Philosophy 281Y
Bioethics
Winter 2004
1160 Bahen Centre Professor Gopal Sreenivasan
MW 2-3:
(416) 978-2824
Reading
Schedule
Distributive
Justice and Health Care
Universality
of Access (continued)
January 5 Sreenivasan, “Paper.”
J 7 Buchanan, “The Right to a Decent Minimum of Health Care,” Philosophy & Public Affairs 13 (1984):
55-78.
J 12 R. Dworkin, Sovereign Virtue (2000), ch. 8.
J 14 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 19 Emanuel, Ends of Human Life (1991), pp. 97-124.
J 21 Emanuel, pp. 124-154.
J 26 Brock, “The problem of low benefit/high cost health care,” in his Life and Death (1993), pp. 325-355.
Rationing
care
J 28 Daniels, “Rationing fairly,” in his Justice and Justification (1996), ch. 15.
February 2 Film. “Transplant Tourism.”
F 4 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. Med. 343 (2000):433-6.
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,”
(1992): 305-25.
F 9 Daniels, “The prudential life-span account of justice across generations,” in his Justice and Justification
(1996), ch. 12.
F 11 No class.
Spring Break.
F 23 Callahan, Setting Limits (1987), ch. 5.
F 25 Mid-term examination. In class.
Research
Ethics
March 1 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 3 Emanuel et al., “What makes clinical research ethical?,” JAMA 283 (2000): 2701-2711.
Tri-Council Policy Statement. (FYI only).
M 8 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. Medicine 324 (1991): 1585-89.
Bryant and Wolmark, “Letrozole after Tamoxifen for
Breast Cancer—What Is the Price of Success?,”
N. Engl. J. Medicine 349 (2003): 1855-57.
M 10 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 15 Freedman, “Placebo-Controlled Trials and the Logic of Clinical Purpose,” IRB 12 (1990): 1-6.
Rothman and Michels, “The Continuing Unethical Use of PlaceboControls,” N. Engl. J. Medicine 331
(1994): 394-398.
Treatments: Ethical and Scientific Issues” Annals of Internal Medicine 133 (2000): 455-463.
Miller and Emanuel, “The Ethics of Placebo-Controlled Trials – A Middle Ground,” N. Engl. J. Medicine
345 (2001): 915-919.
M 17 Levine, “Informed Consent in Research and Practice,” Archives of Internal Medicine 143 (1983):1229-31.
Nelson
and Merz, “Voluntariness of
Consent for Research: An Empirical and
Conceptual Review,” Medical
Care 40 (2002); V69-V80.
M 22 Appelbaum et al., “False Hopes and Best Data: Consent to Research and the Therapeutic Misconception,”
Joffe et al., “Quality of informed consent in cancer clinical trials: a cross-sectional survey,” Lancet 358
(2001): 1772-77.
Sreenivasan, “Does informed consent to research require comprehension?,” Lancet 362 (2003): 2016-18.
M 24 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 29 The Body Hunters.
M 31 Angell, “The Ethics of Clinical Research in the Third World,” N. Engl. J. Medicine 337 (1997): 847-49.
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 Thailand of the Vertical Transmission of HIV,” N. Engl. J. Medicine
338 (1998): 834-835.
Bloom,
“The
Highest Attainable Standard: Ethical
Issues in AIDS Vaccines,”
Science 279 (1998):186-8.
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.
April 5 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 7 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
posted after each graded assignment has been returned.
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.
Students agree that by taking this course all required papers may be subject to submission for textual similarity review to Turnitin.com for the detection of plagiarism. All submitted papers will be included as source documents in the Turnitin.com reference database solely for the purpose of detecting plagiarism of such papers. The terms that apply to the University's use of the Turnitin.com service are described on the Turnitin.com web site.
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.
02 February 2004