StP
640:
Introduction
to
MEDICAL
ETHICS:
SYLLABUS: Spring,
2013.
THIS course will examine the history of Catholic ethical teaching on medicine and health care, with particular attention to common ethical dilemmas concerning the beginning and the end of life. The development of the Catholic moral tradition of health care and bioethics will be examined both from an historical perspective and through careful study of official Catholic teaching documents, including the following: Humanae Vitae (Pope Paul VI); Evangelium Vitae (Pope John Paul II); Jura et Bona (CDF); Donum Vitae (CDF); Dignitas Personae (CDF); and Ethical and Religious Directives (USCCB).
The richly-diverse social, cultural, and ethnic traditions represented by both the students and the communities they will serve will provide the background against which the following contemporary issues will be studied in light of Roman Catholic moral teaching: (1) Human Fertility and Infertility, (natural family planning, contraceptive technology, assisted reproduction, abortion); (2) Genetic and Embryological Dilemmas at the Beginning of Life (pre-natal diagnosis, embryological and fetal malformation, intra-uterine medical and surgical interventions); (3) Research and Experimentation on Human Subjects (informed consent, cloning, stem-cell research, tissue and organ donation); (4) The Perennial Specter of Eugenics; (5) Terminal Illness and Disability (euthanasia, nutrition and hydration, withdrawing life support, palliative and hospice care).
1. THE student will be able to identify important persons, issues, and schools of thought that influenced the development of Catholic teaching concerning health care.
2. The student will learn to make use of relevant primary and secondary sources available in both printed and electronic formats, and will become familiar with appropriate reference works in Catholic bioethics.
3. The student will be able to apply Catholic moral teaching to moral issues concerning reproductive technology and end-of-life care.
4. The student will be able to teach the significance of these moral issues and schools of thought at the parish level in the context of the “New Evangelization”.
1. DISCUSSION FORUMS:
a. This course will combine assigned textbook and online readings, downloadable lectures, and weekly discussion forums. The weekly discussion will be based on lectures and assigned readings. Active participation in discussions is essential, and will figure into the final evaluation, as described below in §4.b.
b. Students are required to post their principal response to each week’s questions by midnight on Saturday of that week. Forums will remain open for an additional three days (i.e. until Tuesday of the following week) to allow students to interact with one another in forums.
c. Late postings will not count toward the final grade.
d. Responses to each week’s questions will be graded on three criteria: (1) demonstration that the student has comprehended the assigned readings; (2) pastoral response to the material, including examples and/or further reflection on the implication of the material presented; (3) pastoral quality and content of students’ responses to other students’ postings.
e. The term “pastoral” in this context includes the students’ capacity to apply church teaching in a way that is both comprehensible and sensitive to the situation of the individual(s) with whom they interact and/or to whom they minister.
2. EXAMINATIONS
a. The midterm and final examination will consist of essay questions based on pastoral situations.
b. Students are required to submit their answers within one week of the date the exams are posted: these must be typed, double-spaced, and contain appropriate references.
3. EXTRA CREDIT RESEARCH
a. An research project may be undertaken. It will count as “extra credit” and will only have a positive effect on the final grade.
b. Topics for the research project include: any ethical issue or author discussed in class; or a comparison of the approaches taken by two different authors. The goal of the research project is to demonstrate familiarity with official Church teaching and current ethical thought in the area of Catholic bioethics.
c. The project may take the form of a written paper between seven and ten pages in length, double-spaced, including appropriate references.
d. In lieu of a written research project, students who prefer the medium of verbal presentation may offer the results of their research as a 20-30 minute powerpoint or web-page presentation, including recorded narrative, intended for use in teaching. The presentation must be of the same academic quality as a graduate-level paper and include appropriate references
4. EVALUATION
a. Students must clearly distinguish between: (a) their own work; and (b) ideas or text they have taken from other sources, including the Internet, published texts or audio-visual materials. The requirement to distinguish clearly between one’s own work and the research of others applies equally to written and oral presentations. Failure to give credit to cited sources constitutes plagiarism and will result in a grade of “F” for the material presented and may result in failure of the course.
b. The final course grade will be computed as follows:
Discussion Forums | 60% |
Midterm Exam |
20 % |
Final Examination |
20 % |
Ford, Norman M., The Prenatal Person, (Blackwell Publishers, 2002), ISBN: 0631234926.
Jones, David Albert, The Soul of the Embryo, An Inquiry into the Status of the Human Embryo in the Christian Tradition, (Continuum, London, 2004), ISBN: 0826462960
May, William, Catholic Bioethics and the Gift of Human Life, 2nd ed., (Our Sunday Visitor, 2008) ISBN: 1592763308
The Catechism of the Catholic Church.
CATHOLIC CHURCH TEACHING DOCUMENTS
Pope Pius XII: Address to the First International Conference on Histopathology of the Nervous System (1952; Address to Anesthesiologists (1957).
Pope John Paul II: Salvifici Doloris, (On The Christian Meaning Of Human Suffering, 1984); Evangelium Vitae, (The Gospel of Life, 1995); On Life-Sustaining Treatment and the Vegetative State, (March, 2004); On Palliative Care, (Nov., 2004)
United States Conference of Catholic Bishops: Nutrition and Hydration; Moral and Pastoral Reflections (1992); Ethical and Religious Directives, rev. ed.(2010); Forming Consciences for Faithful Citizenship (2007, rev. 2012); Twenty Questions for Faithful Citizens (2012).
Sacred Congregation for the Doctrine of the Faith: Declaration On Procured Abortion, (1974); Persona Humana, (Declaration on Sexual Ethics, 1975); Jura et Bona, (Declaration on Euthanasia, 1980);Donum Vitae (On Respect for Human Life in its Origin, 1987); “Uterine Isolation”and Related Matters, (1993); Responses to Certain Questions Concerning Artificial Nutrition and Hydration (2007); Dignitas Personae (On Certain Bioethical Questions, 2008); On the Banalization of Sexuality (2010).
The Pontifical Academy of Sciences: Why the Concept of Brain Death is Valid as a Definition of Death (2008).
ADDITIONAL REQUIRED DOCUMENTS
Atkinson, Gary, M., “Theological History of Catholic Teaching on Prolonging Life”, in Moral Responsibility in Prolonging Life Decisions, ch. 7, ed. McCarthy & Moraczewski, (Pope John Center, St. Louis, 1981, distr. Fran. Herald Pr. Chicago).
De Marco, Donald, The Roman Catholic Church and Abortion: An Historical Perspective.
Sofair, André N., et.al. “Eugenic Sterilization and a Qualified Nazi Analogy: The United States and Germany, 1930-1945,” Annals of Internal Medicine, 15 Feb. 2000. Vol. 132 no. 4, pp. 312-319.
Kevles, Daniel, In the Name of Eugenics, Genetics and the Uses of Human Heredity, (Knopf, New York, 1985), ch.s 5-7, pp. 85-128)
Ashley, Benedict, et.al., Health Care Ethics: A Catholic Theological Analysis, 5th ed. (Georgetown Univ. Press, 2006), ISBN: 9781589011168.
Coleman, Gerald, Human Sexuality, an All-Embracing Gift, (Alba House, 1992), ISBN: 081890643X,
Engelhardt, H. Tristram, The Foundations of Bioethics, Second Edition, (Oxford University Press, 1996) ISBN: 0195057368.
Finnis, John, Moral Absolutes: Tradition, Revision and Truth, (Catholic University of America Press, 1991).
Ford, Norman M., When Did I Begin? Conception of the Human Individual in History, Philosophy and Science, (Cambridge University Press, 1991), ISBN: 0521424283.
Gomez, José H. (Archbishop of Los Angeles), A Will to Live: Clear Answers on End of Life Issues, (Basilica Press, 2006), ISBN: 19303I406X
Grisez, Germain The Way of the Lord Jesus, (1, Christian Moral Principles; 2, Living a Christian Life; 3, Difficult Moral Questions). Electronic version available on Paulist Media: Welcome to the Catholic Church.
Kliever, L. D. ed., Dax’s Case, Essays in Medical Ethics and Medical Meaning, (Southern Methodist Univ. Pr., 1989) ISBN: 0870742787
Smith, Janet,& Kaczor, Christopher, Life Issues, Medical Choices, Questions and Answers for Catholics (Servant Books, St. Anthony Messenger Press, 2007) ISBN: 9780867168082.
WEEK 1: August 27 - September 2
1.
INTRODUCTION
to the
COURSE
Readings:
Course Syllabus .
2. PRINCIPLES of CATHOLIC MORAL THEOLOGY in BIOETHICS
2.00. Relationship Between Moral Theology and Pastoral Theology: The Principle of Gradualness;
2.01. Consequentialist and Deontological Morality; Our Final End (telos); 2.02. Natural Law; 2.03. Double Effect; 2.04. Virtue Theory;
2.05. Formation of Conscience (USCCB, Formation of Conscience for Faithful Citizenship, Introd., & §17-18) ; 2.06. Prudence (FCFC §19-20) ; 2.70. Intrinsic Evil (FCFC §22-23) ; 2.08. Avoid both Moral Equivalence and Misuse of Distinctions (FCFC §27-29) ; 2.09. Limiting Harm /choosing lesser evil. (FCFC §31-33)
2.10. A Brief Glimpse at the Place of Bioethics in Current Catholic Social Teaching and Controversy
Readings: May, Catholic Bioethics Ch. 2, pp. 49-66. Ford, The Prenatal Person: Ethics From Conception To Birth, ch.s 1, “Morality for Persons” (pp. 1-26), and 3, “Ethical Principles for Healthcare” (pp. 41-52). USCCB, Forming Consciences for Faithful Citizenship. USCCB, Twenty Questions for Faithful Citizens.
WEEK 2: September 3-September 9
3. THE HISTORY AND DEVELOPMENT OF CATHOLIC BIOETHICS
3.1. ANCIENT
MEDICINE:
3.1.1.
Hippocratic Texts; 3.1.2.
Ancient Medical Practice; 3.1.3.
Aristotle's Embryology; 3.1.4.
Roman Infanticide and Abortion; 3.1.5.
Jewish Respect for Life
Readings:
Course Website; Jones, The Soul of the Embryo, ch. 1-4 (pp.1-56).
3.2. EARLY
CHRISTIANITY:
3.2.1.
Christ the Divine Physician; 3.2.2.
Opposition to Infanticide and Abortion;
3.2.3. Augustine on Ensoulment and
Suicide; 3.2.4.
Early Canonical Penalties for Abortion and Contraception
Readings: Course
Website; Jones, ch. 5, pp. 57-74.
WEEK 3: September 10-September 16
3.3. MEDIEVAL
MEDICAL
CARE:
3.3.1.
Compassion for the Sick; 3.3.2.
Medieval Medical Practice; 3.3.3.
Penitentials and
Aquinas on Life and Animation; 3.3.4.
Debates on Abortion
Readings: Course
Website; Jones, ch. 8, pp. 109-125.
3.4. RENAISSANCE
BIOETHICS:
3.4.1.
Anatomy and Surgery; 3.4.2.
Moralists on Pain and Abortion; 3.4.3.
Magisterium on Abortion
Readings: Course
Website; Atkinson, “Theological History”.
WEEK 4: September 17-September 23
3.5. THE
17th and
18th CENTURIES:
3.5.1.
Microscopy; 3.5.2.
Pharmacology; 3.5.3.
Medical Dogmatism and Lay Scepticism;
3.5.4. Alphonsus Ligouri
Readings: Course
Website.
3.6. THE
19th CENTURY:
3.6.1.
Anesthesia; 3.6.2.
Antisepsis and Infectious Disease; 3.6.3.
Nursing; 3.6.4.
Public Health and Hygiene; 3.6.5.
Medical Prestige and Paternalism; 3.6.6.
Pius IX and Abortion
Readings: Course
Website; Jones, ch. 3, pp. 72-74.
WEEK 5: September 24-October 30
3.7. THE
20th CENTURY:
3.7.1.
Eugenics and Pius XI (introd.);
3.7.2 Antimicrobials; IV Therapy;
3.7.3.
Nürnberg, Informed Consent, and Pius XII (introd.);
3.7.4.
Respirators and CPR
Readings: Course
Website.
3.8. MAGISTERIAL
DOCUMENTS
on BIOETHICS (introd.):
Readings:
Course Website; May, ch. 1, pp. 21-46.
WEEK 6: October 1-October 7
4.
EUGENICS
Readings: Sofair, “Eugenic Sterilization”; May ch. 6, pp.
237-258; Kevles, In the Name of Eugenics, ch.s 5-7,
pp. 85-128.
WEEK 7: October 8-October 14
5.
INFORMED
CONSENT
and PROXY
CONSENT
Readings: May, ch. 6. pp. 213-228; Pope Pius XII,
Address to Histopath. Conference; The Nürnburg Code
WEEK 8: October 15-October 21
6.
ABORTION
Readings: Course Website; Declaration On Procured
Abortion; May, ch. 5, pp. 165-212.
Ford. Prenatal Person, ch. 5, pp,
51-68.
WEEK 9: October 22-October 28
7.
MARRIAGE,
THEOLOGY
of the BODY
and HUMANAE
VITAE:
Readings:
Course Website; Humanae Vitae; May, ch. 3, pp. 67-72.
WEEK 10: October 29-November 4
8.
FERTILITY
and NATURAL
FAMILY
PLANNING
Readings: Course Website; May, ch. 3, pp. 73-87. “Uterine Isolation”and Related Matters.
9.
ASSISTED
REPRODUCTION
Readings: Course Website; May, ch. 3, pp. 88-94.
WEEK 11: November 5-November 11
10.
IN-VITRO
FERTILIZATION
and PLIGHT
of EMBRYOS
Readings: Course Website; Donum Vitae; Evagelium
Vitae; May, ch. 3, pp. 95-113.
11.
STEM-CELL
RESEARCH
Readings: Course Website; May ch. 6, pp. 229-236; Donum
Vitae.
WEEK 12-13: November 12- November 25
12.
EUTHANASIA
Readings: Course Website; May ch. 7, pp. 259-284;
Declaration on Euthanasia.
13.
CARE
for the
UNCONSCIOUS:
COMA,
THE
PERSISTENT
VEGETATIVE
STATE,
and
BRAIN
DEATH
Readings: Course Website; May ch. 7-8, pp. 285-352;
The Pontifical Academy of Sciences: The Concept of Brain
Death is Legitimate and Useful (texts, 1989-2008).
WEEK 14: November 25- December 2
14.
NUTRITION
and HYDRATION
in the PERSISTENT
VEGETATIVE
STATE
Readings: Course Website; Pope John Paul II on The
Persistent Vegetative State;
SCDF Response to Certain Questions . . . 2007.
[review from prev.
week: May,
ch, 7, pp. 285-301]
15.
PALLIATIVE
CARE
Readings: Pope John Paul II on
Palliative Care (on course website);
Additional Documents
of the Magisterium on Palliative Care [Catechism § 2279, 1994;
John Paul II, Evangelium Vitae, 1985; Addresses of Benedict XVI 2006 &
2007; USCCB Physician-Assisted Suicide - Threat to Improved Palliative Care
2011]
(on course
website);
Broeckaert, Bert,
“Euthanasia and Physician-Assisted Suicide”
in Walsh, Palliative Medicine, 1st ed., ch 21 (2008 Saunders/Elsevier).
WEEK 15: December 3-December 10
16.
ORGAN
DONATION
Readings: [review
from prev. week:
May, ch, 8, pp. 315-360]; Evangelium Vitae; Pope
Benedict XVI, Address to Pontif. Acad. for Life, 2008.
17.
CATHOLIC
SOCIAL
TEACHINGS,
ADVANCE
DIRECTIVES,
and the
PROVISION
of HEALTH
CARE
Readings: May, pp. 302-304. Course Website.