Philosophy 281Y


      Fall 2006


1160 Bahen Centre                                                                                                                                          Professor Gopal Sreenivasan

MW 2-3                                                                                                                                                          215 Huron Street, Room 921

(416) 978-2824





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 20.  The other packages will become available later.  Some readings are only available online, as a link from the syllabus on the course webpage.




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:                    17 %.

            Spring mid-term:                                     5 %.

            Final examination:                                 33 %.


Reading Schedule


September  11              Introduction.


Medical ethics


Physician/patient relationship


S 13                 Kass, “Is there a medical ethic?”  Towards A More Natural Science (1985), ch. 9.


S 18                 Emanuel and Emanuel, “Four Models of the Physician-Patient Relationship,” JAMA 267 (1992):  2221-26.


S 20                 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 25   Feinberg, Harm to Self (1986), ch. 17.


S 27                 Parfit, Reasons and Persons (1984), Appendix I.


October 2        Brock and Wartman, “What happens when competent patients make irrational decisions?,N. Engl. J. Med. 322 (1990): 1995-99.

                        Feinberg, ch. 19.


O 4                  Brock, “Paternalism and Autonomy,” Ethics 98 (1988):  550-65.


O 9                  Thanksgiving.  No class.


Informed Consent & Autonomy


O 11                Berg et al., Informed Consent, 2 ed. (2001), chh. 3-4.

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


O 16                Faden and Beauchamp, History and Theory of Informed Consent (1986), pp. 274-87.


O 18                Mid-term examination.  In class.


O 23                Benn, “Freedom, Autonomy, and the Concept of a Person,” Proceedings of the Aristotelian Society (1976):  109-30.


O 25                G. Dworkin, Theory and Practice of Autonomy (1988), ch. 7.


O 30                Brock, “Informed Consent,” Life and Death (1993):  21-36 and 43-54.


Refusal of Treatment


November 1     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.


N 6                  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 WanglieA New Kind of ‘Right to Die’ Case,” N. Engl. J. Med. 325 (1991): 511-12.


N 8                  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.


Competence & Surrogate Decision-making


N 13                Faden and Beauchamp, pp. 287-94.

                        Brock, “Informed Consent,” 36-43.

                        First essay topics handed out.


N 15                Buchanan and Brock, Deciding for Others (1990):  87-112.


N 20                Buchanan and Brock, 112-151.



Distributive Justice and Health Care


Universality of Access


N 22                Williams, “The Idea of Equality,” Problems of the Self (1973), ch. 14.


N 27                Walzer, Spheres of Justice (1983), ch 3.

First essay due in class.


N 29                Daniels, Just Health Care (1985), ch. 2.                       


December 4     Daniels, ch. 3.


D 6                  Sreenivasan, “Health care and equality of opportunity.”  Hastings Center Report (2007), forthcoming.



End of Fall Term.  Course continues in January.

End-term examination during Fall finals period (D 11-21).





There will be a weekly tutorial in this course with a TA.  Tutorials are offered on Mondays from 3-4 (right after class), on Wednesdays from 1-2 (right before class), and also from 3-4 (right after class again).


Please check the webpage for your specific tutorial assignment (e.g., the room).



Office hours


Sreenivasan                  Tuesdays 1-3.  Room 921, 215 Huron Street.   I will also hold office hours by appointment.


TAs                              Daniel Bader, Katherine Browne, Leanne Garvie, Alex Sinha.   Office hours to be announced.




Please do not e-mail your TA for anything.  E-mail should be directed to the instructor, who will try to reply in a reasonable time.  He is not, however, an e-mail machine.


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 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 for the detection of plagiarism. All submitted papers will be included as source documents in the reference database solely for the purpose of detecting plagiarism of such papers. The terms that apply to the University’s use of the service are described on the 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.







11 September 2006