Philosophy 281Y

Bioethics

Fall 2003

 

1160 Bahen Centre                                                                  Professor Gopal Sreenivasan

MW 2-3:30                                                                              215 Huron Street, Room 921

(416) 978-2824

                                                                                            gopal.sreenivasan@utoronto.ca

 

Readings

 

There will be three course packages.  The first package is now available at the U of T Bookstore on College.  It covers all the readings through November 12.  The other packages will become available later.

 

Assignments

 

There will be four examinations and two essays (2000 words) over the course of the whole year, an essay and two examinations in each term.  Each term there will be an in-class mid-term and an examination during the finals period.

 

The assignments will carry the following weights:

 

            Essays:                                     20 % each.

            Fall mid-term:                                       5 %.

            Fall end-term examination:                    12 %.

            Spring mid-term:                                   10 %.

            Final examination:                                 33 %.

 

 

Reading Schedule

 

September  8                Introduction.

 

 

Medical ethics

 

Physician/patient relationship

 

S 10                 Kass, “Is there a medical ethic?”  Towards A More Natural Science

                                    (1985), ch. 9.

                        Emanuel and Emanuel, “Four Models of the Physician-Patient

                                    Relationship,” JAMA 267 (1992):  2221-26.

 

S 15                 Katz, The Silent World of Doctor and Patient (1984), ch. 6.

                        Gawande, “Whose body is it, anyway?” Complications (2002):  208-27.

Paternalism & Well-Being

 

September 17   Feinberg, Harm to Self (1986), ch. 17.

 

S 22                 Parfit, Reasons and Persons (1984), Appendix I.

 

S 24                 Brock and Wartman, “What happens when competent patients make

                                    irrational decisions?,” N. Engl. J. Med. 322 (1990): 1995-99.

                        Feinberg, ch. 19.

                        Brock, “Paternalism and Autonomy,” Ethics 98 (1988):  550-65.

 

S 29                 Field, Surrogate Motherhood (1988), Introduction and ch. 5.

                        Wertheimer, “Two Questions about Surrogacy and Exploitation,”

                                    Philosophy & Public Affairs 21 (1992):  211-39.

 

Informed Consent & Autonomy

 

October 1        Berg et al., Informed Consent, 2 ed. (2001), chh. 3-4.

                        P.A. Singer (ed.), Bioethics at the Bedside (1999), chh. 1-2.

 

O 6                  Faden and Beauchamp, History and Theory of Informed Consent (1986),                                 pp. 274-87.

 

O 8                  Mid-term examination.  In class.

 

O 13                Thanksgiving.  No class.

                       

O 15                Benn, “Freedom, Autonomy, and the Concept of a Person,” Proceedings

                                    of the Aristotelian Society (1976):  109-30.

 

O 20                G. Dworkin, Theory and Practice of Autonomy (1988), ch. 7.

 

O 22                Brock, “Informed Consent,” Life and Death (1993):  21-36 and 43-54.

 

Refusal of Treatment

           

O 27                Film, “Dax’s Case.”

                        Cowart and Burt, “Confronting Death:  Who Chooses, Who Controls?,

                                    Hastings Center Report 28 (1998):  14-24.

                        Arnold and Menzel, “When Comes ‘The End of the Day?’,” Hastings

                                    Center Report 28 (1998):  25-7.

 

O 29                Annas, “When Suicide Prevention Becomes Brutality:  The Case of

                                     Elizabeth Bouvia,” Hastings Center Report 14 (1984):  20-21, 46.

                        Annas, “Elizabeth Bouvia:  Whose Space Is This Anyway?,Hastings

                                    Center Report 16 (1986):  24-5.

                        Annas, “Transferring the Ethical Hot Potato,” Hastings Center Report 17

                                    (1987):  20-21.

                        Angell, “The Case of Helga Wanglie—A New Kind of ‘Right to Die’

                                    Case,” N. Engl. J. Med. 325 (1991): 511-12.

                        Miles, “Informed Demand for ‘Non-Beneficial’ Medical Treatment,” N.

                                    Engl. J. Med. 325 (1991): 512-15.

                        Quill, “Death and Dignity—A Case of Individualized Decision Making,”

                                    N. Engl. J. Med. 324 (1991): 691-94.

 

November 3     No class.

N  5                 No class.

 

Competence & Surrogate Decision-making

 

N 10                Faden and Beauchamp, pp. 287-94.

                        Brock, “Informed Consent,” 36-43.

 

N 12                Buchanan and Brock, Deciding for Others (1990):  87-112.

                        First essay topics handed out.

 

N 17                Buchanan and Brock, 112-151.

 

 

Distributive Justice and Health Care

 

Universality of Access

 

N 19                Williams, “The Idea of Equality,” Problems of the Self (1973), ch. 14.

                        Walzer, Spheres of Justice (1983), ch 3.

 

N 24                Rawls, Theory of Justice (1971), §§11-14.

 

N 26                Daniels, Just Health Care (1985), ch. 2.

                        First essay due in class.

 

December 1     Daniels, ch. 3.

                       

D 3                  Sreenivasan, “Health care and equality of opportunity.”  MS.

 

 

End of Fall Term.  Course continues in January.

End-term examination during Fall finals period (D 8-17).

 

 

 

 

Office hours

 

Sreenivasan                  Mondays 4-5 and Tuesdays 2-3.  Room 921, 215 Huron Street.

I will also hold office hours by appointment.

 

TAs                              Office hours to be announced.

 

 

Late penalties

 

Essays submitted after the due date will be penalised one increment of a grade (e.g., from B to B-).  Essays submitted a week or more late will be penalised a further increment for each week late.

 

 

Plagiarism

 

Plagiarism is a serious academic offence.  It comes in various forms, all of which carry grave penalties.  If in doubt about what constitutes plagiarism, ask.  You should consult the Philosophy Department’s statement on plagiarism.

 

 

Writing help

 

Help in writing is available from the Philosophy Department’s essay clinic.  You are also encouraged to consult the Department’s guide to writing a philosophy essay.

 

 

Course Web Page

 

http://www.chass.utoronto.ca/~gsreeniv/courses/281.htm

 

 

 

 

 

 

 

 

 

 

8 September 2003