Biomedical Ethics (Bioethics and Biolaw) Spring 2004.. Course Instructor: Sinead Bresson Ladegaard Knox. Mag. art. (Philosophy, University of Copenhagen, 1998). Cand. mag. (Philosophy and Theatre, University of Copenhagen, 1993). Studied, worked and lived in Paris, France 1989-98. Center for Ethics and Law, University of Copenhagen, 1998 and 2000. Visiting scholar (fellowship) at The Hong Kierkegaard Library, St. Olaf College, Minnesota, USA, 1999. Lecturer at People's University, Copenhagen. Co-editor of international bibliography, Dignity. Ethics and Law, 1999. Visiting lecturer at St. Olaf College, Minnesota, USA, since 2002. With DIS since 2000. Introduction to the course: Biology is the study of life. Biotechnology is the industrial application of our knowledge of life. Science and technology in the 20th century have provided mankind with the power to manipulate the make-up of man. The fear and perplexity that many people, patients and non-patients, feel towards much biology, medicine and biotechnology show the need for ethical reflection. This course focuses on biomedical ethics which concerns the identification, analysis and resolution of ethical questions and problems arising in planning for the care of patients. But science and technology have not only called for a bio-ethics. Once laws define the limits to intervention in the lives of all living beings, then law is no longer merely a superstructure to the given social establishment, but an expression of the respect which people ought to have for man's body and nature in general. The complexity and questions of biomedical ethics are great, because it touches the very core of what it means to be a human being. What is man and what do we want man to become? Course objectives: The primary objective of this course is to provide students with the intellectual tools requisite for examining fundamental questions in biomedical ethics, in particularly clinical ethics. The course aims to discover connections between ethical conceptions, judicial practices and legislative procedures and to seek a clarification within the complexity of biomedical ethics and the attempt to legislate morality. Given this, secondary objectives include familiarizing the students with the two classical forms of ethical argumentation and evaluation. 1
The course will focus on biomedical ethics in Europe. Hence, it will give an in depth demonstration of the four ethical principles (autonomy, dignity, integrity and vulnerability) that the EU and the Danish Government are supporting as basic principles to be respected in bio- and genetechnology. Course Content: The course is basically broken down into 3 different aspects of the subject: 1. Ethics: The Two Classic Approaches to Ethics and The Four Ethical Principles in Bioethics & Biolaw will introduce the student to the teleological and deontological way of thinking ethics. The student will learn to identify and argue from these two different ethical perspectives. The student will also examine the ethical foundation of the European way of viewing the problems involved in biomedical ethics. 2. Concrete Issues in Biomedical Ethics will show the body as the axe around which the questions and problems in bioethics and biolaw revolve: the body as an integral part of being an individual or the body as a thing to be regarded as an object and/ or a commodity. The focus is on biomedical ethics (as opposed to research bioethics, animal bioethics or environmental bioethics). 3. International Bioethics will start out by discussing European policy as regards to bioethics and biolaw. Then it will attempt to understand the culture and civilization in which biomedical ethics exist. The characteristics of and the gap between modernism and postmodernism will be examined as well as the question about establishing the ethical bottom line. Class Meetings: Mondays and Thursdays from 13:50-15:10 p.m. Consultation: By appointment (#35 35 55 77), e-mail (knox101@vip.cybercity.dk) or after class. Field Study: Lundbeck (Medical Industry). Wednesday, April 21st at 10 a.m. Guest Speaker: Professor, Dr. Anne Grete Byskov, Head of Department Laboratory of Reproductive Biology. Monday, April 26. 2
Classroom activity: There will be brief lectures followed by discussions. The discussions, led by the professor, will take the form of a facilitated dialogue between the professor and the students. There will be reading assignments for each class. In the course of the semester there will be: Three short essays (2-3 pages) to be written. One class case study (oral and written). A 2 hour written Midterm exam and a 2 hour written Final exam (no books or notes allowed In a class like this, active attendance is crucial. Each student is expected to come prepared to discuss the assigned material, the lecture and to complete all assignments. Others cannot benefit from your input if you are not present or prepared. Absence must be explained in written form (letter or email) on your return. All written assignments and exams must be completed to pass course. Course Evaluation: Participation: 15% Class Case Study: 15% Three short essays: 15% Midterm: 20% Final term: 35% Course Literature: Textbook: Bioethics. An Anthology, Eds. Helga Kuhse & Peter Singer, Blackwell 1999. Principles of Biomedical Ethics, Tom L. Beauchamp & James F. Childress, Oxford University Press, 1994. Course Binder: Understanding Our Genetic Inheritance. The US Human Genome Project: The Five Years, FY 1991-1995. US Department of Health and Human Services, US Department of Energy. Blueprint of The Body. On the Threshold of a Brave New World, by Carol Clark, June 2000, CNN Interactive. 3
A Companion to Bioethics, edited by Helga Kuhse & Peter Singer, Blackwell Companions to Philosophy, Blackwell 1998, pp. 3-11. A Companion to Bioethics, edited by Helga Kuhse & Peter Singer, Blackwell Companions to Philosophy, Blackwell 1998, pp.15-23 & 80-86. Monkey Business in Time Magazine, January 22, 2001. Definition of the Basic Principles in Bioethics and Biolaw, by Jacob Rendtorff, EU Project Biomed II, Working Papers, Research Project, 1997, pp. 7-19. Integrity and Vulnerability in Clinical Medicine: The Dialectic of Appeal and Response, by Richard Zaner, in Bioethics and Biolaw, eds. Kemp, Rendtorff & Johansen, Vol. II, Rhodos International Science & Art Publishers, Copenhagen 2000, pp.123-140. A Companion to Bioethics, edited by Helga Kuhse & Peter Singer, Blackwell Companions to Philosophy, Blackwell 1998, pp. 425-439. Professional codes in Contemporary Issues in Bioethics, 4th edition, 1994, Wadsworth Publishing Company. Eds. Tom L. Beauchamp & Leroy Walters. AIDS and a Duty to Protect in Cases in Bioethics, pp. 43-46. Prepared by Bette-Jane Crigger, St. Martin's Press, 1998. The Equitable Allocation of Limited Resources in Ethics Codes in Medicine, Ashgate 1998, pp. 305-311. Justice in the Distribution of Health Care in Contemporary Issues in Bioethics, 4 th edition, 1994, Wadsworth Publishing Company. Eds. Tom L. Beauchamp & Leroy Walters, pp. 675-682. Two Cardiac Arrests, One Medical Team in Cases in Bioethics, pp. 234-238. Prepared by Bette-Jane Crigger, St. Martin's Press, 1998. Can the Fetus Be an Organ Farm? in Cases in Bioethics, pp. 263-268. Prepared by Bette-Jane Crigger, St. Martin's Press, 1998. Sciences of the Brain & Genetic Engineering in Our Posthuman Future. Consequences of the Biotechnology Revolution, by Francis Fukuyama. Profile Books, 2002. A Companion to Bioethics, edited by Helga Kuhse & Singer, Blackwell Companions to Philosophy, Blackwell 1998, pp.189-197. Designing Genes, The Patenting of Life & The Monopoly on Humanity, in The Human Body Shop: The Cloning, Engineering, and Marketing of Life, by Andrew Kimbrell, Gateway 1997, pp. 157-165; 225-242; 246-254. Ethical, Legal and Social Aspects of the Life Sciences and Technologies Programmes of the Fourth Framework Programme, European Commission, 1998, pp. 9-15, 30-31. III (Notices) Commission. Official Journal of the European Communi.ties, 1999. The Convention on Human Rights and Biomedicine, Council of Europe, 1997. 4
A Theory of International Bioethics: Multiculturalism, Postmodernism, and the Backruptcy of Fundamentalism, by Robert Baker. In Kennedy Institute of Ethics Journal, vol. 8, no. 3,1998, pp. 201-231. A Theory of International Bioethics: The Negotiable the Non-Negotiable, pp. 233-273, by Robert Baker. In Kennedy Institute of Ethics Journal, vol. 8, no. 3, 1998. The Mettle of Moral Fundamentalism: A Reply to Rober Baker, by Tom L. Beauchamp. In Kennedy Institute of Ethics Journal, vol. 8, no. 4, 1998, pp. 389-401. A Defense of Fundamental Principles and Human Rights: A Reply to Robert Baker, by Ruth Macklin. In Kennedy Institute of Ethics Journal, vol. 8, no. 4, 1998, pp. 403-422. A Companion to Bioethics, edited by Helga Kuhse & Singer, Blackwell Companions to Philosophy, Blackwell 1998, pp. 316-325. Always bring the assigned reading as well as this syllabus to class. 5
SEMESTER SCHEDULE: Thursday, February 5: Biotechnology: New Dimension of and Challenge to Ethics and Law. 1) Bioethics. An Anthology,Eds. Helga Kuhse & Peter Singer, Blackwell 1999. Textbook, pp. 1-7. 2) Understanding Our Genetic Inheritance. The US Human Genome Project: The First Five Years, FY 1991-1995. US Department of Health and Human Services, US Department of Energy. Course Binder. 3) Blueprint of The Body. On the Threshold of a Brave New World, by Carol Clark, June 2000, CNN Interactive. Course Binder. 4) A Companion to Bioethics, edited by Helga Kuhse & Peter Singer, pp. 3-11. Course Binder. 1. The Two Basic Approaches to Ethics: A Companion to Bioethics, edited by Helga Kuhse & Peter Singer, Blackwell Companions to Philosophy, Blackwell 1998, page 15-23 is the reading assignment for both classes. Monday, February 9: The Two Basic Approaches to Ethics: a) Teleological. 1) Principles of Biomedical Ethics, Tom L. Beauchamp & James F. Childress, Oxford University Press, 1994. Textbook, pp. 47-55. 2) A Companion to Bioethics, edited by Helga Kuhse & Peter Singer, Blackwell 1998, pp. 15-23 & 80-86. Course Binder. 6
Thursday, February 12: The Two Basic Approaches to Ethics: b) Deontological. 1) Principles of Biomedical Ethics, Tom L. Beauchamp &James F. Childress, Oxford University Press, 1994. Textbook, pp. 56-62. 2) A Companion to Bioethics, edited by Helga Kuhse & Peter Singer, Blackwell 1998, pp. 15-23. Course Binder. 3) MonkeyBusiness intimemagazinejanuary 22, 2001. Course Binder. Four Ethical Principles in Bioethics & Biolaw: Monday, February 16: Four Ethical Principles in Bioethics & Biolaw. a) Autonomy b) Dignity 1) Definition of the Basic Principles in Bioethics and Biolaw, by Jacob Rendtorff, EU Project Biomed II, Working Papers, Research Project, 1997, pp. 7-14. Course Binder. 2) Principles of Biomedical Ethics, Tom L. Beauchamp & James F. Childress, Oxford University Press, 1994. Textbook, pp. 120-132. Election of two class reps Introduction to essay number 1 (2-3 pages). Due February 23. No class Thursday, February 19. 7
Monday, February 23: Four Ethical Principles in Bioethics & Biolaw c) Integrity d) Vulnerability Essay 1 due (2-3 pages). 1) Definition of the Basic Principles in Bioethics and Biolaw, by Jacob Rendtorff, EU Project Biomed II, Working Papers, Research Project, 1997, pp. 14-19. Course Binder. 2) Integrity and Vulnerability in Clinical Medicine: The Dialectic of Appeal and Response, by Richard Zaner, in Bioethics and Biolaw, eds. Kemp, Rendtorff & Johansen, Vol. II, Rhodos International Science & Art Publishers, Copenhagen 2000, pp. 123-140. Course Binder. 2. Concrete issues in Biomedical Ethics: Thursday, February 26: Professional-Patient Relationship 1) A Companion to Bioethics, pp. 425-439. Edited by Helga Kuhse and Peter Singer. Course Binder. 2) Professional Codes in Contemporary Issues in Bioethics, 4th Edition 1992. Course Binder. Introduction to essay number 2 (2-3 pages). Due Thursday, March 4. Monday, March 1: Professional-Patient Relationship 1) AIDS and a Duty to Protect in Cases in Bioethics, pp. 43-46. Prepared by Bette-Jane Crigger, St. Martin's Press, 1998. 2) A Companion to Bioethics, pp. 425-431. Edited by Helga Kuhse and Peter Singer. Course Binder. 8
Thursday, March 4: Essay 2 due (2-3 pages). Resource Allocation 1) The Equitable Allocation of Limited Resources in Ethics Codes in Medicine, Ashgate 1998, pp. 305-311. Course Binder. 2) Justice in the Distribution of Health Care in Contemporary Issues in Bioethics, 4th Edition 1992, pp. 675-682. Course Binder. 3) Two Cardiac Arrests, One Medical Team in Cases in Bioethics, pp. 234-238. Prepared by Bette-Jane Crigger, St. Martin's Press, 1998. Monday, March 8: Euthanasia Bioethics. An Anthology, Eds. Helga Kuhse & Peter Singer, Blackwell 1999. Textbook, pp. 211-214; 236-239; 323-338. Preparation for Midterm. Midterm exams: Tuesday 9 through Friday 12. AFTER MIDTERM Monday, March 15: Class case study: Euthanasia. Presentation: Thursday, May 8. Class is divided into four groups: Politicians, Doctors, Lawyers and Individuals. Written group presentation of main arguments due May 6 (2-3 pages). Thursday, March 18: Organ donation 1) Bioethics. An Anthology, Eds. Helga Kuhse & Peter Singer, Blackwell 1999. Textbook, pp. 383-403. (continued...) 9
2) Can the Fetus Be an Organ Farm? in Cases in Bioethics, pp. 263-268. Prepared by Bette-Jane Crigger, St. Martin's Press, 1998. Monday, March 22: We will watch the movie Gattaca. Discussion follows after snack. NB: Class starts at 5:15 p.m. (to 8 p.m.) at DIS 31. Sciences of the Brain & Genetic Engineering in Our Posthuman Future. Consequences of the Biotechnology Revolution, by Francis Fukuyama. Profile Books, 2002. This is a double class (i.e. no class on Thursday, March 25). Spring break from March 27 to April 18. Thursday, March 25: No class due to double class Monday, March 22. AFTER STUDY TOUR AND SPRING BREAK Monday, April 19: Gene Technology 1) A Companion to Bioethics, edited by Helga Kuhse & Peter Singer, Blackwell Companions to Philosophy, Blackwell 1998: Gene Therapy by Ruth Chadwick, pp. 189-197. Course Binder. 2) Designing Genes, The Patenting of Life & The Monopoly on Humanity, in The Human Body Shop: The Cloning, Engineering, and Marketing of Life, by Andrew Kimbrell, Gateway 1997, pp. 157-165; 225-242; 246-254. Course Binder. Introduction to essay number 3 (2-3 pages). Due Monday, April 26. 10
Thursday, April 22: Reproduction Technology 1) Bioethics. An Anthology, Eds. Helga Kuhse & Peter Singer, Blackwell 1999. Textbook, pp. 87-102. Monday, April 26: Essay no 3 due. Guest Speaker: Professor, Dr. Anne Grete Byskov, Head of Department Laboratory of Reproductive Biology. To be handed out. 3. International Bioethics: Thursday, April 29: Bioethical Legislation in Europe -the EU 1) Ethical, Legal and Social Aspects of the Life Sciences and Technologies Programmes of the Fourth Framework Programme, European Commission, 1998, pp. 9-15, 30-31. Course Binder. 2) III (Notices) Commission. Official Journal of the European Communities, 1999. Course Binder. Monday, May 3: Council of Europe 1) The Convention on Human Rights and Biomedicine, Council of Europe, 1997. Course Binder. Thursday, May 6: Presentation of class case study: Euthanasia. Discussion of Findings. Written presentation of main arguments due (2-3 pages). 11
Monday, May 10: Between Modernism and Postmodernism 1. A Theory of International Bioethics: Multiculturalism, Postmodernism, and the Backruptcy of Fundamentalism, pp. 201-231 2. A Theory of International Bioethics: The Negotiable and the Non-Negotiable, pp. 233-273, by Robert Baker. In Kennedy Institute of Ethics Journal, vol. 8, no. 3,1998,. Course Binder. 3) The Mettle of Moral Fundamentalism: A Reply to Rober Baker, by Tom L. Beauchamp. In Kennedy Institute of Ethics Journal, vol. 8, no. 4, 1998, pp. 389-401. Course Binder. 4) A Defense of Fundamental Principles and Human Rights: A Reply to Robert Baker, by Ruth Macklin. In Kennedy Institute of Ethics Journal, vol. 8, no. 4,1998, pp. 403-422. Course Binder. Thursday, May 13: Between Modernism and Postmodernism 1. A Theory of International Bioethics: Multiculturalism, Postmodernism, and the Backruptcy of Fundamentalism, pp. 201-231 2. A Theory of International Bioethics: The Negotiable and the Non-Negotiable, pp. 233-273, by Robert Baker. In Kennedy Institute of Ethics Journal, vol. 8, no. 3,1998,. Course Binder. 3) The Mettle of Moral Fundamentalism: A Reply to Rober Baker, by Tom L. Beauchamp. In Kennedy Institute of Ethics Journal, vol. 8, no. 4, 1998, pp. 389-401. Course Binder. 4) A Defense of Fundamental Principles and Human Rights: A Reply to Robert Baker, by Ruth Macklin. In Kennedy Institute of Ethics Journal, vol. 8, no. 4,1998, pp. 403-422. Course Binder. 12
Monday, May 17: The Ethical Bottom Line. l)bioethics. An Anthology,Eds. Helga Kuhse & Peter Singer, Blackwell 1999. Textbook, pp. 365-379 & 553-569. 2) A Companion to Bioethics, edited by Helga Kuhse & Singer, Blackwell 1998, pp. 316-325. Course Binder. Preparation for Final Exam. Final exams: from Monday 24 to Friday 28.... The best of luck to you 13