Health Care Ethics Philosophy 386 – LEC X50 Winter 2021

Health Care Ethics

Philosophy 386 – LEC X50 Winter 2021 Course Syllabus

Meeting Time: Wednesdays 6:00 PM – 9:00 PM

Location: Online (Zoom link, see list of Zoom meetings on eClass) Course Website: Login at the e-Class website

(https://eclass.srv.ualberta.ca/portal/index.php) and select “PHIL 386 LEC X50 - Winter 2021 - HEALTH CARE ETHICS”

Instructor: Peter Andes E-mail: [email protected]

Office Hours: Thursdays 2:00 – 3:00 pm, and by appointment (to be conducted through Zoom via link “My Online Office” on eClass) Course Description

This course examines ethical problems that arise in the practice of health care. Topics include the nature and importance of informed consent, substitute decision-making and evaluations of patients’ best interests, end-of-life decision-making (including palliative care, euthanasia, and physician assisted-suicide), abortion and treatment decisions for infants, reproductive decisions (including the use of new reproductive and genetic technologies), distributive justice and access to health care, and the ethics of research involving human subjects. While our primary focus will be on practical ethical problems, we will see how attempts to resolve them will lead us to consider more general ethical questions about what it is for someone’s life to go better or worse, the nature and ethical importance of autonomous choice, what makes death bad, what makes killing wrong, and what general sorts of support we owe to others in need.

There are no prerequisites for this course.

Course Objectives and Expected Learning Outcomes

A primary aim of this course is to help students identify the distinctively ethical questions that arise in the practice of health care and to answer them in ways that are best supported by evidence and philosophical methods. An additional objective is to develop general abilities to identify and fruitfully explore philosophical questions. This involves honing students’

abilities to reason, read, and write clearly, critically, and analytically.

Upon completion of this course you should be able to:

1. Define key concepts in health care ethics, including but not limited to, informed consent, paternalism, and privacy

2. Explain the core principles of health care ethics, such as respect for autonomy, beneficence, and justice

3. Use the concepts and principles of health care ethics to interpret typical issues in health care practice and policy

4. Identify the special moral responsibilities of health care professionals, such as the responsibility to provide appropriate care and the duty to maintain confidentiality

5. Recognize ethical issues in a case or a matter of policy and identify the information needed to deal with the issues

6. Examine and compare ethical arguments for a position in health practice or policy, and assess the strength of competing arguments

7. Recognize how discoveries in medical science and innovations in biomedical technology challenge accepted health care practice and policy

8. Collaboratively and individually, provide well-reasoned arguments for positions on typical issues in health practice, research, or policy.

Course Format

Knowledge of concepts, principles, health law, policies and practices will be attained through formal lectures and assigned readings. Your mastery of this knowledge will be assessed primarily through the examination and other written work. Skills in using this knowledge to interpret issues and reason carefully toward resolutions will be

developed in whole-class and small-group discussions. Your attainment of these skills will be assessed through the examination and your papers.

Textbooks

Principles of Biomedical Ethics Eighth Edition by Tom L. Beauchamp and James F.

Childress, Oxford University Press, 2019

You are responsible for checking the eClass reading schedule regularly.

Important Dates

First Day of Class: January 11 Add/drop date: February 10 Final Withdrawal Date: April 1 Last Day of Classes: April 16

Final Exam Date: April 14 (last day of class)

Course Requirements

10% Class Attendance and Participation

30% First Paper Due Feb 22 (Around 7 pgs / 1,800 words) 30% Second Paper Due March 22 (Around 7 pgs / 1,800 words)

30% Final Exam April 14 (last day of class, question bank issued March 31) There will be no “curve” or enforced grade distribution in this course; work will be assessed by the standards explained below.

Class Attendance and Participation:

Because learning to do philosophy requires actively examining the merits of philosophical ideas, it is imperative that you attend online class and participate in online discussion. Much of the material for the course will come directly from lecture and class discussion, and will not necessarily be covered in the readings. I will take attendance using Zoom’s attendance logs feature you will receive participation credit for attending class and taking part in discussion.

2

Papers

Paper Topics: Paper topics will be provided two weeks before the due dates. You are also encouraged to develop and write on topics of your own design concerning the material we cover. Just make sure to get my approval of your topic in advance. (One general method for developing a topic is to take any of the views we have discussed and either argue that it is wrong or defend it against the strongest objections.)

Submitting papers: Papers should be submitted electronically to the eClass submission link by the end of the day (i.e. midnight) on the due-dates on the syllabus. If for some reason you face seriously extenuating circumstances (e.g. illness or family emergency) and are unable to submit a paper by the deadline, please contact me ahead of time to make arrangements if you can.

Papers submitted late without contacting me ahead of time will receive a -4% penalty for each 24 hour period that transpires past the deadline.

Help with papers: I want to help you with your papers, and I strongly encourage you to come to online office hours to discuss your ideas about them before they are due. You are in particular encouraged to email me outlines and thesis statements, on which I can give you feedback.

Paper Evaluation: Papers will be graded electronically and returned to you via eClass. My objective is for you to learn as much as possible from the feedback I provide. In order to return graded papers in a timely fashion my written comments will be confined to a big-picture

evaluation of your paper’s strengths and weaknesses and my suggestions for improvement. But you are strongly encouraged to come to office hours if you are in any way puzzled about why you received the mark you did and how you can do better on the next assignment. In addition to the official weights I take a history of improvement into account if you are between two different final grades.

Final Exam

The format of the take-home final exam will be three long-answer questions, each

approximately 500-800 words typed. You will be presented with six questions on the day of the final exam, from which you will pick three to answer and submit. The six questions will be selected from a larger bank of twelve questions which I will post (on the eClass website) two weeks before the final exam date.

Standards for grading the long-answer questions will resemble those for grading papers, but there will be less of a requirement to offer particularly striking and original ideas in order to receive high marks. Weight will be placed on your ability to demonstrate a basic understanding of the issues we have covered and an ability to relate and apply this understanding in ways that reflect careful thought and philosophical reasoning and defend a position on the topic

supported by reasoned arguments. Where the papers look to assess how well you can address specific topics in which you are particularly interested, the take-home exam is intended to assess the breadth of your knowledge and reasoning skills.

To do well on the final, students must be sure to have prepared possible answers (either bullet- point style briefs or full responses or by another study method you prefer) before the day of the final, as you will only have two hours to return the completed exam from the time the questions to be answered are posted.

Grading System Letter Grade

Grade Point Percentage

A+ 4.0 90 – 100

A 4.0 85 – 89

A- 3.7 80 – 84

B+ 3.3 76 – 79

B 3.0 73 – 75

B- 2.7 70 – 72

C+ 2.3 66 – 69

C 2.0 62 – 65

C- 1.7 58 – 61

D+ 1.3 54 – 57

D 1.0 50 – 53

F 0.0 49 and under

Plagiarism and Academic Integrity:

If you draw upon the work or ideas of others, you must cite your sources. It is VERY important that you understand what counts as plagiarism and that you do not plagiarize; committing plagiarism will result in failure of the course and the possibility of expulsion from the university.

Definitions and guidelines on what constitutes plagiarism and other breaches of academic integrity can be found in The Code of Student Behaviour

(www.ualberta.ca/governance/studentappeals.cfm). See also the “Don’t Cheat Sheet”

(http://www.uofaweb.ualberta.ca/governance/StudentAppealsCheatsheet.cfm).

The university is very concerned about maintaining standards of academic integrity and honesty and has mandated that all course outlines include the following statement:

The University of Alberta is committed to the highest standards of academic integrity and honesty. Students are expected to uphold the policies of the University in this respect. Students are particularly urged to familiarize themselves with the provisions of the Code of Student Behaviour (online at

www.ualberta.ca/governance/studentappeals.cfm) and avoid any behaviour which could potentially result in suspicions of cheating, plagiarism, misrepresentation of facts and/or participation in an offence. Academic dishonesty is a serious offence and can result in suspension or expulsion from the University.

I am here to help you with your papers, so please let me know if you are struggling with them in any way. Also, the university recognizes the stressors faced by students, and provides a wide variety of support services, which can be found at the Truth in Education [TIE] website (http://www.uofaweb.ualberta.ca/TIE/nav01.cfm?nav01=22064&).

The best all-purpose website for student services is: https://www.ualberta.ca/current-students.

Schedule of Topics and Readings

This list is subject to change. All readings (apart from news articles and brief descriptions of cases, which will be on eClass) will be from the textbook. Lecture slides will be posted on the course website prior to our meetings to aid you in taking notes and referencing various parts of the material in the course of the lecture and discussion.

From time to time I will mention readings during the lectures which are not among the main readings below. These I have placed in the ‘Further Reading’ folder on eClass. They can be especially useful as resources if you are writing a paper on a topic with which they deal. But you should not feel any pressure to read further readings unless you find them particularly helpful or interesting. All the readings below are required reading. I will additionally post news articles and brief descriptions of cases for class discussion on eClass that are not included below.

Week 1 - Jan 13:

Introduction (no readings)

Week 2 - Jan 20:

- Principles of Biomedical Ethics, Chapter 1, “Moral Norms”

Week 3 - Jan 27:

- Principles of Biomedical Ethics, Chapter 2, “Moral Character”

Week 4 - Feb 4:

-Principles of Biomedical Ethics, Chapter 3, “Moral Status”

Week 5 - Feb 10:

- Principles of Biomedical Ethics, Chapter 4, “Respect for Autonomy”

Week 6 - Feb 17: Reading Week (No Class)

Week 7 - Feb 24 (First Paper Due Feb 22):

-Principles of Biomedical Ethics, Chapter 5, “Nonmaleficence”

Week 8 - March 3:

- Principles of Biomedical Ethics, Chapter 6, “Beneficence”

Week 9 - March 10:

- Principles of Biomedical Ethics, Chapter 7, “Justice”

Week 10 - March 17:

- Principles of Biomedical Ethics, Chapter 8, “Professional-Patient Relationships”

Week 11 - March 24 (Second Paper Due March 22):

- Principles of Biomedical Ethics, Chapter 9, “Moral Theories”

Week 12 - March 31:

- Principles of Biomedical Ethics, Chapter 10, “Method and Moral Justification”

Week 13 - April 7: Review (No readings)

April 14: Final Exam (Question bank issued March 31, questions to answer will be posted at 6:00 PM on April 14, to be submitted at 8:00 PM April 14th)

Recording of Lectures

Audio or video recording, digital or otherwise, of lectures, labs, seminars or any other teaching environment by students is allowed only with the prior written consent of the instructor or as a part of an approved accommodation plan. Student or instructor content, digital or otherwise, created and/or used within the context of the course is to be used solely for personal study, and is not to be used or distributed for any other purpose without prior written consent from the content author(s).

Accessibility Resources: (1 – 80 SUB)

The University of Alberta is committed to creating work and learning communities that inspire and enable all people to reach their full potential. Accessibility Resources promotes an

accessible, inclusive, and universally designed environment. For general information to register for services visit the Accessibility Resources webpage.

The Academic Success Centre: (1-80 SUB)

The Academic Success Centre offers a variety of workshops on effective study and exam strategies. There are in-person and online sessions available for a modest fee.

The Centre for Writers: (1-42 Assiniboia Hall)

The Centre for Writers offers free one-on-one writing support to students, faculty, and staff. Students can request consultation for a writing project at any stage of

development. Instructors can request class visits and presentations.

Health and Wellness Support

There are many health and community services available to current students. For more information visit the Health and Wellness Support webpage.

Office of the Student Ombuds

The Office of the Student Ombuds offers confidential interviews, advice and support to students facing academic, discipline, interpersonal and financial difficulties.

Learning and working environment

The Faculty of Arts is committed to ensuring that all students, faculty and staff are able to work and study in an environment that is safe and free from discrimination and harassment. It does not tolerate behaviour that undermines that environment.

Policy about course outlines can be found in the Evaluation Procedures and Grading System section of the University Calendar.

Disclaimer

Any typographical errors in this syllabus are subject to change and will be announced in class and posted on eClass.

Standards for Grading Papers¹

B: The baseline grade of competent but not exceptional work. The grade of "B" functions as a baseline grade, signifying competent but not exceptional work. Papers are graded up or down relative to these baseline "B" criteria:

• the paper addresses all parts of the paper topic

• offers consistent, coherent arguments for a clearly articulated position that makes sense

• considers significant objections to that position

• replies to those objections

• makes relevant use of course readings and lectures, displaying a grasp of, without merely replicating, their content

• is generally well-written and well-organized, with few or no grammatical, punctuation and spelling errors

• does not contain significant misunderstandings

B+: The beginnings of distinction. A "B+" paper meets all of the standards for a "B", but in addition:

• offers the germs of an original, striking, or powerful idea, argument, or

illustration/application--something beyond the ordinary, beyond what one would expect an undergraduate to come up with on a first pass at the topic. An unusually apt analogy that illuminates a previously obscure aspect of the problem; a clever

counterexample to a seemingly persuasive claim; a sharp distinction that does real philosophical work; a subtle point drawn from a close reading of a text; a compelling illustration or application of a principle--all of these can count as an idea that rises the paper above the ordinary

• alternatively, the paper might just work out ordinary ideas to a greater depth (more iterations of significant objections and replies, which help deepen the idea) than usual, or develop relevant arguments that demonstrate real mastery of the course readings

1 These criteria are adapted from standards developed by Elizabeth Anderson.

A- or A: Outstanding work. An A- or A paper meets all of the standards for a B+, but in addition:

• works out the original, striking, or powerful idea, argument, or

illustration/application fully and deeply, with outstanding execution that demonstrates a firm grasp of the underlying concepts, principles, facts, and argumentative strategy

• alternatively, the paper might offer an unusually comprehensive survey of possible moves by both sides, and clearly and systematically evaluate them, coming to a closely reasoned conclusion. The survey must be systematic, not scattershot: it must develop the alternatives logically and to substantial depth, not just assess a random mix of ad hoc considerations. And it must consistently display an understanding of the underlying point of different arguments, what they are really getting at (not just a superficial swipe at them).

• alternatively, for a paper based on a text, the paper might offer an unusually

sophisticated, close and systematic reading of a philosopher's texts, paying attention to tensions and contradictions in the author's work, alternative interpretations of passages (offering persuasive arguments for preferring one interpretation to another), and interpretations that bring out philosophically significant points, especially if they offer fresh, unconventional readings

Now, for the downside:

B-: Most of the paper is O.K., but it but contains significant errors, omissions, or

misunderstandings. A B- paper falls just short of "B" standards, by, for example (this list is not exhaustive):

• failing to answer one of the parts of the paper topic

• misunderstanding a substantial philosophical point, or confusing different positions

• failing to articulate a consistent position

• offering fallacious arguments, or arguments that don't really address the core issue

• failing to consider objections to one's position

• wasting space on issues that are not pertinent to the paper topic

• offering a confused, sloppy, superficial, or erroneous interpretation of course readings or other cited texts

• containing numerous grammatical, spelling, or punctuation errors

• lacking a clear organization, failing to logically order and signpost important points C+, C, C-: Exemplifies one or more of the problems of a B- paper, more often or more pervasively. "C" grades may also be assigned to papers that miss the point of the assignment or confuse polemical assertion with argumentation, or lack proper citation of central points.

D, F: These grades are reserved for moral failings: not bothering to make a serious effort, plagiarism.