Course Syllabus
Medical Ethics |
 |
| Semester & Location: |
Fall 2024 - DIS Stockholm |
| Type & Credits: |
Elective Course - 3 credits |
| Major Disciplines: |
Ethics, Pre-Medicine/Health Science, Public Health |
| Faculty Member: |
Henrik Ahlenius (current students please use the Canvas Inbox) |
| Program Director: |
Susana Dietrich shsupport@dis.dk |
| Time & Place: |
Tuesdays and Fridays, 10:05-11:25, Classroom: 1D-409 |
Course Description
Ethical questions that arise in the biomedical domain belong to the most exciting, dramatic and important we face as individuals and societies: Is human life sacred? What is autonomy, and are there situations where autonomy should not be respected? According to what criteria should scarce medical resources be distributed? Should we change the human genome to make us healthier, happier, more moral? Do people have a right to health-care, or should it be up to market mechanisms how health care is delivered? Should there be a market for kidneys or surrogacy services? Does a woman’s right to bodily integrity and self-determination always override the fetus’ claim to life?
These questions, and many more, will be examined in the course Medical Ethics. Throughout the course, this term is taken in a broad sense to include the clinical and public policy levels of health care as well as biomedical research.
Some of the disagreements that exist in medical ethics are due to disagreements or uncertainties concerning the facts, such as If euthanasia is legal, will there be patients who feel they should ask for it so as not to be a burden on their families? or Is a human fetus at 21 weeks of gestation capable of experiencing pain? Some of the disagreements in medical ethics may therefore be resolved once we know more about the facts. But a large part of the disagreements we find ourselves in are likely to persist, since we often disagree at a more fundamental level: not over the facts, but the values.
Those kinds of disagreements cannot be resolved within science, i.e. with accumulating more (medical) facts. Instead, they are at bottom philosophical. To say something substantial about how organs should be allocated or about the moral permissibility of aborting a fetus because it has Down’s syndrome, we need to say something substantial about justice and the value of human life lacking certain cognitive functions. It is also of importance to note that the solutions we offer to practical, concrete issues hang together via theoretical undercurrents that are not always transparent to us. Suppose, for instance, you are wondering about the moral permissibility of abortion. You would then evaluate a variety of views on what gives an organism moral status and under what circumstances (if any) killing such an organism is morally permissible. Providing answers to these very fundamental questions would, in addition to the abortion debate, have repercussions for other issues, such as the ethics of using animals (moral status and killing) and euthanasia (killing). Medical ethics is about sorting these thorny issues through, as rigorous and clear-headed as possible. Because of this, the course is also an introduction to moral philosophy more broadly.
The course covers the major ethical theories, principles of medical ethics as stated in official documents and professional tradition, and a number of specific topics in medical ethics. Examples include abortion, euthanasia, patient autonomy, allocation of scarce resources, the financing and delivery of health care, cloning, gene therapy, animal testing, informed consent, and many others. Students are welcome to suggest topics for discussion. Though many parts are already fixed, there is room for flexibility concerning what we discuss in class as a result of input from the students.
The first part of the course will be an introduction to ethics, with illustrative examples from the medical domain. After that we'll move on to discuss more concrete topics. Students will be able to influence the content of the course. Here are some possibilities:
- Abortion
- Euthanasia
- What is disease? (Can we know what things are diseases and disorders based solely on biological / physiological data, or is disease (in part) an evaluative or social thing?
- Commodification of the human body: surrogacy services, kidney sales etc.
- The roles of nurses and doctors
- Genetics: designing babies
- Priority setting in (Swedish) health care
- Public health care ethics: intervention or laissez faire + information?
- Medical judgment and legal consequences: legal competence, the biology of decision-making and behavior; free will, responsibility.
- What’s a good doctor? Interaction styles and patient satisfaction.
- The ethics of Infectious disease
- Male infant circumcision (non-medical, as a cultural practice)
- Autonomy (many many angles, one is "Amputees by choice”! Or coercive care in Psychiatry)
- Research ethics: possible topics include the outsourcing of research to developing countries (charges of exploitation); the obligation of researchers to inform and help their subjects after making ancillary findings concerning their medical status; whether participation in research is a moral requirement; the ethics if using animals for scientific research etc.
- AI in medicine.
- Medical ethics in war
I am open to other ideas based on your interests.
As we decide on which of these or other issues we'll discuss, all the "TBA"s in the calendar will be replaced by the corresponding topic.
Learning Objectives
Successfully passing the course means the student will be able to:
- Understand and explain the major ethical theories, such as utilitarianism, deontology, and virtue ethics, and their respective merits and problems.
- Understand and explain how these theories relate to topics in biomedicine, and how disagreements over practical matters often stem from disagreements over fundamental theoretical matters.
- Account for the major positions and arguments surrounding the topics we will consider, such as abortion, euthanasia, sanctity of life, resource allocation, gene therapy etc.
Additionally, the course places an emphasis on
- Critical thinking habits that enable the student to constructively criticize and assess topics in medical ethics.
Faculty
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Henrik Ahlenius PhD in Philosophy, Stockholm University. Visiting student research collaborator, Princeton University 2008. Lecturer, Karolinska Institutet since 2008. With DIS since 2017. In addition to all things ethical, I have strong interests in commonalities of evolutionary biology, psychology, and philosophy. I have two kids and live just south of Stockholm city. |
Readings
Textbooks
- Kuhse H, Schüklenk U, Singer P: Bioethics: An Anthology (3rd edition, Blackwell 2016). Table of contents.
- Rachels J: The Elements of Moral Philosophy (9th edition, McGraw-Hill 2019) Table of contents.
- Additional readings will be made available online or as paper copies
Field Studies
Please see the course calendar for dates and specific visits.
Guest Lecturers
1-2 guest lectures TBA
Approach to Teaching & Expectations of the Students
Different teaching formats will be used. The course is a mix of interactive lectures, class discussions, group work, student presentations and peer feedback. A major part of the course will be based on debating issues, and students are expected to engage actively in oral presentations, discussions, group work, and exercises.
Evaluation and Grading
Regardless of the format (discussions, presentations, papers etc.), some of the characteristics of ethical thinking done well are clarity, nuance, ingenuity, argumentative rigor, and an appreciation of how positions on practical matters are based in principled reasoning, which in turn generate positions for other practical matters.
To be eligible for a passing grade in this class all of the assigned work must be completed.
The factors influencing the final grade and the proportional importance of each factor is shown below:
| Component | Weight |
| Participation and classroom performance | 30 % |
| Midterm | 35 % |
| Final paper | 35 % |
The participation and classroom performance grade (30 %) reflects fulfilling your assigned presentations as well as doing the assigned readings, contributing to discussions, giving constructive feedback to fellow students, asking questions about the material etc.
Midterm (35 %) The midterm will cover the initial, more theoretical part (the Rachels textbook and other texts discussed up until that point).
For the final paper (35 %) you are given considerable freedom in what to write about, as long as the topic plausibly belongs in medical ethics broadly defined. One limitation, however, is that you must choose a different topic from the one you presented on in class. The paper should have approximately 1.500 to 2.000 words. More detailed instructions can be found here.
Academic Regulations
Please make sure to read the Academic Regulations on the DIS website. There you will find regulations on:
DIS - Study Abroad in Scandinavia - www.DISabroad.org
Course Summary:
| Date | Details | Due |
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