Quick Links

Primary Reading:
- Beauchamp, T. and Childress, J. (2009) Principles of Biomedical Ethics (7th ed.), chapter 9 "Moral Theories." Oxford University Press: Oxford. (for weeks 1-3).
Additional Optional Readings:
- James Rachels, The Elements of Moral Philosophy, chs. two, five, seven, eight, nine, ten.

Week 2 (Week of Jan. 15): Introduction to Moral Theory (cont.).

Primary Reading:
- Beauchamp, T. and Childress, J. (2009) Principles of Biomedical Ethics (7th ed.), chapter 9 "Moral Theories." Oxford University Press: Oxford. (for weeks 1-3).
- Gustafsson, J. E. (2022). Bentham’s mugging. Utilitas, 34(4):386–39. (It's a fun, quick read.)
Additional Optional Readings:
- James Rachels, chs. seven, eight, nine and ten.
- A bit higher level entry point but still a good introduction to Virtue Ethics can be found at the Stanford Encyclopedia of Philosophy (SEP). Good entries to check out include Aristotle's Ethics and Virtue Ethics, as well as entries on Mencius and Ancient Chinese Ethics.
Other Stuff:
- See what happens in Peter Singer's basement.
- Bonus! Here's a photo of Jeremy Bentham at UCL. You can see his head (yes, his head) near the bottom between his feet. On the terms of his will, he attends faculty board meetings at UCL. I've heard rumor that he is recorded as "present but not voting," or that in the case of a tie he casts the deciding vote (being "no").

Week 3 (Week of Jan. 22): The Principles of Medical Ethics

Primary Reading:
- Gillon, R. (1994). Medical ethics: Four principles plus attention to scope. BMJ: British Medical Journal, 309(6948): 184–188.
Secondary/Optional Reading:
- Dawson, A. and Garrard, E. (2006). In defence of moral imperialism: four equal and universal prima facie principles. Journal of Medical Ethics, 32(4): 200–204.
Keywords: The Principles of Medical Ethics

Week 4 (Week of Jan. 29): Applying Moral & Ethical Theories (Case Studies)

Case Studies:
- Shaner, D. M. (2010). Up in the air — suspending ethical medical practice. New England Journal of Medicine, 363(21): 1988–1989.
- Young, M. J. and Lehmann, L. S. (2014). Undocumented injustice? Medical repatriation and the ends of health care. New England Journal of Medicine, 370(7):669–673.
Keywords: Applying Moral & Ethical Theories

Week 5 (Week of Feb. 5): Deception in Medicine and Medical Ethics.

Primary Reading:
- Meyer, C. (2021). Deception and the Clinical Ethicist. The American Journal of Bioethics, 21:5, 4-12.
- Kaldjian, L. & Pilkington, B. (2021). Why Truthfulness is the First of the Virtues. The American Journal of Bioethics, 21:5, 36-38.
Secondary Reading (Optional):
- Gallagher et al. (2009). Disclosing Harmful Medical Errors to Patients: Tackling Three Tough Cases. Chest, 136:3, 897-903. (Gallagher et al. have a similar article in NEJM (DOI: 10.1056/NEJMra070568)
- AJOB open peer commentaries on Meyer (2021)
- Villiger, D. (2024). Informed consent under ignorance. The American Journal of Bioethics, 0(0):1–13. PMID: 38181212. doi: 10.1080/15265161.2023.2296429.
Keywords: Deception in Medicine

Week 6 (Week of Feb. 12): The Obligation to Provide Care: Conscientious Objection & Healthcare Providers

Primary Reading:
- Card, R. F. (2007). Conscientious objection and emergency contraception. The American Journal of Bioethics, 7(6):8–14.
  - Select Commentaries in AJOB (2007) 7(6). (Read at least one--your choice.)
Secondary Readings (Optional):
- Childress, J. F. (1985). Civil Disobedience, Conscientious Objection, and Evasive Noncompliance: A Framework for the Analysis and Assessment of Illegal Actions in Health Care. The Journal of Medicine and Philosophy: A Forum for Bioethics and Philosophy of Medicine, 10(1):63–84. doi: 10.1093/jmp/10.1.63
- Cantor, J. and Baum, K. (2004). The limits of conscientious objection — may pharmacists refuse to fill prescriptions for emergency contraception? New England Journal of Medicine, 351(19):2008– 2012.
- Savulescu, J. (2006). Conscientious objection in medicine. BMJ, 332(7536):294–297.
- Curlin, F. A., Lawrence, R. E., Chin, M. H., and Lantos, J. D. (2007). Religion, conscience, and controversial clinical practices. New England Journal of Medicine, 356(6):593–600.
- Harris, L. H. (2012). Recognizing conscience in abortion provision. New England Journal of Medicine, 367(11):981–983.
- Yang, C. (2020). The inequity of conscientious objection: Refusal of emergency contraception. Nursing Ethics, 27(6):1408–1417.
- Wicclair, M. (2020). Allocating ventilators during the covid-19 pandemic and conscientious objection. The American Journal of Bioethics, 20(7):204–207. PMID: 32716798.
- Wasserman, J. A., Brummett, A. L., Navin, M. C., and Menkes, D. L. (2023). Conscientious objection to aggressive interventions for patients in a vegetative state. The American Journal of Bioethics, 0(0):1–12. PMID: 38032547. doi: 10.1080/15265161.2023.2280099
Keywords: Conscientious Objection

Week 7 (Week of Feb. 19): The Obligation to Provide Care: Civil Disobedience in Healthcare and Medicine (With Special Guests MSPH Jami Baayd and Dr. Alexandra Woodcock)

Primary Reading:
- Our guests' paper (be sure to read!):
  - Woodcock, A. L., Carter, G., Baayd, J., Turok, D. K., Turk, J., Sanders, J. N., Pangasa, M., Gawron, L. M., and Kaiser, J. E. (2023). Effects of the Dobbs v Jackson women’s health organization decision on obstetrics and gynecology graduating residents’ practice plans. Obstetrics & Gynecology. DOI: 10.1097/AOG.0000000000005383.
- King, M. L. (1963). Letter from Birmingham jail. The Atlantic Monthly, 212(2):78–88.
- Wynia, M. K. (2022). Professional civil disobedience — medical-society responsibilities after Dobbs. New England Journal of Medicine, 387(11):959–961.
Secondary Reading (Optional):
- Good foundational article on what we mean by civil disobedience and conscientious objection in a health care context:
  - Childress, J. F. (1985). Civil Disobedience, Conscientious Objection, and Evasive Noncompliance: A Framework for the Analysis and Assessment of Illegal Actions in Health Care. The Journal of Medicine and Philosophy: A Forum for Bioethics and Philosophy of Medicine, 10(1):63–84. doi: 10.1093/jmp/10.1.63
- Arey, W., Lerma, K., Beasley, A., Harper, L., Moayedi, G., and White, K. (2022). A preview of the dangerous future of abortion bans — Texas senate bill 8. New England Journal of Medicine, 387(5):388–390.
- For a study similar to the Woodcock, et al. paper, but focused on residency applications:
  - Mermin-Bunnell, K., Traub, A. M., Wang, K., Aaron, B., King, L. P., and Kawwass, J. (2023). Abortion restrictions and medical residency applications. Journal of Medical Ethics. (online only, forthcoming publication). doi: 10.1136/jme-2023-109190.
Keywords: Civil Disobedience

Week 8 (Week of Feb. 26): Organ Donation (With Special Guest Dr. M. Lanspa)

NOTE: we will meet in-person on TUESDAY Feb. 27 (Thursday we will not meet in class).
Primary Reading:
- This 'point-counterpoint' exchange in CHEST (the papers are short--read all four!):
  - - DeCamp, M., Snyder Sulmasy, L., and Fins, J. J. (2022). POINT: Does Normothermic Regional Perfusion Violate the Ethical Principles Underlying Organ Procurement? Yes. CHEST, 162(2):288–290. doi: 10.1016/j.chest.2022.03.012.
    - James, L., Parent, B., Moazami, N., and Smith, D. E. (2022). COUNTERPOINT: Does Normothermic Regional Perfusion Violate the Ethical Principles Underlying Organ Procurement? No. CHEST, 162(2):290–292. doi: 10.1016/j.chest.2022.03.011.
    - DeCamp, M., Fins, J. J., and Snyder Sulmasy, L. (2022). Rebuttal From Dr DeCamp et al. CHEST, 162(2):292–293. doi: 10.1016/j.chest.2022.03.014.
    - James, L., Parent, B., Moazami, N., and Smith, D. E. (2022). Rebuttal From Dr James et al. CHEST, 162(2):293–294. doi: 10.1016/j.chest.2022.03.013.
Secondary Reading (optional):
- Wall, A. E., Fiedler, A., Karp, S., Shah, A., and Testa, G. (2022). Applying the ethical framework for donation after circulatory death to thoracic normothermic regional perfusion procedures. American Journal of Transplantation, 22(5):1311–1315. doi: 10.1111/ajt.16959.
- On Feb. 14 The American Journal of Bioethics released a call for commentaries on a set of four papers on the ethics of NRP cDCD. Proposals for commentaries are due March 1. These four target articles will be published along with accepted commentaries later this year. These are pre-publication copies:
  - "An Ethics Committee’s Evaluation of Normothermic Regional Perfusion (NRP) in 2018 – Unsatisfactory Answers Then – and Now" by Arthur R. Derse.
  - "Restoring the Organism as a Whole: Does NRP Resurrect the Dead?" by Emil J. N. Busch.
  - "The Unified Brain-Based Determination of Death Conceptually Justifies Death Determination in DCDD and NRP Protocols" by James L. Bernat.
  - "Ethical and Equity Guidance for Transplant Programs Considering Thoracoabdominal Normothermic Regional (TA-NRP) Perfusion for Procurement of Hearts" by Denise M. Dudzinski, Jay D. Pal, & James N. Kirkpatrick.
- For those interested in a thorough summary of the ethics on this debate you can take a look at the Organ Procurement & Transplantation Network's (OPTN) white paper on the ethics of NRP cDCD (PDF). The OPTN is associated with the US Department of Health & Human Services. Here's a link to the report page, which provides a little additional context.
- For a (very) brief look at debates over the 'dead donor rule' here's a sample:
  - Smith, A. P. (2023). Abandoning the dead donor rule. Journal of Medical Ethics, 49(10):707– 714. doi: 10.1136/jme-2021-108049.
  - Omelianchuk, A. (2023). Against abandoning the dead donor rule: Reply to Smith. Journal of Medical Ethics, 49(10):715–716. doi: 10.1136/jme-2022-108701.
Keywords: Organ Donation

Week 9 (Week of March 11): Medically-Assisted-Dying

Primary Reading:
- Quill, T. E. (1991). Death and dignity. New England Journal of Medicine, 324(10):691–694. (A classic and very moving article!)
- Quill, T. E., Dresser, R., and Brock, D. W. (1997). The rule of double effect -- a critique of its role in end-of-life decision making. New England Journal of Medicine, 337(24):1768–1771.
  - Letters to the NEJM Editor on "The Rule of Double Effect." (Optional but offers different viewpoints.)
- Boudreau, J. D., Somerville, M. A., and Biller-Andorno, N. (2013). Physician-Assisted-Suicide. New England Journal of Medicine, 368(15):1450–1452.
Secondary Reading (Optional):
- Rachels, J. (1975). Active and passive euthanasia. New England Journal of Medicine, 292(2):78–80. (Classic reading!)
- Quill, T., Lo, B., and Brock, D. (1997). Palliative options of last resort: A comparison of voluntarily stopping eating and drinking, terminal sedation, physician-assisted suicide, and voluntary active euthanasia. JAMA, 278(23):2099–2104.
- Quill, T. E. (2004). Dying and decision making -- evolution of end-of-life options. New England Journal of Medicine, 350(20):2029–2032.
- Amundson, R. and Taira, G. (2005). Our lives and ideologies: The effect of life experience on the perceived morality of the policy of physician-assisted suicide. Journal of Disability Policy Studies, 16(1):53–57.
- Name Withheld by Request (1988). It’s over, Debbie. JAMA, 259(2):272.
- den Hartogh, G. (2017). Two kinds of physician-assisted death. Bioethics, 31(9):666– 673.
One of my colleagues (Prof. Peggy Battin) is internationally recognized as an expert on this topic. Here's a selection of some of her work, including with a U of U psychiatrist, Dr. Brent Kious:
- Battin, M. P. (1980). Manipulated suicide. Bioethics Quarterly, 2(2):123–134.
- Battin, M. P. (2008). Terminal sedation: Pulling the sheet over our eyes. Hastings Center Report, 38(5):27–30.
- Battin, M. P. and Kious, B. M. (2021). Ending one’s life in advance. Hastings Center Report, 51(3):37–47.
- Kious, B. M. and Battin, M. (2019). Physician aid-in-dying and suicide prevention in psychiatry: A moral crisis? The American Journal of Bioethics, 19(10):29–39.
  - You can also read lots of commentarieson this target article in the same issue of AJOB. That includes a response by Kious and Battin to those commentaries.

Keywords: Medically-Assisted-Dying

Week 10 (Week of March 18): Health Care Disparities

Primary Reading:
- Liao, S.-y. and Carbonell, V. (2023). Materialized oppression in medical tools and technologies. The American Journal of Bioethics, 23(4):9–23. PMID: 35262465.
- Plus, read at least one of the associated AJOB Commentaries.
Additional/Secondary Reading:
- Jordan, M., (2017, March 18). Rural areas brace for a shortage of doctors due to visa policy. New York Times.
- Roberts, L. W., Johnson, M. E., Brems, C., & Warner, T. D. (2007). Ethical disparities: challenges encountered by multidisciplinary providers in fulfilling ethical standards in the care of rural and minority people. The Journal of Rural Health, 23(s1), 89-97.
- CDC Press Release
- Blair, I. V., Steiner, J. F., & Havranek, E. P. (2011). Unconscious (implicit) bias and health disparities: where do we go from here? The Permanente Journal, 15(2), 71.
- Nicholl, J., West, J., Goodacre, S., & Turner, J. (2007). The relationship between distance to hospital and patient mortality in emergencies: an observational study. Emergency Medicine Journal, 24(9), 665-668.
- Sabin, J. A., & Greenwald, A. G. (2012). The influence of implicit bias on treatment recommendations for 4 common pediatric conditions: pain, urinary tract infection, attention deficit hyperactivity disorder, and asthma. American journal of public health, 102(5), 988-995.
- Burgess, D., Van Ryn, M., Dovidio, J., & Saha, S. (2007). Reducing racial bias among health care providers: Lessons from social-cognitive psychology. Journal of general internal medicine, 22(6), 882-887.
- Venkatapuram, S. and Marmot, M. (2009). Epidemiology and social justice in light of social determinants of health research. Bioethics, 23(2):79–89.
- Recent AJOB issues addressing health care disparities:
  - "Innovating for a Just and Equitable Future in Genomic and Precision Medicine Research" (2023 special issue), volume 23, no. 7.
  - AJOB special issue on racial injustice, healthcare, and bioethics (2021), volume 21, no. 2.
Clarification on Implicit Bias:
- Banaji, M. R., & Greenwald, A. G. (2016). Blindspot: Hidden biases of good people. Bantam.

Keywords: Healthcare Disparities

Week 11 (Week of March 25): Conversational AI in Psychotherapy

Primary Reading:
- Tekin, S. (2021). Is Big Data the New Stethoscope? Perils of Digital Phenotyping to Address Mental Illness. Philosophy & Technology, 34(3):447–461.
- Knox, B., Christoffersen, P., Leggitt, K., Woodruff, Z., and Haber, M. H. (2023). Justice, vulnerable populations, and the use of conversational AI in psychotherapy. The American Journal of Bioethics, 23(5):48–50. doi: 10.1080/15265161.2023.2191040
Secondary Reading:
- Sedlakova, J. and Trachsel, M. (2023). Conversational artificial intelligence in psychotherapy: A new therapeutic tool or agent? The American Journal of Bioethics, 23(6). PMID: 35362368.
- Washington, N. (2016). Culturally unbound: Cross-cultural cognitive diversity and the science of psychopathology. Philosophy, Psychiatry, & Psychology, 23(2):165–179.
- Take a look at other AJOB Commentaries too: AJOB v.23, n.5.
Keywords: Conversational AI and Psychotherapy

Week 12 (Week of Apr. 1): Group Case Studies: Independent In-Class Work

This week is for you to work on your Group Case Study Report. You can find instructions, guidance, and possible topics by clicking here.
Group Case Study Discussion

Week 13 (Week of Apr. 8): Group Case Presentations

Apr. 9 (or may be reserved for in-class work on presentations)
- Slot 1
- Slot 2
- Slot 3
Apr. 11
- Slot 1: (Matylda, Payton, Peyton, Sam, Yareli, Michael)
- Slot 2: Contraception (Julia, Olivia, Charlotte)

Week 14 (Week of Apr. 15): Group Case Presentations

Apr. 16
- Slot 1: The Boba Fetts (Trevor, Jess, Gwen, Nathan, Nick)
- Slot 2: Xenotransplantation (Jessica, Dahlia, Spencer, Nathaniel, Lauren, Aiden, Jeremy)
- Slot 3:

Apr. 18
- Slot 1: Apphia, Buffy, Emily Wong, Lin, Raghad, and Sara
- Slot 2:
- Slot 3:

Week 15 (Tuesday Apr. 23): Revisiting the Principles of Biomedical Ethics

Primary Reading:
- Gillon, R. (2015). Defending the four principles approach as a good basis for good medical practice and therefore for good medical ethics. Journal of Medical Ethics, 41(1):111–116.
- A link to the special issue of JME: "What is it to do good medical ethics?" (34 papers to browse!)
Refresh Your Memory:
- Gillon, R. (1994). Medical ethics: Four principles plus attention to scope. BMJ: British Medical Journal, 309(6948):pp. 184–188.
- Gillon, R. (2003). Four scenarios. Journal of Medical Ethics, 29(5):267–268.
Then Select At Least One (Or Find Another):
- Beauchamp, T. L. (2003). Methods and principles in biomedical ethics. Journal of Medical Ethics, 29(5):269–274.
- Campbell, A. V. (2003). The virtues (and vices) of the four principles. Journal of Medical Ethics, 29(5):292–296.
- Gardiner, P. (2003). A virtue ethics approach to moral dilemmas in medicine. Journal of Medical Ethics, 29(5):297–302.
- Huxtable, R. (2013). For and against the four principles of biomedical ethics. Clinical Ethics, 8(2-3):39–43.
- Macklin, R. (2003). Applying the four principles. Journal of Medical Ethics, 29(5):275–280.
Keywords: Revisiting the Principles of Biomedical Ethics