Frontiers of Bioethics

FRONTIERS OF BIOETHICS:

EMBODIMENT, PERSONHOOD, AND SOCIAL JUSTICE

HDS 2750

Professor M. Christian Green

Harvard Divinity School

Fall 2004

Wednesdays, 3:00-5:00

Rockefeller Hall, Room 2

 COURSE DESCRIPTION AND OBJECTIVES

This course will center around the recent reports of the President’s Council on Bioethics on stem cell research, cloning, enhancement therapies, and assisted reproduction.  We will begin with some background reading on the classic principles of bioethics—autonomy, nonmaleficence, beneficence, and justice—as well as attention to the development of bioethics as a profession and the relationship of religion to bioethics.  We will then consider the themes and topics raised the President’s Council reports with a view to discerning their theological, social, political, economic, and cultural assumptions and implications.  We will also consider what the reports tell us about contemporary understandings of embodiment, personhood, and relationship to ourselves, our families, our society, and the world in the increasingly globally-conscious field of bioethics.   

In the course of our inquiry, we will press at many “frontiers” of bioethics—asking critical questions about the principles, the profession, the technologies, and the theological, social, political, economic and cultural context of contemporary bioethics.  In so doing, we will, while not bracketing it wholly, seek to get beyond the single issue of the moral status of the embryo, which has dominated much of the recent debate over stem cells and cloning, to consider a variety of issues raised by these new technologies, as well as some specific critiques of their implications. 

First, these technologies have important implications for our understandings of embodiment, personhood, suffering, and perfection.  Second, they raise concerns about the commodification of childhood and our obligations to future generations.  Third, they have elicited important feminist, race, and disability critiques.  Third they raise questions requirements of sustainable medicine, global bioethics, and social justice.  In addressing all of these issues, we will consider the role of religion in bioethics discourse—what it is and what it should be.

 SCHEDULE OF CLASSES AND READINGS

 Week 1 (September 22)

INTRODUCTION:  FRONTIERS OF BIOETHICS

Week 2  (September 29)

PRINCIPLES, PRACTICES, AND THE PROFESSION: SOME BACKGROUND ON BIOETHICS AND ITS RELIGIOUS DIMENSIONS

Readings:

  • Tom L. Beauchamp and James F. Childress, Principles of Biomedical Ethics, 5th ed., pp. 57-69, 113-119, 165-76, 225-35.
  • David J. Rothman, Strangers at the Bedside: A History of How Law and Bioethics Transformed Medical Decision-Making, pp. 1-14, 247-62.
  • Sally Satel and Christine Stolba, “Who Needs Medical Ethics?” Commentary, February 2001.
  • Elliot N. Dorff, “The Jewish Tradition,” in Caring and Curing: Health and Medicine in the Western Religious Traditions, pp. 9-20, 23-25, 28-29, 30-31, 32-34 (selected excerpts).
  • Darrel W. Amundsen and Gary B. Ferngren, “The Early Christian Tradition,” in Caring and Curing: Health and Medicine in the Western Religious Traditions pp. 43-47, 49-50, 51-54.

Optional Readings:

  • Reneé C. Fox, “The Entry of U.S. Bioethics into the 1990’s: A Sociological Analysis,” in A Matter of Principles: Ferment in U.S. Bioethics, pp. 21-71.

Week 3 (October 6)

HUMAN CLONING AND HUMAN DIGNITY (Part 1)

Readings:

  • Human Cloning and Human Dignity, Ch. 1-4 on the Meaning, History, Terminology, and Science of Cloning and Ch. 5 on Reproductive Cloning
  • Karl Rahner, “The Problem of Genetic Manipulation,” in On Moral Medicine, pp. 542-47.

Optional Readings:

  • Thomas B. Okarma, “Human Embryonic Stem Cells:  A Primer on the Technology and Its Medical Applications,” in The Human Embryonic Stem Cell Debate, pp. 1-13.
  • James C. Fletcher, “The Stem Cell Debate in Historical Context,” in The Human Embryonic Stem Cell Debate, pp. 27-34.

Week 4  (October 13)

HUMAN CLONING AND HUMAN DIGNITY (Part 2)

Readings:

  • Human Cloning and Human Dignity, Ch. 6-8 on Therapeutic Cloning and Public Policy Options and Recommendations, along with the Personal Statements of the Council Members in the Appendices
  • Paul Ramsey, “Questionable Aspirations to Godhood,” in Fabricated Man: The Ethics of Genetic Control, pp. 138-60.

Optional Readings:

  • Erik Parens, “On the Ethics and Politics of Embryonic Stem Cell Research,” in The Human Embryonic Stem Cell Debate, pp. 37-50.
  • James C. Fletcher, “NBAC’s Arguments on Embryo Research, in The Human Embryonic Stem Cell Debate, in The Human Embryonic Stem Cell Debate, pp. 61-72.

Week 5  (October 20)

RELIGIOUS PERSPECTIVES ON STEM CELLS AND CLONING

Readings:

  • Laurie Zoloth, “The Ethics of the Eighth Day:  Jewish Bioethics and Research on Human Embryonic Stem Cells,” in The Human Embryonic Stem Cell Debate, pp. 95-111.
  • Michael M. Mendiola, “Human Embryonic Stem Cells:  Possible Approaches from a Catholic Perspective,” in The Human Embryonic Stem Cell Debate, pp. 119-25
  • Gilbert Meilaender, “Some Protestant Reflections,” in The Human Embryonic Stem Cell Debate, pp. 141-47.
  • Ronald Cole-Turner, “Religion Meets Research,” in God and the Embryo, 7-18.
  • Brent Waters, “What Is the Appropriate Contribution of Religious Communities in the Public Debate on Embryonic Stem Cell Research?” in God and the Embryo, 19-28.

Optional Readings:

  • Appendices A-H in God and the Embryo (Containing official statements from a diverse group of Jewish and Christian religious denominations.)
  • National Bioethics Advisory Commission, Ethical Issues in Human Stem Cell Research, Vol. 3, Religious Perspectives (containing testimonies of religious representatives and scholars before the NBAC in 1999.  Available online at: 

http://www.georgetown.edu/research/nrcbl/nbac/stemcell3.pdf )

  • Glenn McGee, ed. The Human Cloning Debate, Pt. 6 “God and the Clone.”

Week 6  (October 27)

BEYOND THERAPY (Part 1):  BODIES, PERFORMANCE, AND AGING

Readings:

  • Beyond Therapy, Chapters 1, 3, and 4 on Enhancement Therapies, Superior Performance, and Aging.
  • Bernard Häring, Ethics of Manipulation, pp. 1-12, 44-81, 180-89.

Week 7  (November 3)

BEYOND THERAPY (Part 2):  MEMORY, MOOD, EMOTIONS, AND ETHICS

Readings

  • Beyond Therapy, Ch. 5 on Happy Souls.
  • Garry Wills, Saint Augustine’s Memory, pp. 3-26.
  • Gilbert Meilaender, “Why Remember?,” pp. 135 First Things  (August/September 2003): 20-24.
  • Miroslav Volf, “Love’s Memory:  The Role of Memory in Contemporary Culture.” Available at:  http://www.ptsem.edu/iym/research/lectures/downloads/2002/1volf.pdf
  • Miroslav Volf, “Love’s Memory: Redemptive Remembering.” Available at:

http://www.ptsem.edu/iym/research/lectures/downloads/2002/2volf.pdf

  • David J. Rothman, “Shiny, Happy People: The Problem with Cosmetic Pharmacology” (Review of Listening to Prozac, by Peter Kramer) The New Republic, 210:7 (February 14, 1994):  34-38.
  • Sally Satel, “The Trauma Society,” The New Republic, May 19, 2003.

Week 8  (November 10)

WHO ARE WE?: EMBODIMENT, PERSONHOOD, PERFECTION, AND SUFFERING

Readings:

  • Carl Elliott, Better than Well, Ch. 2, 3, and 5
  • Jean Bethke Elshtain, “The Body and Projects of Self-Possession,” in Having, pp. 141-161
  • Michael J. Sandel, “The Case Against Perfection,” 23:3 Atlantic Monthly (April 2004): 50-60.
  • Gilbert Meilaender, Bioethics: A Primer for Christians, pp. 1-7, 114-18.
  • Wendy Farley, “The Practice of Theodicy,” in Pain Seeking Understanding, pp. 103-14.
  • Viktor E. Frankl, “The Meaning of Suffering,” in Jewish Values in Bioethics, Levi Meier, ed. (New York: Human Sciences Press, 1986), pp. 117-23.

Optional Readings:

  • Carl Elliott, Better than Well, Ch. 9.

Week 9  (November 17)

COMMODIFICATION OF CHILDHOOD AND OBLIGATION TO FUTURE GENERATIONS

Readings:

  • Beyond Therapy, Ch. 2 on Better Children.
  • Carl Elliott, Better than Well, Ch. 10.
  • Sondra Wheeler, “Contingency, Tragedy, and the Virtues of Parenting,” in Beyond Cloning, pp. 111-23.
  • Eva Feder Kittay, Love’s Labor: Essays on Women, Equality, and Dependency, Ch. 6, 147-61.

Week 10 (November 24) 

NO CLASS!!!—AAR, THANKSGIVING, ETC.

Week 11 (December 1)

FEMINIST, RACE, AND DISABILITY CRITIQUES

Readings:

  • Suzanne Holland, “Beyond the Embryo: A Feminist Appraisal of the Embryonic Stem Cell Debate” in The Human Embryonic Stem Cell Debate, pp. 73-86.
  • Barbara Katz Rothman, “The Products of Conception: The Social Context of Reproductive Choices,” Journal of Medical Ethics, D 85; 11: 188-92.
  • Maura A. Ryan, “The Argument for Unlimited Procreative Liberty: A Feminist Critique,” 20:4 Hastings Center Report (July 1, 1990).
  • Jon Entine and Sally Satel, “Race Belongs in the Stem Cell Debate.”
  • Lee H. Butler, Jr., “Dreaming the Soul: African American Skepticism Encounters the Human Genome Project,” in Adam, Eve, and the Genome, pp. 129-144.
  • Carl Elliot, Better than Well, pp. 160-170, 189-205.
  • Anita Silvers, “A Fatal Attraction to Normalizing,” in Enhancing Human Traits, pp. 95-123.
  • Erik Parens and Adrienne Asch, “The Disability Rights Critique of Prenatal Genetic Testing,” Special Supplement, Hastings Center Report 29:5 (1999):1-22.

Week 12  (December 8 )

HUMAN LONGEVITY, SUSTAINABLE MEDICINE, GLOBAL BIOETHICS, AND SOCIAL JUSTICE

Readings:

  • Carl Elliott, Better than Well, Ch. 11.
  • Leon Kass, “L’Chaim and Its Limits:  Why Not Immortality?” 113 First Things (May 2001): 17-24.
  • Daniel Callahan, “Visions of Immortality,” First Things, 133 (May 2003): 28-35.
  • John Hardwig, “Is There a Duty to Die?” 27:2, Hastings Center Report (March/April 1997):  34-42.
  • Gilbert Meilaender, “I Want to Burden My Loved Ones,” First Things (October 1991): 12-14.
  • Daniel Callahan, False Hopes (chapters to be selected)
  • Dan W. Brock, “Broadening the Bioethics Agenda,” 10:1 Kennedy Institute for Ethics Journal, pp. 21-38.

Week 13 (December 15)

CONCLUSION:  FROM NONMALEFICENCE AND AUTONOMY TO BENEFICENCE AND JUSTICE: RELIGION AND PUBLIC BIOETHICS DEBATES

Readings:

  • Thomas A Shannon, “From the Micro to the Macro,” in The Human Embryonic Stem Cell Debate, pp. 177-84.
  • Cynthia B. Cohen, “Leaps and Boundaries:  Expanding Oversight of Human Stem Cell Research,” in The Human Embryonic Stem Cell Debate, pp. 209-222.
  • Brent Waters, “Does the Human Embryo Have Moral Status?” in God and the Embryo, pp. 67-76.
  • Ronald Cole-Turner, “Principles and Politics: Beyond the Impasse Over the Embryo,” in God and the Embryo, pp. 88-97.
  • Ted Peters and Gaymon Bennett, “A Plea for Beneficence:  Reframing the Embryo Debate,” in The Human Embryonic Stem Cell Debate, pp. 111-130.
  • Laurie Zoloth, “Freedoms, Duties, and Limits: The Ethics of Research in Human Stem Cells,” in God and the Embryo, pp. 141-51.
  • Sondra Wheeler, “Talking Like Believers: Christians and Jews in the Embryonic Stem Cell Debate,” in God and the Embryo, pp. 152-60.
  • Audrey R.Chapman, Unprecedented Choices: Religious Ethics at the Frontiers of Genetic Science, pp. 15-28.

READINGS

Books to Purchase

President’s Council on Bioethics, Human Cloning and Human Dignity: An Ethical Inquiry (July 2002).  Also online at:  http://www.bioethics.gov/reports/cloningreport/index.html

President’s Council on Bioethics, Beyond Therapy:  Biotechnology and the Pursuit of Happiness (October 2003).  Also online at:  http://www.bioethics.gov/reports/beyondtherapy/index.html

Carl Elliott, Better than Well: American Medicine Meets the American Dream (W.W. Norton, 2003).

Brent Waters and Ron Cole-Turner (eds.), God and the Embryo: Religious Voices on Stem Cells and Cloning (Washington, D.C., Georgetown University Press, 2003).

Suzanne Holland, Karen Lebaqcz, and Laurie Zoloth (eds.)  The Human Embryonic Stem Cell Debate (MIT Press, 2001).

Special Note

Many of the assigned readings, including the President’s Council reports in their entirety, and many of the journal article are available online.  In the second week of the course, I will be unveiling a course website that will include links to many of these items.  They are also all available to you at the Andover-Harvard Theological Library reserve desk under my name and the name and number of this course.

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