*mandatory* Course reflections (20 Mar)

Please comment on these questions -- use separate posts if you like.   

• What have you learned in this course that surprised you?
• Would you take another course in philosophy if money/time weren't major barriers?  
• Do you have an understanding of the philosophical dimensions of the study of biomedical ethics?
• Have you developed an appreciation for the relevance of metaphysical, epistemological, and ethical questions in our daily lives?
• Have you improved in your skills of analysis and critique, as well as in written and oral communication due to this course?

Thinking Out Loud Final Exam (18 March)

An excerpt from your final exam to collectively consider here.  Respond to at least two of the points below:

• How do you define health? 
•   What does your ideal health care system look like? (Briefly sketch it out—what kinds of services should it provide?  Who is covered?  How is it paid for?).  You might consider what you saw in the Emperor of All Maladies -- the cost of treatment for cancer, and other high costs associated with medical care (we've seen some stories about it in our Current Events blog). 
•  Kai Nielsen writes:  “If there is the need for some particular regime of care and the society has the resources to meet that need, without undermining structures protecting other at least equally urgent needs, then, ceteris parabus, the society if it is a decent society, must do so” (p. 652).  Do you agree with Nielsen?  Does his argument apply to the U.S.?  Explain.  Can a just society refuse to provide health care to all of its citizens?  Is health care a right, and if so, what kind?  For whom is it a right (citizens, military, the elderly, children, all, none?).  

Case 42 (16 Mar)

Collectively consider the questions at the end of the case here.  Contributing to this prompt will help you think about health care reform, which will get you ready for one of your final exam questions.

Facing Death (16 Mar)

Thinking about death & dying is philosophical thinking:  who am I? what will happen to me after I die?  what gave my life meaning, etc.  It can also give us a way to think holistically about biomedical ethics.  What did you see in the video that relates to class?  Are we fully addressing the needs of dying patients?  Critique our health care system:  what could we be doing better with respect to the dying?

Case 10 on culture (16 Mar)

What would you do if Marie were your patient?  Let's try to get multiple viewpoints represented -- so some of you might have to play devil's advocate.

Case 13 Cochlear implant analysis (16 Mar)

Case 13 Cochlear implant analysis:  what arguments can you make for and against the implants?  Use Macklin's essay in your answer.

HC Elsewhere observations (16 March)

After you've posted your HC Elsewhere research, highlight unusual findings.  After most of us have posted, comment on the highlighted findings.  I'm especially interested in what you think about Cincinnati's data.

Genetics Videos (9 Mar)

You've watched various videos on genetics.  Do you feel optimistic or pessimistic about the personalization of medicine (at the genetic level)?  What are some pros? Cons?  Try to refer to at least two different videos in your response.

Case 34 Huntington's (9 Mar)

Answer the questions at the end of the case.  Argue a position you don't endorse!  :)  Respond to a classmate's post (your real view or your temporary one).

March Current Events

New Procedure Allows Kidney Transplants From Any Donor - NYTimes.com
http://mobile.nytimes.com/2016/03/10/health/kidney-transplant-desensitization-immune-system.html?emc=edit_th_20160310&nl=todaysheadlines&nlid=25414714&_r=0&referer=

Christians Flock to Groups That Help Members Pay Medical Bills - NYTimes.com
http://mobile.nytimes.com/2016/03/11/us/christians-flock-to-groups-that-help-members-pay-medical-bills.html?emc=edit_th_20160311&nl=todaysheadlines&nlid=25414714&referer=

First Uterus Transplant in U.S. Has Failed - NYTimes.com
http://mobile.nytimes.com/2016/03/10/health/first-uterus-transplant-in-us-has-failed.html?nlid=25414714&src=recpb&referer=

When Gene Tests for Breast Cancer Reveal Grim Data but No Guidance - NYTimes.com
http://mobile.nytimes.com/2016/03/12/health/breast-cancer-brca-genetic-testing.html?emc=edit_th_20160312&nl=todaysheadlines&nlid=25414714&referer=

To Maintain Supply of Sex Slaves, ISIS Pushes Birth Control - NYTimes.com
http://mobile.nytimes.com/2016/03/13/world/middleeast/to-maintain-supply-of-sex-slaves-isis-pushes-birth-control.html?emc=edit_th_20160313&nl=todaysheadlines&nlid=25414714&_r=0&referer=

Veterans Seek Help for Infertility Inflicted by Wounds of War - NYTimes.com

http://mobile.nytimes.com/2016/03/01/health/veterans-infertility-benefits.html?emc=edit_th_20160301&nl=todaysheadlines&nlid=25414714&referer=

Helping Women in Africa Avoid H.I.V. - NYTimes.com

http://mobile.nytimes.com/2016/02/26/opinion/helping-women-in-africa-avoid-hiv.html?emc=edit_th_20160226&nl=todaysheadlines&nlid=25414714&referer=

*new* http://www.pih.org/blog/protecting-newborns-against-hiv-in-russia

H.I.V.’s Toll on Black and Latino Men - NYTimes.com

Try to relate to our readings on HIV from 22 Feb.

http://mobile.nytimes.com/2016/02/29/opinion/hivs-toll-on-black-and-latino-men.html?emc=edit_th_20160229&nl=todaysheadlines&nlid=25414714&referer =

 

Steve Beshear on ending Kentucky health care insurance: 'I cannot sit idly by'
We'll soon be discussing health care reform.  What do you think about this real-time, real-life situation in Kentucky?  This article gives some background, but there's more research to do.  Let's try to figure it out together, separately from what the politicians are saying (although, of course, it is a political issue).
http://www.courier-journal.com/story/news/politics/2016/02/11/beshear-ending-kynect-cannot-sit-idly/80223880/#

Not Every Drop of a Person’s Blood Is the Same, a Study Says - NYTimes.com
http://mobile.nytimes.com/2016/02/23/health/not-every-drop-of-a-persons-blood-is-the-same-a-study-says.html?nlid=25414714&src=recpb&referer=

Legionnaires’ Outbreak in Flint Was Met With Silence - NYTimes.com
http://mobile.nytimes.com/2016/02/23/us/legionnaires-outbreak-in-flint-was-met-with-silence.html?emc=edit_th_20160223&nl=todaysheadlines&nlid=25414714&_r=0&referer=

NYTimes: Patient Confidentiality and a Doctor’s Judgment Call
http://www.nytimes.com/2015/12/01/opinion/patient-confidentiality-and-a-doctors-judgment-call.html?smprod=nytcore-iphone&smid=nytcore-iphone-share
A doctor and a lawyer discuss physicians’ obligation.

NYTimes: Francis Says Contraception Can Be Used to Slow Zika
http://www.nytimes.com/2016/02/19/world/americas/francis-says-contraception-can-be-used-to-slow-zika.html?smprod=nytcore-iphone&smid=nytcore-iphone-share
The pope’s remarks stirred up divisions in the leadership of the Roman Catholic Church in South America about whether birth control should be widely allowed.

Case 38 Delayed Twining (1 March)

Answer the questions at the end of the case, referring at least to one of your readings and/or ethical theories.

Case 12 (24 Feb)

Using your readings on HIV (pp. 116-9), and the short CDC video about HIV, examine Case 12.

Play devil's advocate -- challenge each other (even if you really believe the same thing). 

Case 15 (24 Feb)

Building on your informed consent readings (pp. 120-132), and referring to your ethical theories, what should happen in Case 15? Take a position you don't actually believe in and defend it against your classmates.

Research Ethics (24 Feb)

1) Review what we know about the Zika virus.  I've posted some info for you on our current events page and it is in the news almost constantly.
2) Play a character from The Lab,   https://ori.hhs.gov/thelab 
3) Imagine you are members of the TMC Institutional Review Board (IRB).  The IRB reviews research projects for, among other things, ethical treatment of human subjects.  U.S. researchers from TMC are going to run Zika treatment trials on pregnant women in Brazil.  What are you most concerned about with that type of research?  Use your readings on global research (3 essays pp. 78-292 and what you learn in The Lab) to assess the scenario.  (You don't need to address everything in the readings -- there's a lot! -- but show me that you've read and played the game).

Case 7 Cosmetic Surgery (15-17 Feb)

Make a distinction between a procedure for restoration/therapy vs. cosmetic/enhancement and argue about what should happen in this case.  Answer the questions at the end of the case, and then imagine some other medical case involving genetics --- do you feel the same way if the "enhancement" comes from genetic engineering?  (We'll talk about this in a week or two...this is just a preview that there are similar issues.  Don't assume that just because cosmetic surgery is rather familiar to us that it is morally appropriate.  Likewise, don't assume just because genetic engineering is not familiar to us, that it is morally inappropriate).

Case 25 Anencephalic Newborns (15-17 Feb)

Answer the questions at the end of the case, but try to argue for a point of view you don't actually support.  Connect your answer to something else we've read (a case, an article, a theory).

Being Mortal (17 Feb)

Using the doctor-patient relationship models from Beauchamp & Childress reading for this week, analyze Being Mortal (book from last week).  Where do you see that health professionals could do a better job helping patients?  And by "better" take Gawande's lead to define it as following more what gives meaning and value to the patient's life, not what is easier for staff or makes family feel that the patient is safe.

Euthanasia (8 Feb)

Answer collectively - everyone contributes to one full answer.

What are the strongest 2-3 arguments for euthanasia? The strongest 2-3 against? Reference your readings. Note important vocabulary and distinctions, like what's physician assisted suicide (PAS) and how might that differ from euthanasia.

Case 27 re: artificial nutrition (by 10 Feb)

Case 27 re: artificial nutrition

(Work on Case 21 first)

Answer questions at end of case, using one of your theories. Like the previous case, let's cover all the theories, so just rotate to the next one on a first-come, first-serve basis. As the last 2 people post, there might be some repeat.

The theories: Kant, Utilitarianism, Virtue Ethics, Casuistry, Ethics of Care, Ross' Principles, Principles of Bioethics, Coherence theory.

This time, let's critique each other. Each person pick another post and analyze the response.

Case 21 - change of DNR (8 Feb)

• Case 21 re: change of DNR

Answer questions at end of case, using one of your theories. Let's cover all the theories, so just rotate to the next one on a first-come, first-serve basis. As the last 2 people post, there might be some repeat.

The theories: Kant, Utilitarianism, Virtue Ethics, Casuistry, Ethics of Care, Ross' Principles, Principles of Bioethics, Coherence theory.

Case 3 (1 & 5 Feb)

In groups, use the following theories to answer the questions at the end and generally assess the case.

Groups form around whichever theory you pick but no more than 4 of you on any one theory.

• Utilitarianism
• Kant
• Virtue Ethics
• Ethics of Care / Feminist Ethics
• Principles of Biomedical Ethics

Being Mortal (8 Feb)

*new* a related story if you are interested about improving nursing home care:

He Broke the Law to Build a Better Nursing Home – Next Avenue 

http://www.nextavenue.org/he-broke-the-law-to-build-a-better-nursing-home/

 
Using one of the readings for this week (Rachels, Callahan, or Brock on Euthanasia; the reading on futility; the Oregon Physician-Assisted Suicide reading), comment on the main ideas of Dr. Atul Gawande's Being Mortal book and video.  Here's a video interview with him about his book and those ideas.