biomedical ethics
GENERAL GUIDELINES – FINAL (RESEARCH) ESSAY• The Research Essay: Again, students are required to develop a 6 TO 8 PAGE investigativeessay on the basis of possible topics in the field of biomedical ethics found at the end of this section.The final research paper applies ethical theories studied in class to a concrete biomedical issue. Here aresome of the theories that qualify for the project: natural law theory, social contract theory, utilitarianism,Kantianism (deontology), and virtue theory. Examples of topics that qualify for the paper are listedbelow. You are not limited to these topics. However, run topics outside of these past the instructorbefore beginning work.Drawing upon those theories, the student will prepare a written (6 to 8 page typed MLA, APA or CMSstylepages) paper that addresses these current moral problems. Of particular importance is thestudent’s ability to use ethical reasoning to formulate reflective positions on some of the morepressing moral problems in contemporary society. Papers without this element tend to score at best alow B or C. The paper is graded for the following sections:I. Composition (15 points): Composition (15 points): Tell me in ONE sentence what yourpaper will discuss. The introduction may be composed of more than one sentence but yourthesis statement can only be one sentence long and has to be identifiable as such. Forexample this sentence might read like: “This paper examines the topic of abortion fromboth a utilitarian and a deontological viewpoint and assesses the strengths andweaknesses of both approaches.” The grade in this section also reflects whether thepaper was written well with attention to syntax, consistent paragraphing indents and propercitation style.II. History of topic (15 points): set the context for the moral issue from 1960 onward. DoNOT go back earlier without checking with the instructor first.III. Pro/Con (20 points): what are the conflicting sides around the issue? Please note: usingwebsites like procon.org to set up this issue generally reduces the grade in this section. Lookfor journal and newspaper articles that summarize the positions. These are better and morenuanced treatments of the conflicting sides.IV. Application of ethical theories (30 points): I am looking for TWO treatments of the issuefrom two ethical approaches studied during the term. These should be in depth because thissection is worth thirty points.V. Personal Conclusion (20 points): In this last section argue for your personal analysis andthoughts on the issue. Make sure this section receives the treatment and development itdeserves!YOU MUST TITLE THE SECTION OF YOUR ESSAY WITH THE FOLLOWING FIVE SECTIONTITLES. THUS, EVERY ESSAY WILL HAVE SECTION HEADINGS WITH THESE TITLES:Page 8COMPOSITION, HISTORY OF TOPIC, PRO/CON, APPLICATION OF ETHICAL THEORIES,PERSONAL CONCLUSIONTimeline for essay:Final Essay due by start of class week 6 (see syllabus schedule on page 6 for precise due date).• There exists a TREMENDOUS wealth of bibliographical research resources at the end ofeach chapter of our text.Here is the rubric you will receive with your final paper:15/15: Composition: Is paper written well with attention to syntax, grammar, clear thesis statement,consistent paragraphing and proper citations style or are there recurring problems with any of these?
15/15: History of topic: Does paper develop historical context for the moral issue from 1960 onward ina clear and chronologically coherent manner or does the paper fall short of doing this in specific ways?
20/20: Pro versus Con: Does paper spell out clearly conflicting sides of the issue or does it only showone side or is it entirely missing a pro/con section?
30/30: Application of ethical theories: Does author treat issue with two ethical approaches studiedduring the term in depth (or analyzes the issue with unusual and sustained depth from the standpointof one theory)?
20/20: Personal Conclusion: Does author develop a concluding personal analysis that expresses theirstandpoint on the subject in a thorough and clear way or does it sum up the issue superficially or isthe paper missing a genuine personal conclusion?
POSSIBLE TOPICS• Possible topics for the research paper include, but are not limited to the following. Please feel freeto adapt a topic to suit your interests.1. Human tissue. Who owns bone, sinew, corneas, and other saleable body parts? Who can consent toits post-mortem removal? What do state statutes say about the nonconsensual removal of human tissue? Whydoes federal law prohibit the sale of solid organs but permit the sale of other human tissue (and blood, sperm,and ova)? Do the rules that govern these activities sufficiently protect the interests that need to be protected?Or do they go too far and discourage an efficient market?2. Physician-assisted suicide (PAS). Oregon is the only state to have legalized the practice. The SupremeCourt has ruled that considerations of neither due process nor equal protection compel states to allow the practiceand that the Department of Justice may not prosecute Oregon physicians who participate in PAS. Your paper can goin lots of different directions. Should other states follow Oregon’s lead? Is there an equal-protection argumentPage 9that once a state has legalized PAS, it must also legalize active euthanasia? What can we learn from thepractices of other countries?3. Patentatibility of genetic code. Should genetic researchers be able to obtain patents on “raw” geneticcode? What should the Patent and Trademark Office’s policy be on demonstrating “utility” in order toobtain a patent for a snippet of DNA?4. Is “brain dead” really dead? All 50 states and the District of Columbia have rules that define death in termsof the irreversible cessation of all neurological functioning. This notion of “brain death” has been around since1968, when the Harvard Medical School Report on “irreversible coma” (now regarded as something of amisnomer) was issued. Yet, just as soon as we as a nation seem to have become comfortable (more or less) with theconcept, it is coming under increasing scrutiny and criticism. Is it internally inconsistent? Is it a snow job by thetransplant community? Are the NY and NJ variations the way of the future? Is neocortical death preferable towhole-brain criteria for determining when death occurs?5. Charity Care. Texas requires its not-for-profit hospitals to provide charity care as a quid pro quo fortax-exempt status. A dozen or more states do the same, and more states are jumping on the charity-carebandwagon every month. The federal government used to require charity care as a prerequisite for taxexemptstatus, but it dropped that requirement in 1968. Should it resurrect the charity-care requirement? Ifso, what should it look like? What are the pitfalls illustrated by various state experiments in this field? Isthere a better way to deal with the problems of providing health care for the indigent and uninsured?6. Anecephalic newborns. Medical texts usually refer to anencephaly as a condition that is “incompatiblewith life” or to anencephalic newborns as “born dying.” Despite this, a few yearsa go, the Florida SupremeCourt said the organs of a baby born with no neo-cortical hemispheres could not be donated because the babywas still alive under Florida law. (The AMA once opined that anencephalics should be regarded as an exception tothe requirement that organ donors be dead and then turned around at its next session and revoked its own ruling.) Afew years later, the 4th Circuit Court of Appeals said that a Virginia emergency room had an obligation underfederal Medicare law to treat the respiratory distress of an anencephalic infant who was brought to the ER from alocal nursing home. Do we need to rethink the law’s response to anencephaly? Or are anencephalicnewborns entitled to the same level of protection as any other member ofsociety?7. Demands for futile treatment. Surrogate decision makers often ask that “everything be done” fora patient. Sometimes they are more specific. Occasionally this request is for treatment deemed bythe medical team to be “futile.” Should physicians be able to withhold or withdraw nonbeneficialinterventions? If so, under what circumstances? What process values should be respected?8. Should the U.S. Congress ban all human cloning (“reproductive” and “therapeutic” cloning)? Thedistinction between types of cloning activity is driven by the desire of many to create new sources ofembryonic stem cells by creating new embryos. What are the arguments for and against both types of cloning?Which do you find persuasive and why? Note: the President’s Commission on Bioethics has weighed in on this topicwith its first report.Page 109. Ethics of third-world drug research. Drug companies have been accused of running drug-testingprotocols in third-world countries that would be unethical and impossible to run in the U.S. Other times, theyhave been criticized for testing drugs that will eventually be marketed at a price the third-world countrieswon’t be able to afford. What should the rules be for such research?10. Medical decision making for minors. What should the standards be for reviewing and overruling parentalmedical choices? You might focus on one set of such decisions (end-of-life decisions,decisions by ChristianScientists, etc.) for your analysis.11. Sex selection (and other genetic manipulations). What limits, if any, should be placed on the ability ofprospective parents to guide or alter the genetic makeup of their offspring?12. Medicine and capital punishment. Should physicians be allowed to medicate prisoners to make them competentfor trial? For execution? The AMA has opinions on this; are they correct? Are they even coherent? And are they ona collision course with the Eighth Amendment’s prohibition of cruel and unusual punishment?13. Human tissue. Who owns bone, sinew, corneas, and other saleable body parts? Who can consent to itspost-mortem removal? What do state statutes say about the nonconsensual removal of human tissue? Whydoes federal law prohibit the sale of solid organs but permit the sale of other human tissue (and blood, sperm,and ova)? Do the rules that govern these activities sufficiently protect the interests that need to be protected?Or do they go too far and discourage an efficient market?14. Access to experimental drugs. Do terminally ill patients have a constitutional right to get access toexperimental drugs without enrolling in a clinical trial? A divided panel of the DC Circuit said yes in a May2, 2006, opinion. In fact, they concluded that the constitutional right is fundamental and that the appropriatetest of any rule limiting access is strict scrutiny. This is an opinion of potentially far-reaching consequencesfor patients, health care providers, payors, and the future of clinical drug trials in this country.
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