Course:
Morality and Medicine
History and Philosophy of Science 0613
Spring, 2002
Lecture: Monday, Wednesday, and Friday, 1:00—1:50 in Cathedral of Learning 235

Instructor Information:
Instructor: Professor James Tabery
Office: Cathedral of Learning, G5A
Phone#: (412) 624-3181
E-mail: jgt1@pitt.edu
Office Hours: Monday and Friday, 2:00—3:00, and by appointment in CL G5A
Student Contacts:
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Course Description and Objectives:
The 20th century has brought with it some of the most important biomedical discoveries in history. But this knowledge has brought with it many bioethical dilemmas. Whether you are going to become a doctor or a studio artist, you will eventually be faced with important medical decisions with many ethical ramifications: Do you have a right to request a physician to assist your suicide? When should a developing fetus be considered a person? What is the advantage of the U.S.’s health care system being based on a free market? From birth, through life, and including the process of dying, we are all faced with medical situations that force us and others to make decisions. How you answer these questions in many ways defines how you conceptualize life. This course is designed to help you face these questions. It is applicable to anyone ready to learn about and reflect on his or her own philosophical approach to life. 

The primary goal of this course is to familiarize yourself with a sample of the many bioethical debates that are currently being discussed in our society. This process proceeds in two steps:
1.	First, classic cases will be discussed where the bioethical issues first arose or first became famous. Learning the details of these cases provides the initial framework by which the bioethical discussion will focus.
2.	Secondly, classic bioethical works will be read that discuss the ethical issues arising from the previously mentioned cases.

Beyond this general course goal, each specific bioethical issue raises important questions of its own. These questions will be the focus of the classic works we read and the class discussions we create. The more specific learning goals, then, are directed towards discussing and identifying the positions on the following issues/questions:
A. How do we decide if a patient is competent? Furthermore, how are we obligated to treat incompetent patients?
B. How do we define “personhood”? 
C. Who decides what makes a life worth living?
D. Should physicians help terminally ill patients commit suicide?
E. Is there a moral difference between killing and letting die? 
F. What moral principle(s) should guide medical practice?
G. What is the difference between actual and potential?
H. Why is it wrong to “play God” or “interfere with nature”? 
I. What does it mean to have a right? How does that right obligate others?
J. How do we distinguish between genetic and environmental causes of human characteristics?
K. What is eugenics, and why is it wrong? 
L. How do we decide how to allocate scarce resources?
M. How do we judge responsibility?
N. What is the trade-off between a universalized and a free market approach to health care? 
Required Texts:
1. Classic Works in Medical Ethics (CW), Gregory Pence (ed.), McGraw Hill 1998
2. Classic Cases in Medical Ethics, third edition (CC), Gregory Pence, McGraw Hill 2000
*These texts can be purchased at the bookstore, but don’t be afraid to shop around. Take advantage of your rights as a consumer! 

The Learning Environment:
Material will be presented and processed in a variety of ways in this class. Lectures are designed to provide the most important components of both the cases and the bioethical works; they will rarely last more than 10-15 minutes any class. Class Discussions occur between the students and professor and between the students alone. You will be expected to participate in the discussions that develop pertaining to the various issues. Question Generation is a period where the students identify the important bioethical questions that relate to the issue to be discussed; this exercise takes place after each classic case has been presented. Finally, Group Work consists of small groups (4-5 students). You will be given a variety of topics and bioethical problems to solve in these groups. The goal is to establish some consensus in your group around a bioethical issue and be able to defend this position against other groups’ positions. Group Work will take place in the classroom; there is no graded group assignment apart from your class participation (see below). 

Grading:
Your grade will be based on the following 5 criteria:
1.	Class Participation (10 points)
2.	Quizzes (15 points: 6 quizzes=100 possible points, multiplied by 0.15)
3.	5-page Essay (25 points)
4.	Mid-term Exam (25 points)
5.	Final Exam (25 points)
A+ = 100-97		C+ = 79-77
A = 96-93		C = 76-73
A- = 92-90		C- = 72-70
B+ = 89-87		D+ = 69-67
B = 86-83		D = 66-63
B- = 82-80		D- = 63-60
			F = 59-0
Class Participation comes in a variety of ways. There will be Group Work at least once a week. Also, a period of Question Generation occurs at the introduction of every new bioethical issue. In this portion of the class, the students identify the important questions that surround the issue to be discussed. Finally, much of the class is spent discussing the various issues. This discussion may be facilitated by the professor, but it will be between both the professor and the students and between the students themselves. Your class participation score will be based on your participation in all of these different learning environments.

Quizzes will be given, on average, every other week. They will only cover the material covered since the last week. The questions will be based on both the readings and the class work. The quizzes will be almost entirely multiple choice with a short-answer question here and there.

The Essay is designed to help you practice reconstructing a bioethical argument and then responding to it with your own critical evaluation and personal position on a bioethical issue. You will have the option of choosing between two different essay questions on two different bioethical topics. The questions will be given three weeks before the paper is due. Included with the essay assignment will be a grading rubric describing how the essays will be graded. The first drafts will receive extensive comments. You will then have another week to respond to these comments and make adjustments where necessary/suggested. 

The Mid-Term and the Final Exam are both structured alike and worth the same amount towards your final grade (25%). There will be ten objective questions (5 multiple choice and 5 matching). These questions will each be worth 1 point. In addition, you will answer 3 essay questions from a list of 5 available questions. These essay questions are each worth 5 points. The Final Exam will only cover the material discussed after the Mid-Term (i.e. It is not cumulative.)

Class Policies:
Class attendance will be taken every class. It does not directly affect your grade, but quizzes and exams will cover material not in the texts. Therefore, you should either consult the professor or a fellow classmate if any lectures are missed. 

The dates of the Mid-Term, Final Exam, and Essay are strict. If either of the exams cannot be attended, a typed explanation with appropriate documentation must be given to me before or within one week after the exam dates. Regarding the Essay, a letter grade will be lowered from the final grade for each day the paper is late. This applies to both the first draft and the final draft. The Quizzes are more flexible. If you cannot take the Quiz on the assigned date, then you must schedule a date/time to take the Quiz within two days before or after the actual date (omitting weekends).  

Cheating/Plagiarism are widely frowned upon throughout the university and so are not taken kindly to in this class. Anyone caught cheating during a quiz or exam, or anyone caught plagiarizing an essay, will have the quiz/exam/paper confiscated, and a zero will be given to the work. 

Everybody has disabilities of some sort. If you have a disability that requires special testing accommodations or other classroom modifications, then please notify both the instructor and Disability Resources and Services (DRS) by the second week of class. DRS can be contacted at 648-7890 or at http://www.pitt.edu/~osaweb/drs/drs.html. This office is located in the William Pitt Union, Room 216.

There are no prerequisites for this course.   

Semester Schedule:

Week	Class Date	
Topic(s) to be Discussed	Learning Goals	
Reading Assignments	
1
	January 7	Moral Reasoning and Ethical Theories/Principles	F	CC: 1—25 	
2	January 14	Comatose Adults	A, C,E,F, I	CC: 29—55
CW: 21—26 	
3	January 21	Active vs. Passive Euthanasia	D, E,F,I	CW: 27—41
Quiz#1	
4	January 28	Assisted Suicide and Active Euthanasia	C, D,E,F,I	CC: 56—113
CW:45--66	
5	February 4	Assisted Suicide and Active Euthanasia	C,D,E,F,I	CW: 67—80
Quiz#2	
6	February 11	Imperiled Infants	B, E, F, G, I, K	CC:196—222
CW:203—228
Mid-Term Exam	
7	February 18	Assisted Reproduction and Cloning	B, H, I, K	CC:117—141
CW:83—124
Quiz#3	
8	February 25	Abortion	B, C, I, M	CC:169—195
CW:153--200	
9	March 11	Genetic Screening and Genetic Engineering	C, H, J, K	CC:388—416
CW:315—323
First draft of essay due	
10	March 18	Genetic Screening and Genetic Engineering	C, H, J, K	CW:324—356
Quiz#4
First draft of essay returned	
11	March 25	Transplantation	C, L, M	CC:299-339
CW:262—285
Quiz#5
Final draft of essay due	
12	April 1	Health Care	F, I, L, N	CC:447—473
CW:367--381	
13	April 8	Animal Rights	A, B, C, I	CC:225—246
CW:231—246
Quiz#6	
14	April 15	Ethics in the Organization	All issues relevant	http://classes.kumc.edu/son/
nurs440/generic/readings/
introduction_to_clinical_ethics
.pdf	
	April 24	Final Exam		8:00am—9:50am in CL235