Health & Biomedical Ethics

PHI 383 001 CRN 20474

Spring 2005

TH 2:00-3:15 PM

 

Instructor: Dr. Laura Newhart

Office: Case Annex 257

Office Hours: MWF 12:20-1:10; TH 12:30-1:45

Contact Information: Phone: 622-2574  

                                    E-mail: Laura.Newhart@eku.edu or l-newhart@msn.com

 

Course Description:

            In this course, we will examine the ethical dimensions of the health care professions. The first half of the course will lay the foundations for the analysis and evaluation of ethical dilemmas as they arise within the context of medical practice. These foundations include an understanding of the ethical theories and moral principles which have historically been employed in the resolution of ethical issues in health care and a consideration of the nature of the relationship between the patient and the health care provider. The second half of the course will focus on the application of these foundations to specific moral issues including: 1) biomedical research on humans 2) physician-assisted suicide and active euthanasia; 3) abortion  and maternal-fetal conflicts; 4) surrogacy and alternative reproductive technologies;  and 5) genetic testing and therapy, stem cell research and human cloning.

 

Course Format:

            Class time will be divided between lecture, discussion, collaborative group projects, case studies, and audio-visual material. Each student is expected to read the material and to be prepared to discuss it in an informed manner during the class period for which it is assigned.

 

Required Texts:

            Thomas A. Mappes and David DeGrazia, Biomedical Ethics. 5th Edition.  McGraw-Hill, 2000.

           

             Gregory E. Pence, Classic Cases in Medical Ethics. 4th Edition.

                         McGraw-Hill, 2004.

 

Course Requirements and Grading:

            Your grade for the course will be determined by:

               (1) 2 Exams (15% each)                                        30%

               (2) Medical Ethics Committee Project                    30%

               (3) Final Paper                                                       30%

               (4) Attendance and Participation                             10%

 

 

(1)  2 Exams: The first exam will cover the ethical theories and moral principles covered in the first 1/4 of the semester (Chapter 1 in the text). The first exam will be graded and returned before midterm. It is scheduled to take place on Tuesday February 8, 2005. The second exam will cover the and issues surrounding the relationship between the patient and the health care provider(s) covered during the second 1/4  of the semester (Chapters 2-3 in the text). It is scheduled to take place on Tuesday March 15, 2005. The exams will be made up of multiple choice, true/false, fill in the blank, and short answer questions.

 

(2)  Medical Ethics Committee Project: You will be given the chance to use the theoretical tools and reasoning skills that you will acquire in the first half of the semester by leading the discussion for an ethics committee meeting on a specific biomedical issue during the second half. Depending on the size of the class, you will be teamed up with 2 or 3 other members of the class. Each group will be responsible for presenting before the class a recent, real-life, case dealing with one of the following issues: Human Subjects, Physician-Assisted Dying, Abortion, Assisted Reproduction, Genetic Testing and Therapy, Stem Cell Research, or Reproductive Cloning. You will get background information concerning your case from the relevant chapter in Classic Cases in Medical Ethics. During the class period that your issue is to be covered, your group will summarize the material in the chapter for the rest of the class, present the specific case, and facilitate class discussion in such a way as to lead to a resolution to the issue. Feel free to bring in additional information on your issue, especially if there have been recent developments surrounding your issue. Committee presentation dates for the specific issues are listed on the schedule of readings.

 

(3) Final Paper: You will be asked to write a 5-7 page typed double spaced paper in which you apply the relevant ethical theories, moral principles, and factual knowledge covered in class to one of the ethical issues listed in the course description. Your paper will be graded on the basis of: your presentation of the ethical dilemma that the issue embodies, your understanding of the theories and principles which you will be using to resolve the issue, the thoughtfulness and creativity that you exhibit in choosing which theories and principles to apply to the issue, and the organizational structure of your paper. Final papers are due during the final exam period, Tuesday May 3 from 1:00 to 3:00 p.m.

 

(4)  Attendance and Participation: The quality and enjoyment of this course depends on the participation of each of its members. In order to participate, you must attend. Therefore, after three absences I reserve the right to begin deducting points off your final grade up to a maximum of 10%.

 

Grading Policy:

            Out of a possible total of 100 points:

           

            90-100   A                     60-69   D

            80-89     B                      59-below   F

            70-79     C

 

 

 

Important Notes:

 

1. The instructor reserves the right to modify this syllabus if it will better meet the goals and objectives of the course.

 

2. Cheating and plagiarism will not be tolerated and will be dealt with in accordance with the EKU Student Handbook.

 

3. If you are registered with the Office of Services for Individuals with Disabilities, please make an appointment with the course instructor to discuss any academic accommodations you need. If you need academic accommodations and are not registered with the Office of Services for Individuals with Disabilities, please contact the Office directly either in person on the first floor of Turley House or by telephone at (859)622-1500 V/TTY. Upon individual request, this syllabus can be made available in alternative forms.

 

Syllabus

 

  Introduction

 T     1/11            Introduction to Course

 H     1/13            Introduction to Biomedical Ethics                           pp. 1-4

                            Video: Dateline: Medical Ethics

 

Ethical Theories

 T     1/18          Assessing Competing Theories                                 pp. 4-7

                         Utilitarianism                                                             pp. 7-17

 H     1/20         Utilitarianism cont.                                                    

                                                            

  T     1/25        Kantian Deonotology                                                   pp. 18-24                      

 

Alternative Directions and Methods

 H     1/27          Prima Facie Duties                                                     pp. 24-28

                          Virtue Ethics                                                              pp. 28-31

 T      2/1             Ethics of Care                                                          pp. 31-33

                           Casuistry and Reflective Equilibrium                          pp. 34-38

 

Relevant Concepts and Principles

 H       2/3           Autonomy                                                                  pp. 38-44

                           Liberty Limiting Principles                                           pp. 44-50

                           Group Project: Cases Studies in Autonomy and Paternalism

 

T       2/8            Exam 1        

 

The Physician-Patient Relationship

 H     2/10           Physicians Obligations and Virtues                         pp. 56-71

                           Physician-Patient Models                                      pp. 71-85

                 

                 

Truth-Telling and Informed Consent

  T     2/15             Truth-Telling                                                     pp. 85-93

                              Informed Consent                                            pp. 93-109

  H     2/17             Determinations of Competence                         pp. 109-116

                 

Multiculturalism and Managed Care

  T     2/22            Medicine in a Multicultural Society                     pp. 117-129

  H     2/24            Conflicts of Interest and Managed Care             pp. 130-147

              

Hospitals, Nurses, and Medical Confidentiality

  T      3/1           Professional Statements                                        pp. 150-160

                          The Role and Responsibilities of Nurses                pp. 161-187

  H      3/3          Confidentiality                                                       pp. 208-222

                          Group Project: The Tarasoff Case

 

 T 3/8 and H 3/10 No Class!!! Spring Break

 

  T       3/15          Exam 2       

 

 Human Research

  H       3/17         Ethical Codes                                                      pp. 225-237

                            Historical and Cultural Causes for Concern          pp. 238-253

  T        3/22        Clinical Trials in Developing Countries                   pp. 265-272

                            Video: Miss Evers’ Boys

  H        3/24         Miss Evers’ Boys cont.

                            Human Subjects Committee Presentation

                            Classic Cases in Medical Ethics Chapter 11,      pp. 270-300

  

Active Euthanasia

  T         3/29        The Morality of Active Euthanasia                         pp. 398-407

                            The Supreme Court, Physician-Assisted Suicide...  pp. 407-421

  H         3/31        Physician-Assisted Suicide, Active Euthanasia, ...   pp. 421-444

                             Physician-Assisted Dying Committee Presentation

                            Classic Cases in Medical Ethics Chapter 4,           pp. 89-120


Abortion and Maternal-Fetal Conflicts

  T     4/5              The Morality of Abortion                                               pp. 446-478

                             Abortion and Social Policy                                            pp. 478-490

  H    4/7               Maternal-Fetal Conflicts                                               pp. 490-504

                             Abortion Committee Presentation

                             Classic Cases in Medical Ethics Chapter 5,                pp. 122-151

 

Gamete Donation, Surrogacy, and Reproductive Technologies

  T     4/12              Intro. to Genetics and Human Reproduction                pp. 507-515

                               Gamete Donation and Surrogacy                                pp. 546-561

                               Video: The Baby Dance 

  H     4/14              Reproductive Technologies                                        pp. 527-545                           

                              The Baby Dance cont.

                               Assisted Reproduction Committee Presentation

                               Classic Cases in Medical Ethics Chapter 6,             pp. 152-183

 

Genetic Testing and Therapy

  T        4/19          Reproductive Risk, Prenatal Diagnosis, ....                  pp. 516-527

  H        4/21         Genetic Engineering                                                    pp. 577-595

                              Ethical Issues and Genetic Disease Committee Presentation

                              Classic Cases in Medical Ethics Chapter 16,          pp. 395-428

 

Stem Cell Research and Human Cloning

  T       4/26              Battles over Embryos and Stem Cells Committee Presentation
          
                     Classic Cases in Medical Ethics Chapter 7,         pp. 184-197

  H       4/28              Human Cloning                                                     pp. 561-577

                                Reproductive Cloning Committee Presentation

                                Classic Cases in Medical Ethics Chapter 8,         pp. 198-215

 

Final Papers Due During Exam Period Tuesday May 3 1:00 - 3:00 p.m.