Bioethics

Introduction

Bioethical questions have a crucial role both in people’s personal choices and in the political domain. The goal of the course is to introduce students to the main controversies in contemporary bioethics, especially to those concerning freedom of choice, the control of life, and cutting-edge medical research. At the end of the course, students will be equipped with the conceptual tools required to understand the main debates in bioethics and the most relevant positions in the debate. Hopefully, they will be also able to take their own stance on these subjects. For this purpose, for almost every class two opposing readings will be presented and discussed by students.

We will start with a general introduction to the domain and methods of bioethics, and then move to discuss the issues of abortion and reproductive freedom. We will then introduce the issues of valuing life in its extreme and most difficult circumstances and explore the complex theme of autonomy in cases of assisted suicide, euthanasia, and vegetative states. In the last part of the course we will discuss the bioethical challenges prompted by genetics, such as cloning, human enhancement, and patenting genes, and how controversies over these issues impact on medical research. We will conclude by exploring the ethics of medical experimentation on humans and animals, and focus on the questions of justice in the resource allocation for health at the state and global level.

This year, like in the past courses, the teaching format will include a number of speakers and some debates over recent bioethical controversies. Students will be asked to present in favor or against a particular issue (see reading material).

Topics

1 – Introduction 

Arras, John, “Theory and Bioethics”, The Stanford Encyclopedia of Philosophy, (https://plato.stanford.edu/entries/theory-bioethics/)

Suggested: Helga Kuhse and Peter Singer, “What Is Bioethics? A Historical Introduction”, in Helga Kuhse and Peter Singer (eds), A Companion to Bioethics, Wiley-Blackwell, London and New York, 2009; 2009, pp. 3-12

2 — Methods in Bioethics: Principles (I)

James F. Childress, “Methods in Bioethics”, in Bonnie Steinbock (ed), The Oxford Handbook of Bioethics, Oxford University Press, 2007, pp.15- 45;

3 – Methods (II): Case-based reasoning and reflective equilibrium

John D. Arras, “We Way We Reason Now: Reflective Equilibrium in Bioethics”, in Steinbock, Oxford Handbook, pp. 46-7; Daniel P. Sulmasy , ’Reinventing’ the Rule of Double Effect, Oxford Handbook, pp. 114-152

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Controversies: Are There Universal Ethical Principles That Should Govern the Conduct of Medicine and Research?  Daryl Pullman, “There Are”; Kevin S. Decker, “There Are Not”, in Arthur C. Caplan, and Robert Arp (eds), Contemporary Debates in Bioethics, Wiley- Blackwell, 2013, pp. 17-42

 

4 — The Ethics of Abortion

Judith Jarvis Thomson, “A Defence of Abortion”, Philosophy and Public Affairs 1 (1):47-66, 1971 (pdf); Don Marquis, “Abortion Revisited”, Oxford Handbook, pp. 395-415

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Controversies: Is The Deliberately Induced Abortion of a Human Pregnancy Is Ethically Justifiable? 

Jeffrey Reiman “Abortion is ethically justifiable”; Don Marquis, “ Abortion is not ethically justifiable”, Contemporary Debates, pp. 105-136

5 – Issues about Reproductive Freedom 

Carolyn McLeod, For Dignity or Money: Feminists on the Commodification of Women’s    Reproductive Labour, Oxford Handbook, pp. 258-284

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Controversies: Should In Vitro Fertilization Be an Option for a Woman? Laura Purdy, “Yes”; Christopher Tollefsen, “It Should Not”, Contemporary Debates, pp. 435-464

6 – Doing and Allowing Harm 

Howard-Snyder, Frances, “Doing vs. Allowing Harm”, The Stanford Encyclopedia of Philosophy, 2011 (https://plato.stanford.edu/entries/doing-allowing/)

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Controversies: Is Killing always worse than Letting Die?Nesbitt, Winston. “Is killing no worse than letting die?”, Journal of Applied Philosophy, Vol.12, No. I , 199, pp. 101-106 (pdf); Kuhse, Helga. “Why Killing Is Not Always Worse-and Is Sometimes Better-Than Letting Die”, Cambridge Quarterly of Healthcare Ethics (1998), 7, 371-374 (pdf)

7 – Autonomy in Bioethics

Bruce Jennings, “Autonomy”, Oxford Handbook, pp. 72-89; Jeanette Kennett,  “Mental Disorder, Moral Agency, and the Self”, Oxford Handbook, pp. 90-113.

Suggested: Sarah Buss, “Personal Autonomy”, The Stanford Encyclopedia (https://plato.stanford.edu/entries/personal-autonomy/)

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Controversies: Should The Child Have the Right to Refuse Medical Treatment to Which the Child’s Parents or Guardians Have Consented? William J. Winslade, “ He Should”; Catherine M. Brooks, “Should Not”, Contemporary Debates, pp. 167-196

8 – Advance Directives  

John K. Davis, “Precedent Autonomy, Advance Directives, and End-of-Life Care”, Oxford Handbook, pp. 349-374.

9 — Consent, Confidentiality, and Truth-telling  (March 15 – 10.30am-12.30pm, Room A310)

Eyal, Nir, “Informed Consent”, Stanford Encyclopedia (https://plato.stanford.edu/entries/informed-consent/); Allen, Anita, “Privacy and Medicine”, Stanford Encyclopedia (https://plato.stanford.edu/entries/privacy-medicine/)

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Controversies: Are There Are Circumstances in Which a Doctor May Withhold Information? Tom L. Beauchamp, “There Are ”; Jason T. Eberl, “There Are Not”, Contemporary Debates, pp.  401-434.

10 — Organ Transplantation 

Ronald Munson, “Organ Transplantation”, Oxford Handbook, pp. 211-239
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Controversies: “Is It Morally Acceptable to Buy and Sell Organs for Human Transplantation?” Mark J. Cherry, “It is”; Arthur L. Caplan, “It Is Not”, Contemporary Debates, pp. 43-72

11 – End of life (I): Death  

Stuart J. Youngner, “The Definition of Death”, Oxford Handbook, pp. 285-303

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Controversies: Can There Be Agreement as to What Constitutes Human Death? James L. Bernat, “Yes”; Winston Chiong, “No”, Contemporary Debates, pp. 360-400

12 – End of life (II): Assisted Suicide  

Gerald Dworkin, “Physician-Assisted Death: The State of the Debate”, Oxford Handbook, pp. 375-394

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Controversies: Is Physician-Assisted Suicide Ever Ethical? John Lachs,”Yes”; Patrick Lee, “No”, Contemporary Debates, pp. 197- 228

13 – End of life (III): Euthanasia

Young, Robert, “Voluntary Euthanasia”, Stanford Encyclopedia (https://plato.stanford.edu/

entries/euthanasia-voluntary/)

James Rachels, “Active and Passive Euthanasia.” New England Journal of Medicine 292, 2

(1975): 78-80.

 

14 – Vegetative States and Severely Disabled People

Eike-Henner W. Kluge, “Severely Disabled Newborns”, Companion to Bioethics, pp. 274-285

Jeff McMahan, “Death, Brain Death, and Persistent Vegetative State”, Companion to Bioethics,

pp. 285-289

15 – Aging Society 

Stephen G. Post, “The Aging Society and and the Expansion of Senility”, Oxford Handbook, pp. 304-323; Felicia N. Ackerman, “Death Is a Punch in the Jaw: Life-Extension and Its Discontents”, Oxford Handbook, pp. 324-348

16 – Human Enhancement 

Mirko D. Garasic (Visiting Professor in Neuroethics, IMT Lucca) “Neuroethics and Human Enhancement”. Reference material for this lecture are: Farah, M. J. (2005). Neuroethics: the practical and the philosophical;  Mirko D. Garasic, Anti-Love Biotechnology: Was It Not Better to Have Loved and Lost Than Never to Have Loved at All?

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Class readings: Thomas H. Murray, “Enhancement”, Oxford Handbook, pp. 491-515; Julian Savulescu, “Genetic Interventions and the Ethics of Enhancement of Human Beings”, Oxford Handbook, pp. 516-535

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Controversies: Is There a Legitimate Place for Human Genetic Enhancement? Nicholas Agar, “Yes”; Edwin Black, “No”, Contemporary Debates, pp. 335-368

17 – Cloning  

Andrea Bonnicksen, “Therapeutic Cloning: Politics and Policy”, Oxford Handbook, pp. 441-470

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Controversies: Were It Physically Safe, Would Human Reproductive Cloning Be Acceptable? Katrien Devolder, “Yes”; Stephen E. Levick, “No”, Contemporary Debates, pp. 73-104

18 – Patenting Genes

Ezio Di Nucci (Department of Public Health, University of Copenhagen) “In Vitro Fertilization, same-sex couples, and the value of biological ties” (Reference material for the lecture is available here)

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Class readings: Louise Irving and John Harris, Biobanking, Oxford Handbook, pp. 240-257; Gannett, Lisa, “The Human Genome Project”, Stanford Encyclopedia (https://plato.stanford.edu/entries/human-genome/)

 

19 – Research Ethics
Florence Luna, “Research in Developing Countries”, Oxford Handbook, pp. 621-647; Wendler, David, “The Ethics of Clinical Research”, Stanford Encyclopedia (https://plato.stanford.edu/entries/clinical-research/)

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Controversies: Are International Clinical Trials Exploitative?

Jamie Carlin Watson, “Yes”; Richard J. Arneson, “No”, Contemporary Debates, pp. 465-500

20 – Experimenting on humans and animals 

Jason Karlawish, “Research on Cognitively Impaired Adults”, Oxford Handbook, pp. 597-620; Alastair Norcross , “Animal Experimentation”, Oxford Handbook, pp. 648-670

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Controversies: Should We Prohibit the Use of Chimpanzees and Other Great Apes in Biomedical Research? Jean Kazez, “We should”; Carl Cohen “We Should Not”, Contemporary Debates, pp. 261-290

We should: Michela Procoli, Stefania Denni, Serena Valenza; We should not: Margarita Wallace, Olivia Zacks

21 – Genetic and Stem-Cell Research

Bonnie Steinbock, “Moral Status, Moral Value, and Human Embroys: Implications for Stem Cell Research”, in Oxford Handbook, pp. 416-440

Suggested: Matthew DeCamp and Allen Buchanan, “Pharmacogenomics: Ethical and Regulatory Issues”, Oxford Handbook, pp. 536-570;

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Controversies: Should Stem-Cell Research Utilizing Embryonic Tissue Be Conducted? Jane Maienschein: “Yes”; Bertha Alvarez Manninen, “No”, Contemporary Debates, pp. 229-260

22 – Wrongful Life and Future Generations 

M. A. Roberts, The Nonidentity Problem, Stanford Encyclopedia (https://plato.stanford.edu/entries/nonidentity-problem/); Lukas Meyer,Intergenerational Justice”, Stanford Encyclopedia (https://plato.stanford.edu/entries/justice-intergenerational/)

Suggested: Jeff McMahan, “Wrongful Life: Paradoxes in the Morality of Causing People to Live”; David Bonin, The Non-Identity Problem and the Ethics of Future People, Oxford University Press, 2014: 1-28

23 — Bioethics and Justice 

Jeffrey Kahn, Anna Mastroianni, “The Implications of Public Health for Bioethics”, Oxford Handbook, pp. 671-695; Ruth Macklin, “Global Health”, Oxford Handbook, pp. 696-720

Suggested: Jonathan D. Moreno, Bioethics and Bioterrorism, Oxford Handbook, pp. 721-734

References

Class Slides and other materials

Bibliography 

1. Bonnie Steinbock (ed), The Oxford Handbook of Bioethics, Oxford University Press, 2007;

2. The Stanford Encyclopedia of Philosophy, Edward N. Zalta (ed.), URL = <http://plato.stanford.edu/archives/spr2015/entries/life/>.

3. Arthur L. Caplan e Robert Arp (eds), Contemporary Debates in Bioethics, Wiley- Blackwell, 2013.

4. Helga Kuhse and Peter Singer (eds), A Companion to Bioethics, Wiley-Blackwell, London and New York, 2009;

Assessment Method 

– Performance in class (participation to the debate and individual presentations): 30%;

– final oral examination: 70%.

Those who wish to write a final research paper, are welcome to do so, although it is not compulsory. In case they do, the final assessment will be so re-calculated:

– oral examination: 20%;

– final paper: 50%.

For some suggestions on how to write the final paper, check here

Office Hours:  by appointment at  dsantoro@luiss.it.