Graduate School Bulletin

Spring 2024

HCB: Medical Humanities, Compassionate Care & Bioethics

HCB 501: Compassionate Care, Medical Humanities, and the Illness Experience

This course will introduce students to major interpretations of the illness experience, to several classical biographical and autobiographical accounts of illness, and to the important dynamic of compassionate care in the healing relationship. The patient-as-person will be emphasized throughout, as well as the ways in which respect for and empathy toward the patient impacts diagnostic accuracy, patient adherence, and patient and professional satisfaction. Some emotional dynamics of the illness experience will be addressed, such as hope, through the work of eminent physician-writers such as Jerome Groopman, MD. The dynamics of medical mistakes and forgiveness will be explored through psychiatrist Aaron Lazarre's influential writings on effective medical apologies. Some philosophical and metaphysical aspects of personhood and self-identity will be introduced.

Offered in Fall, 3 credits, Letter graded (A, A-, B+, etc.)

HCB 502: Landmark Cases in Bioethics

What is a life worth living? How do we decide, and who decides, when to use medical technologies such as incubators, ventilators, transplants and reproductive technologies? This is an intensive introduction to some of the cases in medical ethics that have changed the ways that we are born, cared for, and die in American hospitals. Examples of topics include: vaccination and public health; eugenics and human subjects research ethics; the right of privacy and health care; end-of-life planning and treatment; women's bodies and fetal rights; disability rights; religious beliefs and health care; triage and allocation of scarce resources; mental illness and individual rights; global clinical trials; and, bioethics and culture.

Offered in Fall, 3 credits, Letter graded (A, A-, B+, etc.)

HCB 503: Traditions and Values in Bioethical Conflicts

This course serves as an introduction to Western moral and religious traditions and to the positions about killing, saving, and enhancing that these traditions have informed. It explores the interface between religion and biomedical ethics and then delves into specific issues in health care in light of more general normative concerns such as justice, love, autonomy and rights, utilitarianism, self-sacrifice, gender, virtue, and community. The issues with which the course deals address the plights of real people, in the concrete, who come from particular backgrounds and whose set of values may make them sometimes recalcitrant to possibilities that technology has made (or is just now making) available.

Offered

Fall, 3 credits, Letter graded (A, A-, B+, etc.)

HCB 504: Special Topic in Biotechnology

Just because we can do it, does this mean that we should do it? This course takes a focused look at controversial practices in health care settings, such as organ donation and enhancements, which have been (and are continuing to be) made available with the advancement of technology. Ought we to regard that which technology makes available as uncontroversially good? If not, why not? What sorts of new issues regarding distributive justice, autonomy, utility, and compassion are ours to consider carefully because of the changing world in which we live?

Offered in Spring, 3 credits, Letter graded (A, A-, B+, etc.)

HCB 510: Literature, Compassion, and Medical Care

How does literature help us understand the nature of human illness and suffering? Can written works of art, ancient and contemporary, that depict moments of compassion and compassionate acts lay bare the moral, spiritual, psychological, and physical reality of suffering? There is a long association between literature and medicine, from the viewpoint of physician-writers, such as Anton Checkov and William Carlos Williams, whose literary skills have eclipsed their medical backgrounds. Sherlock Holmes and Doctor Watson were the creations of a physician-writer, Arthur Conan Doyle. Physicians portrayed in literature, such as Dr. Bernard Rieux, in Albert Camus The Plague, have also explored the relationship between patient and doctor, the nature of healing. This semester-long course will study these relationships through reading of poetry, drama, fiction, memoir, and essay and reflect on the nature of suffering, the intrinsic human need for compassion, and the implications for health and healing.

Offered in Fall, 3 credits, Letter graded (A, A-, B+, etc.)

HCB 511: Bioethics, Disability & Community

Most people will experience disability at some point in their lives, and for some it will shape their social, personal, family, educational, and employment experiences. Viewpoints on disabilities which have emerged in policy and the broader culture have been explicitly challenged by emerging communities of people with disabilities who seek to speak for themselves and claim full inclusion in society. In this context, bioethicists and disability scholars have found points of both common cause and stark disagreement over issues such as neonatal and end-of-life care, the value and values inherent medical decisions and their outcomes. These bioethical debates occur in the context of debates over the rights of individuals with disabilities to self-determination, accommodations for work and schooling, and the potential for people with disabilities to make unique contributions because of--rather than despite--their disabilities. This course will consider major debates in bioethics in light of recent scholarship in disability studies, drawing on perspectives from philosophy, literature and narrative, history, and sociology.

Offered in Fall, 3 credits, Letter graded (A, A-, B+, etc.)

HCB 512: Altruism and Bioethics

What is altruism, and what are its evolutionary roots as a moral dynamic? What impact does altruistic action have on the human agent? Does it impact flourishing and health? When is it experienced as overwhelming by medical professionals? Where does altruism fit within medical and nursing professionalism? How is it related to compassionate care? What about the duty to treat in time of epidemic, auto-experimentation, pro-bono medical treatment, high-risk provision of healthcare in time of conflict, healthcare activism, and the commitment to the patient's good as a guiding professional ideal? How does the practitioner strike a balance between the care of patients and the care of the nearest and dearest or the care of the self? How does altruism correlate with pro-social behavior, happiness, and health?

Offered in Fall, 3 credits, Letter graded (A, A-, B+, etc.)

HCB 513: Disease and Society

What is disease? How do the beliefs, politics, and economies of particular societies shape how diseases are defined, experienced, and treated? In this seminar, students will explore these questions by analyzing historical documents, scientific reports, and historical scholarship. We will look at disease from multiple perspectives as a biological process, clinical entity, population phenomenon, historical actor, and personal experience. We will pay special attention to how diseases have been recognized, diagnosed, named, classified and counted in different times, places, cultures, and settings based on different environmental and social conditions, medical ideas, diagnostic technologies, and available treatments. The course will begin with a review of major approaches to understanding the manifold relationships between disease and society. The remainder of the course will view disease and society relationships through the lens of specific issues, such as epidemic disease, consumption and affluence, globalization, and risk.

Offered in Fall, 3 credits, Letter graded (A, A-, B+, etc.)

HCB 514: Global Bioethics

Bioethics is an American invention. Ideas about medicine and morality, of course, go back to antiquity and are documented as medical ethics in Europe, medical morality in China, and under many other names in cultures around the world. Recently, the process of globalization of ideas, medical practices, clinical trials, and migration of patients has led to clashes of culture around issues such as the appropriate standards and control groups for clinical trials, organ transplantation, brain death, and end-of-life care. Issues of religion, morality, public policy, disability rights and policy, and health system structure and payment all shape how particular societies decide to manage divisive issues such as the beginning and end of life. This course will draw on a growing literature on global and transnational cases, policies, and traditions in the ethics of health, public health, and health care.

Offered in Spring, 3 credits, Letter graded (A, A-, B+, etc.)

HCB 515: Health Policy, History & Ethics

Who gets sick? Who gets health care, what kind, and in what setting? This course covers the major health policy issues of the United States today, including the health status of the U.S. as a whole, the social and economic determinants of health, the role of personal and public health services in affecting health, the organization and financing of health services, and the multiple factors affecting health policies. We will explore the evolution of the US health care system in the past century, and debates about rights to health care or lack thereof, health disparities, conflicts of interest, and the ethics of health policy and practice.

Offered in Fall, 3 credits, Letter graded (A, A-, B+, etc.)

HCB 516: Ethical Issues in Human Reproduction

New technologies have modified human reproduction in numerous ways, raising profound questions about the moral status of human life and the nature of parental and sibling obligations. This course will investigate the values that attach to different relationships, both familial and general. It will cover questions around the treatment of infertility, surrogate mothering, the commodification of the body, and the elevated expectations of familial obligations that correspond to new reproductive technologies.

Offered in Spring, 3 credits, Letter graded (A, A-, B+, etc.)

HCB 517: The Problem of Evil: Philosophical, Biological, and Social Dimensions

What is the nature of evil? Can it be the result of brain malfunction, something that is genetically predetermined? Or, is evil something which is part of or at least necessary to know the good? Alternatively, is evil an arbitrary designation, a perspective from which we can wrest ourselves given the right sort of reinvention? In this class, we shall address the problem of evil from scientific, social-scientific, and philosophical perspectives, using fiction and non-fictional sources. Examples of medical evil, such as the Nazi doctors or Tuskeegee, can be introduced as case studies.

Offered in Spring, 3 credits, Letter graded (A, A-, B+, etc.)

HCB 518: Empirical Bioethics

The formal study of bioethics attempts to define ethical courses of action in a world ever increasing in complexity. But in day to day practice, ethical outcomes are expressed through the individual decisions and resulting actions--of human agents. How do individuals form these judgments? How do people become motivated to engage in behaviors that are designed to benefit someone else? We will explore current scientific approaches to these questions with several areas of emphasis, including a) the neuroscience of compassionate care and altruism, b) cognitive and neuroscientific approaches to understanding judgment and decision making in ethical domains, and c) empirical approaches to quantifying the effects of ethically based policy decisions.

Offered in Spring, 3 credits, Letter graded (A, A-, B+, etc.)

HCB 519: Public Health Law

This course is a survey of legal and policy issues that have special relevance for public health professionals. Topics may vary, but typically will include many of the following: structure of the U.S. legal system; power of state and federal governments in matters affecting health care; governmental power and the right to privacy; constitutional issues in social welfare benefits; governmental regulation of health care providers and payers; the scope and discretion of administrative agencies in health care; the antitrust laws; the fraud and abuse laws; and negligence in the delivery and financing of health care. The course is taught primarily by Socratic method.

Offered in Spring, 3 credits, Letter graded (A, A-, B+, etc.)

HCB 520: Bioethics and Film

Film and television, both fiction and nonfiction, capture man of the human tragedies, challenges, and possibilities that are debated in bioethics books, articles, newspapers, on hospital ethics committees, and in daily clinical care. This course will explore themes of birth, death, hope, fear, faith, finitude and resource allocation through watching, analyzing, and reading about bioethics issues in visual media. The course will draw on material from philosophical ethics to history, health policy, and film criticism to place these issues and their portrayals in context.

3 credits, Letter graded (A, A-, B+, etc.)

HCB 521: Clinical Ethics Practicum

As difficult as settling abstract ethical issues in medicine may be, the delivery of ethical care presents its own set of difficulties. This course aims to introduce students to the practices hospitals employ to ensure the care they deliver meets the relevant legal and moral requirements. At the end of this course, students will have been exposed to many basic, and some advanced, aspects of clinical ethics theory and practice. They will be able to identify, describe, and analyze ethical dilemmas in clinical cases, and will develop an appreciation for the complexity and multi-disciplinary nature of ethical dilemmas in clinical medicine and will be able to apply what they have learned to assess ethical, social, and legal aspects of cases.

3 credits, Letter graded (A, A-, B+, etc.)

HCB 522: The Role of Virtue Ethics in Medicine

Aristotle's Nicomachean Ethics and the role of virtue ethics are central to many religious traditions including Buddhism, Christianity, Confucianism, and the philosophical traditions. Key virtues include honesty, courage, generosity, prudence, justice, compassion, benevolence, loyalty, and hospitality. This course explores the real and potential role of virtue on the development of virtuous physicians. The course's texts offer two diametrically opposed views on the role of virtue in medicine, i.e., one is that virtue can be channeled into the training of medical professionals, whereas the other is that bioethics has extracted virtue from medicine. Through readings, documentaries, dialogue and active leadership of sessions by students, the course will interrogate the claims as well as possibilities for a role of virtue in medicine.

3 credits, Letter graded (A, A-, B+, etc.)

HCB 523: Special Topics in Medical Humanities

As with all multidisciplinary pursuits, the medical humanities project is characterized by an ongoing negotiation among its practitioners over methods, scope and goals. This course will examine, in detail, one of the latest debates within the field.

3 credits, Letter graded (A, A-, B+, etc.)

May be repeated 2 times FOR credit.

HCB 524: Special Topics in Bioethics

Bioethicists are frequently asked to consider the ethical ramifications of new research findings and emerging technologies as they arise. This course will examine one such issue in close detail.

3 credits, Letter graded (A, A-, B+, etc.)

May be repeated 3 times FOR credit.

HCB 598: Independent Study

3 Credits, ABCF Grading

0-4 credits, Letter graded (A, A-, B+, etc.)

May be repeated 2 times FOR credit.

HCB 599: Special Projects Capstone Course

This course, to be offered in the second (spring) semester, is designed to satisfy the special projects requirement of our program. The first part of the course will be devoted to readings and discussions that further illuminate the methodologies of the interdisciplinary field of medical humanities, compassionate care, and bioethics. Students will develop an appreciation for the standards of high quality scholarship and research through review of carefully selected readings. This will prepare them for the second part of the course, where they pursue and present their own research based on the existing literature. This capstone course will be highly collaborative, entail substantial peer review, and be organized around the development of significant student projects which are intended to represent the beginnings of publishable papers. Our entire faculty will be involved in these projects according to their specific areas of expertise.

Offered in Spring, 3 credits, Letter graded (A, A-, B+, etc.)