Philosophy 281Y
Bioethics
Winter 2003
MW 2-3:
(416) 978-2824
Reading
Schedule
Distributive
Justice and Health Care
Universality
of Access (continued)
January 6 Buchanan, “The Right to a Decent Minimum of Health Care,” Philosophy & Public Affairs 13 (1984):
55-78.
J 8 R. Dworkin, Sovereign Virtue (2000), ch. 8.
J 13 No new reading.
J 15 Reinhardt,
“Reforming the Health Care System: The
Universal Dilemma,” American Journal of Law &
Medicine (1993): 21-36.
What
should a health care system cover?
J 20 Emanuel, Ends of Human Life (1991), pp. 97-124.
J 22 Emanuel, pp. 124-154.
J 27 Brock, “The problem of low benefit/high cost health care,” in his Life and Death (1993), pp. 325-355.
J 29 Romanow Report. Executive summary, ch. 8, and ch. 9. (FYI: Full Report).
Rationing
care
February 3 Daniels, “Rationing fairly,” in his Justice and Justification (1996), ch. 15.
F 5 Radcliffe-Richards
et al., “The case for allowing kidney sales,” Lancet 351 (1998):
1950-52.
Friedlaender, “The right to sell or buy a kidney: are we failing our patients?,” Lancet 359 (2002): 971-73.
Delmonico et al., “Ethical Incentives – Not Payment – For Organ Donation,” N. Engl. J. Medicine 346
(2002): 2002-2004.
Matas et al., “Nondirected Donation of Kidneys from Living Donors,” N. Engl. J. Medicine 343 (2000):
433-36.
Cronin et al., “Transplantation of Liver Grafts from Living Donors into Adults – Too Much, Too Soon,”
N. Engl. J. Medicine 344 (2001): 1633-35.
Segre
et al., “Partial Liver Transplantation from Living Donors,”
4 (1992): 305-25.
F 10 Daniels, “The prudential life-span account of justice across generations,” in his Justice and Justification
(1996), ch. 12.
F 12 McKerlie,
“Justice Between the Young and the Old,” Philosophy & Public Affairs
30(2) (2001): 152-77.
Spring
Break.
Social determinants of health (again)
F 24 Daniels, Kennedy, Kawachi, Is Inequality Bad for our Health? (2000),ch.1
F 26 Mid-term examination. In class.
Research
Ethics
March 3 Annas and Grodin (eds.) The Nazi Doctors and the Nuremburg Code (1992), ch. 5.
Brandt, “Racism and Research: The case of the Tuskegee Syphilis Study,” Hastings Center Report
8 (1978): 21-28.
M 5 Emanuel et al., “What makes clinical research ethical?,” JAMA 283 (2000): 2701-2711.
Tri-Council Policy Statement. (FYI only).
M 10 Katz,
“Human Experimentation and Human Rights,”
Schafer,
“The Ethics of the Randomized Clinical Trial,” N. Engl. J. Medicine 307
(1982): 719-724.
Hellman
and Hellman, “Of Mice But Not Men:
Problems of the Randomized Clinical Trial,” N. Engl. J.
Med. 324 (1991): 1585-89.
M 12 Freedman,
“Equipoise and the Ethics of Clinical Research,” N. Engl. J. Medicine
317 (1987): 141-145.
Passamani, “Clinical Trials – Are They Ethical?,” N. Engl. J. Medicine 324 (1991): 1589-1592.
Truog, “Randomized Controlled Trials: Lessons from ECMO,” Clinical Research 40 (1992): 519-527.
Second essay topics handed
out.
M 17 Freedman, “Placebo-Controlled Trials and the Logic of Clinical Purpose,” IRB 12 (1990): 1-6.
Rothman and Michels, “The Continuing Unethical Use of Placebo Controls,” N. Engl. J. Medicine 331
(1994): 394-398.
Miller and Emanuel, “The Ethics of Placebo-Controlled Trials – A Middle Ground,” N. Engl. J. Medicine
345
(2001): 915-919.
M 19 Levine, “Informed Consent in Research and Practice,” Archives of Internal Medicine 143 (1983):
1229-1231.
Nelson and Merz, “Voluntariness of Consent for Research: An Empirical and Conceptual Review,”
Medical Care 40 (2002); V69-V80.
M 24 Appelbaum et al., “False Hopes and Best Data: Consent to Research and the Therapeutic Misconception,”
Lidz and Appelbaum, “The Therapeutic Misconception: Problems and Solutions,” Medical Care 40
(2002): V55-V62.
Joffe et al., “Quality of informed consent in cancer clinical trials: a cross-sectional survey,” Lancet 358
(2001): 1772-77.
M 26 Love and Fost, “Ethical and Regulatory Challenges in a Randomized Controlled Trial of Adjuvant Treatment
for
Breast Cancer in
Second essay due in class.
M 31 The Body
Hunters.
April 2 Angell,
“The Ethics of Clinical Research in the
Lurie and Wolfe, “Unethical Trials of Interventions to Reduce Perinatal Transmission of the HIV in
Developing Countries,” N. Engl. J. Medicine 337 (1997): 853-856.
Phanuphak,
“Ethical Issues in Studies in
338 (1998): 834-835.
Bloom, “The Highest Attainable Standard: Ethical Issues in AIDS Vaccines,” Science 279 (1998):
186-188.
Crouch
and
Grady, “Science in the Service of Healing,” Hasting Center Report 28 (1998): 34-38.
Angell, “Investigators’ Responsibilities for Human Subjects in Developing Countries,” N. Engl. J. Medicine
342 (2000): 967-969.
A 7 Glantz et al., “Research in Developing Countries: Taking ‘Benefit’ Seriously,” Hasting Center Report
28 (1998): 38-42.
Shapiro and Meslin, “Ethical Issues in the Design and Conduct of Clinical Trials in Developing Countries,”
N. Engl. J. Medicine 345 (2001):
139-142.
El Setouhy et al., “Fair Benefits for Research in Developing Countries,” Science 298 (2002): 2133-34.
A 9 No new reading.
End of lectures.
Final
examination in Spring examination period.
Course packages are available at the U of T Bookstore on College. The final package will be available toward the end of February.
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 %.
Office
hours
Sreenivasan Mondays
4-5 and Tuesdays 2-3. Room 921,
I will also hold office hours by appointment.
TAs Office hours are
announced from time to time.
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.