Bioethics

I. MORAL THEORY.

Introduction.
The Major Moral Considerations.


Appealing to the Consequences of Our Actions. Appealing to Rights. Appealing to the Virtues. Appealing to Justice and Equality.

A Brief Introduction to the Major Moral Theories.II. READINGS IN BIOETHICS.

Decision Making.
Introduction.
Capacities and Competencies of Patients.


Mill, Not All Can Be Free. Locke, The Status of Children. Leikin, Minors' Assent or Dissent to Medical Treatment. Gert and Culver, The Logic of Competency. President's Commission, Who Is Incapacitated and How Is It to Be Determined? Abernethy, Compassion, Control, and Decisions About Competency.

The Roles and Virtues of Different Professionals as Providers.


Jamieton, Physicians and Nurses: A Historical Perspective. Winslow, From Loyalty to Advocacy: A New Metaphor for Nursing. Bartlett, Why Physicians Need to Maintain Control of Health Care Delivery. Costello, Engelhardt, and Gardell, Licensig, Certification, and the Restraint of Trade. Hippocrates, The Virtues of a Physician. Dietrich von Engelhardt, The Enlightenment Picture of the Virtuous Physician. Alasdair MacIntyre, How Virtues Become Vices.

The Role of the Patient and the Provider.


President's Commission, The Patient as Decision-Maker. Miller, Types of Autonomy and Their Significance. Clements and Sider, Medical Ethics' Assault Upon Medical Values: A Criticism of Autonomy. Thomasma, Beyond Medical Paternalism and Patient Autonomy.

Informed Consent.


Canterbury v. Spence: The Information Desired by a Reasonable Patient. Capron, The Subjective Standard: Canterbury Can Require Too Little. Jewish Compendium on Medical Ethics, The Best Interest of the Patient: Canterbury Can Require Too Much.

Persons and Their Lives.Introduction.

Devine, The Concept of a Person. The Species Principle and the Potentiality Principle. Sumner, The Criterion of Sentience. Brody, The Criterion of Brain Functioning. Tooley, The Criterion of Awareness of Self as a Continuing Entity. Engelhardt, Multiple Concepts of Personhood.

The Sanctity of the Lives of Persons.


Grisez and Boyle, The Morality of Killing: A Traditional View. Engelhardt and Kenny, Principle of Double Effect. Brody, A Non-Consequentialist Argument for Active Euthanasia. Singer, A Consequentialist Argument for Active Euthanasia. President's Commission, The Traditional Distinctions are Unhelpful. Canadian Law Reform Commission, Roots of the Belief in the Sanctity of Life. Jewish Compendium on Medical Ethics, A Jewish Statement on the Sanctity of Life. President's Commission, Life Is Sometimes Only a Modest Benefit. Engelhardt, Some Qualities of Life Are Not Worth Living.

Health Care and Justice.Introduction.Right to Health Care.


President's Commission, The Right toan Adequate Level of Health Care. Gibbard, When Is the Best Care Too Expensive? Daniels, Health Care as Fair Opportunity. Guttman, Equality in Health Care. Brody, Liberty and the Purchase of Health Care.

Financing and Delivery of Health Care.


McCarthy, The Money We Spend and Its Sources. Enthoven, The Consumer Choice Health Plan. Singer, National Health Plan: Why We Need to Follow the British.

Individual Patients and Social Needs.


Fried, The Primacy of the Physician as Trusted Personal Advisor and Not as Social Agent. Brody, Costs and Clinicians as Agents of Patients.

III. CASE AREAS.

Reproductive Issues.


Decision to Reproduce. New Reproductive Technologies. Abortion. Genetic and Prenatal Counseling.

Perinatal Issues.


Fetal Treatment. Alternative Birth Settings. Cesarean Sections. Defective Newborns. Triage in the NNICU.

Pediatric Health Care.


Assent and Consent to Pediatric Treatment and Experimentation. Pediatric Donation of Organs. Confidentiality and Adolescent Sexuality. Religious Objections to Treatment of Minors.

Adult Patients: General Issues.


Consent of Adults to Treatment. Consent of Adults to Experimentation. Confidentiality. Access to Health Care. Preventive Medicine. Occupational Safety and the Social Responsibility to Prevent Job Related Illness and Death. Alternative Forms of Care.

Adult Patients: Special Issues.


Chronic Pain and Chronic Problems. Religious Objections to Treatment by Adult Patients. Psychiatric Patients. Cancer Surgery. Patients with Serious Burns. Organ Transplantation. Sex Therapy and Counseling.

Geriatric Health Care.


Assessment of Competency. The High Costs of Geriatric Health Care. Independence of the Elderly Patient.

Death and Dying.


Truth-Telling. The Use of Intensive Care Units. Advanced Directives. DNR Orders. The Family's Role in Decisions for Terminal Patients. Hospice Care. Suicide and Euthanasia. Definition of Death. Autopsies and Organ Donations.

APPENDIX: CODE OF ETHICS.