Bioethics
A.A. 2023/2024
Obiettivi formativi
This course aims to provide an overview of some of the most pressing issues addressed in the contemporary bioethical debate and is structured in four parts. The first part aims to offer a methodological introduction to the discipline and an overview of two classical issues discussed in bioethical reflection, namely, abortion and end-of-life. This will serve as a fundamental basis to discuss in detail three of the most pressing topics of bioethics in our nowadays society. The second part explores the ethical issues emerging from structural scarcity in healthcare and the necessity to allocate healthcare resources. The third part investigates the ethics of genetics and examines how current and future assisted reproductive technologies may change our understanding of human reproduction. The fourth and final part discusses the ethical problems emerging from the implementation of artificial intelligence in clinical settings, discussing its impact on the doctor-patient relationship and end-of-life decisions.
Risultati apprendimento attesi
This course will allow students to acquire the knowledge and skills necessary for the development of a critical and non-dogmatic reflection on complex bioethical issues. With regard to knowledge, students will be able to: recognize the aims of bioethical reflection, distinguishing the various areas of practical application of the discipline; recognize the ethical theories and arguments used in dealing with specific bioethical issues. Regarding competencies, students will be able to formulate articulated opinions on the topics covered during the course and present their positions in a coherent and well-argued way.
Periodo: Terzo trimestre
Modalità di valutazione: Esame
Giudizio di valutazione: voto verbalizzato in trentesimi
Corso singolo
Questo insegnamento può essere seguito come corso singolo.
Programma e organizzazione didattica
Edizione unica
Periodo
Terzo trimestre
Programma
FRONTIERS IN BIOETHICS
This course aims to provide an overview of some of the most pressing issues addressed in the contemporary bioethical debate and is structured in four parts. The first part aims to offer a methodological introduction to the discipline and an overview of two classical issues discussed in bioethical reflection, namely, abortion and end-of-life. These notions will serve as a fundamental basis to discuss in detail three of the most pressing topics of bioethics in our nowadays society. Therefore, the second part explores the ethical issues emerging from structural scarcity in healthcare and the necessity to allocate healthcare resources. The third part investigates the ethics of genetics and examines how current and future assisted reproductive technologies may change our understanding of human reproduction. The fourth and final part discusses the ethical problems emerging from the implementation of artificial intelligence in clinical settings, discussing in particular the AI impact on the doctor-patient relationship and end-of-life decisions.
FRONTIERS IN BIOETHICS
Part 1: Basics of bioethics
· Lesson 1: Origins, purposes, and epistemological foundations of bioethics
· Lesson 2: Theories and sound arguments in bioethics
· Lesson 3: An overview of ethical issues of abortion
· Lesson 4: End-of-life issues
Part 2: Scarcity, healthcare ethics, and allocation of resources
· Lesson 5: Theories of justice in healthcare 1
· Lesson 6: Theories of justice in healthcare 2
· Lesson 7: Establishing criteria for healthcare resource allocations
· Lesson 8: Formal fairness in allocating scarce healthcare resources
· Lesson 9: Ethical issues of implicit rationing
Part 3: Genetics and reproduction
· Lesson 10: Ethical issues of genetic testing: non-invasive prenatal testing and newborn screening
· Lesson 11: Preimplatantion genetic testing and the expressivist argument against genetic selection
· Lesson 11: The future of reproduction: ethics of germline genome editing
· Lesson 13: Ethics of genetic enhancement and the obsolescence argument
· Lesson 14:Toward new procreative obligations? Procreative beneficence and the non-identity problem
· Lesson 15: Models of procreative responsibility
Part 4: Artificial intelligence in healthcare
· Lesson 16: An overview of artificial intelligence and its ethical challenges
· Lesson 17: What Should ChatGPT Mean for Bioethics?
· Lesson 18: AI and its impacts on the doctor-patient relationship
· Lesson 19: AI in end-of-life decision-making
Conclusions
· Lesson 20: Conclusions of the course and discussion of the topics reviewed
This course aims to provide an overview of some of the most pressing issues addressed in the contemporary bioethical debate and is structured in four parts. The first part aims to offer a methodological introduction to the discipline and an overview of two classical issues discussed in bioethical reflection, namely, abortion and end-of-life. These notions will serve as a fundamental basis to discuss in detail three of the most pressing topics of bioethics in our nowadays society. Therefore, the second part explores the ethical issues emerging from structural scarcity in healthcare and the necessity to allocate healthcare resources. The third part investigates the ethics of genetics and examines how current and future assisted reproductive technologies may change our understanding of human reproduction. The fourth and final part discusses the ethical problems emerging from the implementation of artificial intelligence in clinical settings, discussing in particular the AI impact on the doctor-patient relationship and end-of-life decisions.
FRONTIERS IN BIOETHICS
Part 1: Basics of bioethics
· Lesson 1: Origins, purposes, and epistemological foundations of bioethics
· Lesson 2: Theories and sound arguments in bioethics
· Lesson 3: An overview of ethical issues of abortion
· Lesson 4: End-of-life issues
Part 2: Scarcity, healthcare ethics, and allocation of resources
· Lesson 5: Theories of justice in healthcare 1
· Lesson 6: Theories of justice in healthcare 2
· Lesson 7: Establishing criteria for healthcare resource allocations
· Lesson 8: Formal fairness in allocating scarce healthcare resources
· Lesson 9: Ethical issues of implicit rationing
Part 3: Genetics and reproduction
· Lesson 10: Ethical issues of genetic testing: non-invasive prenatal testing and newborn screening
· Lesson 11: Preimplatantion genetic testing and the expressivist argument against genetic selection
· Lesson 11: The future of reproduction: ethics of germline genome editing
· Lesson 13: Ethics of genetic enhancement and the obsolescence argument
· Lesson 14:Toward new procreative obligations? Procreative beneficence and the non-identity problem
· Lesson 15: Models of procreative responsibility
Part 4: Artificial intelligence in healthcare
· Lesson 16: An overview of artificial intelligence and its ethical challenges
· Lesson 17: What Should ChatGPT Mean for Bioethics?
· Lesson 18: AI and its impacts on the doctor-patient relationship
· Lesson 19: AI in end-of-life decision-making
Conclusions
· Lesson 20: Conclusions of the course and discussion of the topics reviewed
Prerequisiti
The course has no formal prerequisites. However, it will refer to some issues discussed during the teaching course "Facts, principles and hard choices" (I year).
Metodi didattici
The course is composed of both taught classes and debate lessons. Attending students will be able to present a paper chosen from a list that will be given to the students by the professor during the first lesson. The paper that will be presented must be agreed with the teacher. Presenting a paper during the course is NOT mandatory.
Materiale di riferimento
For attending students: The slides used during the lessons will be available and will form part of the exam material for attending students. In addition, here is a list of suggested readings, organized lesson by lesson, to better follow the course.
· Lesson 1: McMillan, J. (2018). The methods of bioethics: an essay in meta-bioethics. Oxford University Press. (1-25).
· Lesson 2: McMillan, J. (2018). The methods of bioethics: an essay in meta-bioethics. Oxford University Press. (28-42).
· Lesson 3:
1. Marquis, D. (1989). Why abortion is immoral. The Journal of Philosophy, 86(4), 183-202.
2. Thomson, J. J. (1976). A defense of abortion. In Biomedical Ethics and the Law (pp. 39-54). Springer US.
3. Giubilini, A., & Minerva, F. (2013). After-birth abortion: why should the baby live?
4. Tooley, M. (1972). Abortion and infanticide. Philosophy & Public Affairs, 37-65.
· Lesson 4: Rachels, J. (1975). Active and passive euthanasia. Bioethics: An Introduction to the History, Methods, and Practice, 77-82.
· Lesson 5: Engelhardt, H. Tristram. (1979). Rights to Health Care: A Critical Appraisal. The Journal of Medicine and Philosophy: A Forum for Bioethics and Philosophy of Medicine, 4(2), 113-117. https://doi.org/10.1093/jmp/4.2.113.
· Lesson 6:
1. Parfit, D. (1995). Equality or priority? University of Kansas.
2. Daniels, N. (2009). Is There a Right to Health Care and, If So, What Does It Encompass?. In A Companion to Bioethics (eds H. Kuhse and P. Singer). https://doi.org/10.1002/9781444307818.ch31.
· Lesson 7: Persad, G., Wertheimer, A., & Emanuel, E. J. (2009). Principles for allocation of scarce medical interventions. The Lancet, 373(9661), 423-431.
· Lesson 8:
1. Daniels, N., & Sabin, J. (1997). Limits to health care: fair procedures, democratic deliberation, and the legitimacy problem for insurers. Philosophy & public affairs, 26(4), 303-350.
2. Battisti, D., & Camporesi, S. (2023). A proposal for formal fairness requirements in triage emergency departments: publicity, accessibility, relevance, standardisability and accountability. Journal of Medical Ethics.
· Lesson 9: Glover. (2019). The Role of Physicians in the Allocation of Health Care: Is Some Justice Better than None? Kennedy Institute of Ethics Journal, 29(1), 1-31.
· Lesson 10: Johnston, J., Lantos, J. D., Goldenberg, A., Chen, F., Parens, E., Koenig, B. A., & NSIGHT Ethics and Policy Advisory Board. (2018). Sequencing newborns: a call for nuanced use of genomic technologies. Hastings Center Report, 48, S2-S6.
· Lesson 11:
1. Buchanan, A. (1996). Choosing who will be disabled: genetic intervention and the morality of inclusion. Social Philosophy and Policy, 13(2), 18-46.
2. Kahane, G., & Savulescu, J. (2009). The welfarist account of disability. Disability and disadvantage, 14-53.
3. Hofmann, B. (2017). 'You are inferior!' Revisiting the expressivist argument. Bioethics, 31(7), 505-514.
· Lesson 12: Gyngell, C., Douglas, T., & Savulescu, J. (2017). The ethics of germline gene editing. Journal of Applied Philosophy, 34(4), 498-513.
· Lesson 13:
1. Sparrow, R. (2019). Yesterday's child: How gene editing for enhancement will produce obsolescence—and why it matters. The American Journal of Bioethics, 19(7), 6-15.
2. Maillard, D. (2021). The obsolescence of man in the digital society. International Journal for Applied Information Management, 1(3), 99-124.
· Lesson 14: Savulescu, J., & Kahane, G. (2009). The moral obligation to create children with the best chance of the best life. Bioethics, 23(5), 274-290; Parfit, D. (1984). Reasons and persons. Oxford University Press (Part 4, Chapter 16).
· Lesson 15:
1. Douglas, T., & Devolder, K. (2013). Procreative altruism: beyond individualism in reproductive selection. Journal of Medicine and Philosophy, 38(4), 400-419.
2. Saunders, B. (2017). First, do no harm: Generalized procreative non‐maleficence. Bioethics, 31(7), 552-558.
3. Marway, H. K. (2023). Procreative Justice and genetic selection for skin colour. Bioethics, 37(4), 389-398.
4. Magni, S. F. (2021). In defence of person‐affecting procreative beneficence. Bioethics, 35(5), 473-479.
· Lesson 16: Savulescu, J., Giubilini, A., Vandersluis, R., & Mishra, A. (2024). Ethics of artificial intelligence in medicine. Singapore Medical Journal, 65(3), 150-158.
· Lesson 17: Glenn Cohen (2023) What Should ChatGPT Mean for Bioethics? The American Journal of Bioethics, 23(10), 8-16, DOI: 10.1080/15265161.2023.2233357.
· Lesson 18: Dalton-Brown, S. (2020). The ethics of medical AI and the physician-patient relationship. Cambridge Quarterly of Healthcare Ethics, 29(1), 115-121.
· Lesson 19:
1. Ferrario, A., Gloeckler, S., & Biller-Andorno, N. (2023). Ethics of the algorithmic prediction of goal of care preferences: from theory to practice. Journal of Medical Ethics, 49(3), 165-174.
2. Wade, D. (2023). Artificial intelligence algorithms cannot recommend a best interests decision but could help by improving prognostication. Journal of Medical Ethics, 49(3), 179-180.
· Lesson 20: /
Required readings for the exam (plus slides) for attending students:
1. Buchanan, A. (1996). Choosing who will be disabled: genetic intervention and the morality of inclusion. Social Philosophy and Policy, 13(2), 18-46.
2. Daniels, N., & Sabin, J. (1997). Limits to health care: fair procedures, democratic deliberation, and the legitimacy problem for insurers. Philosophy & public affairs, 26(4), 303-350.
3. Douglas, T., & Devolder, K. (2013). Procreative altruism: beyond individualism in reproductive selection. Journal of Medicine and Philosophy, 38(4), 400-419.
4. Ferrario, A., Gloeckler, S., & Biller-Andorno, N. (2023). Ethics of the algorithmic prediction of goal of care preferences: from theory to practice. Journal of Medical Ethics, 49(3), 165-174.
5. Glover. (2019). The Role of Physicians in the Allocation of Health Care: Is Some Justice Better than None? Kennedy Institute of Ethics Journal, 29(1), 1-31.
6. Gyngell, C., Douglas, T., & Savulescu, J. (2017). The ethics of germline gene editing. Journal of Applied Philosophy, 34(4), 498-513.
7. Magni, S. F. (2021). In defence of person‐affecting procreative beneficence. Bioethics, 35(5), 473-479.
8. Parfit, D. (1984). Reasons and persons. Oxford University Press (351-387).
9. Persad, G., Wertheimer, A., & Emanuel, E. J. (2009). Principles for allocation of scarce medical interventions. The Lancet, 373(9661), 423-431.
10. Rachels, J. (1975). Active and passive euthanasia. Bioethics: An Introduction to the History, Methods, and Practice, 77-82.
11. Savulescu, J., Giubilini, A., Vandersluis, R., & Mishra, A. (2024). Ethics of artificial intelligence in medicine. Singapore Medical Journal, 65(3), 150-158.
12. Savulescu, J., & Kahane, G. (2009). The moral obligation to create children with the best chance of the best life. Bioethics, 23(5), 274-290.
13. Sparrow, R. (2019). Yesterday's child: How gene editing for enhancement will produce obsolescence—and why it matters. The American Journal of Bioethics, 19(7), 6-15.
14. Choose one among:
a. Marquis, D. (1989). Why abortion is immoral. The Journal of Philosophy, 86(4), 183-202.
b. Thomson, J. J. (1976). A defense of abortion. In Biomedical Ethics and the Law (pp. 39-54). Springer US.
c. Tooley, M. (1972). Abortion and infanticide. Philosophy & Public Affairs, 37-65.
Non-attending students will be required to read both required and optional papers. Slides are not required.
· Lesson 1: McMillan, J. (2018). The methods of bioethics: an essay in meta-bioethics. Oxford University Press. (1-25).
· Lesson 2: McMillan, J. (2018). The methods of bioethics: an essay in meta-bioethics. Oxford University Press. (28-42).
· Lesson 3:
1. Marquis, D. (1989). Why abortion is immoral. The Journal of Philosophy, 86(4), 183-202.
2. Thomson, J. J. (1976). A defense of abortion. In Biomedical Ethics and the Law (pp. 39-54). Springer US.
3. Giubilini, A., & Minerva, F. (2013). After-birth abortion: why should the baby live?
4. Tooley, M. (1972). Abortion and infanticide. Philosophy & Public Affairs, 37-65.
· Lesson 4: Rachels, J. (1975). Active and passive euthanasia. Bioethics: An Introduction to the History, Methods, and Practice, 77-82.
· Lesson 5: Engelhardt, H. Tristram. (1979). Rights to Health Care: A Critical Appraisal. The Journal of Medicine and Philosophy: A Forum for Bioethics and Philosophy of Medicine, 4(2), 113-117. https://doi.org/10.1093/jmp/4.2.113.
· Lesson 6:
1. Parfit, D. (1995). Equality or priority? University of Kansas.
2. Daniels, N. (2009). Is There a Right to Health Care and, If So, What Does It Encompass?. In A Companion to Bioethics (eds H. Kuhse and P. Singer). https://doi.org/10.1002/9781444307818.ch31.
· Lesson 7: Persad, G., Wertheimer, A., & Emanuel, E. J. (2009). Principles for allocation of scarce medical interventions. The Lancet, 373(9661), 423-431.
· Lesson 8:
1. Daniels, N., & Sabin, J. (1997). Limits to health care: fair procedures, democratic deliberation, and the legitimacy problem for insurers. Philosophy & public affairs, 26(4), 303-350.
2. Battisti, D., & Camporesi, S. (2023). A proposal for formal fairness requirements in triage emergency departments: publicity, accessibility, relevance, standardisability and accountability. Journal of Medical Ethics.
· Lesson 9: Glover. (2019). The Role of Physicians in the Allocation of Health Care: Is Some Justice Better than None? Kennedy Institute of Ethics Journal, 29(1), 1-31.
· Lesson 10: Johnston, J., Lantos, J. D., Goldenberg, A., Chen, F., Parens, E., Koenig, B. A., & NSIGHT Ethics and Policy Advisory Board. (2018). Sequencing newborns: a call for nuanced use of genomic technologies. Hastings Center Report, 48, S2-S6.
· Lesson 11:
1. Buchanan, A. (1996). Choosing who will be disabled: genetic intervention and the morality of inclusion. Social Philosophy and Policy, 13(2), 18-46.
2. Kahane, G., & Savulescu, J. (2009). The welfarist account of disability. Disability and disadvantage, 14-53.
3. Hofmann, B. (2017). 'You are inferior!' Revisiting the expressivist argument. Bioethics, 31(7), 505-514.
· Lesson 12: Gyngell, C., Douglas, T., & Savulescu, J. (2017). The ethics of germline gene editing. Journal of Applied Philosophy, 34(4), 498-513.
· Lesson 13:
1. Sparrow, R. (2019). Yesterday's child: How gene editing for enhancement will produce obsolescence—and why it matters. The American Journal of Bioethics, 19(7), 6-15.
2. Maillard, D. (2021). The obsolescence of man in the digital society. International Journal for Applied Information Management, 1(3), 99-124.
· Lesson 14: Savulescu, J., & Kahane, G. (2009). The moral obligation to create children with the best chance of the best life. Bioethics, 23(5), 274-290; Parfit, D. (1984). Reasons and persons. Oxford University Press (Part 4, Chapter 16).
· Lesson 15:
1. Douglas, T., & Devolder, K. (2013). Procreative altruism: beyond individualism in reproductive selection. Journal of Medicine and Philosophy, 38(4), 400-419.
2. Saunders, B. (2017). First, do no harm: Generalized procreative non‐maleficence. Bioethics, 31(7), 552-558.
3. Marway, H. K. (2023). Procreative Justice and genetic selection for skin colour. Bioethics, 37(4), 389-398.
4. Magni, S. F. (2021). In defence of person‐affecting procreative beneficence. Bioethics, 35(5), 473-479.
· Lesson 16: Savulescu, J., Giubilini, A., Vandersluis, R., & Mishra, A. (2024). Ethics of artificial intelligence in medicine. Singapore Medical Journal, 65(3), 150-158.
· Lesson 17: Glenn Cohen (2023) What Should ChatGPT Mean for Bioethics? The American Journal of Bioethics, 23(10), 8-16, DOI: 10.1080/15265161.2023.2233357.
· Lesson 18: Dalton-Brown, S. (2020). The ethics of medical AI and the physician-patient relationship. Cambridge Quarterly of Healthcare Ethics, 29(1), 115-121.
· Lesson 19:
1. Ferrario, A., Gloeckler, S., & Biller-Andorno, N. (2023). Ethics of the algorithmic prediction of goal of care preferences: from theory to practice. Journal of Medical Ethics, 49(3), 165-174.
2. Wade, D. (2023). Artificial intelligence algorithms cannot recommend a best interests decision but could help by improving prognostication. Journal of Medical Ethics, 49(3), 179-180.
· Lesson 20: /
Required readings for the exam (plus slides) for attending students:
1. Buchanan, A. (1996). Choosing who will be disabled: genetic intervention and the morality of inclusion. Social Philosophy and Policy, 13(2), 18-46.
2. Daniels, N., & Sabin, J. (1997). Limits to health care: fair procedures, democratic deliberation, and the legitimacy problem for insurers. Philosophy & public affairs, 26(4), 303-350.
3. Douglas, T., & Devolder, K. (2013). Procreative altruism: beyond individualism in reproductive selection. Journal of Medicine and Philosophy, 38(4), 400-419.
4. Ferrario, A., Gloeckler, S., & Biller-Andorno, N. (2023). Ethics of the algorithmic prediction of goal of care preferences: from theory to practice. Journal of Medical Ethics, 49(3), 165-174.
5. Glover. (2019). The Role of Physicians in the Allocation of Health Care: Is Some Justice Better than None? Kennedy Institute of Ethics Journal, 29(1), 1-31.
6. Gyngell, C., Douglas, T., & Savulescu, J. (2017). The ethics of germline gene editing. Journal of Applied Philosophy, 34(4), 498-513.
7. Magni, S. F. (2021). In defence of person‐affecting procreative beneficence. Bioethics, 35(5), 473-479.
8. Parfit, D. (1984). Reasons and persons. Oxford University Press (351-387).
9. Persad, G., Wertheimer, A., & Emanuel, E. J. (2009). Principles for allocation of scarce medical interventions. The Lancet, 373(9661), 423-431.
10. Rachels, J. (1975). Active and passive euthanasia. Bioethics: An Introduction to the History, Methods, and Practice, 77-82.
11. Savulescu, J., Giubilini, A., Vandersluis, R., & Mishra, A. (2024). Ethics of artificial intelligence in medicine. Singapore Medical Journal, 65(3), 150-158.
12. Savulescu, J., & Kahane, G. (2009). The moral obligation to create children with the best chance of the best life. Bioethics, 23(5), 274-290.
13. Sparrow, R. (2019). Yesterday's child: How gene editing for enhancement will produce obsolescence—and why it matters. The American Journal of Bioethics, 19(7), 6-15.
14. Choose one among:
a. Marquis, D. (1989). Why abortion is immoral. The Journal of Philosophy, 86(4), 183-202.
b. Thomson, J. J. (1976). A defense of abortion. In Biomedical Ethics and the Law (pp. 39-54). Springer US.
c. Tooley, M. (1972). Abortion and infanticide. Philosophy & Public Affairs, 37-65.
Non-attending students will be required to read both required and optional papers. Slides are not required.
Modalità di verifica dell’apprendimento e criteri di valutazione
The final exam will consist of an oral discussion on the central issues of bioethics. A considerable part of the final assessment will depend on students' involvement in class discussions.
Students who want to explore a specific topic in more detail can write a paper (max 5000 words, bibliography excluded) and discuss it at the oral interview. The weight of the paper in the final evaluation is 40%. The topic of the paper should be first approved by the Professor. The paper should be submitted to [email protected] at least two weeks before the oral discussion.
Students who want to explore a specific topic in more detail can write a paper (max 5000 words, bibliography excluded) and discuss it at the oral interview. The weight of the paper in the final evaluation is 40%. The topic of the paper should be first approved by the Professor. The paper should be submitted to [email protected] at least two weeks before the oral discussion.
SPS/01 - FILOSOFIA POLITICA - CFU: 6
Lezioni: 40 ore
Docente:
Battisti Davide