Dr. Jessica Flanigan
119f Jepson Hall
Drop-in office hours: Wednesdays 3-5
flanigan@richmond.edu
In this class, we will discuss ethical decision-making in healthcare from the perspective of patients, physicians, researchers, and policymakers. In Part 1, we will mainly address clinical ethics. For example, what can physicians permissibly do and what are patients entitled to request?
In Part 2, we turn to health policy. Do medical innovations like human enhancement and radical life extension threaten our moral equality? What about kidney taxes and organ markets? Is paternalism appropriate in public health or research contexts? Does everyone have a right to healthcare, and if so, how much? Are people entitled to elective treatments, enhancements, and life-extension technology?
Part 3 addresses procreative ethics. What do we owe future people? Are there any ethical principles that should inform the kinds of people we create? Is abortion permissible? Is commercial surrogacy permissible? Together, these readings and discussions will provide an introduction to the range of ethical questions that arise in modern medicine and medical research.
This course is designed to give students a better understanding of medical ethics and the ethics of public health. The main learning outcomes center on discovery and creation:
Students will discover philosophical perspectives that change the way they think about the ethics of healthcare.
Students will develop skills that enable them to develop and evaluate moral arguments.
Students will critically evaluate real-world ethical dilemmas in healthcare in order to better understand concepts like consent, wellbeing, and justice.
Students will create original philosophical essays that address the ethics of healthcare.
PART 1: CLINICAL ETHICS
Week 1: Methods
M: Welcome to Y2K
W: Medical Ethics and Philosophy
Savulescu- Why Bioethics Needs Philosophy
Week 2: Consent
M: Paternalism
Buchanan, “Medical Paternalism”
Hippocratic Oaths
W: Children’s Medical Rights and Consent through time
Dare- Parental Rights and Medical Decisions
Davis, Precedent Autonomy and Subsequent Consent AAP statement
Week 3: Addiction and Paternalism
M: Addiction and Choice
Foddy and Savulescu- A Liberal Account of Addiction
W: Drugs and Public Health
Voigt- Smoking and Social Justice
Earp et al- Racial Justice and the War on Drugs
Week 4: Euthanasia and Death
M:Death By Choice
Velleman- A Right to Self Termination?
Fisher- Swiss Right to Die Clinics
W:- Survival
Parfit- Why Our Identity is Not What Matters
Aviv- What does it mean to die?
Week 5- Impairment and Disability
M: MIDTERM #1
W: Impairment
Howard and Aas- On Valuing Impairment
Savulescu- Disability: A Welfarist Approach
Week 6- Allocation
M: Modification
Bayne and Levy- Amputees by Choice
Minerva- Invisible Discrimination
W: Healthcare Systems
Cochrane: After the ACA
Persad et al- Principles of Allocation of Scarce Interventions
Week 7- Organs, Tissue, and Markets
M: Organ Markets McGrath “Organ Procurement, Altruism, and Autonomy” Satz “The Moral Limits of Markets: The Case of Human Kidneys”
W:- Organ Confiscation Fabre- Organ Confiscation
Week 8- Fall Break
W: Pandemics
Blumenthal Barby- Payment of COVID-19 challenge trials
Flanigan- Compulsory Vaccination
PART III- Procreative Ethics
Week 9: Conception
M: M: MIDTERM #2
W: The non-identity problem
Parfit- The Non-Identity Problem
Week 10: Creation Ethics
M: Designer Babies
Savulescu- Procreative Beneficence
Sandel- The Case Against Perfection
W: Transhumanism and Equality
Bostrom, The Reversal Test
Bostrom, “The Fable of the Dragon Tyrant”
Week 11: Pregnancy and Maternal Rights
M:Assisted Reproduction
McLachlan and Swales- Babies, Child Bearers, and Commodification
Anderson- Commercial Surrogate Motherhood
W:Maternal Rights
Thomson- “A Defense of Abortion”
Week 12: Pregnancy and Moral Status
M: A fetus has moral status
Marquis- Why Abortion is Immoral
Liao- The Basis of Human Moral Status
W:A fetus only has moral status in some cases
Harman- Creation Ethics
Week 13: Pregnancy and Moral Status
M: A fetus does not have moral status
Tooley- Abortion and Infanticide
W:Birth
Warren- The Moral Significance of Birth
Week 14: Meta-Normative Solutions
M: We don’t know whether a fetus has moral status
Moller- Abortion and Moral Risk
Week 15:
Weight
15% Midterm #1
15% Midterm #2
25% Final Exam
5% Class Participation
10% Reading Notes
30% Essay
Late Penalties
I will apply a ⅓ grade late penalty to your final essay grade if you do not meet with me and submit a thesis outline by week 5
I will apply a ⅓ grade late penalty to your final essay grade if you do not submit a draft by week 10
Final submissions are due by the end of week 15
Numerical grades
All grades correspond to numbers.
The numerical values for final letter grades are:
A+ 100-97
A 96.99-94
A- 93.99-90
B+ 89.99-87
B 86.99-84
B- 83.99-80
C+ 79.99-77
C 77.99-74
C- 73.99-70
D+ 69.99-67
D 66.99-63
D- 63.99-60
Participation (5%)
Your participation grade is based on how well you contributed to class discussions and activities and how often you attended class.
Reading Notes (10%)
Keep a journal on the readings according to the template I included in your journal. I will initial each entry at the begining of class and update your reading journal grades during each midterm and during the final. Each entry is worth 0, 0.5 or 1 point. The score for this assignment is out of 20 points total, so you only need to write 20 reading responses.
Essay (30%)
One of our goals in this course will be to develop your writing abilities. Specifically, I want you to write the best paper you’ve ever written.
Midterm #1 (15%)
The midterm will be 4 short answer questions.
Midterm #2 (15%)
The midterm will be 4 short answer questions.
Final Exam (25%)
The Registrar sets the final exam time and date. Information about the final is posted online.
Grades:
You can keep track of your own grades, or please feel free to stop by my office during open office hours to check on your grades.