Spring 2008                                                                                        

Andrea Bonnicksen, Zulauf 401, 753-7059, albcorn@niu.edu

Office hours: T 1:00 – 1:50;  T 3:30 – 4:30; Th 3:30 – 4:30



During this semester we will examine key issues in medicine that pose challenges in bioethics and biopolicy. The class, which revolves around a series of issues presented in the textbook, has four basic objectives. First, it will give an appreciation of the range of issues in biomedicine, some of which will touch you and your families at various points in your lives, such as participation in medical research projects, involving children in decisions about their medical care, and preparation of advance directives. Second, it is designed to promote curiosity about and receptivity to differing viewpoints and the values that underlie them. The book’s structure helps in this aim because readings are selected to represent opposing viewpoints for each issue. Third, it will present a systematic way of approaching issues, with reference to principles in bioethics of autonomy, beneficence, and justice, and it will encourage critical thinking about the merits of arguments presented as opposing viewpoints. Fourth, it will suggest different paths for careers or graduate study, such as health law or administration, work in a biomedical advocacy group, specialty in a medical profession, or work for a medically-related federal agency, corporation, or nonprofit organization.



Carol Levine, Clashing Views on Controversial Bioethical Issues. Dubuque, IA:

            McGraw-Hill/Dushkin, 2008. 12th Edition.

Several items are posted on electronic reserves. Information about getting access to these

            readings will be given in the first two weeks of class. Readings from electronic

            reserve are indicated as ER below. Websites listed below are available for you to

            scan and consult as needed.



Grades will be based on two exams, an ongoing journal, and participation/attendance, as follows:

Midterm exam                         25%     50 points

Final exam                               25%     50 points

Journal                                     25%     50 points

Participation/attendance         25%     50 points


Final grades will be allocated as follows:

180 – 200 = A; 160 – 179 = B; 140 – 159 = C; 120 – 139 = D; below 120 = F


Exams (50%)

The exams will be given March 4 and May 6. They will be short answer and multipart essay. Study questions will be given before each exam. Make-up exams will be given only for documented serious illness or a death in the family and only if you contact me AHEAD of the exam (753-7059 -- leave a message if necessary).


Journals (25%)

Journal writing is based on the assumption that people learn when writing and that writing encourages thinking and exploration of ideas. Every two weeks you will submit a typed journal entry related to a topic covered in the readings during this two week period. Here are some examples:


            * Write a critique of L. F. Ross’s essay on health care decisions by children


            * Respond to some aspect of Ross and/or Weir’s essays that stand out for you and

            about which you would like to comment


            * Start with an experience you or a friend has had with medical decision-making

            and tie it with the messages in the Ross and/or Weir readings


The scope of the essay is up to you, but it is better to write a carefully thought out essay on a fairly narrow subject than to write a breezy essay that shifts from one idea to another. In other words, strive for a central message or theme in your essay and ground your ideas in the readings.  If some topics have personal relevance for you, you are encouraged to write about them and to compare/contrast those experiences with concepts and assumptions contained in the readings. A serious entry should be at least 2 typed pages. Late entries will not be accepted, nor will e-mailed entries. Please bring hard copies to class or, if you cannot be in class that day, slide the entries under my door in Zulauf 401. Grammar and spelling count. I will look to the following in grading individual essays. The journal grade will be based on the average of the individual essays:


            Is the essay thoughtful and carefully written?

            Is the essay grounded in some way in the readings?

            Does your position or personality emerge in the readings (i.e., are you engaged in

            the essay)?

            Does the essay make effective use of examples and analogies to illustrate points?

            Is there a unifying message or theme?  

            Is the essay at least two pages long?


Attendance/participation (25%)

The participation grade will be determined primarily by attendance and discussion in class. You are expected to read the material before it is covered in class and knowingly to participate in discussions based on the readings. Participation grades will be decided as follows:

A = regular and informed participation and excellent attendance (3 or fewer absences)

B = occasional and thoughtful participation and good attendance (4 or fewer absences)


C = adequate attendance (5-6 absences)

D = less than adequate attendance (7-9 absences)

F = rare attendance (10 or more absences)


I appeal to the grace of individuals who are more talkative to raise their hands to be recognized before speaking so that all students may be given the opportunity to contribute. I will also give occasional short optional assignments that can count toward class participation.



January 29                   Journal 1 due

February 7                   Journal 2 due

February 21                 Journal 3 due

March 4                       Midterm exam            

March 20                     Journal 4 due

April 3                         Journal 5 due

April 17                       Journal 6 due

May 1                          Journal 7 due

May 6                          Final exam



Students are expected to read the material before each topic is covered in class. The instructor will introduce the topic and the discussion will then revolve around the readings. We will use these questions to structure the discussion:


Author’s credibility: what particular expertise does the author have? (see pp. 345-48)

Purpose: what is the author’s main purpose in writing this article?

Information: what are the author’s main arguments? What kind of information does the

            author use to support these arguments (e.g., facts, experiences, data)?

Assumptions: what are the key assumption(s) underlying the author’s thinking?

Conclusions: what are the author’s conclusions?

Implications: if we took the author’s line of reasoning seriously, what consequences

            would be likely to follow?   

Critique of article






Levine, “Medicine and Moral Arguments,” in Levine, pp. xvii-xxviii




“Is Informed Consent Still Central to Medical Ethics?” Levine, pp. 2-20

1. R.M. Arnold and C.W. Lidz, “Clinical Aspects of Consent in Health Care”

            2. O. O’Neill, “Gaining Autonomy and Losing Trust?”


“Should Truth-Telling Depend on the Patient’s Culture?” Levine, pp. 21-44

            1. L.J. Blackhall et al., “Bioethics in a Different Tongue”

            2. M.Kuczewski and P.J. McCruden, “Informed Consent”


“Does Direct-to-Consumer Advertising of Medication Enhance Patient Choice?”

            Levine, pp. 42-56

            1. A.F. Holmer, “Direct-to-Consumer Prescription Drug Advertising Builds

            Bridges Between Patients and Physicians”

            2. M.F. Hollon, “Direct-to-Consumer Marketing of Prescription Drugs”




 “Should Adolescents Make Their Own Life-and-Death Decisions?” Levine, pp. 164-78

            1. R.Weir and C. Peters, “Affirming the Decisions Adolescents Make About Life

            and Death”

            2. L.F. Ross, “Health Care Decisionmaking by Children”


“Do Parents Harm Their Children When They Refuse Medical Treatment on Religious

            Grounds?” Levine, pp. 179-95

            1. Massachusetts Citizens for Children, “Death By Religious Exemption”

            2. M. Sheldon, “Ethical Issues in the Forced Transfusion of Jehovah’s Witness


            3. http://www.watchtower.org/e/hb/index.htm?article=article_06.htm (scan)

            4. “Old Enough,” Hastings Center Report 37(6):15-16 (Nov./Dec. 2007). ER




“Do Some Advance Directives Limit Patients’ Rights?” Levine, pp. 60-78

            1. C.J. Ryan, “Betting Your Life: An Argument Against Certain Advance


2. S. Luttrell and A. Sommerville, “Limiting Risks by Curtailing Rights: A

Response to Dr. Ryan”

            3. “Statement of Illinois Law on Advance Directives and DNR Orders.”

 http://www.idph.state.il.us/public/books/advin.htm  (scan)


“Do Standard Medical Ethics Apply in Disaster Conditions?” Levine, pp. 79-87

            1. R.W. Donnell, “A Bright Line”

            2. M.F. Marshall, “Oh, the Water”

            3. Susan Okie, “Dr. Pou and the Hurricane – Implications for Patient Care During

            Disasters.” New England Journal of Medicine 358(1):1-5 (January 3, 2008). ER


 “Should Physicians Be Allowed to Assist in Patient Suicide?” Levine, pp. 88-107

            1. M. Angell, “The Supreme Court and Physician-Assisted Suicide—The

            Ultimate Right”

            2. K.M. Foley, “Competent Care for the Dying Instead of Physician-Assisted


3. Quill, Timothy E., “Death and Dignity: A Case of Individualized Decision

Making.” New England Journal of Medicine 324(10):691-694 (March 7,

1991). ER

            4. Eddy, David M., “A Conversation with My Mother.” New England Journal of

            Medicine 272(3):179-181. ER


 “Should Doctors Refuse Demands for ‘Futile’ Treatment?” Levine, pp. 108-120

            1. S. Miles, “Informed Demand for ‘Non-Beneficial’ Medical Treatment”

            2. F. Ackerman, “The Significance of a Wish”

3. http://www.ama-assn.org/ama/pub/category/8390.html






“Should Prisoners Be Allowed to Participate in Research?” Levine, pp. 244-55

            1. Institute of Medicine, “Ethical Considerations”

            2. S.J.A. Talvi, “End Medical Experimentation”

            3. http://www.hhs.gov/ohrp/humansubjects/guidance/prisoner.htm (scan)

            4. http://www.hhs.gov/ohrp/policy/index.html#prisoners (scan)


“Should Research Participants Be Compensated?” 

            1. National Institutes of Health, “What is a Clinical Trial?” ER

            2. Dickert, Neil, and Christine Grady, “What’s the Price of a Research Subject?”

            New England Journal of Medicine 341(3):198-203 (July 15, 1999). ER 


“Should Animal Experimentation Be Permitted?” Levine, pp. 236-253

            1. J.M. Loeb, “Human vs. Animal Rights: In Defense of Animal Research”

            2. T. Regan, “Ill-Gotten Gains”

            3. www.debatabase.org (scan -- click animal experimentation and animal rights)                 4. Nussbaum, Martha C., “Beyond ‘Compassion and Humanity: Justice for

            Nonhuman Animals.” In Cass R. Sunstein and Martha C. Nussbaum, eds., Animal

            Rights: Current Debates and New Directions. Oxford: Oxford University Press,

            2004, pp. 299-320. ER


VI. BIOETHICS AND PUBLIC POLICY     (MARCH 25, 27, APRIL 1, 3, 8, 10, 15)


“Does Military Necessity Override Medical Ethics?” Levine, pp. 270-84

            1. M.L. Gross, “Bioethics and Armed Conflict”

            2. M.G. Bloche and J.H. Marks, “When Doctors Go to War”

3. “Dialysis for a Prisoner of War.” Hastings Center Report 34(6):11-12

            (November-December 2004). ER

            4. http://www.ama-assn.org/ama/pub/category/8421.html (scan)

            5. http://www.wma.net/e/policy/t1.htm (scan)


“Should Performance-Enhancing Drugs Be Banned from Sports?” Levine, pp. 285-94

            1. T. Murray, “Drugs, Sports, and Ethics”

            2. J. Savulescu, et al., “Why We Should Allow Performance Enhancing Drugs in


            3. http://www.wada-ama.org/en/prohibitedlist.ch2 (scan)


“Should There Be a Free Market in Body Parts?” Levine, pp. 295-310

            1. J. Radcliffe-Richards et al., “Case for Allowing Kidney Sales”

2. Institute of Medicine, “Organ Donation”

3. http://www.organdonor.gov/donation/typesofdonation.htm (scan)

4. http://www.organdonor.gov/research/legislation.htm (scan)


“Should Pharmacists Be Allowed to Deny Prescriptions on Grounds of Conscience?”

            Levine, pp. 311-29

            1. D.W. Herbe, “The Right to Refuse”

            2. J. Cantor and K. Baum, “The Limits of Conscientious Objection”

            3. http://www.ncsl.org/programs/health/conscienceclauses.htm (scan)


“Should Federally Funded Health Care Be Tied to Following Doctors’ Orders?” Levine,

            pp. 258-69

            1. West Virginia, “Medicaid Redesign”

            2. G. Bishop and A.C. Brodkey, “Personal Responsibility”


“Should A Pregnant Woman Be Punished for Exposing Her Fetus to Risk?” Levine, pp.


            1. J. Toal, “From Majority Opinion”

            2. L.M. Paltrow, “From ‘Punishment and Prejudice’”

            3. Annas, George, “Testing Poor Pregnant Women for Cocaine: Physicians as

            Police Investigators,” New England Journal of Medicine 344(22):1729-32 (May

            31, 2001). ER 




 “Is the Ban on Federal Funding of Human Stem Cell Research Justifiable?” Levine, pp.


            1. President’s Council on Bioethics, “Monitoring Stem Cell Research”

            2. J. Groopman, “Forward, Medicine!”

            3. http://stemcells.nih.gov/index.asp (scan)


“Is Genetic Enhancement an Unacceptable Use of Technology?” Levine, pp. 211-223

            1. M.J. Sandel, “The Case Against Perfection”

            2. H. Trachtman, “A Man Is a Man”

            3. Baruch, S. et al., Human Germline Genetic Modification: Issues and Options

            for Policymakers. Washington DC: Genetics and Public Policy Center, 2005.

            Print and read pp. 11-37 only.



“Can We Distinguish between a ‘Conservative’ and ‘Progressive’ Bioethics?”

1.      Charo, R. Alta, “Passing on the Right: Conservative Bioethics is Closer Than It Appears.” Journal of Law, Medicine & Ethics 32(2):307-314 (Summer 2004). ER

2. Levin, Yuval, “The Paradox of Conservative Bioethics.” The New Atlantis 1:53-65 (Spring 20-03). ER


“Do Nanotechnology, Synthetic Biology, and Other Innovations Pose New Ethical Challenges?”

1.      Weiss, Rick, “Synthetic DNA on the Brink of Yielding New Life Forms.”

Washington Post, December 17, 2007. ER

2. Keiper, Adam, “Nanoethics as a Discipline?” The New Atlantis 16:55-67 (spring 2007). ER




General websites for bioethics that may be of interest:






You are asked to arrive on time. Late arrivals are very disruptive. If you have an appointment that requires you to leave early, let me know ahead of time and then sit in a chair near the door. Please turn off cell phones before class begins. Do not leave and then return after receiving a phone call. Take notes by hand; laptops will not be necessary.

Other information:

CAAR.-- NIU is committed to making reasonable accommodations for students with documented disabilities. Students with disabilities that may have some impact on their coursework and for which they may need accommodation should contact the Center for Access-Ability Resources (CAAR) on the fourth floor of the Health Services Building during the first two weeks of the semester.

Paper awards.-- The Department of Political Science annually recognizes outstanding undergraduate papers written in conjunction with 300-400 level political science courses (all majors are welcome to compete). Winners are expected to attend the Department’s spring graduation ceremony where they will receive a certificate and $50.00. Submit three papers from any undergraduate political science class to a department secretary in Zulauf 315 by February 28. All copies should have two cover pages – one with the student’s name and one without. Only papers written in the previous calendar year (2007) can be considered for the 2008 award. However, papers completed in the current spring semester are eligible for the 2008 competition even if the author has graduated.