Past Courses Offered
Alphabetical List of Past Courses OR List of Past Courses by Semester
Click on the title of the course to see the description.
- Beyond Quality of Life: Examining Disability in Bioethics
- Bioethics and AIDS
- Bioethics and Cultural Frameworks
- Bioethics and the Law
- Bioethics and National Security
- Bioethics and Sex
- Bioethics at the Movies (Sankar/Jones)
- Bioethics at the Movies (Jones)
- Bioethics Goes to Washington: Bioethics & Public Policy (Caplan and Wolpe)
- Bioethics Goes to Washington (Stebbins)
- Bioethics in the First Person
- Biotechnology and the Body
- Bits & Pieces: Ethical Issues in Transplanting Organs, Tissues, and Blood
- The Call of Stories: Using Narrative in Medical Ethics (Taylor)
- Challenging Clinical Ethics: Managing Patient/Caregiver Conflict Through Mediation
- Chimeras and Frankenpets: Ethical Issues in Animal Biotechnology
- Cinema of Contagion
- Classic Papers in Bioethics
- Clinical Ethics
- Conceptual Foundations
- Desperate Remedies, Emerging Technologies, and Novel Therapies
- Diviners, Healers, and Zombies: An Anthropological Look at Traditional Medicine
- Doctoring and Regulation: Training, Research, and Practice (Bosk)
- Empirical Methods in Bioethics
- Ethical and Legal Issues at the End of Life
- Ethical Issues in Transplantation
- Ethics at the Bedside
- Ethics of Research in Vulnerable Populations
- Family Matters: The Role of Family in Contemporary Bioethics
- The Future of the American Health Care System: Health Policy and the Affordable Care Act
- Genetics, Ethics, and Human Identity
- Health and Illness from an Anthropological Perspective
- History of Bioethics
- Human Genetics and Ethics: Past, Present, and Future (Alpert)
- Innovation in Medicine
- Insider's Guide to Biopolitics
- International Bioethics
- Media and the Doctor-Patient Relationship
- Mediation
- Mediation Intensive (.5 CU)
- Medical Errors
- Medical Issues in the Public Arena
- Mental Health Bioethics
- Mind Wars: Bioethics, National Security, and the Enhanced Brain
- Narrative and Bioethics (Schilling)
- Narrative and Bioethics (Wahlert)
- Nueroethics (Wolpe)
- Neuorethics (Alpert)
- Pharmaceutical Ethics
- Primary Care Bioethics: Dilemmas Through the Life Cycle
- Public Face of Bioethics
- Public Health Ethics
- Race, Gender, Medicine
- Reproductive Ethics (Ravitsky)
- Reproductive Ethics (Taylor)
- Research Ethics
- Research Ethics in the Developing World
- Research Methods
- Sociology of Jewish Bioethics
- Sociology of Medicine
- Specimen, Patient, and Spectacle: An Anthropological Look at the Body in Medicine
- Through the Artist's Eye: Medicine, Power, and the Meaning of Illness
- What a Shot! The Ethical Challenges of Vaccines
Sociology of Medicine, Instructor: Charles Bosk
This course is a graduate level introduction to the sociology of medicine. The sociology of medicine is a broad domain both in terms of topics and methodologies. In this course we will explore the following issues: (1) the demographic and cultural dimensions of health and illness; (2) the experience of illness; (3) the profession of medicine; (4) efforts at health care reform; and (5) the emergence of the field of bioethics.
History of Bioethics; Instructor: Art Caplan
As the field of bioethics has evolved it has developed a set of canonical topics and analyses that every student of bioethics should be familiar with. This course will explore the evolution of bioethics, identify key issues such as rationing, reproductive ethics, research involving children, organ donation and informed consent that have shaped the field, and examine how bioethics has made substantive contributions to public policy, corporate responsibility and individual human rights. The course will also examine the development of bioethics outside the USA and how different cultural and economic points of view differentiate bioethical analyis and the response to American bioethics. The goal of the course is to both critically examine the history of the field and to illustrate how work in bioethics has been given practical application to a wide variety of issues and problems.
The Future of the American Health Care System: Health Policy and the Affordable Care Act; Instructor: Ezekiel Emanuel
This course will provide students a broad overview of the current U.S. healthcare system. The course will focus on the challenges facing the health care system, an in-depth understanding of the Affordable Care Act, and its potential impact upon health care access, delivery, cost, and quality.
The U.S. health care system is the worlds largest, most technologically advanced, most expensive, with uneven quality, and an unsustainable cost structure. This multi-disciplinary course will explore the history and structure of the current American health care system and the impact of the Affordable Care Act. How did the United States get here? The course will examine the history of and problems with employment-based health insurance, the challenges surrounding access, cost and quality, and the medical malpractice conundrum. As the Affordable Care Act is implemented over the next decade, the U.S. will witness tremendous changes that will shape the American health care system for the next 50 years or more. The course will examine potential reforms, including those offered by liberals and conservatives and information that can be extracted from health care systems in other developed countries. The second half of the course will explore key facets of the Affordable Care Act, including improving access to care and health insurance exchanges, improving quality and constraining costs through health care delivery system reforms, realigning capacity through changes in workforce and medical education, and potential impact on biomedical and other innovation. The course will also examine the political context and process of passing major legislation in general and health care legislation in particular, including constitutional arguments surrounding the Affordable Care Act. Throughout lessons will integrate the disciplines of health economics, health and social policy, law and political science to elucidate key principles.
Cinema of Contagion, Instructor: Lance Wahlert
In reality and metaphorically, cinema has served for generations of moviegoers as a site of communal congregation, pedagogical dissemination, and sometimes disease infection. Accordingly, how and where we watch films are just as important as what films have to say about doctors, disease, and death. This course will consider the epidemiological and cultural implications of cinema on bioethics, including how movies and movie theaters themselves have functioned as spaces of contentious discourse regarding public health. Bearing in mind the recent scholarship of film and medical theorists such as Lisa Cartwright, Paula Triechler, and David Serlin, we will study not only the possibility for film to register and comment on cultural understandings of the clinic, but also the ways cinema itself works out, reimagines, and even changes how the clinic is put into practice. Focusing on themes such as quarantine, vaccination, sexual health, end of life care, professional competence, and globalization, we will be watching and discussing public health films and feature-length films by directors such as Alfred Hitchcock, David Croneberg, Tamara Jenkins, Edward Yang, Todd Haynes, and Pedro Almodovar. No background in either cinema studies or bioethics is required for this course.
Mental Health Bioethics, Instructor: Arthur Caplan
Bioethics has not paid sufficient attention to issues involving mental health. This course will seek to remedy that failing.
The course will examine how mental illnesses are defined, how competency is determined, special challenges that arise
in dealing with children, the role of compulsory treatment for addicts, the nature of the recovery movement, the ways in which
health care providers should respect the autonomy of their patients and the rights of mentally ill persons to consent to treatment among other topics. Course requirement is a 20-25 page paper on a topic to be mutually agreed upon between student and instructor.
Research Ethics in the Developing World, Instructors: Jon Merz and Francis Barchi
This is an advanced seminar focused on human subjects research in resource-constrained regions of the world. Students are expected to have a grounding in US regulations and policies. The students will come out of the class with an appreciation for issues raised by research involving populations vulnerable to manipulation and exploitation, a sensitivity to cultural issues, and an awareness of methods for appropriately engaging communities and performing ethically sound research. The course includes reading assignments, lectures, case-based and discussions addressing topics ranging from social and anthropological research, vulnerability and exploitation, biomedical research, pharmaceutical sponsorship, traditional knowledge and biopiracy, and equity and access. Grade will be based on 3 written case evaluations (70%) and class discussion and participation (30%). Please note that if you haven't taken BIOE 580: Research Ethics, you will be required to complete a short on-line training module on research ethics.
Challenging Clinical Ethics: Managing patient/caregiver conflict through mediation, Instructor: Edward Bergman
In the contemporary healthcare system patients, families, institutions and a multiplicity of caregivers engage in disputes over a myriad of issues - appropriate care, authorized decision-makers, managed care, information disclosure, and behavior/personality conflicts - sometimes with life and death hanging in the balance. Such disputes are rife with legal, ethical, emotional and scientific complexity. They are frequently highly charged and are often emergent in nature. In recent years, mediation has grown exponentially as a dispute resolution mechanism of choice. Not surprisingly, the success of mediation, and a wider understanding of the process, has led to its application in the realm of healthcare disputes with encouraging results. This course will provide an overview of negotiation fundamentals critical to the practice of mediation followed by an introduction to classical mediation theory and practice. Similarities and differences between mediation in the healthcare field, as distinct from other contexts, will be examined as will special problems highlighted by various commentators in the field. All class members will participate in mediation role-plays designed to simulate disputes prevalent in the healthcare landscape.
Neuroethics, Instructor Sheri Alpert (BIOE 555; Summer 2009)
Developments in neurotechnology and more sophisticated psychopharmaceuticals have raised new questions in the ways in which we manipulate our mental states. In this class, we will look at a variety of topics in neuroethics -- drugs, implantable brain chips, brain imaging, cochlear implants, lie detection technologies, deep brain stimulators, transcranial magnetic stimulation, brain computer interfaces, forensic neuroscience, neuromarketing, and so on, and look at the astonishing and sometimes troubling technologies that will soon be a part of our therapeutic and civil regimens.
Research Ethics, Instructor: Jon Merz (BIOE 580; Summer 2008)
This seminar is intended to give students a broad overview of research ethics and regulation. The students will come out of the class with an understanding of the moral bases of scientific ethics and the historical evolution of biomedical research ethics. Students will be fully conversant with the development, implementation, and limitations of US human subjects regulations. The course includes reading assignments, lectures, discussions, student-led case-based and topical discussions addressing the following topics: ethics and morality in science; science in society; scientific integrity; misconduct; whistleblowing; conflicts of interest; collegiality, publication and authorship; peer review; human experimentation and regulations (HHS, FDA), Institutional Review Boards; informed consent, waivers, vulnerable populations; privacy and the confidentiality of records; epidemiology; and, finally, research on animals. Grade will be based on: an article peer review task 20%; consent form writing task 30%; weekly quizzes 10%; class discussion and participation 10%; and final exam, 30%.
Ethical and Legal Issues in the End of Life, Instructor: Autumn Fiester
This course will focus on the philosophical and legal issues surrounding end-of-life. We will examine the most significant legal cases of the last few decades, from Quinlan to Schiavo. We will then look at the philosophical literature on death and the process of dying, physician-assisted suicide and euthanasia, the doctrine of double effect; and the distinction between withholding and withdrawing life support. We will explore theoretical questions such as, “why is death bad?”, “what effect does awareness of mortality have on living?”, and “is there such a thing as a ‘good death?” as well as the moral permissibility of hastening death or assisting in death.
Mediation as a Dispute Resolution Mechanism for Healthcare Disputes, Instructor: Edward Bergman
In the contemporary healthcare system patients, families, institutions and a multiplicity of caregivers engage in disputes over a myriad of issues - appropriate care, authorized decision-makers, managed care, information disclosure, and behavior/personality conflicts - sometimes with life and death hanging in the balance. Such disputes are rife with legal, ethical, emotional and scientific complexity. They are frequently highly charged and are often emergent in nature. In recent years, mediation has grown exponentially as a dispute resolution mechanism of choice. Not surprisingly, the success of mediation, and a wider understanding of the process, has led to its application in the realm of healthcare disputes with encouraging results. This course will provide an overview of negotiation fundamentals critical to the practice of mediation followed by an introduction to classical mediation theory and practice. Similarities and differences between mediation in the healthcare field, as distinct from other contexts, will be examined as will special problems highlighted by various commentators in the field. All class members will participate in mediation role-plays designed to simulate disputes prevalent in the healthcare landscape.
Family Matters: the role of families in contemporary bioethics, Instructor: Vardit Ravitsky
Bioethics’ traditional focus on the principle of autonomy and on the patient as a rational independent decision maker, have caused a long standing neglect of the concept of the family. Some important issues surrounding the roles that families play in the clinical context have not been appropriately addressed in the bioethical literature and debate. Some significant moral dimensions of family interactions have been overlooked as well.
The mere idea of the “family” is a politically contested notion these days and for many, invoking "family values" is a way of engaging a deeply conservative agenda, hostile to women and to homosexual people. In this heated context, a productive and levelheaded discussion of the family requires a sensitive and insightful conversation, which will be the objective of this class.
We will address issues such as the concept of family in liberal theory; parents’ rights to make decisions for neonates, children and adolescents; the family as care takers; filial duties - what are our moral responsibilities towards our aging parents; truth-telling; the role of the family at the end of life; families and consent to donate the organs of a loved one; enrolling families in genetic research; reproductive technologies and the deconstruction of the family; protecting women and children within families in minority cultures; and more.
Classes will consist of lectures followed by discussion and debate. Students are expected to choose a topic for a term paper by mid-semester and present it to the class as a "work in progress" in order to receive feedback. The presentation will count as 30% of the grade. Based on the presentation, students are expected to write a 2500-3000 word term paper, which will count as 70% of the grade.
Medical Errors, Instructor: Charles Bosk
The purpose of Bioethics 551 is to provide a basic understanding of some rather ubiquitous social phenomena: mistakes, errors, accidents, and disasters. We will look at these misfirings across a number of institutional domains: aviation, nuclear power plants, and medicine. Our goal is to understand how organizations “think” about these phenomena, how they develop strategies of prevention, how these strategies of prevention create new vulnerabilities to different sorts of mishaps, how organizations respond when things do grow awry, and how they plan for disasters. At the same time we will also be concerned with certain tensions in the sociological view of accidents, errors, mistakes, and disasters at the organizational level and at the level of the individual. Errors, accidents, mistakes, and disasters are embedded in organizational complexities; as such, they are no one’s fault. At the same time, as we seek explanations for these adverse events, we seek out whom to blame and whom to punish. We will explore throughout the semester the tension between a view that sees adverse events as the result of flawed organizational processes versus a view that sees these events as a result of flawed individuals.
Bioethics at the Movies, Instructors: Pamela Sankar, Nora Jones
This course explores key bioethical issues as they have been interpreted and presented in popular film. Four topics will be examined: research ethics, autonomy, justice, and genetics. The goals of the course are to enable students to appreciate and critically evaluate how film represents bioethical issues and to explore how the social, historical, and political context of a film influences its production and reception. This is a seminar course consisting of film viewings, critical discussion, and analytical writing.
Neuroethics, Instructor: Paul Root Wolpe
Developments in neurotechnology and more sophisticated psychopharmaceuticals have raised new questions in the ways in which we manipulate our mental states. In this class, we will look at a variety of topics in neuroethics -- drugs, implantable brain chips, brain imaging, cochlear implants, lie detection technologies, deep brain stimulators, transcranial magnetic stimulation, brain computer interfaces, forensic neuroscience, neuromarketing, and so on, and look at the astonishing and sometimes troubling technologies that will soon be a part of our therapeutic and civil regimens. Guest speakers and field trips will also be included.
Conceptual Foundations, Instructor: Autumn Fiester
This course examines the various theoretical approaches to bioethics and critically assesses their underpinnings. Topics to be covered include an examination of various versions of utilitarianism; deonotological theories; virtue ethics; ethics of care; the fundamental principles of bioethics (autonomy, beneficence, distributive justice, non-maleficence); casuistry; and pragmatism. The course will include the application of the more theoretical ideas to particular topics, such as informed consent, confidentiality, and end of life issues.
Bioethics and Cultural Frameworks, Instructor: Vardit Ravitsky
The field of bioethics encompasses some of the most sensitive and controversial moral issues of our time. From conception to end-of-life, bioethics is charged with the analysis, interpretation and sometimes resolution of some of the most difficult dilemmas facing our society. Bioethical debate does not occur in a vacuum. Rather, it is the outcome of the cultural, social, political and religious context within which it takes place. This class will examine the influence of cultural frameworks on the way bioethical dilemmas are approached and resolved. We will explore Christian, Muslim and Jewish value-systems and the way in which they help shape public policy in different societies and countries. We will study the impact of culture and religion on issues such as the right to health care, end-of-life care, the definition of death, organ procurement and transplantation, assisted reproductive technologies, abortion, genetic testing, embryonic stem cell research, cloning, and research with human subjects. Classes will consist of lectures followed by discussion and debate. Students are expected to attend and participate in discussion, do the assigned readings, write a term paper and take a final exam.
top
Specimen, Patient, and Spectacle: An Anthropological Look at the Body in Medicine, Instructor: Nora Jones
This course is about how the human body is literally being 'seen' by medical students, physicians, patients, and the public. Our focus will be on the ways in which the diseased or sick body is experienced and understood from the perspective of the various actors in contemporary medicine. We will begin with the 'body as specimen,' the patient's body as seen by Western biomedical physicians in training and then in clinical medicine. Here we examine the histories of medical education and medical imaging technologies (i.e. x-rays, CAT scans, photography) to understand the development and perpetuation of what is called in anthropology the ‘biomedical gaze,’ a distinct perspective towards patients that is expressed in the clinical encounter. We then turn to the 'body as patient,’ where we will explore how the experience of illness or disease in the clinical encounter can change one’s self-image and self-understanding. This portion of the class asks how, other than being a patient ourselves, we as social scientists and bioethicists can come to understand the patient’s perspective. We will evaluate various types of first-person sources, including art, literature, and accounts generated through social science research. We conclude with the 'body as spectacle,' in which we will examine how the diseased or ill body has been used in popular culture. We will focus in particular on recent trends in the art world of using the deformed body as subject matter. We will ask for what purpose the patients’ bodies are being used, and what this trend tells us about our cultural attitudes towards and beliefs about illness, disease, and medicine. The end goal of this course is to learn how a viewer's social, personal, and educational history influences how we see the human body, and then to be enabled to use this knowledge when analyzing the origins and complexities of contemporary bioethics problems.
top
Ethics at the Bedside: Clinical Bioethics in Practice, Instructor: Jill Baren
Basic concepts in clinical ethics include autonomy, beneficence, decisional-capacity, substituted judgment, and many others. But how are these concepts actually applied on a day-to-day basis? This course will provide the student with a deeper understanding of applied clinical ethics by exploring how real clinical dilemmas are approached, solved, and implemented in the everyday practice of medicine. Students will learn how detailed ethical case analysis serves as a springboard for discussion and how it can be a valuable mechanism to alert others to similar issues encountered outside an individual practice or institution. Cases will cover dilemmas from a wide spectrum of clinical environments -- ambulatory care, hospital-based care, emergency care, ICU care -- and involve patients of all ages with a variety of illnesses and injuries. Case analysis will be supplemented by readings from the clinical ethics literature covering relevant topics: the doctor-patient relationship, advance directives, privacy and confidentiality, informed consent, refusal of care, etc. Some class time will be devoted to exploring the roles and activities of ethics consultants and committees culminating in a “mock” ethics committee session. Optional clinical “shadowing” experiences will also be offered during the semester.
top
What a shot! The Ethical Challenges of Vaccines, Instructor: Arthur Caplan
Few, if any, medical interventions can match the record of success established by vaccines. Diseases such as polio and smallpox that once afflicted millions each year have been all but eradicated, and many others are rapidly becoming little more than historical footnotes. Despite these achievements, vaccines remain extremely important and controversial. When the United States and the world continue to live under the threat of an avian flu pandemic or an act of bioterrorism vaccines are seen as holding the answer to these threats. The continuing reality of the HIV/AIDS pandemic has made the hunt for preventative or therapeutic vaccines a central feature of private and public philanthropy and policy. The recent licensure of vaccines for rotavirus and cervical cancer is a reminder of the ways in which research ethics and affordable access to valued resources are reflected in vaccine policy. Vaccines present some unique ethical challenges. Unlike pharmaceuticals, many vaccines are given to healthy individuals, seeking to prevent disease rather than treat it. Indeed, babies and children are the primary recipient of vaccinations. This means the concept of risk and benefit do not always easily fit into the standard template of bioethics. Vaccines are often mandated or compelled. A variety of state laws in the U.S. require proof of vaccination in order to enroll in school or day-care. For public health authorities, a successful immunization program requires a high rate of vaccination. Thus, individual liberty may conflict with the best interests of the community as a whole in ways not commonly seen in other domains of bioethics. Allocation issues are especially interesting regarding vaccines. Reports of alleged side effects such as autism have shaken public confidence regarding vaccine safety and necessity. Many people do not want their children vaccinated as a result. Conversely, when shortages occur, difficult decisions must be made as to who should receive scarce resources.
The course will review some of the science of vaccines and then track ethical issues from the initial stages of research through the implementation of vaccination programs in communities. The course will explore these topics through key readings, class discussion, analysis of case studies, presentations by guest speakers drawn from researchers, policymakers, and scholars on the Penn campus and in the Philadelphia region. Students will be expected to write a paper addressing a topic to be agreed upon with the instructor by mid-term related to vaccine ethics in which they identify a key ethical issue, present multiple options for responding to it, and provide support for their preferred resolution.
Chimeras and Frankenpets: Ethical Issues in Animal Biotechnology, Instructor: Autumn Fiester (Summer 2006, Summer 2008)
The issue of human reproductive cloning has received a great deal attention in public discourse. Bioethicists, policymakers, and the media have been quick to identify the key ethical issues involved in human reproductive cloning and to argue, almost unanimously, for an international ban on such attempts. Meanwhile, scientists in labs across the globe have proceeded with extensive research agendas in the cloning and genetic modification of animals. What in 1997 was considered a remarkable feat – the cloning Dolly the sheep -- is today commonplace. To date, scientists have successfully cloned many other species including cats, rabbits, cows, mice, goats, pigs, mules, horses, and most recently, a dog. Scientists have also made extensive “progress” in transgenic science, in which genetic material from one species is introduced into a different species. This technique has long been used in rodents, but has in recent years been used to genetically alter rabbits, fish, pigs, and, most worrisome, non-human primates.
Despite all of this scientific research, there has been very little reflection on the profound ethical issues raised by animal biotechnology. In this course, we will examine the ethical issues that arise in various projects in animal biotechnology including: xenotransplantation, biopharming, pet cloning, cloning for conservation, recreational transgenesis (like “Alba the bunny” or the Glofish), disease modeling, and agricultural cloning and transgenesis.
top
Reproductive Ethics, Instructor: Vardit Ravitsky
An increasing number of people turn to reproductive technologies for help in their attempts to conceive a child. Over 300,000 babies have been born in the US as a result of reported Reproductive Technology procedures. This class will explore the various ethical issues that these technologies raise. We will address questions such as: Is infertility a disease? Should there be any social restrictions on access to reproductive technologies? What is the status of the human embryo outside the human body? What are the ethical concerns that Pre-implantation Genetic Diagnosis raises? Should it be used only to screen for disease? Or maybe also to choose an embryo that would become a matching donor for a sick sibling? Should sex selection be allowed? What are the implications of gamete donation and surrogacy for the identities of children and families? And how does the use of these different technologies impact family relationships and the way children are perceived and treated? Classes will consist of lectures followed by discussion and debate. Students are expected write a 10 page term paper a take a final exam.
Reproductive Ethics, Instructor: Kathy Taylor
This course will explore ethical issues raised by reproduction and the use of various reproductive technologies. We will address: 1) the moral and legal status of the embryo and fetus, in the context of embryonic stem cell research and abortion; 2) the ethical features of the maternal-fetal relationship in terms of prenatal testing and the regulation of the behavior of pregnant women; and 3) ethical issues raised by the reproductive technologies such as IVF, gamete donation, preimplantation diagnosis, and surrogacy, including how these practices affect our perceptions of pregnancy, children, and family relationships.
Medical Issues in the Public Arena, Instructor: Charles Bosk
The public arena is crowded with multiple problems competing for limited attention and resources. Issues as basic as--Is this Illness? Should we invest in treating it?--are part of the competition for attention. The first third of the course will explore how issues are structured in public arenas. Why do some issues become a source of obsessive focus while other, equally serious, issues are ignored? The remaining two-thirds will test the theories presented in first part of the course by looking at a series of case studies that examine successful and unsuccessful framings of health problems in public arenas. Possible case studies include: Abortion as an issue from mid 19th century to the present; public health and the threat of pandemic flu; end of life issues from Karen Anne Quinlan to Terri Schiavo; conflicts between scientific epidemiologists and lay populations around disease causation (autism and vaccination and cancer clusters and environmental risks).
Genetics, Ethics, and Human Identity, Instructor: Vardit Ravitsky
Description: Following the completion of the Human Genome Project, the genomic era has now begun. Genetic information is expected to revolutionize our understanding of health and disease. It will also impact our personal identities, our families and our communities, making certain ethical, legal and social issues an essential part of this revolution. This class will examine future implications of genetics on human identity, focusing on their ethical dimensions. We will address questions such as the psycho-social implications of genetic testing, the social challenge of regulating the use of genetic information, behavioral genetics and the question of determinism, selecting genetic traits in future children, and genetic enhancement. We will read and critically discuss contemporary philosophers, scientists and bioethicists, and will also watch a couple of documentaries. Classes will consist of lectures followed by discussion and debate. Students are expected to choose a topic for a term paper by mid-semester and present it to the class as a "work in progress" in order to receive feedback. Based on the presentation, students are expected to write a 2500-3000 word term paper.
Clinical Ethics, Instructor: M. Mahon
The course in clinical ethics provides an opportunity for students to understand and implement processes of clinical decision making. An understanding of ethics as one component of clinical decision making is foundational. Both clinicians and non-clinicians are encouraged to participate; guidance will be provided for those without a clinical background to facilitate integration of clinical dimensions. Students will be required to identify components of ethics in clinical decision making in a variety of settings, including an ethics committee, an intensive care setting, and a non-intensive care setting. Unique challenges of a range of topics within clinical ethics will be discussed.
International Bioethics, Instructor: A. Reitsma
This course is intended to serve as an opening to the discussion of international issues in bioethics. During the run of this course, we will study a variety of current international perspectives in bioethics and will aim to draw cross-cultural comparisons. The course will mainly focus on the comparison between the various principles, rules and regulations of a number of developed countries, including those in North America, Europe, and the Australasian continent. Regulatory similarities and differences between such developed nations will be explored in regards but not limited to the genetic engineering of foods and livestock, stem cell research, end of life decision making, reproductive technologies, organ procurement for transplantation purposes, healthcare access and insurance and other pressing issues. To a lesser extent, the class will also examine a number of ethical questions that arise from the tension between the developed and developing world, such as research with human subjects investigating pharmaceuticals. At the end of this course, students should be able to identity some of the major issues in the international bioethical debate and the existing cultural and regulatory differences and similarities in the developed world.
The Public Face of Bioethics, Instructor: Arthur L. Caplan
This course will examine the ways in which bioethics shapes public opinion and public policy. The role of the courts, commissions, professional associations and the media will be examined. A critical examination of the ways in which bioethicists have shaped public policy in key areas such as human experimentation, transplantation, end of life care and stem cell research will be undertaken. Finally the ways in which bioethicists interact with government, industry and patient advocacy groups will be examined and issues such as conflicts of interest, legal liability and the need for professional standards will be considered.
Classic Papers in Bioethics, Instructor: Arthur L. Caplan
The twenty-five years from 1968 to 1993 represent the crucial years in the rise of contemporary bioethics. During this time bioethics emerged as a distinctive intellectual pursuit within universities, academic medical centers and in American culture. Core area of consensus, as reflected in law and legal opinions, concerning human experimentation, the definition of death, policies governing the withdrawal of treatment and organ donation, truthtelling, and the centrality of patient autonomy also emerged. This is also the period during which the classic 'canon' of articles in bioethics began to emerge in anthologies, textbooks, journals and course syllabi.
This course will examine some of the key articles that defined the field, look at crucial events during this period such as Tuskegee, the AIDS epidemic, the birth of the first 'test tube' baby-Louise Brown, the deaths of Karen Ann Quinlan and Nancy Cruzan, the first uses of artificial hearts and animal organs for transplants, and the rise of ethics committees and Institutional Review Boards. Some of the key institutions that shaped the field such as the Hastings Center, the Kennedy Institute, the President's Commission on Biomedical And Behavioral Research, as well as the writings of key figures in philosophy, theology, medicine, law and the social sciences will be examined.
This course will be run as a seminar. Some background in contemporary bioethics is a prerequisite. Students will be expected to write a 25 page paper which must be completed by the last day of class. Each student will be expected to present a draft or outline of their paper in class. The paper will count for 80% of the student's grade, class participation 20%.
Primary Care Bioethics: Dilemmas Through the Life Cycle, Instructor: David Doukas
This "first of its kind" graduate level course will examine how medical ethics is intrinsic to primary care medicine. Family medicine is a broad domain of clinical care, and a source of many problematic cases relevant to bioethics research, policy, and education. This course shifts the venue of discussing bioethics from a traditional tertiary care center locale to the setting of the primary care office. The instructor (a family physician and scholar in bioethics) will examine life cycle bioethical issues in primary care practice, including prenatal care, genetic testing, pediatric and adolescent care issues, ethics in prevention, informed consent, "compliance," truth telling, privacy, health system issues, family-based issues of care and consent, and end-of-life care. This course will be case-based and will use extensive discussion and role play, including the involvement of guest primary care practitioners.
Pharmaceutical Ethics: Instructor: Katherine Taylor
Description: The pharmaceutical industry currently confronts serious criticisms from various quarters, including claims that drug prices are dramatically inflated, condemnations of its marketing practices, and charges that the industry puts profits over drug safety. At bottom, the industry faces a crisis of public confidence in its ability to discover, and ethically market, safe and effective drugs at an affordable price.
This course will explore major ethical concerns confronted by the pharmaceutical industry in today’s climate of increased scrutiny and suspicion. We will look at several issues, including 1) the “medicalization” of human conditions through marketing of drugs such as human growth hormone or Ritalin; 2) industry practices aimed at expanding drug markets, such as direct-to consumer advertising, ties to physicians, and the promotion of off-label uses; 3) ethical concerns with industry influence over journal publications and medical research; and, 4) criticisms relating to drug safety, patent protection practices, drug pricing and access.
In each context, we will explore the fundamental questions, what ethical responsibilities, if any, does the pharmaceutical industry have in that particular context, and what is the source, or grounding, of those obligations? How should a for-profit drug company balance its duties to its shareholders with its ethical responsibilities to the public?
Students will be expected to complete some short assignments, and also write a paper on a topic discussed with the instructor.
Health and Illness from an Anthropological Perspective: Instructor: Nora Jones
Description: ‘Cultural competency’ is a common phrase in contemporary medicine, used frequently as a shortcut to refer to the delivery of cultural, ethnic, and/or racially sensitive care. In other words, medical students are being told that ‘culture matters.’ Many of the voices arguing for this turn to cultural competency come from within bioethics. As observers and commentators on biomedicine, some bioethicists have asked for increased awareness and sensitivity to diversity (of race, ethnicity, culture, gender, and class) in clinical care and in research. How such ‘cultural competency’ is being enacted, however, is often far removed from what those asking for it intend. In medical education, research and clinical care settings, ‘culture’ is often reduced to a static variable in a patient’s medical history – “history of diabetes? Check. Regular exercise? Check. Ethnic? Check.” This course will argue for attention to culture while refuting such reductionist thinking. We will approach culture as the field of anthropology does, as a process, as the lens through which daily activities and conditions – such as illness and disease – take on emotion, value, morals, and meaning.
This course begins by tracing the development and rise of cultural competency in the profession. We will read some of the classics of the cultural competency literature, and then move to contemporary critiques and suggestions. We will use case studies and grounded research to explore how we can learn what elements of one’s culture really matters to health/illness, and what bioethicists and clinicians can and should do with this information.
This class is geared towards those who want to explore the patient-physician relationship, those interested in the role of culture in the biomedical encounter, anyone involved in patient care, and anyone with an interest in the role of the social sciences in bioethics.
Bioethics and National Security: Instructor: Jonathan Moreno
Description: Bioethical issues play a critical but largely unrecognized role in national security policy. These issues are also important, though again rarely understood, for a full appreciation of the history and pre-history of bioethics. In this seminar we will explore the intersection of bioethics and national security through the history of human experiments for military purposes, the development of human experimentation policies by national security agencies, the ethics of mass casualty medicine, bioterror events and public health measures, and emerging challenges such as the place of breakthroughs in genetics and neuroscience in national security planning.
Media and the Doctor-Patient Relationship: Instructor: Sheldon Zink
Many individuals only experience with medicine is through the clinical encounter. Others understand the medical profession through fictional representations and public discourse. At the other extreme, there are some whose only knowledge of medicine is what they read in the popular press and what is presented by the entertainment industry. In this class, the students will screen several feature films and critique the fictional representation of the clinical encounter. They will attempt to understand how the images could influence relationships between physicians and patients, the individual and illness, and technology and the body. The course will pay special attention to the way power relationships are expressed in the media and in entertainment and the influence of these representations on clinical, moral, and individual decision-making.
Bioethics Goes to Washington: Bioethics & Public Policy: Instructors: Art Caplan and Paul Root Wolpe
Bioethics Goes to Washington: How has bioethics influenced public policy at the Federal, state, and local levels? What impact has bioethics had on corporate policy? What has the role been of Bioethics commissions? What sort of impact has bioethics had in interacting with courts, religious groups and international regulatory bodies? What is bioethics expertise? How should bioethics position itself in trying to influence and shape policy? What has worked well, what has failed? Should bioethicists be held legally responsible for their advice and input? How does bioethics expertise work in a democracy? How can one decide if bioethics has been useful or not in shaping policy?
Readings will cover cases such as Gelsinger, ACT’s bioethics committee, the role of HFEA in governing reproductive technologies in the UK, Congressional hearings on stem cells, the impact of various bioethics commissions such as NBAC and the President’s Council on Bioethics as well as the role of bioethicists in such court cases as Cruzan, Quinlan, Wanglie, Baby M – Mary Beth Whitehead case, Baby K, etc.
Bioethics Goes to Washington. Instructor: Michael Stebbins
Bioethics issues frequently collide head-on with public policy. The time, location and cause of that collision depends upon a complex web of factors including what branch of government is at the nexus of the controversy as well as political, religious, societal and scientific factors. This highly interactive class will examine the wreckage of previous collisions and explore those that are sure to come. You will hear from experts working in Washington on a wide range of issues involving bioethics including stem cells and cloning, reproductive technology, asbestos, bioterrorism, tobacco, genetic testing, nanotechnology and many more. From extreme cases like Terri Schiavo to less well-known cases involving actions of mercenary scientists working on behalf of big business, we will focus on the techniques used to push public policy and the roll bioethics and science have played.
Bioethics in the First Person: Instructor: Carol Schilling
First-person essays and memoirs about medical experiences comprise valuable, still largely unexplored data for the study of medical ethics. They have an unparalleled capacity to do the ethical work of describing the vulnerabilities that patients and those providing care live with daily. By so doing, these accounts can raise both unexpected ethical issues and vexing questions about how narrative point-of-view operates in our ethical reasoning. Our readings will include narratives by patients, physicians, and caregivers and will represent a wide range of medical events—cancer, AIDS, cognitive and physical disability, pediatric conditions, pain, and end-of-life care. Notable writers will most likely include Anatole Broyard, Andre Dubus, Nancy Mairs, Virginia Woolf, Donald Hall, Lucy Grealy, Oliver Sacks, John Bayley, Sandra Gilbert, Atul Gawande, Richard Selzer, and some chosen by the class. We’ll also read “lay” narratives about illness and some theoretical material on narrative, illness, and ethics.
Empirical Methods in Bioethics: Instructor: Pamela Sankar
This course provides an introduction to social science research design and methods for students interested in conducting research on issues in bioethics. The course is appropriate for students who, rather than conducting research themselves, will use research findings to make or challenge arguments in policy statements or other writings. Emphasis is placed on the logic of research design as the way to relate topic of inquiry with method so that evidence produced is pertinent and useful. Students will design research projects and explore a variety of methods available to conduct research. Students will also learn to integrate research ethics into the formulation and design of their inquiries.
Sociology of Jewish Bioethics: Instructor: Paul Root Wolpe
The Sociology of Jewish Bioethics is intended as an upper-level course intended for students with either a background in bioethics, medical sociology, clinical medicine, Judaic Studies, or some combination of those or related fields who can do graduate-level work. The topic is a different one, as the field that will be our subject of inquiry does not, at the present time, exist. We will be creating it throughout the semester. The goal of the course is to understand how inquiry into the formation of Jewish Bioethics (as a prescriptive system) and the nature of the bioethics of people who call themselves Jews (a descriptive pursuit) might best be formulated. The purpose of such an approach is to explore the cultural, social, political, and professional underpinnings of bioethical argumentation and action. Rather than exploring the merits of a position (e.g., is assisted suicide allowable in the Jewish tradition?), we will ask how the debate has been framed, who is promoting which arguments, what debates are taking place within and between denominations, how the Jewish laity may differ from the Jewish religious and secular leadership, and how the "Jewish perspective" is being presented to the wider public.
Ethical Issues in Transplantation: Instructor: Sheldon Zink
No area of medicine is more imbued with ethical controversy than organ transplantation. This is especially true of the politics and strategies used to obtain organs and tissues for transplantation. The course will examine organ and tissue cadaver donation, procurement, the concept of brain death, the evolution of public policy regarding donation in the United Stats and European nations, and prohibitions on selling organs and most tissues. This course will examine issues raised by efforts to insure fair distribution of organs and tissues and the role played by psychosocial, economic and ethical factors in selecting recipients. Questions of the cost of transplant and the overall impact on the American health care system will also be considered. Key legal cases and legislation governing transplant will be examined.
Research Methods: Instructor: Pamela Sankar
This course provides an introduction to social science research design and qualitative methods for students interested in conducting research on issues in bioethics. The course is appropriate both for students who plan to conduct their own research and for those who, rather than conducting research themselves, will use research findings to make or challenge arguments in policy statements or other writings. Emphasis is placed on the logic of research design as the way to relate topic of inquiry with method so that evidence produced is pertinent and useful. Students will design research projects and explore a variety of qualitative methods available to conduct research. Students will also learn to integrate research ethics into the formulation and design of their inquiries.
The Call of Stories: Using Narrative in Medical Ethics: Instructor: Kathy Taylor
This course will address how narrative, whether in the form of personal memoir, poetry, fiction, or other writings, helps elucidate medical ethical theory, as well as the experiences of the various moral agents in the health care system. We will look at how narrative studies has contributed to the field of bioethics, and examine readings from the patient, caregiver, and caretaker perspectives. We also will explore readings centered on various topics in medical ethics, such as the physician/patient relationship, cross-cultural medicine, death and dying, and mental illness.
Biotechnology and the Body: Instructor: Paul Root Wolpe
New medical and biotechnological innovations, such as new psychopharmaceuticals or brain prosthetics, pose a challenge to our historical sense of selfhood and personality. Implantable brain chips, deep brain stimulators, and cochlear implants are merging biological, mechanical, and chip technologies, and neuroimaging technologies may soon be able to breach the barrier of our private thoughts. Genetics, in turn, may render possible our ability to design traits into our descendants. These innovations pose significant challenges to our moral, ethical and religious systems, as well as to how we situate our bodies in social space. In this course, we will use social science methods and reasoning to examine the implications of these technologies on medicine, human enhancement, and the literature on embodiment, and will also bring in perspectives in philosophy, bioethics, religious studies, and the humanities. The goal is to explore the profound ways biotechnology may change the very nature of being human in this century.
Innovation in Medicine: Instructor: Jon Merz
This seminar is intended to give students a broad overview of medical innovation, addressing questions such as what is it, how does it occur, and what are the policies and tools available for promoting and regulating innovation. Topics to be addressed include: conceptualizing innovation; the economics of innovation; private vs. public sponsorship of R&D; intellectual property; the management and regulation of innovative technologies; technology assessment; and technology diffusion. Cases drawn from across the biomedical spectrum including surgery, drugs and devices will be used to identify ethical and policy dimensions of innovation in medicine.
Bits & Pieces: Ethical Issues in Transplanting Organs, Tissues, and Blood: Instructor: Art Caplan
This course will begin with an examination of the ethical status of the body and its parts throughout Western History. Then we will look at the earliest efforts to transplant bodily parts and tissues prior to World War II and the ethics surrounding those experiments. The course will then shift to an examination of blood transfusion and the ethical, legal and policy questions it raised and continues to raise. Transplants of kidney and solid organs from cadaver sources including issues of donation, procurement, allocation and payment will follow. We will then turn to the emergence of newer forms of transplants including living organ donation, gene transfer, gametes, limb, face and uterine transplants. The course will conclude with an examination of the ethical and legal issues surrounding efforts to locate new sources of replacement tissues and cells including embryonic stem cell research, xenografts and artificial organs.
Through the Artist's Eye: Medicine, Power, and the Meaning of Illness: Nora Jones (BIOE 550 900; Summer 2008)
In this course we will explore the centuries-old relationship between medicine and the arts, a relationship that is at times complementary and at others, adversarial. The range of the arts covered in the course includes illustration, painting, sculpture, photography, theater, and film. Throughout, our gaze will be focused on the theme of power and on the changing and complex meanings of medicine and illness in society.
Perhaps the best examples of the complementary relationship between the visual arts and medicine are the anatomical drawings of early 16th century artists like da Vinci and Vesalius, which laid the foundation for modern medical scientific illustration. Medicine continues to use the arts, as seen in the rise of ‘arts and humanities’ teaching in medical colleges, the use of art therapy for abused children and sufferers of PTSD, physicians as artists, and in calling artists into service for public health education and prevention campaigns.
On the other hand, art has also been used to critique medicine. Contemporary filmmakers and playwrights criticize the health care system and the ways in which it disempowers patients. Critical examinations of the depiction of gender and ethnicity in medically-oriented art provide alternative views to the official versions of medical history and continuing practice. And photographers and other artists are increasing appropriating medical subject matter in their art, challenging the hold and control that medicine has enjoyed over defining illness and disease and exposing medical knowledge and secrets to a wide audience.
Diviners, Healers, and Zombies: An Anthropological Look at Traditional Medicine: Nora Jones
Diviners, nurses, healers, zombies, doctors, missionaries, international aid workers, priests…. all have a role to play in how individuals around the world make sense of their illnesses and their quests for health. In this course we will read two ethnographies (in-depth anthropological studies) that address the relationship between individual’s health care beliefs and behaviors and the social, cultural, political, and economic contexts in which that individual is embedded.
From the Fat of Our Souls: Social Change, Political Process, and Medical Pluralism in Bolivia by Libbet Crandon-Malamud, centers on how medical choices are made not only to enhance health, but also as a tool to negotiate social identity. We will explore how making medical decisions can be used to achieve non-medical ends, such as land, jobs, and social prestige. Our second ethnography, Witches, Westerners, and HIV: AIDS & Cultures of Blame in Africa, by Alexander Reodlach, helps us to understand how beliefs that appear to be contradictory (AIDS being simultaneously understood as a biomedical condition and a phenomenon of sorcery) make sense in particular socio-historic times and places.
Our emphasis will be on exploring the value of qualitative data in the success of learning about local (be it in the highlands of Bolivia, or Zimbabwe, or Philadelphia) understandings of illness and health, how such knowledge can help interventions and other aid programs, and, finally, to critically reflect on how the current medical establishment in the United States influences our own health beliefs and behaviors.
Beyond Quality of Life: Examining Disability in Bioethics. Instructors: Carol Schiling and Teresa Blankmeyer Burke.
This course conducts an inquiry into bioethical responses to human variations that become categorized as disability. The interdisciplinary project of disability studies will provide a fresh theoretical and practical lens through which to view bioethics, its philosophical framework and the library of cases that are argued within that frame. For the most part, bioethics discussions about disability have been limited to quality of life analyses, especially regarding decisions about the beginning and the end of life. Disability studies scholarship has, however, taken a more comprehensive look at ethical issues affecting the lived experiences of people with disabilities, including both clinical and broader social ethical concerns. The disability perspective on bioethics also exposes the ways that headline-making instances of what is framed as the right to die, as well as the less visible surrogacy and best interest decisions made daily, are centrally about how disability is understood. At its core, what’s at stake in this inquiry is who is welcome and graciously accommodated in the human community.
Readings will range from theoretical texts to narratives by the disabled and their families that enable us to work at the intersections of bioethics, disability studies, and the medical humanities. We will pause to ask what conditions constitute disability and who decides (hearing loss, mobility loss, chronic illness, cognitive differences...), what additional frameworks for bioethics (narrative ethics, care ethics, rehabilitation ethics, the humanities, and social sciences) can contribute to discussions of bioethics and disability, and what the creative arts can teach about defining disability. As disability theorists and the World Health Organization propose an inclusive conceptualization of disability as a condition of the human life cycle, rather than an unanticipated, alienating, individual event, and as the number of disabled citizens increases, the need to bring disability studies and bioethics into conversation becomes increasingly urgent.
Doctoring and Regulation: Training, Research, and Practice, Instructor: Charles Bosk
In this course, we will examine the relationship between the medical profession and the various regulations and institutions that govern its practice. Ranging from recent attempts to regulate the working hours of physicians-in-training, to the new movement of patient-centered care, and the proper conduct of clinical research, we will examine the creation of policies and their implications for clinical practice and medical research. We will also critically examine the development of evidence-based guides to clinical decision-making, guidelines on conflict of interest, and the role of bioethics in the professional organizations.
Bioethics at the Movies, Instructor: Nora Jones
In this course we will explore bioethics in film and through film. What this means is that we will look at key bioethical issues as they have been interpreted and presented in film in order to: 1) use film as a catalyst for discussion of the ethical issues presented (bioethics in film), and 2) understand from the contexts of the film’s production and reception what the film can tell us about the social, historical, and political contexts of the ethical issue in question (bioethics through film). For example, what can we learn about the patient ‘right to die’ movement from comparing the 1981 film ‘Whose Life is It Anyway?’ to 2004’s ‘Million Dollar Baby’? How does each film affect our own understanding of and perspective on the issue? What does critical and popular reception of these films tell us about where the issue stands in the larger US culture? To address these and other similar questions, the course will consist of film viewings, critical discussion, and analytical writing.
Human Genetics and Ethics: Past, Present, and Future, Instructor: Sheri Alpert
Long before Gregor Mendel revealed the laws of heredity, there was a tacit understanding that some traits could be passed on and that man could even manipulate some desirable traits, through selective breeding of livestock or the cross-fertilization of plant species. It is astonishing to realize, however, that it is only within the last 50-60 years, at most, that we actually understand the structure and mechanisms of DNA. And we still know very little about the actual functionality of the genes making up the human genome. These facts have not stopped man, however, from continuing to tinker with DNA, and on the molecular level. This class will examine our understanding of genetics, and the attendant ethical issues arising from that understanding (and lack thereof) in the past, the present, and into the future. At the same time, we will also focus how we see ourselves, as a species and as individuals, and how that perception may change into the future. Among the topics we will look at are eugenics and forced sterilizations, psycho-social implications of genetic testing, genetic privacy and the regulation of genetic information, genetic determinism, selecting genetic traits of future generations (e.g., pre-implantation genetic diagnosis), and synthetic biology (e.g., the design and construction of new organisms). To accomplish this, we will rely on works by scientists, bioethicists, policy makers, and philosophers. There will also be at least 2 short films shown during class. Students are expected to choose a topic for a term paper by mid-semester and present it to the class as a "work in progress" in order to receive feedback. Based on the presentation, students are expected to write a 2500-3000 word term paper.
The Insider's Guide to Biopolitics, Instructor: Jonathan Moreno
Bioethics is politics. That statement might not elicit much surprise in 2009, but it would have made the skin of many bioethicists crawl as little as ten years ago. Yet bioethics has always been political, even before there was a field so named. In this course we will explore the historic and modern debates of bioethics through a political lens, starting with classical philosophy and moving through eugenics to stem cells. Guest speakers from the overlapping worlds of science and politics, from various ideological perspectives, will light (or cloud) the way.
Race, Gender, and Medicine, Instructor: Kathy Taylor
This seminar will explore the social categories of race and gender, and the ways in which western medicine, as a social practice, historically played a central role in reinforcing the dominant culture’s understanding of women and people of color as being inferior, deviant, defective, or “other.” We will also explore current issues relating to race and gender in medicine, including disparities between social groups in access to health care and medical treatment, how women and minorities have fared in medicine as an institution, and whether race should be used as a category in drug discovery.
Desperate Remedies, Emerging Technologies, and Novel Therapies, Instructor: Jan Jaeger
This course will examine the ethical dilemmas and social implications generated by the discovery and use of novel therapies and desperate remedies in medicine. We will look at various emerging, converging and cutting edge medical technologies to understand how society benefits, what risks these technologies pose and the accompanying controversies that often arise as they are introduced. Some of the more common topics covered in the course will include organ transplantation, designer drugs and bone marrow transplantation. Additionally, we will examine the emerging nanomedicine landscape to understand how nanotechnology is shaping the practice of medicine today and how it will impact human health in the not so distant future. For example, we will look at the ethical issues associated with prospect of tissue engineering, implantable mobile systems that detect cancer cells, nano devices that deliver drugs to tumor sites and advanced and intelligent biomaterials for use in heart disease, stem cells and regenerative events. We will try to understand how technology is used to prevent death and extend life and the social consequences that arise from the research, development and advent of novel therapies and desperate remedies.
Mediation Intensive I and II (.5 CU), Instructors: Edward Bergman and Autumn Fiester
Students will be placed in a variety of clinical situations in which they will play the roles of disputants and mediators, with ongoing discussions and critiques of mediator performance. Each student will be videotaped during their mediation to elicit feedback from the group and to catalyze self-criticism.
As distinct from the course, BIOE 540: Challenging Clinical Ethics, in which negotiation and mediation theory are taught as a prelude to clinical simulations, this course references the literature solely in relation to problems encountered in the hands-on mediation of specific cases.
Bioethics and Sex, Instructor: Lance Wahlert
While the topics of sex and sexuality have a long and storied history in medical culture, they have been especially complex and problematic in the past century. With the creation of distinct sexually-minded medical fields since the late 19th-century including sexology, psychiatry, and hormonal studies, medicine has also occasioned the very categories and labels of the homosexual, the hermaphrodite, the invert, and the nymphomaniac, to name a few. While medical historians and queer theorists have paid almost obsessive attention to these subjects, bioethicists have intervened to a lesser degree and on only a handful of relevant subjects. In this course, we will address the range of historical and theoretical matters that speak to this intersection of bioethics and sex. Who has sex with whom? What does it mean to pathologize or diagnose such desires? How do we raise the stakes when considering persons who question their sex or who are in sexual transition? And how do such questions reveal the dilemmas of bioethicists at large, not just those related to matters of sex and sexuality?
Accordingly, this course will consider a range of historical and contemporary topics which speak to the bioethical dilemmas of the intersection of medicine, sex, and sexuality, including: the gay adolescent, the intersex person, gay-conversion therapies, the prospect of gay gene studies, sex addiction, and blood/organ donation policies in wake of the HIV/AIDS pandemic.
Specifically, we will focus on literary sources (poetry, memoirs, diaries, and films) as well as on non-literary accounts (medical texts, bioethical scholarship, and historical records) that explore the emotional and somatic aspects of matters related to sex and bioethics.
Mind Wars: Bioethics, National Security, and the Enhanced Brain, Instructor: Jonathan Moreno
This course will provide a systematic historical, ethical and policy overview of brain research and other cutting edge fields in the context of national security. Bioethical issues play a critical but largely unrecognized role in national security policy. These issues are also important, though again rarely understood, for a full appreciation of the history and pre-history of bioethics. In this seminar we will explore the intersection of bioethics and national security through the history of human experiments for military purposes and the development of human experimentation policies by national security agencies. Specific topics and cases will include the ethics of medical expertise in interrogation, ethical issues in mass casualty medicine, bioterror events and public health measures, the implications of breakthroughs in genetics. Special attention will be given to the prospects of neuroenchancement through new psychopharmaceuticals, brain implants and robotics, and the opportunities and challenges they present for national security planners.
Narrative and Bioethics, Instructor: Lance Wahlert
What is it like to live with a chronic, debilitating, or fatal illness? What does it mean to treat a sick person as a doctor, nurse, or other medical professional? And how does it feel to be a caregiver, witness, or outside party in such circumstances? All of these questions will inform the central query of this course: How do personal narratives inform, explain, or complicate our understandings of the medical world?
In recent decades, medical humanities scholars and bioethicists have striven to include the perspectives of multiple persons in the history and story-telling of medicine. Moreover, leading medical, nursing, and public health schools have, incorporated narrative studies as a part of the training of their future doctors, nurses, and clinicians. While such strategies have been innovative at the level of revamping scholastic curriculums, they are hardly new in medical history. From the case study to the medical history to the talking cure, storytelling has been a central component in the diagnostic, therapeutic, and pastoral strategies of medical cosmologies for centuries.
As a trans-historical study of medical storytelling, this course will be concerned with the power of narratives to bring coherence and meaning to the lives of sick persons and medical professionals at moments of great physical and emotional crisis. Accordingly, this course will consider a range of historical and contemporary topics which speak to the bioethical dilemmas of telling, reading, disseminating, and interpreting medically relevant narratives. While we will largely focus on non-fictional accounts (memoirs, medical records, journals, and testimonials), we will also consider how fictional literary sources (stories, poetry, films, and works of art) explore and affect matters related to the topic of “narrative and bioethics.”
Bioethics and the Law, Instructor: Jon Merz
This survey course will present a broad survey of topics at the intersection of law and bioethics. Much of bioethics deals with topics of public policy, and law is the tool of policy. Topics will range from an overview of American law making and enforcement mechanisms and topics ranging from FDA regulations, state interventions into beginning and end of life issues, malpractice and products liability, privacy, animal and human subjects regulation, and international issues related to innovation and access to medicines. Grade will be based on a single research paper focused on the history and development of a policy of interest to the student.
Narrative and Bioethics, Instructor: Carol Schilling
In its broadest interests, our seminar concerns the moral work of stories. Within that framing interest we will concentrate on debates in the developing discipline of bioethics regarding: (1) the ways bioethics uses narrative representations to constitute itself as a discipline, (2) the uses of stories in the construction of moral agency in medical events, and (3) the effect of unacknowledged theories of stories on our ethical debates. Primary texts for the seminar are Tod Chambers, The Fiction of Bioethics (1999); Hilde Nelson, Damaged Identities, Narrative Repair (2001); David Feldshuh, Miss Evers’ Boys (1989).
Public Health Ethics, Instructor: Jason Schwartz
This course will examine issues at the intersection of ethics, politics, and public health, paying particular attention to the centuries-long tension between individual rights and the common good. Ethical considerations are increasingly visible in public health programs and policy in the United States and worldwide. Mandatory vaccination laws, taxes on soft drinks, the regulation of tobacco, and controversies over the risks of pharmaceuticals are just a few examples of the continued relevance of long-standing debates over the proper role of government in protecting the health of individuals and communities. Through case studies reflecting the remarkable breadth of public health regulation and oversight, we will consider the historical context of contemporary policy debates; the scientific, medical, public health, and ethical arguments offered by advocates and critics; and the institutions and individuals responsible for developing and implementing public health policy.
Bioethics and AIDS, Instructor: Lance Wahlert
This course provides a systematic study of the ways that the HIV/AIDS pandemic has shaped our considerations of public health, epidemiology, and bioethics in the past 30 years. Employing a series of contemporary and historical topics related to AIDS and bioethics, this course’s overarching concern is best expressed through two related questions: (1) Has AIDS changed bioethics; or, (2) Has AIDS exaggerated enduring bioethical concerns?
Subjects we will cover, include: blood and organ donation policies for HIV-positive persons and “high risk groups;” the legacies of Patient Zero and initial CDC cluster studies on AIDS; stigma and stereotype in HIV discourse; the closing of gay bathhouses on public health grounds; international funding and resources for HIV prevention; historical and contemporary debates on access to HIV drugs and drug trials; the AIDS vaccine and advancements in pre-exposure prevention (PrEP) procedures/protocols; post-exposure prophylaxis (PEP) ethics; sero-positivity and assisted reproductive technology (ART); and visualizing the AIDS body in art and media.
Ethics of Research in Vulnerable Populations, Instructor: Jon Merz and Francis Barchi
This is an advanced seminar focused on human subjects research in resource-constrained regions of the world. Students are expected to have a grounding in US regulations and policies. The students will come out of the class with an appreciation for issues raised by research involving populations vulnerable to manipulation and exploitation, a sensitivity to cultural issues, and an awareness of methods for appropriately engaging communities and performing ethically sound research. The course includes reading assignments, lectures, case-based and discussions addressing topics ranging from social and anthropological research, vulnerability and exploitation, biomedical research, pharmaceutical sponsorship, traditional knowledge and biopiracy, and equity and access. Grade will be based on 3 written case evaluations (70%) and class discussion and participation (30%). Please note that if you haven't taken BIOE 580: Research Ethics, you will be required to complete a short on-line training module on research ethics.
Past Courses, by Semester
2012 - Spring, Summer
2011 - Spring, Summer, Fall
2010 - Spring, Summer, Fall
2009 - Spring, Summer, Fall
2008 - Spring, Summer, Fall
2007 - Spring, Summer, Fall
2006 - Spring, Summer, Fall
2005 - Spring, Summer, Fall
2004 - Spring, Summer, Fall
2003 - Spring, Summer, Fall
2002 - Summer, Fall
Summer 2012
BIOE 550 900 - Public Health Ethics
Instructor: Jason Schwartz
This course will examine issues at the intersection of ethics, politics, and public health, paying particular attention to the centuries-long tension between individual rights and the common good. Ethical considerations are increasingly visible in public health programs and policy in the United States and worldwide. Mandatory vaccination laws, taxes on soft drinks, the regulation of tobacco, and controversies over the risks of pharmaceuticals are just a few examples of the continued relevance of long-standing debates over the proper role of government in protecting the health of individuals and communities. Through case studies reflecting the remarkable breadth of public health regulation and oversight, we will consider the historical context of contemporary policy debates; the scientific, medical, public health, and ethical arguments offered by advocates and critics; and the institutions and individuals responsible for developing and implementing public health policy.
BIOE 551 900 - Bioethics and AIDS; Instructor: Lance Wahlert
This course provides a systematic study of the ways that the HIV/AIDS pandemic has shaped our considerations of public health, epidemiology, and bioethics in the past 30 years. Employing a series of contemporary and historical topics related to AIDS and bioethics, this course’s overarching concern is best expressed through two related questions: (1) Has AIDS changed bioethics; or, (2) Has AIDS exaggerated enduring bioethical concerns?
Subjects we will cover, include: blood and organ donation policies for HIV-positive persons and “high risk groups;” the legacies of Patient Zero and initial CDC cluster studies on AIDS; stigma and stereotype in HIV discourse; the closing of gay bathhouses on public health grounds; international funding and resources for HIV prevention; historical and contemporary debates on access to HIV drugs and drug trials; the AIDS vaccine and advancements in pre-exposure prevention (PrEP) procedures/protocols; post-exposure prophylaxis (PEP) ethics; sero-positivity and assisted reproductive technology (ART); and visualizing the AIDS body in art and media.
BIOE 585 900 - Ethics of Research in Vulnerable Populations; Instructor: Jon Merz and Francis Barchi
This is an advanced seminar focused on human subjects research in resource-constrained regions of the world. Students are expected to have a grounding in US regulations and policies. The students will come out of the class with an appreciation for issues raised by research involving populations vulnerable to manipulation and exploitation, a sensitivity to cultural issues, and an awareness of methods for appropriately engaging communities and performing ethically sound research. The course includes reading assignments, lectures, case-based and discussions addressing topics ranging from social and anthropological research, vulnerability and exploitation, biomedical research, pharmaceutical sponsorship, traditional knowledge and biopiracy, and equity and access. Grade will be based on 3 written case evaluations (70%) and class discussion and participation (30%). Please note that if you haven't taken BIOE 580: Research Ethics, you will be required to complete a short on-line training module on research ethics.
Spring 2012
BIOE 546/548 - Mediation Intensive II/IV (1 CU); Instructors: Edward Bergman, Autumn Fiester, and Lance Wahlert
This is an immersion experience of learning through role-playing mediation simulations. It has the same format of the other Mediation Intensives, but will NOT duplicate simulations.
Students will:
- Learn to effectively manage clinical disputes among and between caregivers, patients and surrogates through mediation
- Discover how to define problems and assess underlying interests to generate mutually acceptable options
- Role-play in a variety of clinical situations as both disputants and mediators
- Practice mediation with professional actors
- Receive constructive feedback in supportive environments
BIOE 540 001 - Challenging Clinical Ethics: Managing patient/caregiver conflict through mediation; Instructor: Edward Bergman
In the contemporary healthcare system patients, families, institutions and a multiplicity of caregivers engage in disputes over a myriad of issues - appropriate care, authorized decision-makers, managed care, information disclosure, and behavior/personality conflicts - sometimes with life and death hanging in the balance. Such disputes are rife with legal, ethical, emotional and scientific complexity. They are frequently highly charged and are often emergent in nature. In recent years, mediation has grown exponentially as a dispute resolution mechanism of choice. Not surprisingly, the success of mediation, and a wider understanding of the process, has led to its application in the realm of healthcare disputes with encouraging results. This course will provide an overview of negotiation fundamentals critical to the practice of mediation followed by an introduction to classical mediation theory and practice. Similarities and differences between mediation in the healthcare field, as distinct from other contexts, will be examined as will special problems highlighted by various commentators in the field. All class members will participate in mediation role-plays designed to simulate disputes prevalent in the healthcare landscape.
BIOE 551 001 -Cinema of Contagion; Instructor: Lance Wahlert
In reality and metaphorically, cinema has served for generations of moviegoers as a site of communal congregation, pedagogical dissemination, and sometimes disease infection. Accordingly, how and where we watch films are just as important as what films have to say about doctors, disease, and death. This course will consider the epidemiological and cultural implications of cinema on bioethics, including how movies and movie theaters themselves have functioned as spaces of contentious discourse regarding public health. Bearing in mind the recent scholarship of film and medical theorists such as Lisa Cartwright, Paula Triechler, and David Serlin, we will study not only the possibility for film to register and comment on cultural understandings of the clinic, but also the ways cinema itself works out, reimagines, and even changes how the clinic is put into practice. Focusing on themes such as quarantine, vaccination, sexual health, end of life care, professional competence, and globalization, we will be watching and discussing public health films and feature-length films by directors such as Alfred Hitchcock, David Croneberg, Tamara Jenkins, Edward Yang, Todd Haynes, and Pedro Almodovar. No background in either cinema studies or bioethics is required for this course.
BIOE 552 001 - Specimen, Patient, and Spectacle: An Anthropological Look at the Body in Medicine; Instructor: Nora Jones
This course is about how the human body is literally being 'seen' by medical students, physicians, patients, and the public. Our focus will be on the ways in which the diseased or sick body is experienced and understood from the perspective of the various actors in contemporary medicine. We will begin with the 'body as specimen,' the patient's body as seen by Western biomedical physicians in training and then in clinical medicine. Here we examine the histories of medical education and medical imaging technologies (i.e. x-rays, CAT scans, photography) to understand the development and perpetuation of what is called in anthropology the ‘biomedical gaze,’ a distinct perspective towards patients that is expressed in the clinical encounter. We then turn to the 'body as patient,’ where we will explore how the experience of illness or disease in the clinical encounter can change one’s self-image and self-understanding. This portion of the class asks how, other than being a patient ourselves, we as social scientists and bioethicists can come to understand the patient’s perspective. We will evaluate various types of first-person sources, including art, literature, and accounts generated through social science research. We conclude with the 'body as spectacle,' in which we will examine how the diseased or ill body has been used in popular culture. We will focus in particular on recent trends in the art world of using the deformed body as subject matter. We will ask for what purpose the patients’ bodies are being used, and what this trend tells us about our cultural attitudes towards and beliefs about illness, disease, and medicine. The end goal of this course is to learn how a viewer's social, personal, and educational history influences how we see the human body, and then to be enabled to use this knowledge when analyzing the origins and complexities of contemporary bioethics problems.
BIOE 553 001 - History of Bioethics; Instructor: Art Caplan
As the field of bioethics has evolved it has developed a set of canonical topics and analyses that every student of bioethics should be familiar with. This course will explore the evolution of bioethics, identify key issues such as rationing, reproductive ethics, research involving children, organ donation and informed consent that have shaped the field, and examine how bioethics has made substantive contributions to public policy, corporate responsibility and individual human rights. The course will also examine the development of bioethics outside the USA and how different cultural and economic points of view differentiate bioethical analyis and the response to American bioethics. The goal of the course is to both critically examine the history of the field and to illustrate how work in bioethics has been given practical application to a wide variety of issues and problems.
BIOE 575 The Future of the American Health Care System: Health Policy and the Affordable Care Act; Instructor: Ezekiel Emanuel
This course will provide students a broad overview of the current U.S. healthcare system. The course will focus on the challenges facing the health care system, an in-depth understanding of the Affordable Care Act, and its potential impact upon health care access, delivery, cost, and quality.
The U.S. health care system is the worlds largest, most technologically advanced, most expensive, with uneven quality, and an unsustainable cost structure. This multi-disciplinary course will explore the history and structure of the current American health care system and the impact of the Affordable Care Act. How did the United States get here? The course will examine the history of and problems with employment-based health insurance, the challenges surrounding access, cost and quality, and the medical malpractice conundrum. As the Affordable Care Act is implemented over the next decade, the U.S. will witness tremendous changes that will shape the American health care system for the next 50 years or more. The course will examine potential reforms, including those offered by liberals and conservatives and information that can be extracted from health care systems in other developed countries. The second half of the course will explore key facets of the Affordable Care Act, including improving access to care and health insurance exchanges, improving quality and constraining costs through health care delivery system reforms, realigning capacity through changes in workforce and medical education, and potential impact on biomedical and other innovation. The course will also examine the political context and process of passing major legislation in general and health care legislation in particular, including constitutional arguments surrounding the Affordable Care Act. Throughout lessons will integrate the disciplines of health economics, health and social policy, law and political science to elucidate key principles.
BIOE 580 Research Ethics; Instructor: Jon Merz
This seminar is intended to give students a broad overview of research ethics and regulation. The students will come out of the class with an understanding of the moral bases of scientific ethics and the historical evolution of biomedical research ethics. Students will be fully conversant with the development, implementation, and limitations of US human subjects regulations. The course includes reading assignments, lectures, discussions, student-led case-based and topical discussions addressing the following topics: ethics and morality in science; science in society; scientific integrity; misconduct; whistleblowing; conflicts of interest; collegiality, publication and authorship; peer review; human experimentation and regulations (HHS, FDA), Institutional Review Boards; informed consent, waivers, vulnerable populations; privacy and the confidentiality of records; epidemiology; and, finally, research on animals.
BIOE 602 001 - Conceptual Foundations of Bioethics; Instructor: Autumn Fiester
This course examines the various theoretical approaches to bioethics and critically assesses their underpinnings. Topics to be covered include an examination of various versions of utilitarianism; deonotological theories; virtue ethics; ethics of care; the fundamental principles of bioethics (autonomy, beneficence, distributive justice, non-maleficence); casuistry; and pragmatism. The course will include the application of the more theoretical ideas to particular topics, such as informed consent, confidentiality, and end of life issues.
Summer 2011
BIOE 545/547 and BIOE 546/548- Mediation Intensive I/III and II/IV (.5 CU, 1 CU)
This is an immersion experience of learning through role-playing mediation simulations. It has the same format of the other Mediation Intensives, but will NOT duplicate simulations. Students will: Learn to effectively manage clinical disputes among and between caregivers, patients and surrogates through mediation; Discover how to define problems and assess underlying interests to generate mutually acceptable options; Role-play in a variety of clinical situations as both disputants and mediators; Practice mediation with professional actors; Use video-tapes of simulations to improve mediation techniques and strengthen interpersonal skills; Receive constructive feedback in supportive environment.
BIOE 552 - Global Health from an Anthropological Perspective; Instructor: Nora Jones
Diviners, nurses, healers, zombies, doctors, missionaries, international aid workers, priests…. all have a role to play in how individuals around the world make sense of their illnesses and their quests for health. In this course we will address the relationship between individual’s health care beliefs and behaviors and the social, cultural, political, and economic contexts in which that individual is embedded. Our emphasis will be on exploring the value of qualitative data in the success of learning about local understandings of illness and health, how such knowledge can help interventions and other aid programs, and, finally, to critically reflect on how the current medical establishment in the United States influences our own health beliefs and behaviors.
BIOE 580 Research Ethics; Instructor: Jon Merz
This seminar is intended to give students a broad overview of research ethics and regulation. The students will come out of the class with an understanding of the moral bases of scientific ethics and the historical evolution of biomedical research ethics. Students will be fully conversant with the development, implementation, and limitations of US human subjects regulations. The course includes reading assignments, lectures, discussions, student-led case-based and topical discussions addressing the following topics: ethics and morality in science; science in society; scientific integrity; misconduct; whistleblowing; conflicts of interest; collegiality, publication and authorship; peer review; human experimentation and regulations (HHS, FDA), Institutional Review Boards; informed consent, waivers, vulnerable populations; privacy and the confidentiality of records; epidemiology; and, finally, research on animals.
BIOE 590, Ethical and Legal Issues in the End of Life, Instructor: Autumn Fiester
This course will focus on the philosophical and legal issues surrounding end-of-life. We will examine the most significant legal cases of the last few decades, from Quinlan to Schiavo. We will then look at the philosophical literature on death and the process of dying, physician-assisted suicide and euthanasia, the doctrine of double effect; and the distinction between withholding and withdrawing life support. We will explore theoretical questions such as, “why is death bad?”, “what effect does awareness of mortality have on living?”, and “is there such a thing as a ‘good death?” as well as the moral permissibility of hastening death or assisting in death.
Fall 2011
BIOE 545/547 - Mediation Intensive I/III (.5 CU)
This is an immersion experience of learning through role-playing mediation simulations. It has the same format of the other Mediation Intensives, but will NOT duplicate simulations. Students will: Learn to effectively manage clinical disputes among and between caregivers, patients and surrogates through mediation; Discover how to define problems and assess underlying interests to generate mutually acceptable options; Role-play in a variety of clinical situations as both disputants and mediators; Practice mediation with professional actors; Use video-tapes of simulations to improve mediation techniques and strengthen interpersonal skills; Receive constructive feedback in supportive environment.
BIOE 551 001 - History of Medicine; Instructor: Lance Wahlert
While concerns over patient care, research ethics, and vocational duty have been hallmarks of the medical profession for nearly two millennia, bioethics (as a distinct and unified disciple) is relatively new. And yet the history of medicine informs the ways in which clinical practices are effectively conducted and ethically scrutinized even today. Accordingly, this course introduces students to a comprehensive history of the Western Medical Tradition—from the Hippocratic-Galenic method, which dominated Europe and the Middle East from the classical period to the eighteenth century; to the dawn of Paris Medicine, which reorganized clinical practice and professional training in the nineteenth century; to the rise and global proliferation of biomedical research in the early twentieth century.
Engaging in a transhistorical study of Western medicine that features textual, archival, and artistic forms of evidence, we will be focusing on a range of canonical topics: the systematization and triumph of Galen; the development of the fields of physick and surgery; the plague in the early modern period; the role of the asylum in the eighteenth century; the birth of specialties such as gynecology, psychoanalysis, and sexology; the creation of the teaching hospital; and the infusion of laboratory science into clinical research. In addition, students will learn about the methodological principles central to the historiographical study of the histories of science, medicine, and technology.
In providing a survey of the history of the Western Medical Tradition, this course ends chronologically in the mid-twentieth century with the birth of bioethics. Professor Art Caplan will be offering a course on “The History of Bioethics” in Spring 2012, which picks-up where this course ends—although each course can be taken separately.
BIOE 552 001 - Cultural Competency in Medicine and Bioethics; Instructor: Nora Jones
Cultural competency’ is a common phrase in contemporary medicine, used frequently as a shortcut to refer to the delivery of cultural, ethnic, and/or racially sensitive care. In other words, medical students are being told that ‘culture matters.’ Many of the voices arguing for this turn to cultural competency come from within bioethics. As observers and commentators on biomedicine, some bioethicists have asked for increased awareness and sensitivity to diversity (of race, ethnicity, culture, gender, and class) in clinical care and in research. How such ‘cultural competency’ is being enacted, however, is often far removed from what those asking for it intend. In medical education, research and clinical care settings, ‘culture’ is often reduced to a static variable in a patient’s medical history – “history of diabetes? Check. Regular exercise? Check. Ethnic? Check.” This course will argue for attention to culture while refuting such reductionist thinking. We will approach culture as the field of anthropology does, as a process, as the lens through which daily activities and conditions – such as illness and disease – take on emotion, value, morals, and meaning.
This course begins by tracing the development and rise of cultural competency in the profession. We will read some of the classics of the cultural competency literature, and then move to contemporary critiques and suggestions. We will use case studies and grounded research to explore how we can learn what elements of one’s culture really matters to health/illness, and what bioethicists and clinicians can and should do with this information.
This class is geared towards those who want to explore the patient-physician relationship, those interested in the role of culture in the biomedical encounter, anyone involved in patient care, and anyone with an interest in the role of the social sciences in bioethics.
BIOE 570 001 - The Body Politic: Bioethics and Biopolitics; Instructor: Jonathan Moreno
Bioethics has an awkward but seemingly inescapable relationship with biopolitics. In fact, it’s not always easy to tell where one begins and the other ends, an overlap that has interesting consequences for both. Following a roughly chronological order, in this course we will examine some of the most timeless issues in bioethics from the standpoint of biopolitics – evolution, genetics, eugenics and abortion – as well as several recent and still emerging issues, including the stem cell controversy, brain research and control, human/animal chimeras and hybrids, and the “enhancement debate.” We will also consider the role of national bioethics commissions in setting biopolicy and how the standard left-right political spectrum does or does not make sense of discourse on bioethics/biopolitics. Biopolitical positions to be examined will include several versions of progressivism, neoconservatism, libertarianism and transhumanism. Texts for the course will include the instructor's new book, The Body Politic: The Battle over Science in America (Bellevue 2011), and his previous anthology Progress in Bioethics: Science, Policy, and Politics (MIT 2010).
BIOE 601 001 - Introduction to Bioethics; Instructor: Autumn Fiester
This course is intended to serve as a broad introduction to the field of bioethics. The course will focus on three of the most important areas in bioethics: Genetics & Reproduction, Human Experimentation, and End-of-Life. Each module of the course will cover essential bioethics concepts, relevant legal cases, and classical readings on the themes.
Spring 2011
BIOE 540, Challenging Clinical Ethics: Managing patient/caregiver conflict through mediation, Instructor: Edward Bergman
In the contemporary healthcare system patients, families, institutions and a multiplicity of caregivers engage in disputes over a myriad of issues - appropriate care, authorized decision-makers, managed care, information disclosure, and behavior/personality conflicts - sometimes with life and death hanging in the balance. Such disputes are rife with legal, ethical, emotional and scientific complexity. They are frequently highly charged and are often emergent in nature. In recent years, mediation has grown exponentially as a dispute resolution mechanism of choice. Not surprisingly, the success of mediation, and a wider understanding of the process, has led to its application in the realm of healthcare disputes with encouraging results. This course will provide an overview of negotiation fundamentals critical to the practice of mediation followed by an introduction to classical mediation theory and practice. Similarities and differences between mediation in the healthcare field, as distinct from other contexts, will be examined as will special problems highlighted by various commentators in the field. All class members will participate in mediation role-plays designed to simulate disputes prevalent in the healthcare landscape.
BIOE 550, Reproductive Ethics, Instructor: Kathy Taylor
This course will explore ethical issues raised by reproduction and the use of various reproductive technologies. We will address: 1) the moral and legal status of the embryo and fetus, in the context of embryonic stem cell research and abortion; 2) the ethical features of the maternal-fetal relationship in terms of prenatal testing and the regulation of the behavior of pregnant women; and 3) ethical issues raised by the reproductive technologies such as IVF, gamete donation, preimplantation diagnosis, and surrogacy, including how these practices affect our perceptions of pregnancy, children, and family relationships.
BIOE 551, Narrative and Bioethics, Instructor: Lance Wahlert
What is it like to live with a chronic, debilitating, or fatal illness? What does it mean to treat a sick person as a doctor, nurse, or other medical professional? And how does it feel to be a caregiver, witness, or outside party in such circumstances? All of these questions will inform the central query of this course: How do personal narratives inform, explain, or complicate our understandings of the medical world?
In recent decades, medical humanities scholars and bioethicists have striven to include the perspectives of multiple persons in the history and story-telling of medicine. Moreover, leading medical, nursing, and public health schools have, incorporated narrative studies as a part of the training of their future doctors, nurses, and clinicians. While such strategies have been innovative at the level of revamping scholastic curriculums, they are hardly new in medical history. From the case study to the medical history to the talking cure, storytelling has been a central component in the diagnostic, therapeutic, and pastoral strategies of medical cosmologies for centuries.
As a trans-historical study of medical storytelling, this course will be concerned with the power of narratives to bring coherence and meaning to the lives of sick persons and medical professionals at moments of great physical and emotional crisis. Accordingly, this course will consider a range of historical and contemporary topics which speak to the bioethical dilemmas of telling, reading, disseminating, and interpreting medically relevant narratives. While we will largely focus on non-fictional accounts (memoirs, medical records, journals, and testimonials), we will also consider how fictional literary sources (stories, poetry, films, and works of art) explore and affect matters related to the topic of “narrative and bioethics.”
BIOE 570, Bioethics and the Law, Instructor: Jon Merz
This survey course will present a broad survey of topics at the intersection of law and bioethics. Much of bioethics deals with topics of public policy, and law is the tool of policy. Topics will range from an overview of American law making and enforcement mechanisms and topics ranging from FDA regulations, state interventions into beginning and end of life issues, malpractice and products liability, privacy, animal and human subjects regulation, and international issues related to innovation and access to medicines. Grade will be based on a single research paper focused on the history and development of a policy of interest to the student.
BIOE 590, What a shot! The Ethical Challenges of Vaccines, Instructor: Arthur Caplan
Few, if any, medical interventions can match the record of success established by vaccines. Diseases such as polio and smallpox that once afflicted millions each year have been all but eradicated, and many others are rapidly becoming little more than historical footnotes. Despite these achievements, vaccines remain extremely important and controversial. When the United States and the world continue to live under the threat of an avian flu pandemic or an act of bioterrorism vaccines are seen as holding the answer to these threats. The continuing reality of the HIV/AIDS pandemic has made the hunt for preventative or therapeutic vaccines a central feature of private and public philanthropy and policy. The recent licensure of vaccines for rotavirus and cervical cancer is a reminder of the ways in which research ethics and affordable access to valued resources are reflected in vaccine policy. Vaccines present some unique ethical challenges. Unlike pharmaceuticals, many vaccines are given to healthy individuals, seeking to prevent disease rather than treat it. Indeed, babies and children are the primary recipient of vaccinations. This means the concept of risk and benefit do not always easily fit into the standard template of bioethics. Vaccines are often mandated or compelled. A variety of state laws in the U.S. require proof of vaccination in order to enroll in school or day-care. For public health authorities, a successful immunization program requires a high rate of vaccination. Thus, individual liberty may conflict with the best interests of the community as a whole in ways not commonly seen in other domains of bioethics. Allocation issues are especially interesting regarding vaccines. Reports of alleged side effects such as autism have shaken public confidence regarding vaccine safety and necessity. Many people do not want their children vaccinated as a result. Conversely, when shortages occur, difficult decisions must be made as to who should receive scarce resources.
The course will review some of the science of vaccines and then track ethical issues from the initial stages of research through the implementation of vaccination programs in communities. The course will explore these topics through key readings, class discussion, analysis of case studies, presentations by guest speakers drawn from researchers, policymakers, and scholars on the Penn campus and in the Philadelphia region. Students will be expected to write a paper addressing a topic to be agreed upon with the instructor by mid-term related to vaccine ethics in which they identify a key ethical issue, present multiple options for responding to it, and provide support for their preferred resolution.
BIOE 602, Conceptual Foundations of Bioethics, Instructor: Autumn Fiester
This course examines the various theoretical approaches to bioethics and critically assesses their underpinnings. Topics to be covered include an examination of various versions of utilitarianism; deonotological theories; virtue ethics; ethics of care; the fundamental principles of bioethics (autonomy, beneficence, distributive justice, non-maleficence); casuistry; and pragmatism. The course will include the application of the more theoretical ideas to particular topics, such as informed consent, confidentiality, and end of life issues.
Fall 2010
BIOE 550, Pharmaceutical Ethics, Instructor: Kathy Taylor
The pharmaceutical industry currently confronts serious criticisms from various quarters, including claims that drug prices are dramatically inflated, condemnations of its marketing practices, and charges that the industry puts profits over drug safety. At bottom, the industry faces a crisis of public confidence in its ability to discover, and ethically market, safe and effective drugs at an affordable price.
This course will explore major ethical concerns confronted by the pharmaceutical industry in today’s climate of increased scrutiny and suspicion. We will look at several issues, including 1) the “medicalization” of human conditions through marketing of drugs such as human growth hormone or Ritalin; 2) industry practices aimed at expanding drug markets, such as direct-to consumer advertising, ties to physicians, and the promotion of off-label uses; 3) ethical concerns with industry influence over journal publications and medical research; and, 4) criticisms relating to drug safety, patent protection practices, drug pricing and access.
In each context, we will explore the fundamental questions, what ethical responsibilities, if any, does the pharmaceutical industry have in that particular context, and what is the source, or grounding, of those obligations? How should a for-profit drug company balance its duties to its shareholders with its ethical responsibilities to the public?
Students will be expected to complete some short assignments, and also write a paper on a topic discussed with the instructor.
BIOE 551, Bioethics and Sex, Instructor: Lance Wahlert
While the topics of sex and sexuality have a long and storied history in medical culture, they have been especially complex and problematic in the past century. With the creation of distinct sexually-minded medical fields since the late 19th-century including sexology, psychiatry, and hormonal studies, medicine has also occasioned the very categories and labels of the homosexual, the hermaphrodite, the invert, and the nymphomaniac, to name a few. While medical historians and queer theorists have paid almost obsessive attention to these subjects, bioethicists have intervened to a lesser degree and on only a handful of relevant subjects. In this course, we will address the range of historical and theoretical matters that speak to this intersection of bioethics and sex. Who has sex with whom? What does it mean to pathologize or diagnose such desires? How do we raise the stakes when considering persons who question their sex or who are in sexual transition? And how do such questions reveal the dilemmas of bioethicists at large, not just those related to matters of sex and sexuality?
Accordingly, this course will consider a range of historical and contemporary topics which speak to the bioethical dilemmas of the intersection of medicine, sex, and sexuality, including: the gay adolescent, the intersex person, gay-conversion therapies, the prospect of gay gene studies, sex addiction, and blood/organ donation policies in wake of the HIV/AIDS pandemic.
Specifically, we will focus on literary sources (poetry, memoirs, diaries, and films) as well as on non-literary accounts (medical texts, bioethical scholarship, and historical records) that explore the emotional and somatic aspects of matters related to sex and bioethics.
BIOE 552, Through the Artist's Eye: Medicine, Power, and the Meaning of Illness, Instructor: Nora Jones
In this course we will explore the centuries-old relationship between medicine and the arts, a relationship that is at times complementary and at others, adversarial. The range of the arts covered in the course includes illustration, painting, sculpture, photography, theater, and film. Throughout, our gaze will be focused on the theme of power and on the changing and complex meanings of medicine and illness in society.
Perhaps the best examples of the complementary relationship between the visual arts and medicine are the anatomical drawings of early 16th century artists like da Vinci and Vesalius, which laid the foundation for modern medical scientific illustration. Medicine continues to use the arts, as seen in the rise of ‘arts and humanities’ teaching in medical colleges, the use of art therapy for abused children and sufferers of PTSD, physicians as artists, and in calling artists into service for public health education and prevention campaigns.
On the other hand, art has also been used to critique medicine. Contemporary filmmakers and playwrights criticize the health care system and the ways in which it disempowers patients. Critical examinations of the depiction of gender and ethnicity in medically-oriented art provide alternative views to the official versions of medical history and continuing practice. And photographers and other artists are increasing appropriating medical subject matter in their art, challenging the hold and control that medicine has enjoyed over defining illness and disease and exposing medical knowledge and secrets to a wide audience.
BIOE 570, Mind Wars: Bioethics, National Security, and the Enhanced Brain, Instructor: Jonathan Moreno
This course will provide a systematic historical, ethical and policy overview of brain research and other cutting edge fields in the context of national security. Bioethical issues play a critical but largely unrecognized role in national security policy. These issues are also important, though again rarely understood, for a full appreciation of the history and pre-history of bioethics. In this seminar we will explore the intersection of bioethics and national security through the history of human experiments for military purposes and the development of human experimentation policies by national security agencies. Specific topics and cases will include the ethics of medical expertise in interrogation, ethical issues in mass casualty medicine, bioterror events and public health measures, the implications of breakthroughs in genetics. Special attention will be given to the prospects of neuroenchancement through new psychopharmaceuticals, brain implants and robotics, and the opportunities and challenges they present for national security planners.
BIOE 601, Introduction to Bioethics, Instructor: Autumn Fiester
This course is intended to serve as a broad introduction to the field of bioethics. The course will focus on three of the most important areas in bioethics: Genetics & Reproduction, Human Experimentation, and End-of-Life. Each module of the course will cover essential bioethics concepts, relevant legal cases, and classical readings on the themes.
Summer 2010
BIOE 545 and 546 Mediation Intensive I and II (.5 CU), Instructors: Edward Bergman and Autumn Fiester
Students will be placed in a variety of clinical situations in which they will play the roles of disputants and mediators, with ongoing discussions and critiques of mediator performance. Each student will be videotaped during their mediation to elicit feedback from the group and to catalyze self-criticism.
As distinct from the course, BIOE 540: Challenging Clinical Ethics, in which negotiation and mediation theory are taught as a prelude to clinical simulations, this course references the literature solely in relation to problems encountered in the hands-on mediation of specific cases.
BIOE 552, Bioethics at the Movies, Instructor: Nora Jones
In this course we will explore bioethics in film and through film. What this means is that we will look at key bioethical issues as they have been interpreted and presented in film in order to: 1) use film as a catalyst for discussion of the ethical issues presented (bioethics in film), and 2) understand from the contexts of the film’s production and reception what the film can tell us about the social, historical, and political contexts of the ethical issue in question (bioethics through film). For example, what can we learn about the patient ‘right to die’ movement from comparing the 1981 film ‘Whose Life is It Anyway?’ to 2004’s ‘Million Dollar Baby’? How does each film affect our own understanding of and perspective on the issue? What does critical and popular reception of these films tell us about where the issue stands in the larger US culture? To address these and other similar questions, the course will consist of film viewings, critical discussion, and analytical writing.
BIOE 580, Research Ethics, Instructor: Jon Merz
This seminar is intended to give students a broad overview of research ethics and regulation. The students will come out of the class with an understanding of the moral bases of scientific ethics and the historical evolution of biomedical research ethics. Students will be fully conversant with the development, implementation, and limitations of US human subjects regulations. The course includes reading assignments, lectures, discussions, student-led case-based and topical discussions addressing the following topics: ethics and morality in science; science in society; scientific integrity; misconduct; whistleblowing; conflicts of interest; collegiality, publication and authorship; peer review; human experimentation and regulations (HHS, FDA), Institutional Review Boards; informed consent, waivers, vulnerable populations; privacy and the confidentiality of records; epidemiology; and, finally, research on animals. Grade will be based on: an article peer review task 20%; consent form writing task 30%; weekly quizzes 10%; class discussion and participation 10%; and final exam, 30%.
The issue of human reproductive cloning has received a great deal attention in public discourse. Bioethicists, policymakers, and the media have been quick to identify the key ethical issues involved in human reproductive cloning and to argue, almost unanimously, for an international ban on such attempts. Meanwhile, scientists in labs across the globe have proceeded with extensive research agendas in the cloning and genetic modification of animals. What in 1997 was considered a remarkable feat – the cloning Dolly the sheep -- is today commonplace. To date, scientists have successfully cloned many other species including cats, rabbits, cows, mice, goats, pigs, mules, horses, and most recently, a dog. Scientists have also made extensive “progress” in transgenic science, in which genetic material from one species is introduced into a different species. This technique has long been used in rodents, but has in recent years been used to genetically alter rabbits, fish, pigs, and, most worrisome, non-human primates.
Despite all of this scientific research, there has been very little reflection on the profound ethical issues raised by animal biotechnology. In this course, we will examine the ethical issues that arise in various projects in animal biotechnology including: xenotransplantation, biopharming, pet cloning, cloning for conservation, recreational transgenesis (like “Alba the bunny” or the Glofish), disease modeling, and agricultural cloning and transgenesis.
topSpring 2010
BIOE 552, Specimen, Patient, and Spectacle: An Anthropological Look at the Body in Medicine, Instructor: Nora Jones
This course is about how the human body is literally being 'seen' by medical students, physicians, patients, and the public. Our focus will be on the ways in which the diseased or sick body is experienced and understood from the perspective of the various actors in contemporary medicine. We will begin with the 'body as specimen,' the patient's body as seen by Western biomedical physicians in training and then in clinical medicine. Here we examine the histories of medical education and medical imaging technologies (i.e. x-rays, CAT scans, photography) to understand the development and perpetuation of what is called in anthropology the ‘biomedical gaze,’ a distinct perspective towards patients that is expressed in the clinical encounter. We then turn to the 'body as patient,’ where we will explore how the experience of illness or disease in the clinical encounter can change one’s self-image and self-understanding. This portion of the class asks how, other than being a patient ourselves, we as social scientists and bioethicists can come to understand the patient’s perspective. We will evaluate various types of first-person sources, including art, literature, and accounts generated through social science research. We conclude with the 'body as spectacle,' in which we will examine how the diseased or ill body has been used in popular culture. We will focus in particular on recent trends in the art world of using the deformed body as subject matter. We will ask for what purpose the patients’ bodies are being used, and what this trend tells us about our cultural attitudes towards and beliefs about illness, disease, and medicine. The end goal of this course is to learn how a viewer's social, personal, and educational history influences how we see the human body, and then to be enabled to use this knowledge when analyzing the origins and complexities of contemporary bioethics problems.
BIOE 540, Challenging Clinical Ethics: Managing patient/caregiver conflict through mediation, Instructor: Edward Bergman
In the contemporary healthcare system patients, families, institutions and a multiplicity of caregivers engage in disputes over a myriad of issues - appropriate care, authorized decision-makers, managed care, information disclosure, and behavior/personality conflicts - sometimes with life and death hanging in the balance. Such disputes are rife with legal, ethical, emotional and scientific complexity. They are frequently highly charged and are often emergent in nature. In recent years, mediation has grown exponentially as a dispute resolution mechanism of choice. Not surprisingly, the success of mediation, and a wider understanding of the process, has led to its application in the realm of healthcare disputes with encouraging results. This course will provide an overview of negotiation fundamentals critical to the practice of mediation followed by an introduction to classical mediation theory and practice. Similarities and differences between mediation in the healthcare field, as distinct from other contexts, will be examined as will special problems highlighted by various commentators in the field. All class members will participate in mediation role-plays designed to simulate disputes prevalent in the healthcare landscape.
BIOE 585, Research Ethics in the Developing World, Instructors: Jon Merz and Francis Barchi
This is an advanced seminar focused on human subjects research in resource-constrained regions of the world. Students are expected to have a grounding in US regulations and policies. The students will come out of the class with an appreciation for issues raised by research involving populations vulnerable to manipulation and exploitation, a sensitivity to cultural issues, and an awareness of methods for appropriately engaging communities and performing ethically sound research. The course includes reading assignments, lectures, case-based and discussions addressing topics ranging from social and anthropological research, vulnerability and exploitation, biomedical research, pharmaceutical sponsorship, traditional knowledge and biopiracy, and equity and access. Grade will be based on 3 written case evaluations (70%) and class discussion and participation (30%). Please note that if you haven't taken BIOE 580: Research Ethics, you will be required to complete a short on-line training module on research ethics.
BIOE 590, Mental Health Bioethics, Instructor: Arthur Caplan
Bioethics has not paid sufficient attention to issues involving mental health. This course will seek to remedy that failing.
The course will examine how mental illnesses are defined, how competency is determined, special challenges that arise
in dealing with children, the role of compulsory treatment for addicts, the nature of the recovery movement, the ways in which
health care providers should respect the autonomy of their patients and the rights of mentally ill persons to consent to treatment among other topics. Course requirement is a 20-25 page paper on a topic to be mutually agreed upon between student and instructor.
BIOE 602, Conceptual Foundations of Bioethics, Instructor: Autumn Fiester
This course examines the various theoretical approaches to bioethics and critically assesses their underpinnings. Topics to be covered include an examination of various versions of utilitarianism; deonotological theories; virtue ethics; ethics of care; the fundamental principles of bioethics (autonomy, beneficence, distributive justice, non-maleficence); casuistry; and pragmatism. The course will include the application of the more theoretical ideas to particular topics, such as informed consent, confidentiality, and end of life issues.
Fall 2009
BIOE 550, Race, Gender, and Medicine, Instructor: Kathy Taylor
This seminar will explore the social categories of race and gender, and the ways in which western medicine, as a social practice, historically played a central role in reinforcing the dominant culture’s understanding of women and people of color as being inferior, deviant, defective, or “other.” We will also explore current issues relating to race and gender in medicine, including disparities between social groups in access to health care and medical treatment, how women and minorities have fared in medicine as an institution, and whether race should be used as a category in drug discovery.
BIOE 552, Cultural Competency in Medicine, Instructor: Nora Jones
‘Cultural competency’ is a common phrase in contemporary medicine, used frequently as a shortcut to refer to the delivery of cultural, ethnic, and/or racially sensitive care. In other words, medical students are being told that ‘culture matters.’ Many of the voices arguing for this turn to cultural competency come from within bioethics. As observers and commentators on biomedicine, some bioethicists have asked for increased awareness and sensitivity to diversity (of race, ethnicity, culture, gender, and class) in clinical care and in research. How such ‘cultural competency’ is being enacted, however, is often far removed from what those asking for it intend. In medical education, research and clinical care settings, ‘culture’ is often reduced to a static variable in a patient’s medical history – “history of diabetes? Check. Regular exercise? Check. Ethnic? Check.” This course will argue for attention to culture while refuting such reductionist thinking. We will approach culture as the field of anthropology does, as a process, as the lens through which daily activities and conditions – such as illness and disease – take on emotion, value, morals, and meaning.
This course begins by tracing the development and rise of cultural competency in the profession. We will read some of the classics of the cultural competency literature, and then move to contemporary critiques and suggestions. We will use case studies and grounded research to explore how we can learn what elements of one’s culture really matters to health/illness, and what bioethicists and clinicians can and should do with this information. This class is geared towards those who want to explore the patient-provider relationship, those interested in the role of culture in the biomedical encounter, anyone involved in patient care, and anyone with an interest in the role of the social sciences in bioethics.
BIOE 555, Desperate Remedies, Emerging Technologies, and Novel Therapies, Instructor: Jan Jaeger
This course will examine the ethical dilemmas and social implications generated by the discovery and use of novel therapies and desperate remedies in medicine. We will look at various emerging, converging and cutting edge medical technologies to understand how society benefits, what risks these technologies pose and the accompanying controversies that often arise as they are introduced. Some of the more common topics covered in the course will include organ transplantation, designer drugs and bone marrow transplantation. Additionally, we will examine the emerging nanomedicine landscape to understand how nanotechnology is shaping the practice of medicine today and how it will impact human health in the not so distant future. For example, we will look at the ethical issues associated with prospect of tissue engineering, implantable mobile systems that detect cancer cells, nano devices that deliver drugs to tumor sites and advanced and intelligent biomaterials for use in heart disease, stem cells and regenerative events. We will try to understand how technology is used to prevent death and extend life and the social consequences that arise from the research, development and advent of novel therapies and desperate remedies.
BIOE 570, The Insider's Guide to Biopolitics, Instructor: Jonathan Moreno
Bioethics is politics. That statement might not elicit much surprise in 2009, but it would have made the skin of many bioethicists crawl as little as ten years ago. Yet bioethics has always been political, even before there was a field so named. In this course we will explore the historic and modern debates of bioethics through a political lens, starting with classical philosophy and moving through eugenics to stem cells. Guest speakers from the overlapping worlds of science and politics, from various ideological perspectives, will light (or cloud) the way.
BIOE 601, Introduction to Bioethics, Instructor: Autumn Fiester
This course is intended to serve as a broad introduction to the field of bioethics. The course will focus on three of the most important areas in bioethics: Genetics & Reproduction, Human Experimentation, and End-of-Life. Each module of the course will cover essential bioethics concepts, relevant legal cases, and classical readings on the themes
Summer 2009
BIOE 555, Neuroethics, Instructor: Sheri Alpert
Developments in neurotechnology and more sophisticated psychopharmaceuticals have raised new questions in the ways in which we manipulate our mental states. In this class, we will look at a variety of topics in neuroethics -- drugs, implantable brain chips, brain imaging, cochlear implants, lie detection technologies, deep brain stimulators, transcranial magnetic stimulation, brain computer interfaces, forensic neuroscience, neuromarketing, and so on, and look at the astonishing and sometimes troubling technologies that will soon be a part of our therapeutic and civil regimens.
BIOE 580, Ethics of Human Subjects Research, Instructor: Jon Merz
This seminar is intended to give students a broad overview of research ethics and regulation. The students will come out of the class with an understanding of the moral bases of scientific ethics and the historical evolution of biomedical research ethics. Students will be fully conversant with the development, implementation, and limitations of US human subjects regulations. The course includes reading assignments, lectures, discussions, student-led case-based and topical discussions addressing the following topics: ethics and morality in science; science in society; scientific integrity; misconduct; whistleblowing; conflicts of interest; collegiality, publication and authorship; peer review; human experimentation and regulations (HHS, FDA), Institutional Review Boards; informed consent, waivers, vulnerable populations; privacy and the confidentiality of records; epidemiology; and, finally, research on animals. Grade will be based on: an article peer review task 20%; consent form writing task 30%; weekly quizzes 10%; class discussion and participation 10%; and final exam, 30%.
BIOE 590, Ethical and Legal Issues in the End of Life, Instructor: Autumn Fiester
This course will focus on the philosophical and legal issues surrounding end-of-life. We will examine the most significant legal cases of the last few decades, from Quinlan to Schiavo. We will then look at the philosophical literature on death and the process of dying, physician-assisted suicide and euthanasia, the doctrine of double effect; and the distinction between withholding and withdrawing life support. We will explore theoretical questions such as, “why is death bad?”, “what effect does awareness of mortality have on living?”, and “is there such a thing as a ‘good death?” as well as the moral permissibility of hastening death or assisting in death.
Spring 2009
BIOE 550, Doctoring and Regulation: Training, Research, and Practice, Instructor: Charles Bosk
In this course, we will examine the relationship between the medical profession and the various regulations and institutions that govern its practice. Ranging from recent attempts to regulate the working hours of physicians-in-training, to the new movement of patient-centered care, and the proper conduct of clinical research, we will examine the creation of policies and their implications for clinical practice and medical research. We will also critically examine the development of evidence-based guides to clinical decision-making, guidelines on conflict of interest, and the role of bioethics in the professional organizations.
BIOE 552, Bioethics at the Movies, Instructor: Nora Jones
In this course we will explore bioethics in film and through film. What this means is that we will look at key bioethical issues as they have been interpreted and presented in film in order to: 1) use film as a catalyst for discussion of the ethical issues presented (bioethics in film), and 2) understand from the contexts of the film’s production and reception what the film can tell us about the social, historical, and political contexts of the ethical issue in question (bioethics through film). For example, what can we learn about the patient ‘right to die’ movement from comparing the 1981 film ‘Whose Life is It Anyway?’ to 2004’s ‘Million Dollar Baby’? How does each film affect our own understanding of and perspective on the issue? What does critical and popular reception of these films tell us about where the issue stands in the larger US culture? To address these and other similar questions, the course will consist of film viewings, critical discussion, and analytical writing.
BIOE 580, Research Ethics, Instructor: Jon Merz
This seminar is intended to give students a broad overview of research ethics and regulation. The students will come out of the class with an understanding of the moral bases of scientific ethics and the historical evolution of biomedical research ethics. Students will be fully conversant with the development, implementation, and limitations of US human subjects regulations. The course includes reading assignments, lectures, discussions, student-led case-based and topical discussions addressing the following topics: ethics and morality in science; science in society; scientific integrity; misconduct; whistleblowing; conflicts of interest; collegiality, publication and authorship; peer review; human experimentation and regulations (HHS, FDA), Institutional Review Boards; informed consent, waivers, vulnerable populations; privacy and the confidentiality of records; epidemiology; and, finally, research on animals. Grade will be based on: an article peer review task 20%; consent form writing task 30%; weekly quizzes 10%; class discussion and participation 10%; and final exam, 30%.
BIOE 590, Human Genetics and Ethics: Past, Present, and Future, Instructor: Sheri Alpert
Long before Gregor Mendel revealed the laws of heredity, there was a tacit understanding that some traits could be passed on and that man could even manipulate some desirable traits, through selective breeding of livestock or the cross-fertilization of plant species. It is astonishing to realize, however, that it is only within the last 50-60 years, at most, that we actually understand the structure and mechanisms of DNA. And we still know very little about the actual functionality of the genes making up the human genome. These facts have not stopped man, however, from continuing to tinker with DNA, and on the molecular level. This class will examine our understanding of genetics, and the attendant ethical issues arising from that understanding (and lack thereof) in the past, the present, and into the future. At the same time, we will also focus how we see ourselves, as a species and as individuals, and how that perception may change into the future. Among the topics we will look at are eugenics and forced sterilizations, psycho-social implications of genetic testing, genetic privacy and the regulation of genetic information, genetic determinism, selecting genetic traits of future generations (e.g., pre-implantation genetic diagnosis), and synthetic biology (e.g., the design and construction of new organisms). To accomplish this, we will rely on works by scientists, bioethicists, policy makers, and philosophers. There will also be at least 2 short films shown during class. Students are expected to choose a topic for a term paper by mid-semester and present it to the class as a "work in progress" in order to receive feedback. Based on the presentation, students are expected to write a 2500-3000 word term paper.
BIOE 602, Conceptual Foundations, Instructor: Autumn Fiester
This course examines the various theoretical approaches to bioethics and critically assesses their underpinnings. Topics to be covered include an examination of various versions of utilitarianism; deonotological theories; virtue ethics; ethics of care; the fundamental principles of bioethics (autonomy, beneficence, distributive justice, non-maleficence); casuistry; and pragmatism. The course will include the application of the more theoretical ideas to particular topics, such as informed consent, confidentiality, and end of life issues.
top
BIOE 603, Ethics at the Bedside, Instructor: Jill Baren
Basic concepts in clinical ethics include autonomy, beneficence, decisional-capacity, and substituted judgment. But how are these concepts actually applied on a day-to-day basis? This course will provide the student with a deeper understanding of applied clinical ethics by exploring how real clinical dilemmas are approached, solved, and implemented in the everyday practice of medicine. Students will learn how to perform a detailed ethical case analysis which serves as a springboard for discussion and as a valuable mechanism to alert others to similar issues encountered elsewhere. Cases will cover dilemmas from a wide spectrum of clinical environments -- ambulatory care, hospital-based care, emergency care, ICU care -- and involve patients of all ages with a variety of illnesses and injuries. Case analysis will be supplemented by readings from the clinical ethics and medical literature covering relevant topics: the doctor-patient relationship, advance directives, privacy and confidentiality, informed consent, refusal of care, end-of-life. Some class time will be devoted to exploring the roles and activities of ethics consultants and committees culminating in a “mock” ethics committee session.
Fall 2008
BIOE 550, Reproductive Ethics, Instructor: Kathy Taylor
This course will explore ethical issues raised by reproduction and the use of various reproductive technologies. We will address: 1) the moral and legal status of the embryo and fetus, in the context of embryonic stem cell research and abortion; 2) the ethical features of the maternal-fetal relationship in terms of prenatal testing and the regulation of the behavior of pregnant women; and 3) ethical issues raised by the reproductive technologies such as IVF, gamete donation, preimplantation diagnosis, and surrogacy, including how these practices affect our perceptions of pregnancy, children, and family relationships.
BIOE 552, Diviners, Healers, and Zombies: An Anthropological Look at Traditional Medicine, Instructor: Nora Jones
Diviners, nurses, healers, zombies, doctors, missionaries, international aid workers, priests…. all have a role to play in how individuals around the world make sense of their illnesses and their quests for health. In this course we will read two ethnographies (in-depth anthropological studies) that address the relationship between individual’s health care beliefs and behaviors and the social, cultural, political, and economic contexts in which that individual is embedded.
From the Fat of Our Souls: Social Change, Political Process, and Medical Pluralism in Bolivia by Libbet Crandon-Malamud, centers on how medical choices are made not only to enhance health, but also as a tool to negotiate social identity. We will explore how making medical decisions can be used to achieve non-medical ends, such as land, jobs, and social prestige. Our second ethnography, Witches, Westerners, and HIV: AIDS & Cultures of Blame in Africa, by Alexander Reodlach, helps us to understand how beliefs that appear to be contradictory (AIDS being simultaneously understood as a biomedical condition and a phenomenon of sorcery) make sense in particular socio-historic times and places.
Our emphasis will be on exploring the value of qualitative data in the success of learning about local (be it in the highlands of Bolivia, or Zimbabwe, or Philadelphia) understandings of illness and health, how such knowledge can help interventions and other aid programs, and, finally, to critically reflect on how the current medical establishment in the United States influences our own health beliefs and behaviors.
BIOE 570, Bioethics Goes to Washington, Instructor: Michael Stebbins
Bioethics issues frequently collide head-on with public policy. The time, location and cause of that collision depends upon a complex web of factors including what branch of government is at the nexus of the controversy as well as political, religious, societal and scientific factors. This highly interactive class will examine the wreckage of previous collisions and explore those that are sure to come. You will hear from experts working in Washington on a wide range of issues involving bioethics including stem cells and cloning, reproductive technology, asbestos, bioterrorism, tobacco, genetic testing, nanotechnology and many more. From extreme cases like Terri Schiavo to less well-known cases involving actions of mercenary scientists working on behalf of big business, we will focus on the techniques used to push public policy and the roll bioethics and science have played.
BIOE 590, Beyond Quality of Life: Examining Disability in Bioethics, Instructors: Carol Schilling and Teresa Blankmeyer BurkeThis course conducts an inquiry into bioethical responses to human variations that become categorized as disability. The interdisciplinary project of disability studies will provide a fresh theoretical and practical lens through which to view bioethics, its philosophical framework and the library of cases that are argued within that frame. For the most part, bioethics discussions about disability have been limited to quality of life analyses, especially regarding decisions about the beginning and the end of life. Disability studies scholarship has, however, taken a more comprehensive look at ethical issues affecting the lived experiences of people with disabilities, including both clinical and broader social ethical concerns. The disability perspective on bioethics also exposes the ways that headline-making instances of what is framed as the right to die, as well as the less visible surrogacy and best interest decisions made daily, are centrally about how disability is understood. At its core, what’s at stake in this inquiry is who is welcome and graciously accommodated in the human community.
Readings will range from theoretical texts to narratives by the disabled and their families that enable us to work at the intersections of bioethics, disability studies, and the medical humanities. We will pause to ask what conditions constitute disability and who decides (hearing loss, mobility loss, chronic illness, cognitive differences...), what additional frameworks for bioethics (narrative ethics, care ethics, rehabilitation ethics, the humanities, and social sciences) can contribute to discussions of bioethics and disability, and what the creative arts can teach about defining disability. As disability theorists and the World Health Organization propose an inclusive conceptualization of disability as a condition of the human life cycle, rather than an unanticipated, alienating, individual event, and as the number of disabled citizens increases, the need to bring disability studies and bioethics into conversation becomes increasingly urgent.
BIOE 601, Introduction to Bioethics, Instructor: Autumn Fiester
This course is intended to serve as a broad introduction to the field of bioethics. The course will focus on three of the most important areas in bioethics: Genetics & Reproduction, Human Experimentation, and End-of-Life. Each module of the course will cover essential bioethics concepts, relevant legal cases, and classical readings on the themes.
Summer 2008
BIOE 550, Through the Artists’ Eye, Instructor: Nora Jones
In this course we will explore the centuries-old relationship between medicine and the arts, a relationship that is at times complementary and at others, adversarial. The range of the arts covered in the course includes illustration, painting, sculpture, photography, theater, and film. Throughout, our gaze will be focused on the theme of power and on the changing and complex meanings of medicine and illness in society.
Perhaps the best examples of the complementary relationship between the visual arts and medicine are the anatomical drawings of early 16th century artists like da Vinci and Vesalius, which laid the foundation for modern medical scientific illustration. Medicine continues to use the arts, as seen in the rise of ‘arts and humanities’ teaching in medical colleges, the use of art therapy for abused children and sufferers of PTSD, physicians as artists, and in calling artists into service for public health education and prevention campaigns.
On the other hand, art has also been used to critique medicine. Contemporary filmmakers and playwrights criticize the health care system and the ways in which it disempowers patients. Critical examinations of the depiction of gender and ethnicity in medically-oriented art provide alternative views to the official versions of medical history and continuing practice. And photographers and other artists are increasing appropriating medical subject matter in their art, challenging the hold and control that medicine has enjoyed over defining illness and disease and exposing medical knowledge and secrets to a wide audience.
BIOE 580, Research Ethics, Instructor: Jon Merz
This seminar is intended to give students a broad overview of research ethics and regulation. The students will come out of the class with an understanding of the moral bases of scientific ethics and the historical evolution of biomedical research ethics. Students will be fully conversant with the development, implementation, and limitations of US human subjects regulations. The course includes reading assignments, lectures, discussions, student-led case-based and topical discussions addressing the following topics: ethics and morality in science; science in society; scientific integrity; misconduct; whistleblowing; conflicts of interest; collegiality, publication and authorship; peer review; human experimentation and regulations (HHS, FDA), Institutional Review Boards; informed consent, waivers, vulnerable populations; privacy and the confidentiality of records; epidemiology; and, finally, research on animals. Grade will be based on: an article peer review task 20%; consent form writing task 30%; weekly quizzes 10%; class discussion and participation 10%; and final exam, 30%.
BIOE 590, Chimeras and Frankenpets, Instructor: Autumn Fiester
The issue of human reproductive cloning has received a great deal attention in public discourse. Bioethicists, policymakers, and the media have been quick to identify the key ethical issues involved in human reproductive cloning and to argue, almost unanimously, for an international ban on such attempts. Meanwhile, scientists in labs across the globe have proceeded with extensive research agendas in the cloning and genetic modification of animals. What in 1997 was considered a remarkable feat – the cloning Dolly the sheep -- is today commonplace. To date, scientists have successfully cloned many other species including cats, rabbits, cows, mice, goats, pigs, mules, horses, and most recently, a dog. Scientists have also made extensive “progress” in transgenic science, in which genetic material from one species is introduced into a different species. This technique has long been used in rodents, but has in recent years been used to genetically alter rabbits, fish, pigs, and, most worrisome, non-human primates.
Despite all of this scientific research, there has been very little reflection on the profound ethical issues raised by animal biotechnology. In this course, we will examine the ethical issues that arise in various projects in animal biotechnology including: xenotransplantation, biopharming, pet cloning, cloning for conservation, recreational transgenesis (like “Alba the bunny” or the Glofish), disease modeling, and agricultural cloning and transgenesis.
Spring 2008
BIOE 540, Mediation as a Dispute Resolution Mechanism for Healthcare Disputes, Instructor: Edward Bergman
In the contemporary healthcare system patients, families, institutions and a multiplicity of caregivers engage in disputes over a myriad of issues - appropriate care, authorized decision-makers, managed care, information disclosure, and behavior/personality conflicts - sometimes with life and death hanging in the balance. Such disputes are rife with legal, ethical, emotional and scientific complexity. They are frequently highly charged and are often emergent in nature. In recent years, mediation has grown exponentially as a dispute resolution mechanism of choice. Not surprisingly, the success of mediation, and a wider understanding of the process, has led to its application in the realm of healthcare disputes with encouraging results. This course will provide an overview of negotiation fundamentals critical to the practice of mediation followed by an introduction to classical mediation theory and practice. Similarities and differences between mediation in the healthcare field, as distinct from other contexts, will be examined as will special problems highlighted by various commentators in the field. All class members will participate in mediation role-plays designed to simulate disputes prevalent in the healthcare landscape.
BIOE 551, The Call of Stories: Using Narrative in Medical Ethics, Instructor: Kathy Taylor
This course will address how narrative, whether in the form of personal memoir, poetry, fiction, or other writings, helps elucidate medical ethical theory, as well as the experiences of the various moral agents in the health care system. We will look at how narrative studies has contributed to the field of bioethics, and examine readings from the patient, caregiver, and caretaker perspectives. We also will explore readings centered on various topics in medical ethics, such as the physician/patient relationship, cross-cultural medicine, death and dying, and mental illness.
BIOE 555, Biotechnology and the Body, Instructor: Paul Root Wolpe
New medical and biotechnological innovations, such as new psychopharmaceuticals or brain prosthetics, pose a challenge to our historical sense of selfhood and personality. Implantable brain chips, deep brain stimulators, and cochlear implants are merging biological, mechanical, and chip technologies, and neuroimaging technologies may soon be able to breach the barrier of our private thoughts. Genetics, in turn, may render possible our ability to design traits into our descendants. These innovations pose significant challenges to our moral, ethical and religious systems, as well as to how we situate our bodies in social space. In this course, we will use social science methods and reasoning to examine the implications of these technologies on medicine, human enhancement, and the literature on embodiment, and will also bring in perspectives in philosophy, bioethics, religious studies, and the humanities. The goal is to explore the profound ways biotechnology may change the very nature of being human in this century.
BIOE 570, Innovation in Medicine, Instructor: Jon Merz
This seminar is intended to give students a broad overview of medical innovation, addressing questions such as what is it, how does it occur, and what are the policies and tools available for promoting and regulating innovation. Topics to be addressed include: conceptualizing innovation; the economics of innovation; private vs. public sponsorship of R&D; intellectual property; the management and regulation of innovative technologies; technology assessment; and technology diffusion. Cases drawn from across the biomedical spectrum including surgery, drugs and devices will be used to identify ethical and policy dimensions of innovation in medicine.
BIOE 590, Bits & Pieces: Ethical Issues in Transplanting Organs, Tissues, and Blood, Instructor: Art Caplan
This course will begin with an examination of the ethical status of the body and its parts throughout Western History. Then we will look at the earliest efforts to transplant bodily parts and tissues prior to World War II and the ethics surrounding those experiments. The course will then shift to an examination of blood transfusion and the ethical, legal and policy questions it raised and continues to raise. Transplants of kidney and solid organs from cadaver sources including issues of donation, procurement, allocation and payment will follow. We will then turn to the emergence of newer forms of transplants including living organ donation, gene transfer, gametes, limb, face and uterine transplants. The course will conclude with an examination of the ethical and legal issues surrounding efforts to locate new sources of replacement tissues and cells including embryonic stem cell research, xenografts and artificial organs.
BIOE 602, Conceptual Foundations, Instructor: Autumn Fiester
This course examines the various theoretical approaches to bioethics and critically assesses their underpinnings. Topics to be covered include an examination of various versions of utilitarianism; deonotological theories; virtue ethics; ethics of care; the fundamental principles of bioethics (autonomy, beneficence, distributive justice, non-maleficence); casuistry; and pragmatism. The course will include the application of the more theoretical ideas to particular topics, such as informed consent, confidentiality, and end of life issues.
Fall 2007
BIOE 550, Pharmaceutical Ethics, Instructor: Katherine Taylor
Description: The pharmaceutical industry currently confronts serious criticisms from various quarters, including claims that drug prices are dramatically inflated, condemnations of its marketing practices, and charges that the industry puts profits over drug safety. At bottom, the industry faces a crisis of public confidence in its ability to discover, and ethically market, safe and effective drugs at an affordable price.
This course will explore major ethical concerns confronted by the pharmaceutical industry in today’s climate of increased scrutiny and suspicion. We will look at several issues, including 1) the “medicalization” of human conditions through marketing of drugs such as human growth hormone or Ritalin; 2) industry practices aimed at expanding drug markets, such as direct-to consumer advertising, ties to physicians, and the promotion of off-label uses; 3) ethical concerns with industry influence over journal publications and medical research; and, 4) criticisms relating to drug safety, patent protection practices, drug pricing and access.
In each context, we will explore the fundamental questions, what ethical responsibilities, if any, does the pharmaceutical industry have in that particular context, and what is the source, or grounding, of those obligations? How should a for-profit drug company balance its duties to its shareholders with its ethical responsibilities to the public?
Students will be expected to complete some short assignments, and also write a paper on a topic discussed with the instructor.
BIOE 551, Medical Errors, Instructor: Charles Bosk
The purpose of Bioethics 551 is to provide a basic understanding of some rather ubiquitous social phenomena: mistakes, errors, accidents, and disasters. We will look at these misfirings across a number of institutional domains: aviation, nuclear power plants, and medicine. Our goal is to understand how organizations “think” about these phenomena, how they develop strategies of prevention, how these strategies of prevention create new vulnerabilities to different sorts of mishaps, how organizations respond when things do grow awry, and how they plan for disasters. At the same time we will also be concerned with certain tensions in the sociological view of accidents, errors, mistakes, and disasters at the organizational level and at the level of the individual. Errors, accidents, mistakes, and disasters are embedded in organizational complexities; as such, they are no one’s fault. At the same time, as we seek explanations for these adverse events, we seek out whom to blame and whom to punish. We will explore throughout the semester the tension between a view that sees adverse events as the result of flawed organizational processes versus a view that sees these events as a result of flawed individuals.
BIOE 552, Health and Illness from an Anthropological Perspective, Instructor: Nora Jones
‘Cultural competency’ is a common phrase in contemporary medicine, used frequently as a shortcut to refer to the delivery of cultural, ethnic, and/or racially sensitive care. In other words, medical students are being told that ‘culture matters.’ Many of the voices arguing for this turn to cultural competency come from within bioethics. As observers and commentators on biomedicine, some bioethicists have asked for increased awareness and sensitivity to diversity (of race, ethnicity, culture, gender, and class) in clinical care and in research. How such ‘cultural competency’ is being enacted, however, is often far removed from what those asking for it intend. In medical education, research and clinical care settings, ‘culture’ is often reduced to a static variable in a patient’s medical history – “history of diabetes? Check. Regular exercise? Check. Ethnic? Check.” This course will argue for attention to culture while refuting such reductionist thinking. We will approach culture as the field of anthropology does, as a process, as the lens through which daily activities and conditions – such as illness and disease – take on emotion, value, morals, and meaning.
This course begins by tracing the development and rise of cultural competency in the profession. We will read some of the classics of the cultural competency literature, and then move to contemporary critiques and suggestions. We will use case studies and grounded research to explore how we can learn what elements of one’s culture really matters to health/illness, and what bioethicists and clinicians can and should do with this information.
This class is geared towards those who want to explore the patient-physician relationship, those interested in the role of culture in the biomedical encounter, anyone involved in patient care, and anyone with an interest in the role of the social sciences in bioethics.
BIOE 570, Bioethics and National Security, Instructor: Jonathan Moreno
Bioethical issues play a critical but largely unrecognized role in national security policy. These issues are also important, though again rarely understood, for a full appreciation of the history and pre-history of bioethics. In this seminar we will explore the intersection of bioethics and national security through the history of human experiments for military purposes, the development of human experimentation policies by national security agencies, the ethics of mass casualty medicine, bioterror events and public health measures, and emerging challenges such as the place of breakthroughs in genetics and neuroscience in national security planning.
BIOE 601, Proseminar, Instructor: Autumn Fiester
This course is intended to serve as a broad introduction to the field of bioethics. The course will focus on three of the most important areas in bioethics: Genetics & Reproduction, Human Experimentation, and End-of-Life. Each module of the course will cover essential bioethics concepts, relevant legal cases, and classical readings on the themes.
Summer 2007
BIOE 551, Sociology of Medicine, Instructor: Charles Bosk
This course is a graduate level introduction to the sociology of medicine. The sociology of medicine is a broad domain both in terms of topics and methodologies. In this course we will explore the following issues: (1) the demographic and cultural dimensions of health and illness; (2) the experience of illness; (3) the profession of medicine; (4) efforts at health care reform; and (5) the emergence of the field of bioethics.
BIOE 580, Research Ethics, Instructor Jon Merz
This seminar is intended to give students a broad overview of research ethics and regulation. The students will come out of the class with an understanding of the moral bases of scientific ethics and the historical evolution of biomedical research ethics. Students will be fully conversant with the development, implementation, and limitations of US human subjects regulations. The course includes reading assignments, lectures, discussions, student-led case-based and topical discussions addressing the following topics: ethics and morality in science; science in society; scientific integrity; misconduct; whistleblowing; conflicts of interest; collegiality, publication and authorship; peer review; human experimentation and regulations (HHS, FDA), Institutional Review Boards; informed consent, waivers, vulnerable populations; privacy and the confidentiality of records; epidemiology; and, finally, research on animals. Grade will be based on: an article peer review task 20%; consent form writing task 30%; weekly quizzes 10%; class discussion and participation 10%; and final exam, 30%.
BIOE 590, Ethical and Legal Issues in the End of Life, Instructor Autumn Fiester
This course will focus on the philosophical and legal issues surrounding end-of-life. We will examine the most significant legal cases of the last few decades, from Quinlan to Schiavo. We will then look at the philosophical literature on death and the process of dying, physician-assisted suicide and euthanasia, the doctrine of double effect; and the distinction between withholding and withdrawing life support. We will explore theoretical questions such as, “why is death bad?”, “what effect does awareness of mortality have on living?”, and “is there such a thing as a ‘good death?” as well as the moral permissibility of hastening death or assisting in death.
Spring 2007
BIOE 540, Mediation as a Dispute Resolution Mechanism for Healthcare Disputes, Instructor: Edward Bergman
In the contemporary healthcare system patients, families, institutions and a multiplicity of caregivers engage in disputes over a myriad of issues - appropriate care, authorized decision-makers, managed care, information disclosure, and behavior/personality conflicts - sometimes with life and death hanging in the balance. Such disputes are rife with legal, ethical, emotional and scientific complexity. They are frequently highly charged and are often emergent in nature. In recent years, mediation has grown exponentially as a dispute resolution mechanism of choice. Not surprisingly, the success of mediation, and a wider understanding of the process, has led to its application in the realm of healthcare disputes with encouraging results. This course will provide an overview of negotiation fundamentals critical to the practice of mediation followed by an introduction to classical mediation theory and practice. Similarities and differences between mediation in the healthcare field, as distinct from other contexts, will be examined as will special problems highlighted by various commentators in the field. All class members will participate in mediation role-plays designed to simulate disputes prevalent in the healthcare landscape.
BIOE 550, Family Matters: the role of families in contemporary bioethics, Instructor: Vardit Ravitsky
Bioethics’ traditional focus on the principle of autonomy and on the patient as a rational independent decision maker, have caused a long standing neglect of the concept of the family. Some important issues surrounding the roles that families play in the clinical context have not been appropriately addressed in the bioethical literature and debate. Some significant moral dimensions of family interactions have been overlooked as well.
The mere idea of the “family” is a politically contested notion these days and for many, invoking "family values" is a way of engaging a deeply conservative agenda, hostile to women and to homosexual people. In this heated context, a productive and levelheaded discussion of the family requires a sensitive and insightful conversation, which will be the objective of this class.
We will address issues such as the concept of family in liberal theory; parents’ rights to make decisions for neonates, children and adolescents; the family as care takers; filial duties - what are our moral responsibilities towards our aging parents; truth-telling; the role of the family at the end of life; families and consent to donate the organs of a loved one; enrolling families in genetic research; reproductive technologies and the deconstruction of the family; protecting women and children within families in minority cultures; and more.
Classes will consist of lectures followed by discussion and debate. Students are expected to choose a topic for a term paper by mid-semester and present it to the class as a "work in progress" in order to receive feedback. The presentation will count as 30% of the grade. Based on the presentation, students are expected to write a 2500-3000 word term paper, which will count as 70% of the grade.
BIOE 551, Medical Errors, Instructor: Charles Bosk
The purpose of Bioethics 551 is to provide a basic understanding of some rather ubiquitous social phenomena: mistakes, errors, accidents, and disasters. We will look at these misfirings across a number of institutional domains: aviation, nuclear power plants, and medicine. Our goal is to understand how organizations “think” about these phenomena, how they develop strategies of prevention, how these strategies of prevention create new vulnerabilities to different sorts of mishaps, how organizations respond when things do grow awry, and how they plan for disasters. At the same time we will also be concerned with certain tensions in the sociological view of accidents, errors, mistakes, and disasters at the organizational level and at the level of the individual. Errors, accidents, mistakes, and disasters are embedded in organizational complexities; as such, they are no one’s fault. At the same time, as we seek explanations for these adverse events, we seek out whom to blame and whom to punish. We will explore throughout the semester the tension between a view that sees adverse events as the result of flawed organizational processes versus a view that sees these events as a result of flawed individuals.
BIOE 552, Bioethics at the Movies, Instructors: Pamela Sankar, Nora Jones
This course explores key bioethical issues as they have been interpreted and presented in popular film. Four topics will be examined: research ethics, autonomy, justice, and genetics. The goals of the course are to enable students to appreciate and critically evaluate how film represents bioethical issues and to explore how the social, historical, and political context of a film influences its production and reception. This is a seminar course consisting of film viewings, critical discussion, and analytical writing.
BIOE 555, Neuroethics, Instructor: Paul Root Wolpe
Developments in neurotechnology and more sophisticated psychopharmaceuticals have raised new questions in the ways in which we manipulate our mental states. In this class, we will look at a variety of topics in neuroethics -- drugs, implantable brain chips, brain imaging, cochlear implants, lie detection technologies, deep brain stimulators, transcranial magnetic stimulation, brain computer interfaces, forensic neuroscience, neuromarketing, and so on, and look at the astonishing and sometimes troubling technologies that will soon be a part of our therapeutic and civil regimens. Guest speakers and field trips will also be included.
BIOE 602, Conceptual Foundations, Instructor: Autumn Fiester
This course examines the various theoretical approaches to bioethics and critically assesses their underpinnings. Topics to be covered include an examination of various versions of utilitarianism; deonotological theories; virtue ethics; ethics of care; the fundamental principles of bioethics (autonomy, beneficence, distributive justice, non-maleficence); casuistry; and pragmatism. The course will include the application of the more theoretical ideas to particular topics, such as informed consent, confidentiality, and end of life issues.
Fall 2006
BIOE 550: Bioethics and Cultural Frameworks, Instructor: Vardit Ravitsky
The field of bioethics encompasses some of the most sensitive and controversial moral issues of our time. From conception to end-of-life, bioethics is charged with the analysis, interpretation and sometimes resolution of some of the most difficult dilemmas facing our society. Bioethical debate does not occur in a vacuum. Rather, it is the outcome of the cultural, social, political and religious context within which it takes place. This class will examine the influence of cultural frameworks on the way bioethical dilemmas are approached and resolved. We will explore Christian, Muslim and Jewish value-systems and the way in which they help shape public policy in different societies and countries. We will study the impact of culture and religion on issues such as the right to health care, end-of-life care, the definition of death, organ procurement and transplantation, assisted reproductive technologies, abortion, genetic testing, embryonic stem cell research, cloning, and research with human subjects. Classes will consist of lectures followed by discussion and debate. Students are expected to attend and participate in discussion, do the assigned readings, write a term paper and take a final exam.
BIOE 552, Specimen, Patient, and Spectacle: An Anthropological Look at the Body in Medicine, Instructor: Nora Jones
This course is about how the human body is literally being 'seen' by medical students, physicians, patients, and the public. Our focus will be on the ways in which the diseased or sick body is experienced and understood from the perspective of the various actors in contemporary medicine. We will begin with the 'body as specimen,' the patient's body as seen by Western biomedical physicians in training and then in clinical medicine. Here we examine the histories of medical education and medical imaging technologies (i.e. x-rays, CAT scans, photography) to understand the development and perpetuation of what is called in anthropology the ‘biomedical gaze,’ a distinct perspective towards patients that is expressed in the clinical encounter. We then turn to the 'body as patient,’ where we will explore how the experience of illness or disease in the clinical encounter can change one’s self-image and self-understanding. This portion of the class asks how, other than being a patient ourselves, we as social scientists and bioethicists can come to understand the patient’s perspective. We will evaluate various types of first-person sources, including art, literature, and accounts generated through social science research. We conclude with the 'body as spectacle,' in which we will examine how the diseased or ill body has been used in popular culture. We will focus in particular on recent trends in the art world of using the deformed body as subject matter. We will ask for what purpose the patients’ bodies are being used, and what this trend tells us about our cultural attitudes towards and beliefs about illness, disease, and medicine. The end goal of this course is to learn how a viewer's social, personal, and educational history influences how we see the human body, and then to be enabled to use this knowledge when analyzing the origins and complexities of contemporary bioethics problems.
BIOE 560, Ethics at the Bedside, Instructor: Jill Baren
Basic concepts in clinical ethics include autonomy, beneficence, decisional-capacity, substituted judgment, and many others. But how are these concepts actually applied on a day-to-day basis? This course will provide the student with a deeper understanding of applied clinical ethics by exploring how real clinical dilemmas are approached, solved, and implemented in the everyday practice of medicine. Students will learn how detailed ethical case analysis serves as a springboard for discussion and how it can be a valuable mechanism to alert others to similar issues encountered outside an individual practice or institution. Cases will cover dilemmas from a wide spectrum of clinical environments -- ambulatory care, hospital-based care, emergency care, ICU care -- and involve patients of all ages with a variety of illnesses and injuries. Case analysis will be supplemented by readings from the clinical ethics literature covering relevant topics: the doctor-patient relationship, advance directives, privacy and confidentiality, informed consent, refusal of care, etc. Some class time will be devoted to exploring the roles and activities of ethics consultants and committees culminating in a “mock” ethics committee session. Optional clinical “shadowing” experiences will also be offered during the semester.
BIOE 590, What a Shot! The Ethical Challenges of Vaccines, Instructor: Arthur Caplan
Few, if any, medical interventions can match the record of success established by vaccines. Diseases such as polio and smallpox that once afflicted millions each year have been all but eradicated, and many others are rapidly becoming little more than historical footnotes. Despite these achievements, vaccines remain extremely important and controversial. When the United States and the world continue to live under the threat of an avian flu pandemic or an act of bioterrorism vaccines are seen as holding the answer to these threats. The continuing reality of the HIV/AIDS pandemic has made the hunt for preventative or therapeutic vaccines a central feature of private and public philanthropy and policy. The recent licensure of vaccines for rotavirus and cervical cancer is a reminder of the ways in which research ethics and affordable access to valued resources are reflected in vaccine policy. Vaccines present some unique ethical challenges. Unlike pharmaceuticals, many vaccines are given to healthy individuals, seeking to prevent disease rather than treat it. Indeed, babies and children are the primary recipient of vaccinations. This means the concept of risk and benefit do not always easily fit into the standard template of bioethics. Vaccines are often mandated or compelled. A variety of state laws in the U.S. require proof of vaccination in order to enroll in school or day-care. For public health authorities, a successful immunization program requires a high rate of vaccination. Thus, individual liberty may conflict with the best interests of the community as a whole in ways not commonly seen in other domains of bioethics. Allocation issues are especially interesting regarding vaccines. Reports of alleged side effects such as autism have shaken public confidence regarding vaccine safety and necessity. Many people do not want their children vaccinated as a result. Conversely, when shortages occur, difficult decisions must be made as to who should receive scarce resources.
The course will review some of the science of vaccines and then track ethical issues from the initial stages of research through the implementation of vaccination programs in communities. The course will explore these topics through key readings, class discussion, analysis of case studies, presentations by guest speakers drawn from researchers, policymakers, and scholars on the Penn campus and in the Philadelphia region. Students will be expected to write a paper addressing a topic to be agreed upon with the instructor by mid-term related to vaccine ethics in which they identify a key ethical issue, present multiple options for responding to it, and provide support for their preferred resolution.
BIOE 601, Proseminar, Instructor: Autumn Fiester
This course is intended to serve as a broad introduction to the field of bioethics. The course will focus on three of the most important areas in bioethics: Genetics & Reproduction, Human Experimentation, and End-of-Life. Each module of the course will cover essential bioethics concepts, relevant legal cases, and classical readings on the themes.
Summer 2006
BIOE 590, Chimeras and Frankenpets, Instructor: Autumn Fiester
The issue of human reproductive cloning has received a great deal attention in public discourse. Bioethicists, policymakers, and the media have been quick to identify the key ethical issues involved in human reproductive cloning and to argue, almost unanimously, for an international ban on such attempts. Meanwhile, scientists in labs across the globe have proceeded with extensive research agendas in the cloning and genetic modification of animals. What in 1997 was considered a remarkable feat – the cloning Dolly the sheep -- is today commonplace. To date, scientists have successfully cloned many other species including cats, rabbits, cows, mice, goats, pigs, mules, horses, and most recently, a dog. Scientists have also made extensive “progress” in transgenic science, in which genetic material from one species is introduced into a different species. This technique has long been used in rodents, but has in recent years been used to genetically alter rabbits, fish, pigs, and, most worrisome, non-human primates.
Despite all of this scientific research, there has been very little reflection on the profound ethical issues raised by animal biotechnology. In this course, we will examine the ethical issues that arise in various projects in animal biotechnology including: xenotransplantation, biopharming, pet cloning, cloning for conservation, recreational transgenesis (like “Alba the bunny” or the Glofish), disease modeling, and agricultural cloning and transgenesis.
BIOE 580, Research Ethics, Instructor: Jon Merz
This seminar is intended to give students a broad overview of research ethics and regulation. The students will come out of the class with an understanding of the moral bases of scientific ethics and the historical evolution of biomedical research ethics. Students will be fully conversant with the development, implementation, and limitations of US human subjects regulations. The course includes reading assignments, lectures, discussions, student-led case-based and topical discussions addressing the following topics: ethics and morality in science; science in society; scientific integrity; misconduct; whistleblowing; conflicts of interest; collegiality, publication and authorship; peer review; human experimentation and regulations (HHS, FDA), Institutional Review Boards; informed consent, waivers, vulnerable populations; privacy and the confidentiality of records; epidemiology; and, finally, research on animals. Grade will be based on: an article peer review task 20%; consent form writing task 30%; weekly quizzes 10%; class discussion and participation 10%; and final exam, 30%.
BIOE 590: Reproductive Ethics, Instructor Vardit Ravitsky
An increasing number of people turn to reproductive technologies for help in their attempts to conceive a child. Over 300,000 babies have been born in the US as a result of reported Reproductive Technology procedures. This class will explore the various ethical issues that these technologies raise. We will address questions such as: Is infertility a disease? Should there be any social restrictions on access to reproductive technologies? What is the status of the human embryo outside the human body? What are the ethical concerns that Pre-implantation Genetic Diagnosis raises? Should it be used only to screen for disease? Or maybe also to choose an embryo that would become a matching donor for a sick sibling? Should sex selection be allowed? What are the implications of gamete donation and surrogacy for the identities of children and families? And how does the use of these different technologies impact family relationships and the way children are perceived and treated? Classes will consist of lectures followed by discussion and debate. Students are expected write a 10 page term paper a take a final exam.
Spring 2006
BIOE 540, Mediation as a Dispute Resolution Mechanism for Healthcare Disputes, Instructor: Edward Bergman
In the contemporary healthcare system patients, families, institutions and a multiplicity of caregivers engage in disputes over a myriad of issues - appropriate care, authorized decision-makers, managed care, information disclosure, and behavior/personality conflicts - sometimes with life and death hanging in the balance. Such disputes are rife with legal, ethical, emotional and scientific complexity. They are frequently highly charged and are often emergent in nature. In recent years, mediation has grown exponentially as a dispute resolution mechanism of choice. Not surprisingly, the success of mediation, and a wider understanding of the process, has led to its application in the realm of healthcare disputes with encouraging results. This course will provide an overview of negotiation fundamentals critical to the practice of mediation followed by an introduction to classical mediation theory and practice. Similarities and differences between mediation in the healthcare field, as distinct from other contexts, will be examined as will special problems highlighted by various commentators in the field. All class members will participate in mediation role-plays designed to simulate disputes prevalent in the healthcare landscape.
BIOE 570, Medical Issues in the Public Arena, Instructor: Charles Bosk
The public arena is crowded with multiple problems competing for limited attention and resources. Issues as basic as--Is this Illness? Should we invest in treating it?--are part of the competition for attention. The first third of the course will explore how issues are structured in public arenas. Why do some issues become a source of obsessive focus while other, equally serious, issues are ignored? The remaining two-thirds will test the theories presented in first part of the course by looking at a series of case studies that examine successful and unsuccessful framings of health problems in public arenas. Possible case studies include: Abortion as an issue from mid 19th century to the present; public health and the threat of pandemic flu; end of life issues from Karen Anne Quinlan to Terri Schiavo; conflicts between scientific epidemiologists and lay populations around disease causation (autism and vaccination and cancer clusters and environmental risks).
BIOE 580, Research Ethics, Instructor: Jon Merz
This seminar is intended to give students a broad overview of research ethics and regulation. The students will come out of the class with an understanding of the moral bases of scientific ethics and the historical evolution of biomedical research ethics. Students will be fully conversant with the development, implementation, and limitations of US human subjects regulations. The course includes reading assignments, lectures, discussions, student-led case-based and topical discussions addressing the following topics: ethics and morality in science; science in society; scientific integrity; misconduct; whistleblowing; conflicts of interest; collegiality, publication and authorship; peer review; human experimentation and regulations (HHS, FDA), Institutional Review Boards; informed consent, waivers, vulnerable populations; privacy and the confidentiality of records; epidemiology; and, finally, research on animals. Grade will be based on: an article peer review task 20%; consent form writing task 30%; weekly quizzes 10%; class discussion and participation 10%; and final exam, 30%.
BIOE 590, Genetics, Ethics, and Human Identity, Instructor: Vardit Ravitsky
Following the completion of the Human Genome Project, the genomic era has now begun. Genetic information is expected to revolutionize our understanding of health and disease. It will also impact our personal identities, our families and our communities, making certain ethical, legal and social issues an essential part of this revolution. This class will examine future implications of genetics on human identity, focusing on their ethical dimensions. We will address questions such as the psycho-social implications of genetic testing, the social challenge of regulating the use of genetic information, behavioral genetics and the question of determinism, selecting genetic traits in future children, and genetic enhancement. We will read and critically discuss contemporary philosophers, scientists and bioethicists, and will also watch a couple of documentaries. Classes will consist of lectures followed by discussion and debate. Students are expected to choose a topic for a term paper by mid-semester and present it to the class as a "work in progress" in order to receive feedback. Based on the presentation, students are expected to write a 2500-3000 word term paper.
BIOE 602, Conceptual Foundations, Instructor: Autumn Fiester
This course examines the various theoretical approaches to bioethics and critically assesses their underpinnings. Topics to be covered include an examination of various versions of utilitarianism; deonotological theories; virtue ethics; ethics of care; the fundamental principles of bioethics (autonomy, beneficence, distributive justice, non-maleficence); casuistry; and pragmatism. The course will include the application of the more theoretical ideas to particular topics, such as informed consent, confidentiality, and end of life issues.
Fall 2005
BIOE 550, International Bioethics, Instructor: A. Reitsma
This course is intended to serve as an opening to the discussion of international issues in bioethics. During the run of this course, we will study a variety of current international perspectives in bioethics and will aim to draw cross-cultural comparisons. The course will mainly focus on the comparison between the various principles, rules and regulations of a number of developed countries, including those in North America, Europe, and the Australasian continent. Regulatory similarities and differences between such developed nations will be explored in regards but not limited to the genetic engineering of foods and livestock, stem cell research, end of life decision making, reproductive technologies, organ procurement for transplantation purposes, healthcare access and insurance and other pressing issues. To a lesser extent, the class will also examine a number of ethical questions that arise from the tension between the developed and developing world, such as research with human subjects investigating pharmaceuticals. At the end of this course, students should be able to identity some of the major issues in the international bioethical debate and the existing cultural and regulatory differences and similarities in the developed world.
BIOE 551, Medical Errors, Instructor: Charles Bosk
The purpose of Bioethics 551 is to provide a basic understanding of some rather ubiquitous social phenomena: mistakes, errors, accidents, and disasters. We will look at these misfirings across a number of institutional domains: aviation, nuclear power plants, and medicine. Our goal is to understand how organizations “think” about these phenomena, how they develop strategies of prevention, how these strategies of prevention create new vulnerabilities to different sorts of mishaps, how organizations respond when things do grow awry, and how they plan for disasters. At the same time we will also be concerned with certain tensions in the sociological view of accidents, errors, mistakes, and disasters at the organizational level and at the level of the individual. Errors, accidents, mistakes, and disasters are embedded in organizational complexities; as such, they are no one’s fault. At the same time, as we seek explanations for these adverse events, we seek out whom to blame and whom to punish. We will explore throughout the semester the tension between a view that sees adverse events as the result of flawed organizational processes versus a view that sees these events as a result of flawed individuals.
BIOE 590, The Public Face of Bioethics, Instructor: Arthur L. Caplan
This course will examine the ways in which bioethics shapes public opinion and public policy. The role of the courts, commissions, professional associations and the media will be examined. A critical examination of the ways in which bioethicists have shaped public policy in key areas such as human experimentation, transplantation, end of life care and stem cell research will be undertaken. Finally the ways in which bioethicists interact with government, industry and patient advocacy groups will be examined and issues such as conflicts of interest, legal liability and the need for professional standards will be considered.
BIOE 601, Proseminar, Instructor Autumn Fiester
This course is intended to serve as a broad introduction to the field of bioethics. The course will focus on three of the most important areas in bioethics: Genetics & Reproduction, Human Experimentation, and End-of-Life. Each module of the course will cover essential bioethics concepts, relevant legal cases, and classical readings on the themes.
Summer 2005
BIOE 540, Mediation as a Dispute Resolution Mechanism for Healthcare Disputes, Instructor: Edward Bergman
In the contemporary healthcare system patients, families, institutions and a multiplicity of caregivers engage in disputes over a myriad of issues - appropriate care, authorized decision-makers, managed care, information disclosure, and behavior/personality conflicts - sometimes with life and death hanging in the balance. Such disputes are rife with legal, ethical, emotional and scientific complexity. They are frequently highly charged and are often emergent in nature. In recent years, mediation has grown exponentially as a dispute resolution mechanism of choice. Not surprisingly, the success of mediation, and a wider understanding of the process, has led to its application in the realm of healthcare disputes with encouraging results. This course will provide an overview of negotiation fundamentals critical to the practice of mediation followed by an introduction to classical mediation theory and practice. Similarities and differences between mediation in the healthcare field, as distinct from other contexts, will be examined as will special problems highlighted by various commentators in the field. All class members will participate in mediation role-plays designed to simulate disputes prevalent in the healthcare landscape.
BIOE Dilemmas of Doctoring, Instructor: Fuedntner
BIOE 590, Ethical Issues at the End of Life, Instructor: Arthur Caplan
Spring 2005
BIOE 552, Health Disparities, Instructor: Pamela Sankar, Hughes
BIOE 580, Research Ethics, Instructor: Jon Merz
This seminar is intended to give students a broad overview of research ethics and regulation. The students will come out of the class with an understanding of the moral bases of scientific ethics and the historical evolution of biomedical research ethics. Students will be fully conversant with the development, implementation, and limitations of US human subjects regulations. The course includes reading assignments, lectures, discussions, student-led case-based and topical discussions addressing the following topics: ethics and morality in science; science in society; scientific integrity; misconduct; whistleblowing; conflicts of interest; collegiality, publication and authorship; peer review; human experimentation and regulations (HHS, FDA), Institutional Review Boards; informed consent, waivers, vulnerable populations; privacy and the confidentiality of records; epidemiology; and, finally, research on animals. Grade will be based on: an article peer review task 20%; consent form writing task 30%; weekly quizzes 10%; class discussion and participation 10%; and final exam, 30%.
BIOE 602, Conceptual Foundations, Instructor: Autumn Fiester
This course examines the various theoretical approaches to bioethics and critically assesses their underpinnings. Topics to be covered include an examination of various versions of utilitarianism; deonotological theories; virtue ethics; ethics of care; the fundamental principles of bioethics (autonomy, beneficence, distributive justice, non-maleficence); casuistry; and pragmatism. The course will include the application of the more theoretical ideas to particular topics, such as informed consent, confidentiality, and end of life issues.
BIOE 603, Clinical Ethics, Instructor: M. Mahon
The course in clinical ethics provides an opportunity for students to understand and implement processes of clinical decision making. An understanding of ethics as one component of clinical decision making is foundational. Both clinicians and non-clinicians are encouraged to participate; guidance will be provided for those without a clinical background to facilitate integration of clinical dimensions. Students will be required to identify components of ethics in clinical decision making in a variety of settings, including an ethics committee, an intensive care setting, and a non-intensive care setting. Unique challenges of a range of topics within clinical ethics will be discussed.
Fall 2004
BIOE 555, Neuroethics, Instructor: Paul Root Wolpe
Developments in neurotechnology and more sophisticated psychopharmaceuticals have raised new questions in the ways in which we manipulate our mental states. In this class, we will look at a variety of topics in neuroethics -- drugs, implantable brain chips, brain imaging, cochlear implants, lie detection technologies, deep brain stimulators, transcranial magnetic stimulation, brain computer interfaces, forensic neuroscience, neuromarketing, and so on, and look at the astonishing and sometimes troubling technologies that will soon be a part of our therapeutic and civil regimens. Guest speakers and field trips will also be included.
BIOE 551, Medical Errors, Instructor: Charles Bosk
The purpose of Bioethics 551 is to provide a basic understanding of some rather ubiquitous social phenomena: mistakes, errors, accidents, and disasters. We will look at these misfirings across a number of institutional domains: aviation, nuclear power plants, and medicine. Our goal is to understand how organizations “think” about these phenomena, how they develop strategies of prevention, how these strategies of prevention create new vulnerabilities to different sorts of mishaps, how organizations respond when things do grow awry, and how they plan for disasters. At the same time we will also be concerned with certain tensions in the sociological view of accidents, errors, mistakes, and disasters at the organizational level and at the level of the individual. Errors, accidents, mistakes, and disasters are embedded in organizational complexities; as such, they are no one’s fault. At the same time, as we seek explanations for these adverse events, we seek out whom to blame and whom to punish. We will explore throughout the semester the tension between a view that sees adverse events as the result of flawed organizational processes versus a view that sees these events as a result of flawed individuals.
BIOE 552, Ethical Issues in Transplantation: Instructor: Sheldon Zink
No area of medicine is more imbued with ethical controversy than organ transplantation. This is especially true of the politics and strategies used to obtain organs and tissues for transplantation. The course will examine organ and tissue cadaver donation, procurement, the concept of brain death, the evolution of public policy regarding donation in the United Stats and European nations, and prohibitions on selling organs and most tissues. This course will examine issues raised by efforts to insure fair distribution of organs and tissues and the role played by psychosocial, economic and ethical factors in selecting recipients. Questions of the cost of transplant and the overall impact on the American health care system will also be considered. Key legal cases and legislation governing transplant will be examined.
BIOE 601, Proseminar, Instructor Autumn Fiester
This course is intended to serve as a broad introduction to the field of bioethics. The course will focus on three of the most important areas in bioethics: Genetics & Reproduction, Human Experimentation, and End-of-Life. Each module of the course will cover essential bioethics concepts, relevant legal cases, and classical readings on the themes.
BIOE 603, Clinical Ethics, Instructor: M. Mahon
The course in clinical ethics provides an opportunity for students to understand and implement processes of clinical decision making. An understanding of ethics as one component of clinical decision making is foundational. Both clinicians and non-clinicians are encouraged to participate; guidance will be provided for those without a clinical background to facilitate integration of clinical dimensions. Students will be required to identify components of ethics in clinical decision making in a variety of settings, including an ethics committee, an intensive care setting, and a non-intensive care setting. Unique challenges of a range of topics within clinical ethics will be discussed.
Summer 2004
BIOE 551, Sociology of Medicine, Instructor: Charles Bosk
This course is a graduate level introduction to the sociology of medicine. The sociology of medicine is a broad domain both in terms of topics and methodologies. In this course we will explore the following issues: (1) the demographic and cultural dimensions of health and illness; (2) the experience of illness; (3) the profession of medicine; (4) efforts at health care reform; and (5) the emergence of the field of bioethics.
BIOE 554, Sociology of Jewish Bioethics: Instructor: Paul Rot Wolpe
The Sociology of Jewish Bioethics is intended as an upper-level course intended for students with either a background in bioethics, medical sociology, clinical medicine, Judaic Studies, or some combination of those or related fields who can do graduate-level work. The topic is a different one, as the field that will be our subject of inquiry does not, at the present time, exist. We will be creating it throughout the semester. The goal of the course is to understand how inquiry into the formation of Jewish Bioethics (as a prescriptive system) and the nature of the bioethics of people who call themselves Jews (a descriptive pursuit) might best be formulated. The purpose of such an approach is to explore the cultural, social, political, and professional underpinnings of bioethical argumentation and action. Rather than exploring the merits of a position (e.g., is assisted suicide allowable in the Jewish tradition?), we will ask how the debate has been framed, who is promoting which arguments, what debates are taking place within and between denominations, how the Jewish laity may differ from the Jewish religious and secular leadership, and how the "Jewish perspective" is being presented to the wider public.
BIOE 580, Research Ethics, Instructor: Jon Merz
This seminar is intended to give students a broad overview of research ethics and regulation. The students will come out of the class with an understanding of the moral bases of scientific ethics and the historical evolution of biomedical research ethics. Students will be fully conversant with the development, implementation, and limitations of US human subjects regulations. The course includes reading assignments, lectures, discussions, student-led case-based and topical discussions addressing the following topics: ethics and morality in science; science in society; scientific integrity; misconduct; whistleblowing; conflicts of interest; collegiality, publication and authorship; peer review; human experimentation and regulations (HHS, FDA), Institutional Review Boards; informed consent, waivers, vulnerable populations; privacy and the confidentiality of records; epidemiology; and, finally, research on animals. Grade will be based on: an article peer review task 20%; consent form writing task 30%; weekly quizzes 10%; class discussion and participation 10%; and final exam, 30%.
Spring 2004
BIOE 552, Research Workshop, Instructor: Pamela Sankar
This course provides an introduction to social science research design and qualitative methods for students interested in conducting research on issues in bioethics. The course is appropriate both for students who plan to conduct their own research and for those who, rather than conducting research themselves, will use research findings to make or challenge arguments in policy statements or other writings. Emphasis is placed on the logic of research design as the way to relate topic of inquiry with method so that evidence produced is pertinent and useful. Students will design research projects and explore a variety of qualitative methods available to conduct research. Students will also learn to integrate research ethics into the formulation and design of their inquiries.
BIOE 553, Historical Topics in Bioethics, Instructor: Cowan/Caplan
BIOE 580, Research Ethics, Instructor: Jon Merz
This seminar is intended to give students a broad overview of research ethics and regulation. The students will come out of the class with an understanding of the moral bases of scientific ethics and the historical evolution of biomedical research ethics. Students will be fully conversant with the development, implementation, and limitations of US human subjects regulations. The course includes reading assignments, lectures, discussions, student-led case-based and topical discussions addressing the following topics: ethics and morality in science; science in society; scientific integrity; misconduct; whistleblowing; conflicts of interest; collegiality, publication and authorship; peer review; human experimentation and regulations (HHS, FDA), Institutional Review Boards; informed consent, waivers, vulnerable populations; privacy and the confidentiality of records; epidemiology; and, finally, research on animals. Grade will be based on: an article peer review task 20%; consent form writing task 30%; weekly quizzes 10%; class discussion and participation 10%; and final exam, 30%.
BIOE 590 001, Reproductive Ethics, Instructor: McGee
An increasing number of people turn to reproductive technologies for help in their attempts to conceive a child. Over 300,000 babies have been born in the US as a result of reported Reproductive Technology procedures. This class will explore the various ethical issues that these technologies raise. We will address questions such as: Is infertility a disease? Should there be any social restrictions on access to reproductive technologies? What is the status of the human embryo outside the human body? What are the ethical concerns that Pre-implantation Genetic Diagnosis raises? Should it be used only to screen for disease? Or maybe also to choose an embryo that would become a matching donor for a sick sibling? Should sex selection be allowed? What are the implications of gamete donation and surrogacy for the identities of children and families? And how does the use of these different technologies impact family relationships and the way children are perceived and treated? Classes will consist of lectures followed by discussion and debate. Students are expected write a 10 page term paper a take a final exam.
BIOE 590 002, Death and Dying, Instructor: Mahon
BIOE 602, Conceptual Foundations, Instructor: Autumn Fiester
This course examines the various theoretical approaches to bioethics and critically assesses their underpinnings. Topics to be covered include an examination of various versions of utilitarianism; deonotological theories; virtue ethics; ethics of care; the fundamental principles of bioethics (autonomy, beneficence, distributive justice, non-maleficence); casuistry; and pragmatism. The course will include the application of the more theoretical ideas to particular topics, such as informed consent, confidentiality, and end of life issues.
BIOE 603, Clinical Ethics, Instructor: David Doukas
The course in clinical ethics provides an opportunity for students to understand and implement processes of clinical decision making. An understanding of ethics as one component of clinical decision making is foundational. Both clinicians and non-clinicians are encouraged to participate; guidance will be provided for those without a clinical background to facilitate integration of clinical dimensions. Students will be required to identify components of ethics in clinical decision making in a variety of settings, including an ethics committee, an intensive care setting, and a non-intensive care setting. Unique challenges of a range of topics within clinical ethics will be discussed.
Fall 2003
BIOE 550, Media and the Doctor-Patient Relationship: Instructor: Sheldon Zink
Many individuals only experience with medicine is through the clinical encounter. Others understand the medical profession through fictional representations and public discourse. At the other extreme, there are some whose only knowledge of medicine is what they read in the popular press and what is presented by the entertainment industry. In this class, the students will screen several feature films and critique the fictional representation of the clinical encounter. They will attempt to understand how the images could influence relationships between physicians and patients, the individual and illness, and technology and the body. The course will pay special attention to the way power relationships are expressed in the media and in entertainment and the influence of these representations on clinical, moral, and individual decision-making.
BIOE 601, Proseminar, Instructor: Autumn Fiester
This course is intended to serve as a broad introduction to the field of bioethics. The course will focus on three of the most important areas in bioethics: Genetics & Reproduction, Human Experimentation, and End-of-Life. Each module of the course will cover essential bioethics concepts, relevant legal cases, and classical readings on the themes.
BIOE 603, Clinical Ethics, Instructor: David Doukas
The course in clinical ethics provides an opportunity for students to understand and implement processes of clinical decision making. An understanding of ethics as one component of clinical decision making is foundational. Both clinicians and non-clinicians are encouraged to participate; guidance will be provided for those without a clinical background to facilitate integration of clinical dimensions. Students will be required to identify components of ethics in clinical decision making in a variety of settings, including an ethics committee, an intensive care setting, and a non-intensive care setting. Unique challenges of a range of topics within clinical ethics will be discussed.
Summer 2003
BIOE 551, Medical Errors, Instructor: Charles Bosk
The purpose of Bioethics 551 is to provide a basic understanding of some rather ubiquitous social phenomena: mistakes, errors, accidents, and disasters. We will look at these misfirings across a number of institutional domains: aviation, nuclear power plants, and medicine. Our goal is to understand how organizations “think” about these phenomena, how they develop strategies of prevention, how these strategies of prevention create new vulnerabilities to different sorts of mishaps, how organizations respond when things do grow awry, and how they plan for disasters. At the same time we will also be concerned with certain tensions in the sociological view of accidents, errors, mistakes, and disasters at the organizational level and at the level of the individual. Errors, accidents, mistakes, and disasters are embedded in organizational complexities; as such, they are no one’s fault. At the same time, as we seek explanations for these adverse events, we seek out whom to blame and whom to punish. We will explore throughout the semester the tension between a view that sees adverse events as the result of flawed organizational processes versus a view that sees these events as a result of flawed individuals.
BIOE 554, Spirituality and Bioethics
BIOE 580, Research Ethics, Instructor: Jon Merz
This seminar is intended to give students a broad overview of research ethics and regulation. The students will come out of the class with an understanding of the moral bases of scientific ethics and the historical evolution of biomedical research ethics. Students will be fully conversant with the development, implementation, and limitations of US human subjects regulations. The course includes reading assignments, lectures, discussions, student-led case-based and topical discussions addressing the following topics: ethics and morality in science; science in society; scientific integrity; misconduct; whistleblowing; conflicts of interest; collegiality, publication and authorship; peer review; human experimentation and regulations (HHS, FDA), Institutional Review Boards; informed consent, waivers, vulnerable populations; privacy and the confidentiality of records; epidemiology; and, finally, research on animals. Grade will be based on: an article peer review task 20%; consent form writing task 30%; weekly quizzes 10%; class discussion and participation 10%; and final exam, 30%.
BIOE 590, Feminism and Bioethics
Spring 2003
BIOE 553, Historical Topics in Bioethics, Instructor: David Magnus
BIOE 560, Primary Care Bioethics: Dilemmas Through the Life Cycle, Instructor: David Doukas
This "first of its kind" graduate level course will examine how medical ethics is intrinsic to primary care medicine. Family medicine is a broad domain of clinical care, and a source of many problematic cases relevant to bioethics research, policy, and education. This course shifts the venue of discussing bioethics from a traditional tertiary care center locale to the setting of the primary care office. The instructor (a family physician and scholar in bioethics) will examine life cycle bioethical issues in primary care practice, including prenatal care, genetic testing, pediatric and adolescent care issues, ethics in prevention, informed consent, "compliance," truth telling, privacy, health system issues, family-based issues of care and consent, and end-of-life care. This course will be case-based and will use extensive discussion and role play, including the involvement of guest primary care practitioners.
BIOE 580, Research Ethics, Instructor: Jon Merz
This seminar is intended to give students a broad overview of research ethics and regulation. The students will come out of the class with an understanding of the moral bases of scientific ethics and the historical evolution of biomedical research ethics. Students will be fully conversant with the development, implementation, and limitations of US human subjects regulations. The course includes reading assignments, lectures, discussions, student-led case-based and topical discussions addressing the following topics: ethics and morality in science; science in society; scientific integrity; misconduct; whistleblowing; conflicts of interest; collegiality, publication and authorship; peer review; human experimentation and regulations (HHS, FDA), Institutional Review Boards; informed consent, waivers, vulnerable populations; privacy and the confidentiality of records; epidemiology; and, finally, research on animals. Grade will be based on: an article peer review task 20%; consent form writing task 30%; weekly quizzes 10%; class discussion and participation 10%; and final exam, 30%.
BIOE 590, Classic Papers in Bioethics, Instructor: Arthur L. Caplan
The twenty-five years from 1968 to 1993 represent the crucial years in the rise of contemporary bioethics. During this time bioethics emerged as a distinctive intellectual pursuit within universities, academic medical centers and in American culture. Core area of consensus, as reflected in law and legal opinions, concerning human experimentation, the definition of death, policies governing the withdrawal of treatment and organ donation, truthtelling, and the centrality of patient autonomy also emerged. This is also the period during which the classic 'canon' of articles in bioethics began to emerge in anthologies, textbooks, journals and course syllabi.
This course will examine some of the key articles that defined the field, look at crucial events during this period such as Tuskegee, the AIDS epidemic, the birth of the first 'test tube' baby-Louise Brown, the deaths of Karen Ann Quinlan and Nancy Cruzan, the first uses of artificial hearts and animal organs for transplants, and the rise of ethics committees and Institutional Review Boards. Some of the key institutions that shaped the field such as the Hastings Center, the Kennedy Institute, the President's Commission on Biomedical And Behavioral Research, as well as the writings of key figures in philosophy, theology, medicine, law and the social sciences will be examined.
This course will be run as a seminar. Some background in contemporary bioethics is a prerequisite. Students will be expected to write a 25 page paper which must be completed by the last day of class. Each student will be expected to present a draft or outline of their paper in class. The paper will count for 80% of the student's grade, class participation 20%.
BIOE 602, Conceptual Foundations, Instructor: Autumn Fiester
This course examines the various theoretical approaches to bioethics and critically assesses their underpinnings. Topics to be covered include an examination of various versions of utilitarianism; deonotological theories; virtue ethics; ethics of care; the fundamental principles of bioethics (autonomy, beneficence, distributive justice, non-maleficence); casuistry; and pragmatism. The course will include the application of the more theoretical ideas to particular topics, such as informed consent, confidentiality, and end of life issues.
Summer and Fall 2002
BIOE 550, Narrative and Bioethics, Instructor: Carol Schilling (Summer)
In its broadest interests, our seminar concerns the moral work of stories. Within that framing interest we will concentrate on debates in the developing discipline of bioethics regarding: (1) the ways bioethics uses narrative representations to constitute itself as a discipline, (2) the uses of stories in the construction of moral agency in medical events, and (3) the effect of unacknowledged theories of stories on our ethical debates. Primary texts for the seminar are Tod Chambers, The Fiction of Bioethics (1999); Hilde Nelson, Damaged Identities, Narrative Repair (2001); David Feldshuh, Miss Evers’ Boys (1989).
BIOE 551, Sociology of Medicine, Instructor: Charles Bosk
This course is a graduate level introduction to the sociology of medicine. The sociology of medicine is a broad domain both in terms of topics and methodologies. In this course we will explore the following issues: (1) the demographic and cultural dimensions of health and illness; (2) the experience of illness; (3) the profession of medicine; (4) efforts at health care reform; and (5) the emergence of the field of bioethics.
BIOE 590, Genetics and Ethics, Instructor: Magnus
BIOE 601, Proseminar, Instructor: Magnus
BIOE 603, Clinical Ethics, Instructor: M. Mahon
The course in clinical ethics provides an opportunity for students to understand and implement processes of clinical decision making. An understanding of ethics as one component of clinical decision making is foundational. Both clinicians and non-clinicians are encouraged to participate; guidance will be provided for those without a clinical background to facilitate integration of clinical dimensions. Students will be required to identify components of ethics in clinical decision making in a variety of settings, including an ethics committee, an intensive care setting, and a non-intensive care setting. Unique challenges of a range of topics within clinical ethics will be discussed.
BIOE 604, Empirical Methods in Bioethics: Instructor: Pamela Sankar
This course provides an introduction to social science research design and methods for students interested in conducting research on issues in bioethics. The course is appropriate for students who, rather than conducting research themselves, will use research findings to make or challenge arguments in policy statements or other writings. Emphasis is placed on the logic of research design as the way to relate topic of inquiry with method so that evidence produced is pertinent and useful. Students will design research projects and explore a variety of methods available to conduct research. Students will also learn to integrate research ethics into the formulation and design of their inquiries.