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PHIL 4380

PHILOSOPHY OF MEDICINE
Welcome to Philosophy of Medicine. While it is evident from even a cursory
glance at the newspaper the words “ethics” or “morality” are bandied about
frequently, and “medical ethics” and “bioethics” are frequently referred to, it is
difficult to find a course, in the USA at least, on the “philosophy of medicine.”
The purpose of this course is to address the broad concept of the philosophy of
medicine, thus it will necessarily encompass these other concepts and will deal
extensively with issues having to do with ethics in medicine. But, in addition, it
will deal with the broader issue of “what is this thing called Medicine?” and what
is the purpose or function of the enterprise?

In the course, it will be necessary to look not only at the philosophy of medicine
and issues pertaining to ethics of the activity, it will be necessary to look at the
history of medicine, since, presumably, the philosophy as been influenced by
what was actually happening in medicine at different times of the history of
mankind.

This course is designed so that no one single theory of philosophy is dominant,


rather several theories of medicine are introduced and examined. The major goal
is to convince the student to continue to be a student, not only of health and
medicine, but also of the theory of value – to be forever open to the views of
others so that everyone is working towards the same goal – a morally justified
and healthy human experience.

Course Title and Number

PHIL 4380

Course Policies

Emergency

If you have an emergency that affects your ability to meet any of the course
requirements please call any of the following:

Contact Telephone FAX email

Wayne Cooper 903 714-5639 903 589-5450 mwaycoop@msn.com


903-589-5430
Office Hours:
One hour before class, each week.

Assignments

Assignments are understood to include readings in the text, presentations and


discussion of readings in class, in-class exams and written papers.

Assignments must be presented at the scheduled time unless prior arrangements


have been made with the instructor. Exceptions must be approved at least 48
hours in advance of the scheduled time that the assignment is due.

Failure to meet the deadline without prior approval from the instructor will result
in a reduction of a letter grade from the earned grade for each day after the
assignment is due.

Grading

Grades will be determined in the following manner:

1. 3 in-class exams ----------------------------------------15% each = 45% of final


grade
2. 2 pre-term-papers-------------------------------10% each = 20% of final
3. Research term paper--------------------------------------------------= 30% of final
4. Class participation------------------------------------------------------= 10% of
final

(I am aware that this equals more than 100%. I merely want to point out the
importance of in-class participation.)

Examinations

Examinations will be in-class multiple choice exams covering the material


presented in class and in the readings.

A scheduled examination must be taken at the scheduled time for the


examination, unless prior arrangements have been made with the instructor.
Exceptions must be approved at least 48 hours in advance of the scheduled time
of the examination. Instructor approval is discretionary.

Petitions for an exception must include a new, proposed time for taking the
examination. Failure to comply with this policy will result in an automatic “F” for
the examination.

Pre-term-paper
A pre-term-paper paper should be approximately 5 pages long and
have at least 3 references. It should make a clear claim, present supporting
evidence, present an opposing side with relevant evidence and draw a clearly
supported conclusion. The purpose of this .paper is to see that the student
learns how to make a clear argument.

Term paper

The term paper represents a substantial portion of the final grade. It


should have the same basic format as the pre-term-paper paper (claim,
evidence…etc.), but it must be at least 10 pages in length and use at least 5
supporting references.

All papers should be in 12 font, using 1 ½ spacing with standard margins.


References should use standard format and be included either as footnotes
or endnotes.

Students will be able to:

1. From the readings and the exams:


a. Recall important historical facts and conceptual
issues relevant to the philosophy of medicine and
bioethics.
b. Recall, describe and critique the major ethical
theories which have developed in philosophical
ethics.
c. Apply the philosophical theories of ethics to
practical everyday private and public activities.
d. Recognize and critique ethical issues in
publications, editorials, movies and creative
literature.

2. From the written papers:


a. Come to be able to make a clear and concise claim
concerning a bioethical issue.
b. Recognize and utilize peer-reviewed literature to
support an ethical claim.
c. Critique contradictory claims regarding ethical
issues.
d. Draw conclusions regarding ethical issues from
relevant peer-reviewed literature.

3. From the in-class participation and reading summary:


a. Identify the central ethical claim of a piece of
literature.
b. Summarize the argument of the material.
c. Critique the argument presented in the material.
d. Responsibly and courteously express his/her own
opinion and viewpoint publicly with other students.
e. Responsibly and courteously critique the opinions
and arguments of other students.

Evaluations:

1. Three in-class exams


a. The purpose of the exams is to test the student’s
knowledge and comprehension of major historical
facts and conceptual issues relevant to ethics.
b. The content of the exams will come from both
reading and lectures
c. The exams will be 20 multiple choice questions.
d. Each exam will count towards 15% of the final
grade.

2. Papers: There will a requirement to write three papers


for the course – two pre-term papers and one term paper.
a. Pre-term papers:
i. Each paper is required to be at least 5 pages
in length and have at least 5 peer-reviewed
references supporting the major claim of the
argument.
ii. Papers are to be 1 ½ space and 12 font.
iii. Each pre-term paper is to have three
ingredients:
1. A claim, which states what ethical issue
is being contested.
2. Peer-reviewed literature supporting the
claim.
3. A conclusion which connects the claim
to the evidence.

iv. The student may choose to take one side of a


claim for one pre-term paper, then take the
opposite side for the second pre-term paper.

v. Each pre-term paper will count 10% towards


the final grade.

b. Term paper:
i. Each term paper is required to be at least 10
pages in length and have at least 10 peer-
reviewed references supporting the major
claim of the argument.
ii. Papers are to be 1 ½ spacing and 12 font.
iii. Each term paper is to have four ingredients:
1. A claim, which states what ethical issue
is being contested.
2. Peer-reviewed literature supporting the
claim.
3. Peer-reviewed literature which supports
the side contradictory to the claim.
4. A conclusion showing how the claim is
best supported by the peer-reviewed
literature noted in #2.
5. The term paper will count 30% towards
the final grade.

c. In-class participation:
i. Each student is encouraged to participate in
class discussions and to be prepared to
discuss the reading of the day.
ii. Students are encouraged to express their own
opinion responsibly and courteously on
relevant ethical issues.
iii. Students are encouraged to critique and
criticize other student’s opinions and
viewpoints on relevant ethical issues. Logical
fallacies will be identified and critiqued.
Personal ad hominem attacks will be cause
for an automatic F in this activity.
iv. To insure class participation, each student
will be required to prepare a one-page
summary of the reading relevant to a
particular class meeting. Students will sign
up for these readings at the beginning of the
semester.
v. The summary is to be turned in on the day of
the reading. The summary will not be graded,
but will be noted and will count towards the
final grade.
vi. The value of the summary towards the final
grade is 10%.

Scoring of pre-term and term papers will be determined by the


following:

Level 0 Off-the-subject or otherwise unscorable


Grade = F

Level 1 Paraphrase Grade = D


Students paraphrase information, they repeat and
restate the question
Add little or nothing new to the issue or question.

Level 2 Takes a Side but simplistically Grade = C


Takes a side, but does not explore other alternatives
Makes unsupported assertions and makes simplistic
arguments
Gives an assertion, without evidence, often in the
form of a question that modestly advances the
discussion
Challenges an assertion without evidence
Gives simplistic explanations
Cites rules, “laws,” as proof
Does not address conflicts with opposing views or
does not explore them

Level 3 Makes serious attempt to analyze an argument


Grade = B-
Makes a serious attempt to analyze an argument or
competing arguments
and evaluates with evidence
Appeals to a recognized appropriate authority
Makes casual observations, gives anecdotal data (vs.
objective data)
Makes assertions with explicit evidence but does not
integrate it within a
logical framework
Gives a singular Socratic-like question
Lists numerous factors as evidence but does not
integrate them within a
logical framework
Gives no clear conclusion or choice between
alternatives

Level 4 Employs theory Grade =B+


Employs the use of theory to make a cohesive
argument
Makes logical statements based on the discipline’s
accepted models or
theories
Identifies assumptions
Challenges a key assumption of another’s theory
Gives a series of logical Socratic-style questions

Level 5 Uses Empiric Evidence Grade = A-


Adds to Level 4 a level of sophistication introducing
empirical evidence to
strengthen the theoretical argument
Uses appropriate historical data to “test” the validity
of an argument
Uses data to reach a clear conclusion or to choose
between alternative
theories
Challenges the validity of another’s empirical
evidence

Level 6 Makes an Ethical Argument Grade = A+


Moves beyond objective analysis to incorporate
subjective interests, particular normative
consequences of a particular viewpoint

Modified from: Greenlaw SA, DeLoach SB, “Teaching Critical


Thinking with Electronic Discussion,” in Journal of Economic
Education, Winter 2003.

Grade Reports

University policy specifies that the secretary cannot report student grades in
person or over the telephone.

Informing students about grades before the Office of the Registrar mails grades
to the student is a decision of the course instructor.

University Policies

Academic Dishonesty
The faculty expects from its students a high level of responsibility and academic
honesty. Because the value of an academic degree depends upon the absolute
integrity of the work done by the student for that degree, it is imperative that a
student demonstrate a high standard of individual honor in his or her scholastic
work.

Scholastic Dishonesty: Any student who commits an act of scholastic dishonesty


is subject to discipline. Scholastic dishonesty includes but is not limited to
cheating, plagiarism, collusion, the submission for credit of any work or materials
that are attributable in whole or in part to another person, taking an examination
for another person, any act designed to give unfair advantage to a student or the
attempt to commit such acts.

Plagiarism, especially from the web, from portions of papers of other classes,
and from any other source is unacceptable and will be dealt with under the
university’ policy on plagiarism (see general catalog for details). This course will
use the resources of turnitin.com which searches the web for possible plagiarism
and it is over 90% effective.

Copyright Notice

The copyright law of the United States (Title 17, United States Code) governs the making
of photocopies or other reproductions of copyrighted materials, including music and
software. Copying, displaying, reproducing or distributing copyrighted works may
infringe the copyright owner’s rights and such infringement is subject to appropriate
disciplinary actions as well as criminal penalties provided by federal law. Usage of such
material is only appropriate when that usage constitutes “fair use” under the Copyright
Act. As a UT Dallas student, you are required to follow the institution’s copyright policy
(Policy Memorandum 8401.3-46). For more information about the fair use exemption,
see http://www.utsystem.edu/ogc/intelectualproperty/copypol2.htm

Technical Support

If you experience any problems with your UTD account you may send an
email to: assist@utdallas.edu or call UTD Computer Helpdesk at 972-883-2911.

Student Conduct & Discipline

The University of Texas System and the University of Texas at Dallas


have rules and regulations for the orderly and efficient conduct of their business.
It is the responsibility of each student and each student organization to be
knowledgeable about the rules and regulations which govern student conduct
and activities. General information on student conduct and discipline is
contained in the UTD printed publication, A to Z Guide, which is provided to all
registered students each academic year.

The University of Texas at Dallas administers student discipline within the


procedures of recognized and established due process. Procedures are defined
and described in the Rules and Regulations, Series 50000, Board of Regents,
The University of Texas System, and in Title V, rules on Student Services and
Activities of the university’s Handbook of Operating Procedures. Copies of these
rules and regulations are available to students in the Office of the Dean of
Students, where staff members are available to assist students in interpreting the
rules and regulations (SU 1.602, 972/883-6391) and online at

http://www.utdallas.edu/judicialaffairs/UTDJudicialAffairs-HOPV.HTML

A student at the university neither loses the rights nor escapes the
responsibilities of citizenship. He or she is expected to obey federal, state, and
local laws as well as the Regents’ Rules, university regulations, and
administrative rules. Students are subject to discipline for violating the standards
of conduct whether such conduct takes place on or off campus, or whether civil
or criminal penalties are also imposed for such conduct.

Email Use

The University of Texas at Dallas recognizes the value and efficiency of


communication between faculty/staff and students through electronic mail. At the
same time, email raises some issues concerning security and the identity of each
individual in an email exchange. The university encourages all official student
email correspondence be sent only t a student’s UT Dallas email address and
that faculty and staff consider email from students official only if it originates from
a UTD student account. This allows the university to maintain a high degree of
confidence in the identity of all individual corresponding and the security of the
transmitted information. UTD furnishes each student with a free email account
that is to be used in all communication with university personnel. The
Department of Information Resources at UT Dallas provides a method for
students to have their UT Dallas mail forwarded to other accounts.

Withdrawal from Class

The administration of this institution has set deadlines for withdrawal of any
college-level courses. These dates and times are published in that semester’s
course catalog. Administration procedures must be followed. It is the student’s
responsibility to handle withdrawal requirements from any class. In other words,
I cannot drop or withdraw any student. You must do the proper paperwork to
ensure that you will not receive a final grade of “F” in a course if you choose not
to attend the class once you are enrolled.
Student Grievance Procedures

Procedures for student grievances are found in Title V, rules on Student Services
and Activities, of the university’s Handbook of Operating Procedures.

In attempting to resolve any student grievance regarding grades, evaluations, or


other fulfillments of academic responsibility, it is the obligation of the student first
to make a serious effort to resolve the matter with the instructor, supervisor,
administrator, or committee with whom the grievance originates (hereafter called
“the respondent”). Individual faculty members retain primary responsibility for
assigning grades and evaluations. If the matter cannot be resolved at that level,
the grievance must be submitted in writing to the respondent with a copy of the
respondent’s School Dean. If the matter is not resolved by the written response
provided by the respondent, the student may submit a written appeal to the
School Dean. If the grievance is not resolved by the School Dean’s decision, the
student may make a written appeal to the Dean of Graduate or Undergraduate
Education, and the dean will appoint and convene an Academic Appeals Panel.
The decision of the Academic Appeals Panel is final. The results of the
academic appeals process will be distributed to all involved parties.

Copies of these rules and regulations are available to students in the Office of
the Dean of Students, where staff members are available to assist students in
interpreting the rules and regulations.

Incomplete Grade Policy

As per university policy, incomplete grades will be granted only for work
unavoidably missed at the semester’s end and only if 70% of the course work
has been completed. An incomplete grade must be resolved within eight (8)
weeks from the first day of the subsequent long semester. If the required work to
complete the course and to remove the incomplete grade is not submitted by the
specified deadline, the incomplete grade is changed automatically to a grade of
F.

Disability Services

The goal of Disability Services is to provide students with disabilities education


opportunities equal to those of their non-disabled peers. Disability Services is
located in room 1.610 in the Student Union. Office hours are Monday and
Thursday, 8:30a.m. to 6:30 p.m.; Tuesday and Wednesday, 8:30 a.m. to 7:30
p.m.; and Friday, 8:30 a. m. to 5:30 p.m.

The contact information for the Office of Disability Services is:

The University of Texas at Dallas, SU 22


PO Box 830688
Richardson, Texas 75083-0688
(972)883-2098 (voice or TTY)
disabilityservice@utdallas.edu

If you anticipate issues related to the format or requirements of this course,


please meet with the Coordinator of Disability Services. The Coordinator is
available to discuss ways to ensure your full participation in the course. If you
determine that formal, disability-related accommodations are necessary, it is very
important that you be registered with Disability Services to notify them of your
eligibility for reasonable accommodations. Disability Services can then plan how
best to coordinate your accommodations.

It is the student’s responsibility to notify his or her professors of the need for such
an accommodation. Disability Services provides students with letters to present
to faculty members to verify that the student has a disability and needs
accommodations. Individuals requiring special accommodation should contact
the professor after class or during office hours.

Religious Holy Days

The University of Dallas will excuse a student from class or other required
activities for the travel to and observance of a religious holy day for religion
whose places of worship are exempt from property tax under Section 11.20 Tax
Code, Texas Code Annotated.

The Student is encouraged to notify the instructor or activity sponsor as soon as


possible regarding the absence, preferably in advance of the assignment. The
student, so excused, will be allowed to take the exam or complete the
assignment within a reasonable time after the absence: a period equal to the
length of the absence, up to a maximum of one week. A student who notifies the
instructor and completes any missed exam or assignment may not be penalized
for the absence. A student who fails to complete the exam or assignment within
the prescribed period may receive a failing grade for that exam or assignment.

If a student or an instructor disagrees about the nature of the absence (i.e., for
the purpose of observing a religious holy day) or if there is similar disagreement
about whether the student has been given a reasonable time to complete any
missed assignments or examinations, either the student or the instructor may
request a ruling from the chief executive officer of the institution, or his or her
designee. The chief executive officer or designee must take into account the
legislative intent of TEC 51.911(b), and the student and instructor will abide by
the decision of the chief executive officer or designee.

These descriptions and timelines are subject to change at the discretion of


the Professor.
Course Syllabus
Selected References

Pellegrino ED (2008) The Philosophy of Medicine: A Pelligrino Reader University


of Notre Dame Press

Rosenstand, N. (2006). The Moral of the Story: An Introduction to Ethics. Boston:


McGraw-Hill

Dewey, R. E, and Hurlbutt III, R. H, (1977). An Introduction to Ethics. New York:


MacMillan Publishing Co.

Gilligan, Carol. In a Different Voice. Cambridge. Harvard University Press, 1988.

Hick, J. (1992). An Interpretation of Religion, New Haven, Yale University Press.

Hinderer, Drew E. & Hinderer, Sara R. (2001). A Multidisciplinary Approach to


Health Care Ethics. Mountain View: Mayfield Publishing Company.

Hobbes, Thomas. Leviathan. Indianapolis, IN: Bobbs-Morrill, 1959.

Kane, R. H. (1999). The Quest for Meaning: Values, Ethics and Modern
Experience. Springfield: The Teaching Co.

Kant, Immanuel. The Critique of Pure Reason. Translated by N.K. Smith,


London: MacMillan, 1958.

Locke, John. Two Treatises on Government. Edited by Peter Laslett. Cambridge:


Cambridge University Press, 1988.

McGee, G. Pragmatic Bioethics, 1999, Vanderbilt University Press, Nashville.

Nozick, Robert. Anarchy, State and Utopia. New York: Basic Books, 1974.

Pence, GE. (2000). Classic Cases in Medical Ethics. Boston: McGraw-Hill.

Rawls, John. A Theory of Justice. Cambridge. Harvard University Press, 1971.

Singer, Peter. Ethics. Oxford: Oxford University Press, 1994.

Solomon, R. C, and Higgins, K. M. (1996). A Short History of Philosophy, New


York: Oxford University Press.
Walton, Douglas Ethical Argumentation. Oxford, UK: Lexington Books, 2003.

Sharkey, Paul W. A Philosophical Examination of the History and Values of


Western Medicine, The Edwin Mellen Press.

Textbooks:

Vaughn: Bioethics

Gert, Clouser, et.al. Bioethics

Handouts of Philosophy of Medicine

Syllabus of classes

August 20: 1. Introduction:


THE GREAT DEBATE IN PHILOSOPHY OF MEDICINE:
WHOSE MEDICINE IS IT ANYWAY?

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August 27:2.TOWARD A PHILOSOPHY OF MEDICINE and MORAL


REASONING IN BIOETHICS

Lecture: Pre-Greek medicine


a. Egypt
i. Harris Papyrus
ii. Book of Dead
b. Homer
i. Prayer to Apollo
ii. Wounding in the Iliad

c. The Philosophy/Ethics of medicine


i. Patroclus and empathy

Reading: HANDOUT: ACKERKNECHT:PRIMITIVE


MEDICINE T0 PRE-HIPPOCRATIC TIMES

Vaughn: 3-29
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September 3: 3.TOWARD A PHILOSOPHY OF MEDICINE and
BIOETHICS AND MORAL THEORIES

Lecture: Classical Greek medicine


d. The context
i. Classical Greece
ii. Pericles and the plague

e. Hippocrates

f. The Philosophy/Ethics of medicine


i. Earth, Air and Waters
ii. The Hippocratic Oath

g. Plato and medicine


h. Aristotle and medicine

Reading: HANDOUT: HIPPOCRATIC OATH;


NUTTON: BEYOND THE HIPPOCRATIC OATH;
OSLER: PLATONIC MEDICINE
CAPLAN: DOES THE PHILOSOPHY OF MEDICINE
EXIST?

VAUGHN: 30-48
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September 10: 4. THE MEDICAL PROFESSION and PATERNALISM


AND PATIENT AUTONOMY
Lecture: Galenic medicine
a. The context
i. neo-Platonism
ii. Roman Empire

b. Galen

c. Arabic medicine
i. the Context
ii. Rejection and outcome

d. The Philosophy/Ethics of medicine


i. Church medicine
Reading: HANDOUT: NUTTON: ROMAN MEDICINE,
250-200AD;
THE ARAB-ISLAMIC MEDICAL TRADITION;
CHRISTIAN MEDICINE

VAUGHN: 51-103
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September 17: NO CLASS - MEETING

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SEPTEMBER 24:5. THE MEDICAL PROFESSION and


PATERNALISM AND PATIENT AUTONOMY
First Exam
Lecture: From Reformation to Enlightenment
i. The context
i. Luther, Kopernicus and Galileo
ii. F. Bacon, Wren, Newton and the other “xxxxbritches.”

j. Harvey

k. The Philosophy/Ethics of Science

Reading: HANDOUT: KING: PROGRESS AND


PITFALLS;
FOUCAULT – BIRTH OF THE CLINIC

VAUGHN: 51-103

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October 1: 6. 18TH AND 19Th CENTURIES MEDICAL SCIENCE AND
MEDICAL PHILOSOPHY and TRUTH-TELLING AND
CONFIDENTIALITY in BIOETHICS

Lecture: Growth of the Professions

a. AMA Code of Ethics


b. Moralization of the Deviant
c. Development of Medical Technology

Reading: Handout: GEORGE WASHINGTON’S FINAL


ILLNESS;
DISEASES OF THE NEGRO RACE;
CONTAGIONISM;
MORALIZATION OF THE DEVIANT; THE
MEDICALIZATION OF SUICIDE;
THE DISCOVERY OF HOMOSEXUALITY

VAUGHN: 105-138

First Pre-term paper due

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October 8: 7. EARLY 20TH CENTURY MEDICINE and INFORMED


CONSENT IN BIOETHICS)

Lecture: Authority and Professionalization in Medicine


Flexner Report

Reading: HANDOUT: SCIENCE, DISEASE AND


PRACTICE;
DOCTORS AND PATIENTS;
WILLIAMS: THE USE OF FORCE;
SELZER:IMELDA;
OSLER: AEQUANIMATAS
SELDIN: THE BOUNDARIES OF MEDICINE
VAUGHN: 144-189

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October 15: 8. NATIONAL SOCIALIST MEDICINE and HUMAN


RESEARCH IN BIOETHICS

Lecture: Early 20th Century German medical science – The Doctor and His
Mission
National Socialist Comprehensive World-View

Reading: RAMM: NATIONALSOCIALIST


WELTANSCHAUUNG;
RACIAL HYGIENE;
NAZI EXPERIMENTS ON HUMANS

VAUGHN: 193-246

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October 22: No class – MEEING

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October 29: 9. THE BIRTH OF BIOETHICS and THE ISSUE OF


ABORTION IN BIOETHICS)

Second Exam

Lecture: The Birth of Bioethics

Reading: COLE:MEDICAL ETHICS AND LIVING A


LIFE;
OLSON: MISCARRIAGE;
WALKER:MEDICINE;
HILFIKER: MISTAKES
COOPER: HERMENEUTICS

VAUGHN: 253-347

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NOV. 5: 10. PHILOSOPHY OF MEDICINE and REPRODUCTIVE


TECHNOLOGY IN BIOETHICS

LECTURE: Philosophy of Medicine vs. Bioethics

READING: PELLEGRINO: PHILOSOPHY OF


MEDICINE

VAUGHN: 354-452

Second Pre-term paper due

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November 12: 11. INTERNAL MORALITY OF MEDICINE AS


PHILOSOPHY and GENETIC CHOICES IN BIOETHICS

TH
l. Lecture: 20 CENTURY PHILOSOPHY OF MEDICINE

Reading: PELLEGRINO:INTERNAL MORALITY OF


MEDICINE

VAUGHN: 460-525

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November 19: 12.AGAINST AN INTERNAL MORALITY OF
MEDICINE and EUTHANASIS IN BIOETHICS

m. Lecture. Against an internal morality of medicine


Social Construction of morals

Reading: GERT, CULVER, CLOUSER: PATERNALISM


AND ITS JUSTIFICATION; DEATH; EUTHANASIA

VAUGHN: 526-604

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November 26: THANKSGIVING

__________________________________________________________
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DEC. 3: INTERNATIONAL PHILOSOPHY OF MEDICINE and


JUSTICE AND HEALTH CARE

x. Lecture: International Medicine


International Bioethics

READINGS: GLOBAL BIOETHICS


GERT: WHAT A DOCTOR MUST KNOW;
COOPER: EMBODIED TECHNOLOGY;
BAYESIANISM

VAUGHN: 613-682
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December 10: CONCLUSION

EXAM # 3 – LAST DAY OF CLASS


TERM PAPER DUE –DAY BEFORE GRADES DUE

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