Dr. Bill Myers

Winter 1997, Adult Studies

Biomedical Ethics, Thomas A. Mappes and David DeGrazia, 4th ed. (BE)

Tough Decisions, John M. Freeman and Kevin McDonnell (TD)

The primary objective of this course is to enable you to raise effectively ethical issues related to the managerial process of health care. In recent years, managers in the health care profession have been called upon to evaluate more carefully their roles as decision makers and to evaluate their decisions from an ethical perspective. Both the popular and professional journals have given much space to the ethical problems related to health care management. While it is surely not the case that making ethical decisions is the exclusive domain of the philosopher, it is an assumption of this course that philosophy with its long history of the discussion of ethical problems can make some contribution to the issues at hand. In order to develop skills in this area, we will examine some of the classical writers in philosophical ethics as well as commentators on the more specifically designed area of health care management.

Our classes will be a blend of lecture, discussion, cases studies and class presentations. As a community of inquiry, we will be learning from one another. As such, it is imperative that for each meeting, you read carefully the materials assigned for that day. This kind of course only works when all are prepared.

1. Groups of 4-6 (depending on the size of the class) will give an oral presentation on a pre-assigned case for weeks 5-7 (approximately). You may use whatever format you think is useful for the presentation of the issues. You should also have a joint written report to be given to me no later than the beginning of the class in which the presentation is to take place. Groups will be self-selected by the third week.

2. An individual paper of at least 1500 words (6 typewritten pages) will be required. Following our first unit, I will give out an assigned question and you will have one week to complete the paper. It will be possible for you to write on a different question, but you must clear the question with me first. This paper will be due on February 29th.

3. A final exam will be given on the regularly scheduled exam date (March 12). The final exam will be a series of case study analyses.

4. Your informed participation is assumed. Your are expected to have read carefully the materials for the week. I will have no hesitancy in calling on anyone, whether a hand is raised or not. Each student is expected to attend all of the class meetings and to be an active participant in those meetings. If you are not able to attend class or you are not able to be prepared, you should let me know. Excessive absences will result in failure in the course. We only have 9 meetings this semester. Everyone is allowed one free absence. After two absences, there will be a 20% penalty on the final grade. After three, you will no longer be able to pass the course.

Each of the above components (paper, presentation, exam, participation) counts equally in the determination of your grade. Evaluation of class participation is, as you can imagine, difficult at best, but the "Guidelines for Class Discussion" (given below) will be used in an attempt to be fair. Evaluation of papers is difficult as well. I will evaluate them according to the criteria noted below. I assume that everyone enrolled in this course has the ability to perform well and I expect each of you to make an acceptable grade.

In developing a well-argued position on a case, you should be concerned with the relevant facts and with the implications of alternative courses of action. You should defend your proposed course of action or position with reasonable arguments. The articles in our text (as well as the ample outside sources available) should help your support your position.

As noted above, a major assumption of this course is that the philosopher has something relevant to bring to the ongoing dialogue concerning moral issues in management. Your paper should address that assumption, either explicitly utilizing the philosophical categories presented or rejecting the relevance of such categories with solid supporting arguments.

Some guidelines for evaluating your papers:

(1) Does the essay answer the question at hand?

(2) Are various alternatives noted, discussed, considered, and analyzed? Are the consequences of alternative positions examined fairly?

(3) Are the appropriate theoretical categories used to shed light on evaluate the situation described?

(4) Does the paper utilize articles from the text to aid in the analysis? Are other sources, when available, brought to bear on the analysis of the problem?

(5) Are the uses of sources properly documented with a standard citation paraphernalia, e.g., Turabian, MLA/APA?

The following guidelines have been borrowed and adapted from Kirk Hanson of Stanford University School of Business.

(1) Are the points made substantive, relevant to the discussion? Are they linked to the comments of others?

(2) Is the participant a good listener? Do comments show the participant has been listening?

(3) Do comments show evidence of analysis of the issue at hand?

(4) Do comments add to our understanding of the situation?

(5) Does the participant distinguish among different kinds of data (i.e., facts, opinions, beliefs, etc.)?

(6) Is there a willingness to participate?

(7) Is there a willingness to test new ideas or are all comments "safe" (e.g., repetition of case facts without analysis and conclusions)?

(8) Is the participant willing to interact with other class members?

(9) Do comments clarify and highlight the important aspects of earlier comments and lead to the clearer statement of the concepts being covered?

(10) Has the participant attempted to bring other readings, both from the text and from other sources, to bear on the cases under consideration?

(11) Do the comments show awareness of the ethical dimensions of the problem at hand and do these comments fit into a consistent, coherent ethical framework?

As you prepare for discussion, you should not only know the details of the cases but you should hypothesize concerning alternative situations which might arise. In effect, you will be doing "what if" analysis. Then you will want to know if changing the factors or assumptions will alter our ethical evaluations of the case. In preparing for the discussion, be sure to relate the current issues raised both with the other issues we have already discussed and with any relevant theoretical considerations.

All work at Birmingham-Southern is done under the student honor code. If you have any doubts about the application of the code, feel free to ask your instructor.

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1. Jan. 8 Introduction to the course. Some introductory discussion of ethical theory.

2. Jan. 15 Continued on Ethical Theory.

Reading: BE 1-50

3. Jan. 22 Abortion and impaired infants.

Reading: BE 427-477; 408-424

Case: TD 137-143

4. Jan. 29 Autonomy, Informed Consent, Truth-Telling, and Confidentiality

Reading: BE 64-107; 162-180

Case: TD 81-106

5. Feb. 5 Human and Animal Experimentation

Reading: BE 193-249

Case: TD 115-119

6. Feb. 12 Death and Decisions Regarding Life-Sustaining Treatment

Reading: BE 304-365

Case: TD 3-12

7. Feb. 19 Suicide and Active Euthanasia

Reading: BE 368-407

Case: TD 62-76

8. Feb. 26 Mental Illness, Dementia and Mental Retardation

Reading: BE 252-302

Case: TD 77-80

9. March 5 Social Justice and Health Care Policy

Reading: BE 554-622

Case: TD 34-35 (Tom) and 48-56 (Tom Revisited)

Final Exam: March 12, 5:30-8:30

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