Up@dawn 2.0

Saturday, January 31, 2015


As of Saturday afternoon we still have no author summaries posted. I was afraid that might happen, if we didn't make sure to do it before leaving the classroom on Thursday.

So, we'll resume that practice on Tuesday. Meanwhile, the three designated group authors PLUS our peripatetic discussion groups all need to post summaries of their discussions. Everyone else can post their comments, FQs, DQs, & links here in the interim.


Thursday, January 29, 2015

Quiz Jan.29

Bioethics today is about the ways our vision of issues and outcomes may be occluded, blurred, or otherwise compromised by our respective points of view or perspectives. Of course this is not unique to bioethics, all human comprehension is subject to bias by the attenuation of culture, gender, religion, ideology, experience, the absence of experience, greed, egoism, and on our list could go. It is in our nature to see what we've seen, to see what we want to see, to see through a glass darkly. Without corrected vision the people perish.

Our native tendency to frame experience incorrectly, conformable to our own pre-vision and hence occlusive of other ways of seeing and clinically intervening, is a constant challenge to the fair-minded ethicist. Bioethical philosophers across the perspectival spectrum presume to prescribe corrective frames, but inattention to the varieties of sight is a constant hazard. Here's a link to a good little essay on the subject, from esteemed bioethicist Arthur Caplan: "When Religion Trumps Medicine."

We should play with this metaphor. As a lifetime wearer of framed corrective lenses, I can attest to the temporary excitement of a new prescription, or even just a stylish new frame to house the old set of lenses. The trick is always to find frames that hold up through every season of wear, that don't grow tiresome, and that justify the expense of change. (My wife returned from Costco one day reporting that the same frames she'd found at the Eye Doc's were $100s cheaper there.) Sometimes new lenses in the old frame suffice, sometimes you just need a new look.

So, some of the perspectives we'll try to focus and reframe today: attitudes and assumptions around HIV/AIDS, especially as occluded by miseducation; violence as a public health issue; "feminist critiques" of contingently-drawn, historically-conditioned categories of masculinity and femininity, locked into patriarchal institutions and practices that discriminate against women; misogyny; marginalization; advocacy; embodiment; empowerment; relational autonomy; metaphysical dualism; care; furor therapeuticus; female genital mutilation; "Asian bioethics";  Plato's Euthyphro;  Abraham & Isaac;  Buddhism; and more.

How do you get that "new look"? I always like to suggest trying the John Rawls Original Position/Veil of Ignorance frames. Some of us can wear them.

One more indulgence, before the quiz: I enjoyed our impromptu discussion of House last time. Maybe some of us can find a few good YouTube moments, illustrative of what we were saying about how some practitioners seem driven less by the patient's best care than by their own egoism. But, getting the diagnosis and treatment right regardless of motive and ego still seems the most important thing. Doesn't it?

1. Chapter 3 begins by asking if our bioethical perspective ("vision") is skewed by _____... (a) cultural assumptions, (b) gender bias, (c) religious faith, (d) all of the above (BB 48)

2. What's the leading global cause of death among women of reproductive age? (49)

3. (T/F) The "feminist critique" says bioethics has been dominated by culturally masculine thinking. (50)

4. What ethical perspective did Nel Noddings (supported by Carol Gilligan's research) describe as the "feminine approach"? (55)

5. What's a furor therapeuticus? (56)

6. Does Campbell consider the outlawing of female genital mutilation culturally insensitive? (58)


What role do feminist bioethicists see themselves as performing, with respect to the victims of gender discrimination? What perspective do they wish to "re-assert"? and what classic (Cartesian) metaphysical/philosophical perspective do they oppose? (51-2)

What's allegedly distinctive about "Asian bioethics"? (59)

How do you think your own attitudes and assumptions about gender, religion, etc. influence your Bioethical perspective?

What do Plato's Euthyphro and the Biblical story of Abraham & Isaac suggest to you about the place of religion in addressing biotethical issues? (61-2)

What is Buddhism's bioethical relevance? (69)

BB chapter 3 quiz questions and discussion questions

Quiz questions
1. What is the "heart" of bioethics? (P.50)
2.What is one of the key concepts in the feminist bioethics literature?(p.51)
3. The WHO reported that women's natural advantages in health and longevity have been eroded by___________and_____________ polices. (P.51)
4.What does  ethnical relativism mean? (P. 57)
5.What are the five major religion discussed in the
Chapter? (63)
6. What religion is the most influential in the development of modern culture? (P. 73)

Discussion Questions?
1.How does religion and culture influence bioethics?  Is it a positive or negative influence?
2. How important is the feminist approach to bioethics?

Wednesday, January 28, 2015

Group 2 discussion 1/27

Similar to group 3, our group discussed what would we do in the mayor's situation. About half of the group talked about killing the two guerillas IF it was definite that the colonel would not kill the eighty people. We thought that Fox news would be the first to announce the murders that the mayor committed because he is a political figure. Also, killing the guerillas wouldn't really set the eighty people free. They would be enslaved for life. This is where the other half of the group came in. We thought that there isn't any certainty in whether or not the colonel would do what he said. A better thought to the other half was to take an act of defiance against the colonel. Dying trying to protect the people is better than letting them get enslaved. Basically, pull a super hero maneuver or in more humane terms, possibly pull what Denzel Washington did when he starred in the recent movie The Equalizer. If the mayor could pull killing the colonel and his army, he would be a hero to his people, and he will have shown that their lives mean a lot to them. Even if he were to die trying, he would still show the people in his town that he cared for them. The people would most likely be enslaved and if they are, after witnessing the mayor's example of defiance, they would have the courage to plan their own act of defiance against the colonel and their men. It would then be similar in context to the history of the American Revolution or the Haitian Revolution.

Tuesday, January 27, 2015

Group 3 Discussion 1/27

Our group focused on the mayor's dilemma, and what each group member would do when presented with the choice of death or murder.  Many said that they would attempt to kill the colonel with the weapon.  One person said that they would kill a citizen to try to confuse the soldiers.  The discussion then turned to why a gun was chosen and how the soldiers should have allowed the use of a sword, or pistol, or bat, or some other weapon.  Class ended amidst this very interesting discussion.

How would you react to this dilemma?
Is there a universally "right" course of action?

Today’s Quiz

1. (BB 20) Jeremy Bentham devised the:
A. George Town Mantra
B. Greatest Happiness Principle
C. Deontological Theory

2. (BB 26) What is the Golden Rule?
A: Do to others what you would want them to do to you.

3. (BB 32) What is Aristotle’s contribution to ethics called?
A. Virtue Ethics

4. (BB24) A reaction of distaste based solely on emotion and unexamined prejudice is the Yuk Factor

5. (BB 25) What are Immanuel Kant’s 2 imperatives?
A: Hypothetical and Categorical

6. (BB 43) True or false: the four Bioethics principles are Autonomy, Maleficence, Beneficence, and Justice.
A: False (Non-Maleficence)

Class quiz questions 01/27/2014

1. Jeremy Bentham devised the (BB 20):
a. Georgetown Mantra
b. Greatest Happiness Principle
c. Deontological Theory

2. What is the Golden Rule? (BB26)

3. What is Aristotle's contribution to virtue ethics? (BB 32)

4. A reaction of distaste or disapproval base solely on emotion and unexamined prejudice is? (BB 24)

5. Immanuel Kant had two imperatives. What are they? (BB 25-26)

6. True or False. The Four Bioethics principles are Autonomy, Maleficence, Beneficence, and Justice. (BB 43-46)

Quiz Jan.27


1. (T/F) In the Mayor's Dilemma, one of the possible actions considered is to set an example of defiance.

2. Which theory has been dominant in bioethics and often used by many health professionals?

3. In deontological theory, what is the difference between hypothetical and categorical imperatives?

4. What ethical principle (and whose), 
in the name of rational consistency, absolute dutifulness, and mutual respect, "requires unconditional obedience and overrides our preferences and desires" with respect to things like lying, for example?

5.  What would Kant say about Tuskegee, or about the murderer "at our door"?

6. What more do we want from a moral theory than Kant gives us?

7. What is the distinctive question in virtue ethics?

8. What Greek philosopher was one of the earliest exponents of virtue ethics?

9. Paraphrase the Harm Principle. Who was its author?

10. Name one of the Four Principles in Beauchamp and Childress's theories on bio
medical ethics?


Monday, January 26, 2015

BB Chapter 2 Discussion and Fact Questions

Fact Questions

1. What is consequentialism?
2. What is the best form of consequentialism?
3. What does the Greatest Happiness Principle say? Who made it?
4. The _________ of _________ is also a feature of all medicine and health.
5. What are the problems with consequentialism?
6. What is the deontological theory?
7. Immanuel Kant had two imperatives. What are they?
8. What is virtue ethics?
9. What is communitarianism?
10. What is libertarianism?
11. What are the components of the Georgetown Mantra? Who made it?

Discussion Questions

1. What exactly is justice in medicine?
2. If moral rules such as the Golden Rule or "never tell a lie" only applies to some situations, is it really okay to tell younger generations about these rules?
4. Is it a necessity to have good reason and emotion to be quite virtuous? What if you're missing one or both?
5. Should paternalism be eliminated from healthcare?

Thursday, January 22, 2015

Author posts

Group 1 - In regard to medical tourism, the group thinks that governments should not establish regulations. Also, patients should be able to access treatment as long as they are willing to take responsibility and risks.
When it comes to medical tourists, should government regulate medical tourism?

Group 2 -With regards to the relationship between doctors and patients, where does the primary responsibility lie in maintaining health? Who is more responsible for providing a solution to health problems (the doctor or patient)?

Who is primarily responsible for educating the general population on what constitutes a healthy lifestyle? Should the general population educate itself, or does such education require the input of healthcare professionals (such as medical doctors or potentially other mid-level practitioners)?
Author: James Hayes
Group 3 - What implications could plastic surgery supply to personal medicalization? Are we slowly forming a new form of biological evolution? Such as with cosmetic surgery, are people changing themselves for psychological reasons over medical ones?
Author Cassandra Taylor

When it comes to medical tourists, how far is too far? Is it acceptable to seek a doctor who will agree to a personal diagnosis over the diagnosis of a practitioner?

Fact Question and Discussion Question BB Chapter 1

Chapter 1

FQ: What are some historical atrocities that happened to peak the creation of Bioethics?

DQ 1: The first chapter introduced the revealing of the human genome project and privacy. Is predicting a person's genetic disease invading privacy? Even if the parents consented to genetic testing?

DQ 2: If doctors and patients are like salesmen and customers, is the customer always right?

Monday, January 12, 2015


We begin, as in all my classes, with an invitation: tell us who you are, and why you're here. We'll introduce ourselves in class and here. I'll start.

I'm the prof for this course, PHIL 3345, Bioethics. I hold degrees from the University of Missouri and Vanderbilt, and I'm here because the ethics of life and death is at the very heart of what philosophy, defined as the love of (and quest for) wisdom, is supposed to be about. I'm still here in middle Tennessee, after relocating for Grad School, because it's the place where I met my wife and decided to call home. No regrets.

Enough about me (unless you're curious for just a bit more).

Who are you? Why are you here? (Bear in mind, as you reply, that this is an open site. There's nothing preventing the world from reading what we post here, except of course the world's own distraction.)

America's Bitter Pill

Steven Brill's new book may worth a look in Bioethics this semester, along with last night's 60 Minutes segment.

Thursday, January 8, 2015

Bioethics needs philosophy

It is the JME's 40th anniversary and my 20th anniversary working in the field. I reflect on the nature of bioethics and medical ethics. I argue that both bioethics and medical ethics together have, in many ways, failed as fields. My diagnosis is that better philosophy is needed. I give some examples of the importance of philosophy to bioethics. I focus mostly on the failure of ethics in research and organ transplantation, although I also consider genetic selection, enhancement, cloning, futility, disability and other topics. I do not consider any topic comprehensively or systematically or address the many reasonable objections to my arguments. Rather, I seek to illustrate why philosophical analysis and argument remain as important as ever to progress in bioethics and medical ethics. Julian Savalescu

Coercion, discrimination and why medical ethics needs philosophy, better philosophy

Objecting to genetic selection and cloning, Leon Kass writes,A third objection, centered around issues of freedom and coercion… comes closer to the mark. … [T]here are always dangers of despotism within families, as parents already work their wills on their children with insufficient regard to a child's independence or real needs. Even partial control over genotype—say, to take a relatively innocent example, musician parents selecting a child with genes for perfect pitch—would add to existing social instruments of parental control and its risks of despotic rule. This is indeed one of the central arguments against human cloning: the charge of genetic despotism of one generation over the next.1
This objection from ‘coercion’ is the objection that Michael Sandel gives to genetic selection, which he calls ‘hyper-parenting’.2 In a similar vein, Jürgen Habermas argues that germline enhancements would represent a threat to the enhanced child's freedom because the parent's choice of enhancements would not only imply their endorsement of particular goods, but also communicate to their child that they expect her to pursue those goods.3 These expectations, Habermas suggests, may serve to hinder the child's freedom to do what she wants, when her desires do not align with her parent's expectations.4
The paradigm case of coercion could be said to be when a robber stops you and says, ‘Your money or your life’. Coercion involves the restriction of freedom (reduction of options), which causes that person to do what she does not want to do. Coercion is wrong when it harms a person or fails to respect that person's autonomy. That is a conceptual analysis of coercion.
Even professionals working in bioethics (which includes medical ethics), including Leon Kass, misuse this term. Embryos cannot be coerced since they are not persons and lack freedom of will. But more importantly, future people cannot be coerced by the act of genetic selection or cloning. Imagine that IVF produces two embryos, Anne and Bob. The parents choose Bob because that embryo has perfect pitch (or is a clone). Later in life, can Bob complain that his parents coerced or limited his freedom by selecting him on the basis of having perfect pitch (or being a clone)? No—he owes his very existence (all his options and freedom) to their act of selection. Without assisted reproduction and selection (or cloning), he would not have existed. It is metaphysical fact that those who owe their existence to a reproductive act cannot be coerced by that act. Even more broadly, they cannot be harmed by that act unless it makes their existence so bad that their lives are not worth living.
Failure to appreciate this metaphysical fact about identity-determining reproductive acts infects legislation and policy...
  1. Professor Julian Savulescu, Faculty of Philosophy, Oxford Uehiro Centre for Practical Ethics, Suite 8, Littlegate House, Oxford OX1 1PT, UK; julian.savulescu@philosophy.ox.ac.uk

Monday, January 5, 2015

"Doctor, Shut Up and Listen"

...communication failure (rather than a provider’s lack of technical skill) was at the root of over 70 percent of serious adverse health outcomes in hospitals.
A doctor’s ability to explain, listen and empathize has a profound impact on a patient’s care. Yet, as one survey found, two out of every three patients are discharged from the hospital without even knowing their diagnosis. Another study discovered that in over 60 percent of cases, patients misunderstood directions after a visit to their doctor’s office. And on average, physicians wait just 18 seconds before interrupting patients’ narratives of their symptoms. Evidently, we have a long way to go...