SOCS 645
Leading Issues in Bioethics, Public Policy, and the Law

Barry Schaller

Course Schedule
Class 1

Introduction to Bioethics: Course overview, schedule and methodology; class participation requirements (reporting of developments and discoveries, discussion, oral presentations); methods of legal and ethical analysis; guidelines for written exercises; briefing cases; sources of information about bioethics; case studies for ethical and legal analysis; history of bioethics; origins of ethical theory; relationship of bioethics to law, culture, philosophy and literature; multi-disciplinary nature of field; limitations of law and ethics; four principles approach versus contextual approach to ethical analysis. 

Reading Material: Steinbock, Arras & London, eds., Ethical Issues in Modern Medicine, Sixth Edition: "Introduction: Moral Reasoning in the Medical Context," pp 1 - 41; Understanding Bioethics, chapter 1, Introduction.

Class 2

The Physician-patient relationship I: Foundations of the physician-patient relationship; historical perspective; exploring respect for persons and legal autonomy; the four models of the physician-patient relationship; disclosure and informed consent; Hippocratic oath; beneficence, non-maleficence, and informed consent; methodology of making clinical ethical decisions. 

Reading Material:
"Foundations of the Health Professional-Patient Relationship, pp. 43-54;
"The Hippocratic Oath," p. 55;
"Beneficence Today, or Autonomy (Maybe) Tomorrow?" and "Commentaries," pp. 64-67;
"Four Models of the Physician-Patient Relationship," pp. 67-76;
"Offering Truth," pp. 76-82; "Arato v. Avedon," pp. 83-90; "Transparency: Informed Consent in Primary Care," pp. 100-106
Understanding Bioethics, chapter 2, The Context of Bioethics.

Writing Assignment for Class 2: Response to the reading #1

Class 3

The Physician-patient relationship II: conflicting professional roles and responsibilities; liability of physicians; ethics in the health care bureaucracy; confidentiality; distributive justice considerations; allocating resources; health care policy. 

Reading Material:
"Errors in Medicine: Nurturing Truthfulness," pp. 107-111;
Tarasoff v Regents, pp. 111-116;
"Please Don't Tell" and Commentaries, pp. 117-119;
"The HMO Physician's Duty to Cut Costs," pp128-129;
"The Doctor's Master," pp. 129-132;
Other reading to be assigned. 

Writing Assignment for Class 3: Response to the reading #2

Class 4

Human research, experimentation and clinical trials I: historical views of human experimentation; the Tuskegee Syphilis Experiment and its aftermath; research abuses on vulnerable groups; the Belmont Report; Nuremberg Code; federal regulation and the role of institutional review boards; clinical trials.  

Reading Material:
"Experimentation on Human Subjects," pp. 693-703;
"The Nuremberg Code," pp. 705-706;
"The Jewish Chronic Disease Hospital Case,"pp. 706-717;
"The Willowbrook Hepatitis Studies," pp. 717-721;
"Willowbrook Revisited," pp. 722-727;
"Racism and Research," pp. 727-738;
"The Belmont Report," pp. 738-745;
"The Ethics of Randomized Clinical Trials," pp. 747-759 
Understanding Bioethics, chapter 3, Legal Landscape of Human Research Litigation.

Writing Assignment for Class 4: Response to the reading #3

Class 5

Human research, experimentation and clinical trials II: current status of clinical trials including malpractice liability of researchers; Belmont 25 years later; the crisis in human research; current role of pharmaceutical companies; conflicts of interest; recent regulatory developments. 

Reading Material: cases and materials to be assigned. 

Writing Assignment for Class 5: Response to the reading #4

Class 6

Law and Medicine at the end of life I: the right to refuse care and treatment; a good death, Dax's case; care of the dying; determining medical futility; truth-telling; clinical case management; defining death. 

Reading Material:
"Defining Death, Foregoing Life-Sustaining Treatment, and Euthanasia," pp. 245-258;
"Defining Death," pp. 259-268;
"The Impending Collapse of the Whole-Brain Definition of Death," pp. 268-276;
State of Tennessee v. Northern, pp. 283-290;
"Deciding for Others: Competency," pp. 290-300;
"A Chronicle: Dax's Case as it Happened," and Commentaries, pp. 301-308;
"The Wendland Case and the Treacherous Road to Nonpersonhood," pp. 348-356;
other reading to be assigned. 

Writing assignment for Class 6: Optional Response to the reading #5

Class 7

Law and Medicine at the end of life II: The historical context of medical futility situations – Quinlan, Cruzan, et al; competency and disability; analysis of and reflections on the Terri Schiavo case; cases following Schiavo; the legal and ethical implications. 

Reading Material:
pp. 309-333; Cruzan v Missouri Dept. of Health; In re Karen Ann Quinlan; Schiavo case material; Understanding Bioethics, chapter 7, Boundaries at the End of Life; other reading to be assigned.

Writing Assignment for Class 7: Topic and Abstract [one paragraph minimum] of essay

Class 8

Reproduction and Birth Issues I: abortion, the maternal-fetal conflict, status of the pre-embryo, fundamentals of medicine, law and ethics in this field, parental rights and obligations.  

Reading Materials:
"Reprogentics," pp. 441-460; 463-471; 483-492
Roe v. Wade;
Planned Parenthood v. Casey; Gonzales cases
Marquis, pp. 463-471;
Thomson, pp. 483-492;
Alice Munro, "Before the Change;"  
Understanding Bioethics, chapter 4, Better Off Dead?

Writing Assignment for Class 8: Outline of essay

Class 9

Reproductive issues II: Human Cloning and Stem Cell Research: current status and implications of stem cell research; choosing our children, cloning and the "new genetics", assisted reproduction, genetic engineering, ownership of life issues, multiple parenthood, sperm and egg donation, disputes involving frozen embryos; controversies concerning multiple births. 

Reading Materials:
"What is Wrong with Commodification?" pp. 615-624;
"Selling Babies and Selling Bodies," pp. 625-630;
Matter of Baby M (NJ, 1988);
Human Cloning and Stem Cell Research, pp. 631-683. Pp 513-552; 595-605;
Understanding Bioethics, chapter 6, Stem Cells, chapter 7, Body Parts.

Writing Assignment for Class 9: work on essay

Class 10

Introduction to Neuroethics I: Current ethical issues in the field of neuroscience and brain scanning technology.

Reading Material: to be assigned.

Assignment for Class 10: Oral presentations of essays 

Writing Assignment for Class 10: First draft of paper due for comments

Class 11

Neuroethics II: Impact on the courts; special problems in neuroscience and the law.  

Reading: to be assigned.

Assignment for Class 11: Oral presentations of essays
Class 12

Justice in Society: current controversies in organ donation and allocation; defining brain death; medical research; ownership and commodification issues regarding the human body; allocating scarce medical resources; market approaches to increasing the supply of organs and sales of reproductive materials; discussion and analysis of problems and issues in distributive justice in society as identified throughout the course. 

Reading: Reading Material:
"Issues in Retrieval and Transplant of Organs;
In re T.A.C.P., FL. (1992);
L. Ross et al., Ethics of a Paired-Kidney-Exchange Program" (1997);
Moore v. Regents, CA (1990);
Mead, "Eggs for Sale"
pp. 155-164
pp. 164-167
pp. 167-176
pp. 177-186
materials previously identified for justice issues;
Understanding Bioethics, chapter 8, New Frontiers;
Additional reading to be assigned 

Assignment for class 12: Final essay due; oral presentations of papers
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