CONCORDIA UNIVERSITY, Montreal, Que, Canada
SCIENCE AND HUMAN AFFAIRS
"Seminar in Science and Human Affairs: Bioethics"
SCHA 454/3 Section AA
Fall/Winter 1989/90
Professor Kathleen Cranley Glass
--------------------------------------------------------------------------------------------------------------------A. Course Description and Objectives
The revolution in biotechnology has given man powers unimaginable just a few decades ago.
Human life is being created. in the laboratory with in vitro fertilization and such life may eventually
result in a laboratory "birth". The capacity to splice human to non-human genetic material now exists
and the ability to alter the human genome may not be far away. I t is now possible to keep a person
"alive" virtually indefinitely using a respirator, cardiac pacemaker and intravenous feeding of
artificial food. Ethical dilemmas which were once no more than interesting and entertaining
speculations about the future are now an everyday reality. This reality impacts not only upon the
scientist and health professional but also upon all individuals as consumers of health services and
shapers of social policy in the realms of scientific inquiry and medical care.
The Bioethics course is offered as a senior level seminar which will provide students with
a framework for identifying, reflecting upon and resolving bioethical dilemmas. The emphasis will
be upon understanding the moral conflicts raised by the application of scientific discovery and
technology to modern medicine and resolving those conflicts in a pluralist context.
B. Teaching Methods and Materials
Classes will be held from 16:05 to 17:55 each Thursday from September 7, 1989 to April 5,
1990. These sessions will utilize a combination of lecture, discussion, case consultation, guest
speakers, short films and oral presentation by the students. Questioning and interchange between the
professor or guest lecturer and students as well as amongst the students themselves will be an
important part of the learning process.
A bibliography of selected readings for each class will be available to students. It will include
both required readings for each class as well as references to additional relevant materials. All
required readings will be photocopied and available at the Geography Department. The text selected
for the course is Principles of Biomedical Ethics (2nd ed.) by T. Beauchamp and J. Childress.
1. Written Assignments
There will be 4 written assignments the first term on subjects of the student's choosing.
They should be short (5 double-spaced typewritten pages), focusing on one problem, issue or
case and should show the student's personal analysis. These are not meant to be detailed or
lengthy research papers.
Suggestions: Analyze an article (it may be from the reading list) giving your viewpoint.
Select a medical condition, such as Alzheimer's Disease, and discuss what ethical
questions may be encountered in a patient's care and treatment.
Review a book, movie or TV show which deals with a question of bioethics.
The second half of the course will give students the opportunity to focus on research projects
of their own choosing. Research methodology will be explored, beginning with choosing a topic and
using a library. Seminar times will be used for progress reports as well as class discussions of the
papers themselves. The research projects will be discussed more fully at the beginning of the second
term.
2. Oral Presentations
During the first term, each student will be assigned a topic or question to prepare for
presentation in class. These reports should last no more than 10 minutes per student. During the
second term, students will make oral presentations of the materials prepared for their research papers.
Possible Research Topics
- Research Involving Human Subjects
- Should There Be Limits to Scientific Inquiry?
- Treatment of Defective Newborns
- Relationship Between Law and Morality in Medical Matters
- Truth Telling and the Right to Information
- New Reproductive Technologies
•
In Vitro Fertilization
•
Artificial Insemination
•
Surrogate Motherhood
•
Embryo Freezing
- Establishing Ethical Principles in a Pluralist Society
- Ethical Aspects of Medical Confidentiality.
- Involuntary Hospitalization of the Mentally Ill
- Fetal Surgery and Maternal Rights
- The Body as Property
- Sterilization of the Mentally Retarded
- Ethical Problems Arising from Development and Use of Recombinant DNA
- Abortion: Medical or Non-Medical Act?
- Research or Experimentation Involving Children
- Problems of Informed Consent in Randomized Drug Trials
- Ethical Issues Involved in Compulsory Genetic Screening
- Euthanasia and Aid to Suicide
- Aids and Confidentiality
- Aids and Mandatory Screening
- Witholding Nutrition & Hydration to the Dying Patient
- Aids and Mandatory Blood Testing
- Rationing Scarce Health Care Resources
- Medical Decision Making and the Elderly Patient
- Medical Decision Making and the Adolescent Patient
- Fetal Tissue Transplants
Any other appropriate topic suggested by the student may be explored as well.
CONCORDIA UNIVERSITY
SCIENCE AND HUMAN AFFAIRS
"Seminar in Science and Human Affairs: Bioethics"
SCHA 454/3 Section AA
Fall/Winter 1989/90
Professor Kathleen Cranley Glass
--------------------------------------------------------------------------------------------------------------------Term I Class Schedule
Sept. 7
Introduction: Course Objectives, Methodology, Materials
Student Evaluations
Sept. 14
The Range of Issues
Basic Principles
Sept. 21
The Patient as Person: Truth Telling and Consent
Sept. 28
Abortion
5 page paper due
Oct. 5
Genetic Screening
Oct. 12
New Reproductive Technologies
Oct. 19
Surrogate Motherhood
5 page paper due
Oct. 26
The Limits of Scientific Inquiry: Recombinant DNA
Nov. 2
Gene Therapy
Nov. 9
Organ Replacement: Human and Artificial
5 page paper due
Nov. 16
The Body as Property
Nov. 23
AIDS: The Ethical and Legal Issues
Nov. 30
Witholding and Withdrawing Treatment
5 page paper due
CONCORDIA UNIVERSITY
SCIENCE AND HUMAN AFFAIRS
"Seminar in Science and Human Affairs: Bioethics"
SCHA 454/3 Section AA
Fall/Winter 1989/90
Professor Kathleen Cranley Glass
--------------------------------------------------------------------------------------------------------------------BIBLIOGRAPHY
Class #2: - General Overview, The range of Issues, Basic Principles
*Beauchamp and Childress, Principles of Biomedical Ethics (2nd ed.) (1983), pp.3-58
Beauchamp and McCullough, Medical Ethics (1984), pp. 22-51
Beauchamp and Walters, Contemporary Issues in Bioethics (2nd ed.) (1982), pp.1-42
Gilligan, In a Different Voice (1982), pp.16-21 & 64-69
*Nolan and Kirkpatrick, Living Issues in Ethics (1982), pp.46-51
Toulmin, "How Medicine Saved the Life of Ethics" in DeMarco and Fox (eds.), New Directions in
Ethics, pp. 265-281
Warnock, M., Existentialist Ethics (1967), pp. 53-57.
* indicates required reading
CONCORDIA UNIVERSITY
SCIENCE AND HUMAN AFFAIRS
"Seminar in Science and Human Affairs: Bioethics"
SCHA 454/3 Section AA
Fall/Winter 1989/90
Professor Kathleen Cranley Glass
--------------------------------------------------------------------------------------------------------------------BIBLIOGRAPHY
Class #3: The Patient as Person: Truth Telling and Consent
* Beauchamp and Childress, Principles of Biomedical Ethics (2nd ed.) (1983), pp. 59-93,148-158.
* Bok S. "Lies to the Sick and Dying" in Beauchamp and Walters (2nd ed.) pp. 175-180.
"Faith Healing", Case Study, Hastings Center Report, February 1981, pp. 10-11.
* Williams, W. C., "The Use of Force" in Life Along the Passaic River, pp. 131-135.
Consent Forms
Englehardt, T., The Foundations of Bioethics, pp. 262-284.
Veach, R., Case Studies in Medical Ethics, pp. 43-48.
* indicates required reading.
CONCORDIA UNIVERSITY
SCIENCE AND HUMAN AFFAIRS
"Seminar in Science and Human Affairs: Bioethics"
SCHA 454/3 Section AA
Fall/Winter 1989/90
Professor Kathleen Cranley Glass
--------------------------------------------------------------------------------------------------------------------Bibliography
Class #4: Abortion
* Brody, B., "The Morality of Abortion" in Contemporary Issues in Bioethics (2nd), Beauchamp, T.
and Walters, L. (eds.) (1982), pp.240-250.
*Case Studies in Bioethics, "The Unwanted Child: Caring for the Fetus Born Alive After Abortion",
Hastings Center Report 6: 5 (1976).
*Devine, P., “Abortion” in Beauchamp and Walters, pp. 260-267.
Hellegers, A., “The Beginning of Life”, Theological Studies 31: 1, pp. 3-9 (1970).
Langerak, E., "Abortion: Listening to the Middle" Hastings Center Report 9: 5 (1979), pp.24-28.
Law Reform Commission of Canada, Crimes Against the Fetus (1989), pp. 5-14.
Thomson, J., "A Defense of Abortion" in Beauchamp and Walters, pp. 231- 240.
*Warren, M., “On the Moral and Legal Status of Abortion” in Beauchamp and Walters, pp. 260-267.
*United States Supreme Court, Roe v. Wade 410 U. S. R. 113 (1973) excerpts.
CONCORDIA UNIVERSITY
SCIENCE AND HUMAN AFFAIRS
"Seminar in Science and Human Affairs: Bioethics"
SCHA 454/3 Section AA
Fall/Winter 1989/90
Professor Kathleen Cranley Glass
--------------------------------------------------------------------------------------------------------------------Bibliography
Class #5: Genetic Screening
Annas, G., "Is Genetic Screening Test Ready When Lawyers Say It is? (1985) Hastings Center
Report, pp. 16-18.
Fletcher, J., "Moral Problems and Ethical Guidelines in Prenatal Diagnosis" in Genetic Disorders
and the Fetus (2d), (1986) pp. 819-859.
* Fletcher, J., "Knowledge, Risk and the Right to Reproduce" in Genetics and the Law II (1980),
Milunsky, A. and Annas, G. (eds) pp. 131-137.
* Fletcher, J., "Costs and Benefits, Rights and Regulation, and Screening" in Biomedical Ethics,
Mappes and Zimbaty (eds.).
*Genewatch, Vol. 4:1 (1986) Whole Issue.
*Katz, J. “Disclosure and Consent” in Genetics and the Law II, Milunsky and Annas (eds.) (1980)
pp. 121-129.
*Kolata, Gina, "Tests of Fetuses Rise Sharply Amid Doubts", New York Times, September 22,
1987.
*Milunsky, A., "Genetic Counseling" in Genetic Disorders and the Fetus (2d ed.) (1986), pp. 1-29
Omen, G. "Prenatal Diagnosis and Public Policy" in Milunsky, A. (1986) pp. 861-871.
Wexler, N. "Will the Circle Be Unbroken?: Sterilization of the Genetically Impaired" in Milunsky
and Annas (1980), pp. 313-329.
CONCORDIA UNIVERSITY
SCIENCE AND HUMAN AFFAIRS
"Seminar in Science and Human Affairs: Bioethics"
SCHA 454/3 Section AA
Fall/Winter 1989/90
Professor Kathleen Cranley Glass
--------------------------------------------------------------------------------------------------------------------BIBLIOGRAPHY
Class #6: New Reproductive Technologies
* Annas, G., "Fathers Anonymous: Beyond the Best Interests of the Sperm Donor” in Genetics
and the Law II (1980), Milunsky, A. and Annas, G. (eds), pp. 331-343.
*Annas, G. and Elias, S., "Social Policy Considerations in Noncoital Reproduction" in Genetics
and the Law III (1984) Milunsky and Annas, pp.147-158.
*Albury, R., "Who Owns the Embryo", in Test Tube Women, Arditi, Klein and Minden (eds), pp.
55-65.
Brody, E., "Reproduction Without Sex - But With the Doctor", American J. of Law, Med. & Health
Care (1987) 15: 3, pp. 152-155.
Corea, G., "The socialized Sperm: Institutionalizing Artificial Insemination" and “Sex
Determination: A Question of Gynicide" in The Mother Machine, pp. 49-57 and 188-191.
*Corea, G., "Reproductive Continuity" in The Mother Machine, pp. 283- 289.
"Identical Twin Sisters Born 17 months Apart", Gazette 23/05/89.
Marwick, C., "Artificial Insemination Faces Regulation, Testing of Donor Semen, Other Measures"
JAMA 260: 10 (1988) pp. 1339-1340.
*Ozar, D., "The Case Against Thawing Unused Frozed Embryos", (1985) 15 Hastings Center
Report, pp. 7-12.
Parpalaix c. Centre d’Etude et de Conservation du Sperme, J.C.P., 1984, no. 20321.
CONCORDIA UNIVERSITY
SCIENCE AND HUMAN AFFAIRS
"Seminar in Science and Human Affairs: Bioethics"
SCHA 454/3 Section AA
Fall/Winter 1989/90
Professor Kathleen Cranley Glass
--------------------------------------------------------------------------------------------------------------------BIBLIOGRAPHY
Class #7: Surrogate Motherhood
Andrews, L. "Surrogate Motherhood: The Challenge for Feminists", (1988)16 Law, Medicine
and Health Care 72-80.
*Annas, G., "Fairy Tales Surrogate Mothers Tell", ( 1988) 16 Law Medicine and Health Care 27-33.
Annas, G. "Death Without Dignity for Commercial Surrogacy: The Case of Baby M", (1983)
Hastings Center Report 21-24.
*Baber, H., "FOR the Legitimacy of Surrogate Contracts", in On the Problem of Surrogate
Parenthood, H. Richardson (ed.) (1987), 31-40.
Brahams, D., "The Hasty British Ban on Commercial Surrogacy". (1987) Hastings Center Report
16-19.
*Macklin, R., "Is There Anything Wrong With Surrogate Motherhood? An Ethical Analysis", (1988)
16 Law, Medicine and Health Care 37-64.
* Werhane, P. "AGAINST the Legitimacy of Surrogate Contracts", in Richardson, pp.21-40.
*"When Baby's Mother Is Also Grandma... And Sister" Case Study, Hastings Center Report.
* indicates required readings
CONCORDIA UNIVERSITY
SCIENCE AND HUMAN AFFAIRS
"Seminar in Science and Human Affairs: Bioethics"
SCHA 454/3 Section AA
Fall/Winter 1989/90
Professor Kathleen Cranley Glass
--------------------------------------------------------------------------------------------------------------------BIBLIOGRAPHY
Class #8: The Limits of Scientific Inquiry: Recombinant DNA
Bean, L., "Entrepreneurial Science and the University, Hastings Center Report (Oct. 1982) pp. 5-9.
*Callahan, D., "Ethical Responsibility in Science in the Face of Uncertain Consequences" Annals
of N.Y. Academy of Sciences (1976) 265, pp. 1-12.
*Frost, N., "Regulating Genetic Technology" in Genetics and the Law II, pp. 15-21.
Grant, G., "Thinking About Technology" in Technology and Justice (1981) pp. 11-34.
Krimsky, S., "The Corporate Capture of Academic Science and its Social Costs" in Genetics and the
Law III, Milunsky and Annas (eds) (1984) pp. 45-55.
Ozonoff, D., "Just When You Thought It Was Safe" in Genetics and the Law III pp. 467-474.
Sinsheimer, R., "The Presumptions of Science" in Limits of Scientific Inquiry, Holton and Morison
(eds.) (1979), pp.23-35.
CONCORDIA UNIVERSITY
SCIENCE AND HUMAN AFFAIRS
"Seminar in Science and Human Affairs: Bioethics"
SCHA 454/3 Section AA
Fall/Winter 1989/90
Professor Kathleen Cranley Glass
--------------------------------------------------------------------------------------------------------------------BIBLIOGRAPHY
Class #9: The Body As Property
*Annas, G. "Whose Waste Is it Anyway? The Case of John Moore" Hastings Center Report 18 (5)
37-39 (1988).
*Andrews, L. "My Body, My Property" Hastings Center Report 16 (5) 28-38 (1986).
*American Federation for Clinical Research. "The Legal, Ethical, and Economic Impact of Patient
Materials Used for Product Development in the Biomedical Industry" Clinical Research 33:
4; 441-458 (1985).
*Heath, E. "In a 'NO-Risk' Protocol, Does Purpose Count?" and "Property
Rights and Excised Tissues", Glanz, L. IRB: Review of Human Subjects Research 1; 6; 5-6
(1979).
Holder, A. and Levine, R. "Informed Consent for Research in Specimens Obtained at Autopsy or
Surgery: A Case Study in the Overprotection of Human Subjects" Clinical Research 24: 1:
68-77 (1976).
"Medical Researchers Can't Exploit Body Tissues Without Patients’ Consent" August 23, 1988 57
LW 1030.
Moore, V. The Regents of the University of California 249 Cal. Rptr. 494 (Cal. App. 2 Dist. 1988)
(headnote).
*Murray, T. "Gifts of the Body and the Needs of Strangers" Hastings Center Report 17 (2) 30-38
(1987).
Those readings marked with an asterisk are required.
CONCORDIA UNIVERSITY
SCIENCE AND HUMAN AFFAIRS
"Seminar in Science and Human Affairs: Bioethics"
SCHA 454/3 Section AA
Fall/Winter 1989/90
Professor Kathleen Cranley Glass
--------------------------------------------------------------------------------------------------------------------BIBLIOGRAPHY
Class #10: Organ Replacement: Human and Artificial
*Annas, G. "The Prostitute, the Playboy, and the Poet: Rationing Schemes for Organ
Transplantation" AJPH 75: 2: 187-189 (1985).
*Annas, G. "No Cheers for Temporary Artificial Hearts" Hastings Center Report 15: 5: 27-28
(1985).
*Beauchamps; T. and Childress, J. Principles of Biomedical Ethics (2nd ed.) pp.183-220.
*Brauer, R. "Heartache: Death-Defying Experiments with Artificial Hearts Raise Agonizing Ethical
and Social Questions" The Sunday Star Aug. 28, 1988, p. B6.
*Caplan, Arthur "Professional Arrogance and Public Misunderstanding” Hastings Center Report 18:
2: 34-37 (1988).
Martyn, S., Wright, R. and Clark, L. "Required Request for Organ Donations: Moral, Clinical and
Legal Problems" Hastings Center Report 18: 2: 27-34 (1088).
Preston, T. "Who Benefits from the Artificial Heart?" Hastings Center Report 15: 1: 5-7 .(1988).
Taylor, P. "Kidneys Sold by Poor for Transplants, MD Says" The Globe and Mail Aug 22, 1989, p.
A1.
*“The Subject is Baby Fae” Hastings Center Report 15: 1: 8-17 (1985).
Those readings marked with an asterisk are required.
CONCORDIA UNIVERSITY
SCIENCE AND HUMAN AFFAIRS
"Seminar in Science and Human Affairs: Bioethics"
SCHA 454/3 Section AA
Fall/Winter 1989/90
Professor Kathleen Cranley Glass
--------------------------------------------------------------------------------------------------------------------BIBLIOGRAPHY
Class #11: Gene Therapy
U.S. Congress of Technology Assessment. Human Gene Therapy (1984) pp. 5-49
Grobstein, C. and Flower, M.. "Gene Therapy: Proceed With Caution". Hastings Center Report
(April 1984) pp. 13-14.
*Medical Research Council of Canada, Discussion Paper. Research on Gene Therapy in Humans:
Background and Guidelines (1989) pp. 7-36.
*Fletcher, J., "Ethical Issues in and Beyond Prospective Clinical Trials of Human Gene Therapy"
10 Journal of Medicial and Philosophy (1985) pp. 293-309.
*Sinsheimer, R., "The Presumptions of Science" "in The Limits of Scientific Inquiry, Holton and
Morison (eds.) (1979) pp. 234-235 (in Class #8 folder).
*Case study: Gene Therapy for Thalasemia.
7 Questions concerning Gene Therapy.
*indicates required reading.
CONCORDIA UNIVERSITY
SCIENCE AND HUMAN AFFAIRS
"Seminar in Science and Human Affairs: Bioethics"
SCHA 454/3 Section AA
Fall/Winter 1989/90
Professor Kathleen Cranley Glass
--------------------------------------------------------------------------------------------------------------------BIBLIOGRAPHY
Class #12: Experimentation with Human Subjects
*Barber, B., "The Ethics of Experimentation with Human Subjects". Scientific American 234: 2;
25-31 (1976).
Caplan, A., "Is There an Obligation to Participate in Biomedical Research" in The Use of Human
Beings in Research, Spicker et al. (eds.), pp. 229-248 (1988).
Freedman, B., "Equipoise and the Ethics of Clinical Research" New Eng. J. Med. 317: 141-145
(1987).
*Halushka v. U. of Saskatchewan (1965) 53 D.L.R. (2d) 436-447.
Jonas, H. "Philosophical Reflections on Experimenting with Human Subjects" in Experimentation
with Human Subjects, Freund, P. (ed.) pp .1- 31 (1969).
*Levine, R., Ethics and Regulation of Clinical Research (2nd ed), pp. 1- 316 (1986).
Moore, J., "A Cultural and Historical View", in Experiments and Research with Humans: Values in
Conflict, National Academy of Sciences (1975) pp. 15-30.
*Vaux, K. and Schade, S., "The Search for Universality in the Ethics of Human Research: Andrew
C. Ivy, Henry K. Beecher, and the Legacy of Nuremburg" in Spicker et al., pp. 3-16.
* indicates required reading.
CONCORDIA UNIVERSITY
SCIENCE AND HUMAN AFFAIRS
"Seminar in Science and Human Affairs: Bioethics"
SCHA 454/3 Section AA
Fall/Winter 1989/90
Professor Kathleen Cranley Glass
--------------------------------------------------------------------------------------------------------------------BIBLIOGRAPHY
Class #13: Withholding and Withdrawing Treatment
*
Beauchamp & Children. pp.115-143, Cases 17,18 & 19
Criminal Code, sections 197(1)(c), 199, 202-205, 207
*
Dresser, R. and Robertson, J., “Quality of Life and Non-Treatment Decisions for
Incompetent Patients: a critique of the Orthodox Approach”, 17 (3) Law,
Medicine and Health Care 232-244 (1989).
Lynn, Joanne., "Brief and Appendix for Amicus Curiae: The American Geriatrics
Society" In the Matter of Claire C. Conroy. 32(12) J. Am. Ger. 915-922 (1984).
Younger, S. "Do-Not-Resuscitate Orders: No Longer Secret, But still a problem" 17(1)
Hastings Center Report 24-30 (1987).
*
Meilaender, G. "On Removing Food and Water: Against the Stream 14(6) Hastings
Center Report 11-13 (1984).
*
Kafka, F. "Metamorphosis". Penguin Modern Classics pp.9-63.
Ramsay, P. Ethics at the Edges of Life (1978) 148-188.
Readings marked with an * are required.