Transcript Philosophy 242 MEDICAL ETHICS

Philosophy 242
MEDICAL ETHICS
SUM2014, M-F, 9:40-10:40, SAV 156
INSTRUCTOR: BENJAMIN HOLE
OFFICE HOURS: M-F, 10:40-11
EMAIL: [email protected]
Agenda
•
•
•
•
No Clicker Quiz
Finish Dax’s Case
Where we are and what we’re doing
Discuss Dax’s Case
Where we are and what
we’re doing
Schedule
Paper Writing
Participation
Week
June 22-26: Introduction to Bioethics in
Philosophy
June 29- July 3: Bioethics and Moral Reasoning
Writing Assignment due June 30
Required

Benjamin Hole, Phil242 Syllabus and Course Website

Chapter 1 “Moral Reasoning in Bioethics” (3-32)

Chapter 2 “Bioethics and Moral Theories” (33-40)

“Writing Philosophy” (PDF), Mark Woodhouse

“The Principle of Utility” (PDF), Jeremy Bentham

“Utilitarianism,” John Stuart Mill (52-54)

“The Moral Law,” Immanuel Kant (55-60)
July 6-10: Access to Healthcare




Chapter 11, “Dividing up Health Care Resources” (681-695)
“Famine, Affluence, and Morality” (PDF), Peter Singer
“Lifeboat Ethics” (PDF), Garrett Hardin
“The Survival Lottery,” (PDF) John Harris
July 13-17: Patient Autonomy and Informed
Consent




Dax’s Case (in-class movie)
Chapter 3, “Paternalism and Patient Autonomy” (71-83)
Chapter 5, “Informed Consent” (180-185)
“Confronting Death: Who Chooses, Who Controls?” (PDF), Robert Burt and Dax Cowart
July 20-24: Disability and Culture




Sound and Fury (in-class movie)
“Paternalism,” Gerald Dworkin (84-93)
“Ethical Relativism in a Multicultural Society,” Ruth Macklin (164-174)
“Defending Deaf Culture,” (PDF) Robert Sparrow
July 27-31: Disability and Biomedical
Enhancement



FIXED: The Science/Fiction of Human Enhancement (in-class movie)
“A Fatal Attraction to Normalizing” (PDF), Anita Silvers
“Ethical Issues in Human Enhancement” (PDF), Nick Bostrom & Rebecca Roache
August 3-7: Reproductive Genetic and Ethics




“Is Gene Therapy a Form of Eugenics?,” John Harris (571-577)
“Genetic Dilemmas and the Child’s Right to an Open Future,” Dena Davis (553-562)
“The Non-Identity Problem and Genetic Harms,” Dan W. Brock (567-570)
“The Wisdom of Repugnance,” Leon Kass (483-498)
August 10-14: Abortion




“The Unspeakable Crime of Abortion” (PDF), Pope John Paul II
“On the Legal and Moral Status of Abortion,” Mary Anne Warren (333-342)
“Why Abortion is Immoral,” Don Marquis (317-328)
“A Defense of Abortion,” Judith Thomson (307-316)
Writing Assignment due July 14
Writing Assignment due July 28
Writing Assignment due August 11
August 17-21: Paper Conference and Review
This week
• Monday
•
•
•
•
• Dax’s Case
Tuesday
• Today
Wednesday
• “Paternalism and Patient Autonomy”
Thursday
• “Informed Consent”
Friday
• “Confronting Death: Who Chooses, Who
Controls?”
 Dax’s Case (in-class movie)
 Chapter 3, “Paternalism and Patient
Autonomy” (71-83)
 Chapter 5, “Informed Consent” (180-185)
 “Confronting Death: Who Chooses, Who
Controls?” (PDF), Robert Burt and Dax
Cowart
Your paper must include all of the following elements:
I.
II.
III.
IV.
V.
VI.
Introduction
a. Give your thesis statement.
b. Lay out your argumentative structure.
c. Is your thesis a strong and simple statement of your core argument’s conclusion?
Exegetical argument
a. Explain the philosopher’s argument.
b. Are you being as charitable as possible?
Your Core Argument
a. Explain your argument.
b. Does the argument engage with a premise in the argument from the previous section?
Possible Objection
a. Explain the objection argument.
b. Does the argument engage with a premise in the argument from the previous section?
c. Is the argument strong or a straw-man?
Your Response
a. Explain the response argument.
b. Does the argument engage with a premise in the argument from the previous section?
c. Does the argument avoid foot-stomping?
Conclusion
a. Recapitulate your thesis.
b. Recapitulate your argumentative structure.
c. Consider possible implications of your argument.
The italicized are questions to consider when planning your paper, not questions to be responded to directly.
Final Paper (35%)
Week
June 22-26: Introduction to Bioethics in
Philosophy
June 29- July 3: Bioethics and Moral Reasoning
Writing Assignment due June 30
Required

Benjamin Hole, Phil242 Syllabus and Course Website

Chapter 1 “Moral Reasoning in Bioethics” (3-32)

Chapter 2 “Bioethics and Moral Theories” (33-40)

“Writing Philosophy” (PDF), Mark Woodhouse

“The Principle of Utility” (PDF), Jeremy Bentham

“Utilitarianism,” John Stuart Mill (52-54)

“The Moral Law,” Immanuel Kant (55-60)
July 6-10: Access to Healthcare




Chapter 11, “Dividing up Health Care Resources” (681-695)
“Famine, Affluence, and Morality” (PDF), Peter Singer
“Lifeboat Ethics” (PDF), Garrett Hardin
“The Survival Lottery,” (PDF) John Harris
July 13-17: Patient Autonomy and Informed
Consent




Dax’s Case (in-class movie)
Chapter 3, “Paternalism and Patient Autonomy” (71-83)
Chapter 4, “Informed Consent” (180-185)
“Confronting Death: Who Chooses, Who Controls?” (PDF), Robert Burt and Dax Cowart
July 20-24: Disability and Culture




Sound and Fury (in-class movie)
“Paternalism,” Gerald Dworkin (84-93)
“Ethical Relativism in a Multicultural Society,” Ruth Macklin (164-174)
“Defending Deaf Culture,” (PDF) Robert Sparrow
July 27-31: Disability and Biomedical
Enhancement



FIXED: The Science/Fiction of Human Enhancement (in-class movie)
“A Fatal Attraction to Normalizing” (PDF), Anita Silvers
“Ethical Issues in Human Enhancement” (PDF), Nick Bostrom & Rebecca Roache
August 3-7: Reproductive Genetic and Ethics




“Is Gene Therapy a Form of Eugenics?,” John Harris (571-577)
“Genetic Dilemmas and the Child’s Right to an Open Future,” Dena Davis (553-562)
“The Non-Identity Problem and Genetic Harms,” Dan W. Brock (567-570)
“The Wisdom of Repugnance,” Leon Kass (483-498)
August 10-14: Abortion




“The Unspeakable Crime of Abortion” (PDF), Pope John Paul II
“On the Legal and Moral Status of Abortion,” Mary Anne Warren (333-342)
“Why Abortion is Immoral,” Don Marquis (317-328)
“A Defense of Abortion,” Judith Thomson (307-316)
Writing Assignment due July 14
Writing Assignment due July 28
Writing Assignment due August 11
August 17-21: Paper Conference and Review
Discuss Dax Cowart
Dax’s Case
Please Let Me Die was filmed
in 1974
A follow-up documentary
titled Dax's Case was filmed
in 1984
Discussion Question
• Reflect on the arguments from ethical theory we discussed earlier this
quarter.
• From a perspective of ethical theory, how would you describe Dax Cowart’s
rationale for the right to refuse treatment?
Construct Arguments
• 1.
• 1.
• 2.
• 2.
_____________________________
_____________________________
• 3. Therefore, Dax Cowart should
• 3. Therefore, Dax Cowart should
have been allowed to refuse
treatment
not have been allowed to refuse
treatment.
Construct and Objection and Response
Objection
Response
• 1.
• 1.
• 2.
• 2.
_____________________________
_____________________________
• 3. Therefore, X premise from my
• 3. Therefore, Y argument from the
argument is false.
possible objection is false.
Discussion Question
• One of the physicians says that, in severe cases, burn patients are incompetent to
make decisions when they first enter the hospital because they are in such a great
deal of pain. However, patients such as Dax can be in a great deal of pain for a very
long time. In such cases, what should be done to determine competence, and when
should this be done?
• What options, if any, should Dax have been offered immediately after his accident?
He says that he expressed a wish not to be taken to any hospital. Presumably, no
one paid any attention. Should severely burned patients be offered the choice of not
being treated?
In severe cases, burn patients are incompetent to make decisions when they first enter the
hospital because they are in such a great deal of pain.
A. Strongly Agree
B. Agree
C. Somewhat Agree
D. Neutral
E. Somewhat Disagree
F. Disagree
G. Strongly Disagree
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Discussion Question
• Dax says that he could see no future for himself, after the accident. He does
not want to live as a “blind cripple” (his words) “selling pencils” (mother’s
words). Could his outlook on life have clouded his judgment? Did his
outlook undermine his competence?
• Since the accident, Dax has had a career as a lawyer, he has been married,
and grew to value his life after the accident. Does the fact that Dax’s outlook
on his life changed undermine his original refusal of treatment?
After the accident, Dax’s pessimism about his future undermined
his competence.
A. Strongly Agree
B. Agree
C. Somewhat Agree
D. Neutral
E. Somewhat Disagree
F. Disagree
G. Strongly Disagree
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Discussion Question
• Part of Dax’s plan for stopping treatment was that he would leave the hospital and
go home, but that rather than die from the inevitable wound infection, he would
seek some way to hurry up the dying process.
• Suppose that you are the physician and found Dax to be fully competent, and
suppose that he requests your help as a physician in hastening his death, either by
giving him a lethal drug he could take himself (physician-assisted suicide) or by injecting
a deadly drug (voluntary active euthanasia).
• Would you agree to this request? What considerations besides respect for patient
autonomy would be relevant to your answer?
If you were Dax’s physician and found him to be fully competent to refuse
treatment, you would respect his request and hasten his dying process.
A. Strongly Agree
B. Agree
C. Somewhat Agree
D. Neutral
E. Somewhat Disagree
F. Disagree
G. Strongly Disagree
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You would respect Dax’s refusal of treatment and hasten his dying process by:
A. giving him a lethal drug he could
take himself (physician-assisted suicide)
B. injecting a deadly drug (voluntary active
euthanasia)
C. it doesn’t matter (whether you
choose A or B)
D. neither
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Construct and Objection and Response
Objection
Response
• 1.
• 1.
• 2.
• 2.
_____________________________
_____________________________
• 3. Therefore, X premise from my
• 3. Therefore, Y argument from the
argument is false.
possible objection is false.