586-316-7
Keane, Philip S. Catholicism and Health Care-Justice (New York: Paulist Press, 2002).
ISBN: 0-8091-4059-4
Meilaender, Gilbert. Bioethics: A Primer for Christians (William B. Eerdmans, 2005)
R725 56M46 2005.
________________________________________________________________________
-----------------------------------------------------------Class Sessions.
This course is intended for students who have taken previous courses in biomedical ethics and
also for those for whom this will be their first formal study of this subject. It will thus
concentrate on a basic outline of biomedical ethics and a treatment of the issues that are most
frequently discussed in contemporary debates.
The aim of the course is to provide students with a framework within which they can interpret the
positions adopted by the Catholic tradition. This framework will be a philosophy and theology of
the receiving and giving of gifts. Catholic teachings will be presented and explained. Other
religious traditions will be taken into account, as will some significant “secular” perspectives.
Specific biomedical questions will also be treated with emphasis being given to those with which
students may have to deal in the course of the exercise of their professions.
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---------------------------------------------------------------------------------------------------------------------Jan 12.
1. Introduction.
An explanation of the scope of the course and the requirements.
Jan 26.
2. The “dignity of the human person.” What do I mean when I recognize another as a person?
What do I mean when I accept that I am a person?
The views of those who reject the concept of “dignity of the human person”. (Macklin, Singer)
The basic response: “dignity” has meaning within in a community with a tradition.
The meaning of the dignity of the person in the Catholic tradition.
Readings:
Congregation for the Doctrine of the Faith, “Instruction Dignitatis Personae (The Dignity of the
Human Person) on Certain Bioethical Questions” Available on Blackboard, (BB8) at the above
address: Course documents no. 101.
Pope John Paul II, The Gospel of Life, pars. 29-50; Ashley and O’Rourke, 3;
Johnstone, Brian, “The Dignity of the Human Person,” BB.
.
Supplementary Readings:
Daniel P. Sulmasy, O.F.M., “Dignity and the Human as a Natural Kind,” in Taylor and
Dell’Oro, Health and Human Flourishing, 71-87. (Blackboard)
President’s Council on Bioethics, Human Dignity and Bioethics: Essays Commissioned by the
President’s Council on Bioethics (Washington. D.C.: 2008).
“Biotechnology and Human Dignity,” in Ben Mitchell, Biotechnology and the Human Good, 5886.
3. The Freedom and Autonomy of the Person: Basic elements of Dignity.
Free and Informed Consent.
“Autonomy” as the basic value of “secular” biomedical ethics.
The meaning of autonomy in the Christian tradition: autonomy achieved in receiving and giving.
Readings: Ashley, 57-8, 99-100, 105, 114-11.
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Feb 2
4. The Health Care community as a community of receiving and giving.
The Goals of Health Care: 1) The Promotion of Health and the Cure of Disease, 2) Relief of
Suffering, 3) Equitable distribution of Health Care.
The Meaning of Health and the Cure of Disease.
Readings: Ashley, 33-36.
5. The Gift of Relief from Suffering. The distinction between suffering and pain.
Does suffering have a meaning or a purpose?
Readings: Ashley, deBlois, O’Rourke, 163-169.
Supplementary Reading.
Pope John Paul II, On the Meaning of Human Suffering. (1984)
Eric J. Cassell, The Nature of Suffering and the Goals of Medicine, 2nd. ed. (Oxford: Oxford
University Press, 2004).
Feb. 9.
6. Life and Death.
The good or value of life. Life as an intrinsic good or value? What is meant by a “good?” What
is meant by a “value?” We can speak of a “meaningful life” Can we also speak of a “meaningful
death.”?
The Christian understanding of death.
Readings: The Value of Life. Pope John Paul II, The Gospel of Life, pars. 7-28.
7. Suicide, Euthanasia, Assisted suicide.
Readings: Pope John Paul II, The Gospel of Life, pars. 56-111.
Ashley, 178-197.
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Bowring, “The Dying of the Light: The Drawn-Out Indignities of The American Way of Death,
The Washington Post,” January 11, 2008.
8. Issues of Nutrition and hydration: The “Vegetative State.”
Debate 1: It is morally acceptable to withdraw food and water from a patient in a “vegetative
state:” in favor; against.
Readings: the Papal Directive, “Care for Patients in a Permanent Vegetative State” Origins 33
(43): 737-40. (Blackboard)
Ashley, 55-57; 182-199.
Feb. 16.
8. The Community of Health Care: Receivers and Givers.
The Foundations: (1) Love. “Beneficience.”
Reading:
Beauchamp and Childress. 117-21.
9. The Community of Health Care: The Foundations(2) Justice. Theories of Justice; Justice in
Health Care; Allocation; Universal insurance coverage.
Readings: Philip Keane, Catholicism and Health Care-Justice (New York: Paulist, 2002) 1-45.
Feb. 23.
10. The Persons engaged in Health Care: the Givers and the Receivers.
Moral character: the kind of person who can freely receive and freely give;
The virtues of the health professional.
The vices of the health professional.
Readings: Ashley, 42-49.
11. The Virtue of Truthfulness: Truthfulness, confidentiality, privacy.
Debate 2: A medical professional may never reveal confidential information, even in the case of
danger to a third party: In favor; against.
Readings:
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Ashley, 58-60, 213-14.
Supplementary Reading:
Beauchamp and Childress, 302-316; 296-97.
Truth telling to the dying,
Ashley, 173.
Feb. 25 (Monday classes are held this day, “Administrative Monday.”
12. The Structures of the Catholic community as a whole: tradition and Church authority.
The Sources of Moral Teaching in the Catholic Tradition (1): Scripture, Tradition, Magisterium.
Conscience , Freedom of Conscience and authority.
Readings: Ashley, 22-30.
13. The Sources of Moral Teaching in the Catholic Tradition (2) The Natural Law.
The standard theory of the natural law; Ashley, DeBlois and O’Rourke’s version of the natural
law. “The New Natural Law” theories. The natural law in the framework of receiving and
giving.
Debate 3: The natural law is a valid ethical theory: in favor; against.
14. Other religious traditions and health care.
Readings: Gilbert Meilander, Bioethics: A Primer for Christians (Grand Rapids: William B.
Eerdmans, 1996).
Supplementary Reading.
Aaron L. Mackler, Jewish and Catholic Bioethics: A Comparative Analysis (Washington, D.C.:
Georgetown, 2003).
Mar 16.
15. “Secular” ethical traditions, theories relevant to health care. An Analysis and Critique:
Consequentialism; Utilitarianism; Rights Theories; Proceduralism; Contractualism;
“Emotivism.”
Debate 4: Utilitarianism is a valid ethical theory: In favor; against.
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Readings: Ashley, 9-30.
Supplementary Reading:
Tom L Beauchamp and James F. Childress, Principles of Biomedical Ethics, 6th. ed. (Oxford:
Oxford University Press, 2008) 333-402. (check)
Mar 16
16. Institutional aspects of Health Care:
(1) The “Identity” of the Religious Hospital and, in particular, of the Catholic hospital.
The Question of Cooperation with other traditions.
Reading:
Ashley, 79-80.
Watt, Helen. Cooperation, Complicity and Conscience.
USCCB Ethical Directives, Part 6.
(2) Law, State and Federal Law in the U.S.A. Examples of conflict between law and Church
teaching, for example, abortion. The “Freedom of Choice Act.” FOCA
Debate 5: The Freedom of Choice Act: Is morally acceptable; Is not morally acceptable.
Mar 23
17. Dealing with complex issues in the Catholic tradition.
Casuistry; The Principle of the Double Effect; The principle of Totality; The lesser evil;
Counseling the lesser evil; Intrinsically evil acts; Relativism.
Debate 6: There are absolute values; there are no absolute values.
Readings: Ashley, 12-13; Beauchamp and Childress, 376-81.
Mar 30
18. Sexuality and Procreation.
The relationships of persons in a sexual relationship, procreative relationships: Contraception,
Sterilization.
The issue of “emergency contraception.”
Readings: Ashley, 63-90.
The inseparability of love union and procreation.
Supplementary Readings:
Paul VI Encyclical Human Life (1968) (Blackboard)
19. Assisted reproduction, reproductive technologies. IVF. GIFT. “Prenatal adoption.”
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Readings: Ashley, 86-88.
Supplementary Readings:
Congregation for the Doctrine of the Faith, The Gift of Life; The Dignity of the Person.
(Blackboard)
Debate 7: Prenatal adoption: is morally acceptable; is not morally acceptable.
April 6
20. Relation to a person in the process of becoming, the embryo. Responsibility to the human
embryo, abortion.
Readings: Ashley, 80-81. 101-102; The Gospel of Life 57- 103; CDF, Declaration on Procured
Abortion, (1974) (Blackboard.)
Supplementary Readings: David Albert Jones, The Soul of the Embryo (New York: Continuum,
2004); Robert P. George and Christopher Tollefsen, Embryo: A Defense of Human Life (New
York: Doubleday, 2008).
Debate 8: Rowe v. Wade should be overturned: In favor; against.
21 Medical Experimentation
Readings: Ashley, 92-98; 113-23, 119-20.
Beauchamp: 318-23
April 20
22 Genetics: Genetic therapy. The Genome Project.
Readings: Ashley, 98-102;
Beauchamp, 301-10.
23 Embryonic cloning.
Readings: Ashley, 119-22.
Supplementary Readings: Brent Waters and Ronald Cole Turner, eds. God and the Embryo:
Religious Voices on Stem Cells and Cloning (Washington: Georgetown University Press, 2003);
24 Stem cells.
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Embyonic stem cells; adult stem cells. The ethical issues.
Debate 9. The obtaining and use of embryonic stem cells: In favor; not in favor.
Readings: stemcells-mailer@alerts.stanford.edu
Altered Nuclear Transfer (ANT) Oocyte Assisted Reprogramming, (OAR)
http://www.eppc.org/publications/pubID.2374pub_details.asp
http://ww.communio-icr.com/ant.htm
April 27
25 Transplantation of organs: the gift of an organ.
Readings: Ashley, 103-177.
The meaning of death: the debate on the acceptability of brain-death criteria.
Debate 10. Brain-death criteria: Morally acceptable; not acceptable.
Readings: Ashley, 103, 107-108, 163-65, 169-73.
Beauchamp, 64-70.
26 The person who suffers from AIDS and those who care for them.
The personal, social and political dimension.
Questions regarding AIDS prevention.
Debate 11: Providing clean needles for drug users: for and against.
Readings: Ashley, 214.
National Catholic Bioethics Center, 3 articles available on BB.
______________________________________________________________________
Supplementary Reading.
Tom L. Beauchamp and James F. Childress, Principles of Biomedical Ethics, 5th. ed. (Oxford:
Oxford University Press, 2001).
Tom L. Beauchamp and James F. Childress, Principles of Biomedical Ethics, 6th. ed. (Oxford:
Oxford University Press, 2008).
C. Ben Mitchell, Edmund D. Pellegrino, et. al. Biotechnology and the Human Good
(Washington, D.C.: Georgetown University Press, 2007).
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Cahill, Lisa Sowle. Theological Bioethics (Washington, D.C. Georgetown University Press,
2005).
H. Tristram Engelhardt, The Foundations of Bioethics, 2nd. ed. (Oxford: Oxford University
Press, 1996.
H. Tristram Engelhardt Jr., Global Bioethics: The Collapse
of Consensus (Salem, MA, M. & M. Scrivener Press, 2006).
H. Tristram Engelhardt Jr ,and Mark J. Cherry, eds. Allocating Medical Resources: Roman Catholic
Perspectives (Washington, D. C. Georgetown University Press, 2002).
Norman M. Ford, When did I Begin? Conception of the Human Individual in History,
Philosophy and Science (Cambridge: Cambridge University Press, 1988).
Norman M. Ford, The Prenatal Person: Ethics from Conception to Birth (Malden, MA,
Blackwell, 2002).
Norman M. Ford, Stem Cells (Strathfield: St. Pauls Publications, 2003).
David F. Kelly, Contemporary Health Care Ethics (Washington, D.C. Georgetown University
Press, 2004).
Gerald P. McKenny, To Relieve the Human Condition: Bioethics, Technology, and the Body
(Albany: State University of New York Press, 1997).
Gilbert C. Meilander, Body, Soul and Bioethics (Notre Dame: University of Notre Dame Press,
1995).
President’s Council on Bioethics, Human Dignity and Bioethics: Essays Commissioned by the
President’s Council on Bioethics (Washington. D.C.: 2008).
Carol R. Taylor and Robert Dell,Oro, eds. Health and Human Flourishing (Washington, D.C.:
Georgetown University Press, 2006).
Brent Waters and Ronald Cole-Turner, eds. God and the Embryo: Religious Voices on Stem
Cells and Cloning (Washington, D.C. Georgetown University Press, 2003).
Kevin Wm. Wildes, S. J., Moral Acquaintances: Methodology in Bioethics (Notre Dame:
University of Notre Dame Press, 2000).
----------------------------------------------------------------------------------------------------------------Additional Sources of Information.
Catholic Medical Association. cathmed.org
The Center for Bioethics and Human Dignity
Do No Harm: The Coalition of Americans for Research Ethics.
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Ethics and Medics. nccbcenter.org/em/
Ethics and Public Policy Center.
Family Research Council. (Dr. David Prentice)
Google Directory. Bioethics.
Hastings Center. www.thehastingcenter.org
Kennedy Institute of Ethics. http://Kennedyinstitute.georgetown.edu/
Linacre Center. www.linacre.org
National Catholic Bioethics Center. www.ncbcenter.org
President’s Council on Bioethics. www.bioethics.gov (Dr. Edmund Pellegrino)
Stem Cells. www.stemcellresearch.org: www.burnham.org; stemcells.nih.gov/info/basics
USCCB. Www.nccbuscc.org life issues.
Journals
Ethics and Medics.
The Hasting Center Report
Journal of Medical Ethics
Kennedy Institute of Ethics Journal
The Linacre Quarterly
National Catholic Bioethics Quarterly