Download Ethics and Enhancing the Life of the Dying Sulmasy, Daniel

Fall 2017-Spring 2018
Graduate Seminar on Ethics and Enhancing the Life of the Dying
In this course we will explore how one might enhance the lives of those who are dying by investigating
the ethical choices we make with respect to their medical care. A fundamental assumption for the
course is that those who are dying are still living, and retain a capacity for flourishing as the mortal kinds
of things that they are. Moreover, as part of the human community, they can enhance the lives of those
who survive them. We will read both classical and contemporary works to help us delve deeply into
specific ethical issues, including: suffering and the goals of medicine, the withholding and withdrawing
of life-sustaining treatments, the distinction between killing and allowing to die, euthanasia and assisted
suicide, the medical application of the rule of double-effect, palliative sedation, brain death, organ
donation after cardiac death, advance directives, surrogate decision making, therapy, healing, and
death, and the ethics of attending to the spiritual needs of dying patients. The class will be conducted in
classical seminar style, with students assigned to lead class discussions of particular texts. Our
interdisciplinary conversation will exemplify and provide a context for the interdisciplinary nature of the
field of bioethics. Class size will be limited to 25.
Fall 2017
1. Liberal Naturalism and “Natural Kinds”
a. anti-essentialism in bioethics
b. “naming and necessity” -- Kripke
c. natural kinds -- Wiggins, Brody
d. dispositional predicates – Lisska
e. perfectionism – Hurka, Rasmussen
2. Human Flourishing
a. Aristotle
b. MacIntyre
c. being- in-relationship
d. the common good (4 senses)
e. the virtues and human flourishing
3. Moral Psychology I
a. agency
b. acts and events
c. propositional attitudes: intention, belief, desire
d. motive
e. affect
4. Moral Psychology II
readings – Aquinas and Lisska
a. acts
b. intentions
c. ends
d. circumstances
5. Moral Ontology I
a. subject-relativity
b. subjectivity
c. freedom
d. happiness
e. the good
6. Moral Ontology II
a. against relativism
b. cultural-relativity
c. epistemic moral humility
d. tolerance
7. Dignity and Value Theory
a. intrinsic dignity and natural kinds
b. attributed dignity
8. Suffering
a. finitude of the human natural kind
i. intellectual
ii. moral
iii. biological
b. finitude and freedom
c. suffering and theodicy
10. Health and Illness
a. Christopher Boorse
b. Thomas Szasz
c. Gert and Culver
d. perturbations in relationship
e. illness as an occasion of suffering
Spring 2018
1. Healing and the Goals of Medicine
2. The Central Acts of Medicine
3. The Physician-Patient Relationship
4. Medicine as a Profession
5. Clinical Care as Dialogue
6. Forgoing Treatment
7. Deciding for Others
8. Doing No Harm
9. Health Care and Justice
10. The Rule of Double-Effect in Medicine
14. Physician-Assisted Suicide and Euthanasia
Readings
Moral Psychology
Anscombe, G. E. M. (1958). ‘Modern Moral Philosophy’, Philosophy, 33: 1-19.
_______________ . (1969). Intention. Ithaca, N.Y.: Cornell University Press.
Aristotle (1985). Nichomachean Ethics. Terence Irwin (trans.) Indianapolis, Indiana: Hackett.
Boyle, Joseph (1980). ‘Toward Understanding the Principle of Double Effect’, Ethics, 90:
527-538.
Bratman, Michael (1987). Intention, Plans, and Practical Reason. Harvard University Press.
Cavanaugh, Thomas A. (2006). Double Effect Reasoning.Clarendon/Oxford.
Davidson, Donald (1980). Essays on Actions and Events. Oxford: Clarendon Press.
Donagan, Alan (1987). Choice: The Essential Element in Human Action. London: Routledge.
Foot, Philippa (1978). Virtues and Vices and Other Essays in Moral Philosophy. Berkeley,
California: University of California Press, 19-32.
Kaczor, Christopher (1998). ‘Double-Effect Reasoning from Jean Pierre Gury to Peter Knauer’,
Theological Studies, 59: 297-316.
Mangan, Joseph T., S.J. (1949). ‘An Historical Analysis of the Principle of Double Effect’,
Theological Studies, 10: 41-61.
Quinn, Warren (1989). ‘Actions, Intentions, and Consequences: The Doctrine of Double Effect’,
Philosophy and Public Affairs, 18: 334-351.
Searle, John. (1983). Intentionality: An Essay in the Philosophy of Mind. Cambridge U Press.
Philosophy of Medicine
Gadamer, Hans-Georg. (1996). The Enigma of Health. Stanford U Press.
Jonas, Hans (2001). The Phenomenon of Life. Evanston, IL: Northwestern U Press.
Lain-Entralgo P. (1969). Doctor and patient. New York: McGraw-Hill.
Pellegrino ED, Thomasma DC. (1981). A philosophical basis of medical practice. NY: OUP.
Dignity
Macklin, Ruth. “Dignity is a Useless Concept,” British Medical Journal 327 (2003): 1419-20.
Cicero, De Officiis, W. Miller transl., pp. 106-109.
Kant, Immanuel. (1983). Ethical Philosophy, JW Ellington, transl. Indianapolis, IN: Hackett.
__________ (1981). Grounding for the Metaphysics of Morals, Ellington, transl.: Hackett.
Hill, Thomas E. (1992). Dignity and Practical Reason in Kant's Moral Theory. Ithaca, NY: Cornell.
Baker-Fletcher, Garth. Somebodyness: Martin Luther King, Jr. and the Theory of Dignity, Harvard
Dissertations in Divinity, No. 31 (Minneapolis, Minnesota: Fortress Press, 1993).
Velleman, J. David. “A Right to Self-Termination?” Ethics 109 (April, 1999): 605-628.
Natural Kinds, Medicine, and Ethics
Saul Kripke, “Identity and Necessity,” In: Milton K. Munitz, ed. Identity and Individuation (New
York: New York University Press, 1971), 135-164
Saul Kripke, “Naming and Necessity.” In: Gilbert Harman and Donald Davidson, eds.
Semantics of Natural Language (Dordrecht, Netherlands: D. Reidel, 1972), 253-355.
Anthony P. Lisska, Aquinas’s Theory of Natural Law: An Analytic Reconstruction.
Clarendon/Oxford, 1997.
David Wiggins, Sameness and Substance Renewed (Cambridge University Press, 2001).
Intrinsic Value
Rønnow-Rasmussen, Toni, & Michael J. Zimmerman. Recent Work on Intrinsic Value.
Dordrecht, Netherlands: Springer, 2005.
Rolston, III, Holmes. Environmental Ethics (Philadelphia: Temple University Press, 1988)
Zimmerman, Michael J. “Intrinsic vs. Extrinsic Value,” Stanford Encyclopedia of Philosophy
(2004 Edition), Edward N. Zalta (ed.).