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1


1


International Bioethics

LAWG
/J
-
984
-
09


Spring 2011

Tuesdays
1:20
-
3:20 pm

Hotung Building, Room
5013

Prof. Emily Mok




Course Syllabus



This course provides students with the opportunity to engage in the bioethical analysis of
issues that are of global health concern.
In this age of globalization and rapid biomedical
advancements, it is necessary for global health lawyers, policy advisors,

and government
officials to have a solid and balanced understanding of the bioethical dimensions of
current and emerging global health issues for the formulation and interpretation of policy
and law.




The first part of the course will introduce students

to the foundational concepts in
bioethics, which will provide the
foundation

for the ethical analysis of issues covered
later in the course.
Following this introduction, the course will then set out to
contextualize the use of bioethical analysis in the i
nternational arena.

Given the
increasing international interactions (e.g., international clinical trials, travel or migration,
and international trade), growing global interdependence, and differing international
perspectives (in terms culture, religion, s
ocio
-
economic status, etc.), it is important to
consider these factors in bioethics.
Students will engage in the exploration of

recent
ethical controversies in global health through the use of case studies, class exercises, and
discussion.



Students will

be evaluated based on class participation

(20%), a midterm examination
(25%), and a final project (55
%)


which is comprised of a short paper and presentation.

This course meets once a week on Tuesdays from 1:20
-
3:20 pm and carries two credit
hours.


2


2


I.

C
ourse Materials




There is one required text for the course: Ronald Green, Aine Donovan, and Steven Jauss

(eds.),

G
LOBAL
B
IOETHICS
:

I
SSUES OF
C
ONSCIENCE FOR THE
T
WENTY
-
F
IRST
C
ENTURY
,
available in the bookstore (
hereinafter

T
EXT
”).




T.L. Beauchamp and J.F. Childress.
P
RINCIPLES OF
B
IOMEDICAL
E
THICS

(6
th

ed), (Oxford
Univ. Press, 2009) will serve as a supplementary book to this class. It is available for
purchase from the bookstore and has been placed on
r
eserve with Williams Library
.
(If there
is
a
required

reading

from the Beauchamp and Childress book, I will make a scan of the text
available on Courseware.)




Other s
upplementary readings (such as academic articles and institutional report
s) will also
be used and can be found on C
ourseware.

The password to the Courseware site for this class
is:
intbioe
.



II.

Course Requirements




Attendance
:

I expect everyone to attend each class, subject only to illness, emergency or
a problem of similar magnitude. The class preparation described
below will also serve an
attendance function and more than one unexcused absence will be grounds for a half
-
step
reduction in the final grade.





Grading:

o

Class
Preparation and Participation (20%):
For each class,
student
s will be expected
to submit

a brief (1
-
3
) sentence summary
of each
required
reading assigned for that class.
In addition to the short summary, you should list

two

questions that you would like to
raise
/discuss

based on each reading.

The submissions are due by
8am on the day of the

class and should be sent to me via email.
The quality of these submissions along with
your participation in class will form the basis of evaluation for this portion of the grade.

o

Midter
m Examination (25
%):
This will entail a
n in
-
class
(open book)
examina
tion,
which
will
be
describe
d

later in the course for your preparation.

o

Final Project (55
%):

This entails a short final
paper (
about 10
-
12

double
-
spaced

pages)
and
a
presentation.



The final paper will be due on
May 10, 2011
(or May 3, 2011
-

if you are
graduating)
.



E
ach of you will
also
be expected to give a 15
-
20 minute presentation on
the
paper

on the final day of class
.




More details on this final project will be provided later in the course. I am happy
to meet with each of you individually to
discuss project topics.


3


3




III.

Instructor Contact and Office Hours



I have reserved a
room (
Williams Library
-

EBW 364
)
for

office hours on Tuesdays from
3:30


5pm. As I
usually
need to work from another location, please give me a call
/email

or
let me know right after class if you would like to meet with m
e at that time. Otherwise, I

can

meet

by appointment at another time.

4


4


C
LASS
S
ESSIONS AND
R
EADING
A
SSIGNMENTS



Class # 1

Jan. 25

Course Overview and
Introduction


Required:


1.

TEXT:
Chapter 3


“The Evolving Norms of Medical Ethics” by E
䕭b湵n氠⡰瀮‵l
J
㜵⤠a湤⁃桡灴敲‴


“Convergent Trends in Modern
䵥摩捡氠䕴桩捳㨠䵥摩h楮e
J
based Ethics and Human Rights” by J van Delden
⡰瀮‷T
J
㠶U




T Beauchamp and J Childress (2009). “Moral Norms”
楮⁐物湣楰ie猠潦s
B楯ie摩捡氠䕴桩捳⁢y⁔ Beauc桡浰⁡湤⁊⁃桩h摲d獳Ⱐ㙴栠h摩d楯渠⡰瀮‱
J
㈵O



H Kuhse and P Singer (2009). “What is Bioethics? A historical
introduction” in A Companion to Bioethics by H Kuhse and P Singer, 2nd
e摩d楯渠⡰瀮″
J
ㄱN


Supplementa
ry:


1.

S Benatar, A Daar, and P Singer. "Global Health Ethics: The Rationale for
Mutual Caring." International Affairs 79 (2003): 107
-
36.

2.

R. Baker. "A Theory of International Bioethics: Multiculturalism,
Postmodernism, and the Bankruptcy of Fundamentalism."
Kennedy Institute
of Ethics Journal 8 (1998): 201
-
231.

3.

D DeGrazia. “Common Morality, Coherence, and the Principles of
Biomedical Ethics.” Kennedy Institute of Ethics Journal Vol. 13, No. 3,
㈱O

㈳〮



T Beauchamp. "A Defense of the Common Morality," Kennedy
Institute
Journal of Ethics 13 (2003): 259
-
74.




Class # 2

Feb. 1

A Population
-
based Approach to Bioethics


Required:


1.

TEXT: Chapter 1


“Population
J
Level Bioethics: Mapping a New Agenda”
by⁄⁗楫ie爠r湤n䐠䉲潣欠⡰k⸠ㄵ
J
㌶P



TEXT: Chapter 2


“What is
楴 步⁴漠扥⁡⁢楲 ? t楫ie爠r湤⁂牯r欠潮⁴ke
Ethics of Population Health” by N Eyal (pp. 37
J
㔲F



NE Kass. “Public Health Ethics: From Foundations and Frameworks to
Global Public Health.”
J of Law, Med & Ethics

32 (2004): 232
-
242.

4.

R Bayer et al. “Introducti
on: Ethical Theory and Public Health” in Public
5


5


Health Ethics, R Bayer et al. (eds). (pp. 3
-
22)


Supplementary:


1.

G Rose. “Sick Individuals and Sick Populations”
Int. J. Epidemiol. (2001)
30 (3): 427
-
432.

2.

G Persad, A Wertheimer, and E Emanuel. “Principles for allocation of
scarce medical interventions”
Lancet

373

(2009)
: 423

31.




Class # 3

Feb. 8

Moral Principles and Bioethical Approaches




Required:


-

To Be Announced


Supplementary:


-

To Be Announced




Class # 4

Feb. 15

Global Health,
Justice

and Human Rights



Required:


1.

TEXT: Chapter 7


“Global Justice, Human Rights, and Health” by R
䵡c歬k渠⡰n⸠
ㄴN
J
ㄶN
F



J Dwyer.


䝬潢d氠桥l汴栠a湤畳瑩ceK



Bioethics

83 (2005): 460
-
475
.

3.

P Farmer and NG Campos. "New Malaise: Bioethics and Human rights in
the Global Era."
Journal of Law, Medicine and Ethics
32 (2004): 243
-
51.

4.

DC Thomasma. "Bioethics and International Human Rights."
Journal of
Law, Medicine and Ethics
25 (1997): 295
-
306.

5.

G

Yamey.

“AIDS

a湤

d汯扡l

Justice”.

BMJ

324 (2002): 181
-
182.


Supplementary:


1.

J
P Ruger
.

䝬潢d氠䡥a汴栠h畳u楣iK


Public Health Ethics

2 (2009): 261
-
274.

2.

UNESCO.

The Universal Declaration on Bioethics and Human Rights
(2005).

Available at:
http://portal.unesco.org/en/ev.php
-
URL_ID=31058&URL_DO=DO_TOPIC&URL_SECTION
=201.html

3.

R Andorno. “
䝬潢d氠扩oe瑨tc猠s琠啎tpC伺⁩渠摥le湣e映瑨f⁕湩癥牳r氠
6


6


Declaration on Bioethics and Human Rights.”
J Med Ethics
33 (2007): 150
-
154.




Class # 5

TBD

Bioethics in Developing Countries

Religion,
Culture and Bioethics



Required:


1.

TEXT: Chapter 14
-

“The Role and Influence of Religions in Bioethics” by
䐠䵵汬e爮
灰⸠㈷p
J
㈹㐩O



P Marshall and B Koenig. “Accounting for Culture in Globalized
Bioethics.”
J of Law, Medicine and Ethics
, 32 (2004): 252
-
266.

3.

ZA Bhutta. "Ethics in Internat
ional Health Research: A Perspective from the
Developing World."
Bulletin of the World Health Organization

80 (2002):
114

ㄲ〮



S.
Benatar, "Reflections and Recommendations on Research Ethics in
Developing Countries."
Social Science and

Medicine
54 (2002):
1131
-
41.


Supplementary:


1.

J. Killen, C. Grady, G. Folkers, and A. Fauci. "Ethics of Clinical Research
in the Developing World."
Nature Reviews 2

(2002): 210
-
14.

2.

H Widdows. “Is Global Ethics Moral Neo
J
C潬潮oa汩獭?⁁渠f湶n獴s条瑩潮o
潦⁴桥 f獳略⁩渠瑨攠
Context of Bioethics.” Bioethics, 21 (2007): 305
J
㌱㔮



U Schuklenk and B Bello. “Globalization and Health: a developing world
perspective on ethical and policy issues,” in
Globalization and Health:
Challenges for health law and bioethics
, B Bennet (ed), (Sp
ringer, 2006).
(pp. 13
-
23).






Class # 6

March 1


MIDTERM EXAMINATION (IN CLASS)




N
O
C
LASSES
M
EET ON
M
ARCH
6

(T
UES
.)



S
PRING
B
REAK



7


7


Class # 7

March 15

Class Exercise on Access to Medicines


Required:


-

To be announced


Supplementary:


1.

TA Faunce. “Global Intellectual Property Protection of ‘Innovative’
Pharmaceuticals: Challenges for Bioethics and Health Law.” In
Globalization and Health: Challenges for health law and bioethics
, B
Bennet (ed), (Springer, 2006).

2.

JC

Cohen

and
P

Illingworth
. “
The Dilemma of Intellectual Property Rights
for Pharmaceuticals: The Tension Between Ensuring Access of the Poor to
Medicines and Committing to International Agreements.”
Developing
World Bioethics
. 3 (2003): 27
-
48.




Class # 8

March 22

Organ
Procurement and Donation for Transplantation



Required:


1.

N Scheper
-
Hughes. "The Global Traffic in Human Organs."
Current
Anthropology
41 (2000): 191
-
224.

2.

A Iltis. “
Organ Donation and Global Bioethics.”

Journal of Medicine and
Philosophy

35 (2010): 213

ㄹN



J Radcliffe
-
Richards, AS Daar, RD Guttman, R Hoffenberg, I Kennedy, M
Lock, RA Sells, NL Tilney. "The Case for Allowing Kidney Sales." in
Ethical Issues in Modern Medicine
(6
th

ed), In

B

Steinbock, JD Arras, AJ
London (eds). (McGraw
-
Hi
ll Companies, 2008).

4.

Donald Joralemon and Phil Cox, "Body Values: The Case Against
Compensating for Transplant Organs”
Hastings Center Report

Jan
-
Feb
(2003): 27
-
32.


Supplementary:


1.

C Ikels. "Kidney Failure and Transplantation in China."
Social Science and
Medicine
44 (1997): 1271
-
83.

2.

PA Marshall and AS Daar. "Ethical Issues in Human Organ Replacement: A
Case Study from India," in
Global Health Policy,

Local Realities: The
Fallacy of the Level Playing Field,
L.M. Whiteford and L. Manderson
, eds.,
(Lynne Publishers, 2000).

3.

B.J. Spielman. “Acquiring and allocating human organs for transplant: U.S.
8


8


Law,” In
Legal Perspectives in Bioethics
, A.S. Iltis, S.H. Johnson and B.A.
Hinze, (Routledge, 2008).







Class # 9

March 29

The Migration of
Healthcare Professionals



Required:


1.

J Dwyer.


“What's wrong with the global migration of health care
professionals? Individual rights and international justice.”


Hastings Center
Report 37 (
2007):36
-
43.

2.

SR Benatar. “An examination of ethical aspects of

浩g牡瑩潮⁡湤n
recruitment of health care professionals from developing countries.”
Clinical Ethics

2 (2007):2
-
7.

3.

N Eyal and SA Hurst. “
Physician Brain Drain: Can Nothing Be Done?”
Public Health Ethics

1 (2008): 180
-
192.


Supplementary:


-

To Be
Announced




Class # 10

April 5

Pandemic Influenza

and Virus Sample Sharing


Required:


1.

World Health Organization. “Ethical Considerations in Developing a Public
Health Response to Pandemic Influenza” (2007).
t䡏⽃䑓a䕐o⽇fm⼲〰㜮㈠⁁癡楬a扬攠b琺
桴h瀺p⽷睷⹷桯⹩湴Kc獲⽲s獯畲se猯灵s汩ca瑩潮猯t䡏彃䑓彅ao彇fm弲_〷
弲_⹰摦


⡰瀮‱
J
ㄹF



AL Caplan and DR Curry. “Leveraging genetic resources or moral
扬慣歭慩氿⁉湤潮ns
ia and Avian Flu Virus Sample Sharing.”
American
Journal of Bioethics

7 (2007): 1
-
2.


Supplementary:


1.

World Health Organization. “Addressing ethical issues in pandemic
influenza planning: discussion papers” (2008).
9


9


WHO/HSE/EPR/GIP/2008.2. Available at:
http://www.who.int/csr/resources/publications/cds_flu_ethics_5web.pdf








Class # 11

April 12

Genetically Modified Crops


Required:


1.

Nuffield Council on Bioethics. “The Use of Genetically Modified Crops in
Developing Countries” (2003). Available at:
桴h瀺p⽷睷⹮畦K楥汤扩潥瑨楣献潲g⽦楬Li楢牡ry⽰摦L䝍彃牯灳彄楳d畳獩潮彐a
灥牟㈰r㐮灤4

⡒Ea搠dh

N

a湤‴
ⰠI歩k⁃栠h
F



Soraj Hongladarom. “
䝬潢d汩za瑩潮Ⱐo楯整桩捳⁡湤⁴桥⁃畬瑵牥猠潦s
Developing Countries.”
䕵扩潳⁊潵牮o氠潦⁁獩慮⁡湤nf湴敲na瑩潮o氠l楯整桩c猠
N
㈠⠲O〲⤺‱〳
J




R Hails. “Bioethics for Technology?” Current Opinion in Biotechnology 15
⠲〰E⤺′㔰

㈵㌮


Supplementary:


1.

A Myhr. “A Precautionary Approach to Genetically Modified Organisms:
Challenges and Implications for Policy and Science” J Agric
䕮癩牯渠
䕴桩c献
㈰〹sK



L Kass. “Triumph or Tragedy? The Moral Meaning of Genetic
Technologies”
American Journal of
Jurisprudence

45 (2000): 1
-
16.

4.

Y

Devos, P

Maeseele, D

Reheul, L

Van

Speybroeck and D

De

Waele.
“Ethics in the Societal Debate on Genetically Modified Organisms: A
⡒E⥑略獴⁦s爠
pe湳n⁡湤npe湳楢n汩ty
.”
Journal of Agricultural and
Environmental Ethics
. 21 (2008): 29
-
61.

3.

UNESCO. “The Universal Declaration on the Human Genome and Human
Rights” (2000).

䅶a楬a扬e⁡琺
桴h瀺p⽵湥獤潣⹵湥獣漮潲g⽩浡ge猯〰s㈯〰ㄲ㈹Oㄲ㈹㤰䕯⹰摦



UNESCO. “
oe灯牴p⁴桥 fBC渠䕴桩c猬sf湴敬汥c瑵慬⁐牯灥牴y⁡湤n
Genomics” (2002). Available at:
桴h瀺p⽰潲瑡氮畮敳l漮潲o⽳桳⽥港晩汥猯㈱㌹h㄰㔴ㄳ〴㈰ㅆ楮慬剥灯itfm彥渮nd
是f楮慬剥灯itfm彥渮灤n



Nuffield Council on Bioethics. “The Use of Geneti
ca汬y⁍潤 晩f搠d牯灳⁩渠
Developing Countries” (2003). Available at:
桴h瀺p⽷睷⹮畦K楥汤扩潥瑨楣献潲g⽦楬Li楢牡ry⽰摦L䝍彃牯灳彄楳d畳獩潮彐a
灥牟㈰r㐮灤4


瑨敲⁣ha灴敲猠楮⁴桥⁤潣畭敮u
F

10


10





Class # 12

April 1
9

Global Bioethics Consultations
, Guidelines and Politics


Required:


1.

TEXT: Chapter 15


“Global Norms, Informed Consensus, and Hypocrisy
in Bioethics” by J Harris (pp. 297
J
㌲㈩



TEXT: Chapter 16


“Global Norms in Bioethics: Problems and Prospects”
by c⁂ay汩猠⡰瀮″㈳
J
㌴PF



TEXT:
Chapter 8



“Achieving Global Justice in Health through Global
Research Ethics: Supplementing Macklin’s ‘Top
J
Down’ approach with one
from the ‘Ground Up’”

by 䕍⁍b獬sn


瀮p
ㄶN
J
ㄷT
F


Supplementary:


1.


[Review] R Andorno. “
䝬潢d氠扩潥瑨tc猠s琠啎tpC伺⁩渠摥le湣e映瑨
Universal Declaration on Bioethics and Human Rights.”
J Med Ethics
33
(2007): 150
-
154.

2.

L London, “Ethical Oversight of Public Health Research: Can Rules and
IRBs Make a Difference in Developing Countries?”
Health Policy and
Ethics Forum
92 (2002): 1079
-
1083.




Class # 13

April 26


Last Class


S
TUDENT
P
RESENTATIONS




F
INAL
P
APERS
D
UE
:

May 10
, 2011


(
NOTE:
F
or g
raduating students, the
deadline is
May 3
, 2011
.)