Electives

This course examines bioethical issues that arise in the representation of mental illness and its treatment in film and literature. Course requirements include viewing 3 films and reading 3 or more books during the course of the semester, in-class discussion, and assigned writing. The films and works of literature will be rotated each year, with some possible repetitions.

Focus and Scope of Course: The course examines the interplay of politics, governmental structures, culture and religion and their impact on ethics questions that arise in the health arena. The course provides a broad overview of the basic tenets of several major faith traditions and examines how and why the interpretation of such tenets and their impact on bioethics issues varies across different societies. The specific domains in which we explore such issues, e.g., reproductive health, regenerative medicine, end-of-life issues, infectious disease, may be rotated each year.

Objectives: Students will be able to: 

• Describe how religious views and interests affect policymaking with respect to a variety of health-related issues
• Enunciate strategies for the reconciliation of bioethics perspectives stemming from diverse religious interests in a pluralistic society
• Compare and contrast the perspective of various world religions with respect to specific bioethics issues

We all grow old (if we are so lucky!). But who wants to be called "old"? And how does the experience of "growing old" differ based on one's sex or gender, sexuality, race or ethnicity, and socioeconomic or disability status? In this course, we will consider the social, cultural, scientific, medical, and personal meanings of aging, and how these meanings, as well as the embodied experience of aging in America, are influenced by multiple forms of ageism. We will interrogate the assumptions and stereotypes about age that circulate through mainstream American culture and medicine and how these shape interpersonal and institutional practices. How might we begin to recognize, respond to, and change ageism, and thus our own inevitable experiences of aging? The course requires reading quizzes, papers, participation, and attendance, and for graduate students an additional presentation.

*Required for Medicine, Society, and Culture Concentration

Topics will include comparative medical systems and concepts of health, medical history, illness narratives and narrative ethics, social determinants of health and health inequalities, analysis of representations of illness and medicine in literature and the arts, and medical rhetoric. Students who complete the course should develop a command of the basic problems, approaches, and literatures in the social and cultural contexts of health sickness, and medicine. Students will be able to identify epistemology, theory, methodology and data from neighboring disciplines and understand affordances and costs in each.

Narrative Medicine, or medicine practiced with narrative skills (as defined by Rita Charon, MD, PhD), is a methodology in patient-centered medical education. Narrative medicine is informed by the theory and practice of reading, writing, telling, and receiving of stories as a clinically empowering practice for anyone engaged (or planning to engage) in the field of healthcare. This course will employ various methods of learning and experiencing narrative, including fundamental skills of close reading and reflective writing and other forms of self-representation. Narrative competence is an important skill that enables a person to "recognize, absorb, interpret, represent, and be moved by the stories of illness". Major themes throughout the course will include caregivers' and patients' empowerment, empathy, narrative ethics, testimony, reflexive writing, and illness and medical stories. The course will be conducted in a seminar-type format. Each session will have readings that relate to the theory of narrative (primarily from the Charon textbook but also from other sources in the Ethics and Humanities professional literature) and related health humanities. Many of the sessions will also include the application of reflective practice/close reading. Additional elements will be writing workshops and use of film and visual art as narrative. The class will meet once weekly for a 3 hour session. This class is open to graduate students in any humanities or healthcare field, and will be especially useful to those who intend to have a future career in which direct care of patients/clients is a part of their work.

This course is designed to familiarize graduate students with the major controversies over the generation and use of new human genetic information. Topics will include the spread of predictive genetic testing, prenatal diagnosis, genetic discrimination, human genetic variation research, eugenics, genetic counseling, and the limits of human gene therapy. The course will be conducted as a seminar, involving discussions of readings, guest speakers, and student presentations.

This 3-credit course allows students to familiarize themselves with social policies and practices related to women's health in the United States and the Netherlands. Issues covered in the course include birth control and family planning, abortion, prenatal testing, childbirth, health care disparities, cosmetic surgery, prostitution and trafficking in women. This course also addresses the US and Dutch national policies regarding the public provision of health care for women. The course places an emphasis on the ways in which social norms shape policies over time, which political actors are involved in shaping women's health policy, and the balance between women's health as a matter of the public good or individual responsibility. This course substantively explores gender-specific cultural values and practices in relation to women's health in the United States and the Netherlands and will help students develop the analytical skills necessary for evaluating social policy and ethical issues related to women's health.

This 3-credit course gives students the unique opportunity to observe patients and practitioners encounter in a radically different health care system. Costa Rica has one of the most comprehensive health care systems in the Western hemisphere, featuring the innovative use of mid-level health care workers organized in basic comprehensive health care teams. This has resulted in a longer life expectancy than the United States, despite a per capita GDP of only $10,000 per person. Students will gain first-hand experience of Costa Rican health care through field experiences at sites including a national hospital in the capital city, San Jose; a peripheral treatment clinic in a smaller town; and observation of the work of an integrated basic health care team in an indigenous reserve. Following each visit, students will discuss the practical and ethical dilemmas that practitioners face in the context of the Costa Rican health care system. Specific topics include: health inequalities within and between nations; the ethics of transplantation, medical research, and end-of-life care; and health care in rural environments and with indigenous populations.

This 3-credit intensive course will be held in Granada, Spain. Taught by faculty from CWRU and University of Granada, this course offers students a cross-cultural perspective on bioethics in the United States and Spain. This course uses the medium of film, complemented by readings in bioethics, film criticism, and medical research, to introduce students to a number of compelling bioethics problems facing physician-scientists today, including: when life begins, the nature and limits of informed consent, use of randomization without equipoise, medical imperialism (or the appearance thereof), the treatment of so-called "orphan" diseases, use of deception in research, and financial conflicts of interests caused by among other things, the involvement of the pharmaceutical industry in the drug invention process.

Is it ever permissible for physicians to kill their patients? In the Netherlands, the answer is yes. In the United States, it is no. Are the Dutch sliding down a moral slippery slope? Are the Americans compromising the rights and dignity of dying patients? This 3-credit course is a unique opportunity to examine a range of Dutch and American end-of-life policies and practices with special focus on the unique ethical, cultural, religious, and legal contexts in which they developed. This course will compare how two liberal democracies, the United States and the Netherlands, have handled difficult end-of-life issues, including: The Dutch regulation of euthanasia; Regulation of physician-assisted suicide in the state of Oregon; Terminal sedation; End-of-life decisions in newborns; Withholding and withdrawing of artificially-provided fluids and nutrition; The legal basis for end-of-life decision making in the USA; Palliative care and hospice; Public trust in medicine and physicians. In the United States, teaching methods will include lectures, case discussion, and exposure to how some of the course's themes are reflected in popular culture such as movies.

This course will offer students the opportunity to compare and contrast the ways in which the Netherlands and the United States approach drug use. In particular, students will be asked to carefully examine the ethical dimensions of harm reduction programs, policies regarding the availability and the decriminalization of drugs, and the critical role of detention and correctional medical care in addressing drug use. The course will include an introduction to the Dutch and U.S. health care and health insurance systems and will consider how the construction of the patient-physician relationship impacts the prevalence and treatment of drug use in each country. In addition, students will explore the ethics of public health initiatives and social programs aimed at drug users in both settings, including those designed for particular populations such as immigrants and older users. The course will pay special attention to the unique challenges and ethics of the opioid crisis in the U.S. 

This class brings together the study of conservation, ethics and human well-being in a hands-on investigation at Yellowstone National Park. The course returns to the original meaning of the term bioethics as including the biome. It covers conservation ethics and human relationships with the environment and other species as they impact human health across multiple levels. The course draws on theories, models, and methods from psychological anthropology and political ecology to frame the complex dynamics of interaction. The evolution and psychology of compassion and awe are engaged in processual models of human interaction with the natural world and other species. Both have important implications for human health in everyday behavioral practice and in clinical settings. The course involves pre-departure study and then will integrate the materials in the field in Yellowstone National Park looking at contemporary and historical issues in partnership with Yellowstone Forever Institute instructors. In particular, the case of the conservation of the American bison will be used to understand multi-level issues over time in culture, politics, environment, human behavior, and health. The course requires papers, participation, attendance and a field journal. 

"Despite death’s inevitability, we consciously and unconsciously disguise or resist its reality in dreams, fairy tales, allegories, and even jokes."  In his book, How We Die: Reflections on Life’s Final Chapter, Sherwin Nuland describes how we have turned increasingly to modern medicine as one more means of denying the reality of death.  As a surgeon with more than forty years of experience in a major metropolitan hospital, Nuland admits to actively participating in this denial.  Modern medicine, he argues, influences how we as individuals and as a culture not only view but also experience death.  “Modern dying,” he contends, “takes place in the modern hospital, where it can be hidden, cleansed of its organic blight, and finally packaged for modern burial.”  This course uses literature, history, and personal and critical accounts related to death as points of reference for examining the role modern medicine has come to play in how we die. The course will have a heavy reading load, but of accessible and engaging material. Course requirements include reading quizzes, papers, participation, and attendance. For graduate students, there are additional paper and presentation requirements. No prerequisites required.

The course will introduce students to theoretical and practical aspects of ethics and public health. This course will help students develop the analytical skills necessary for evaluating of ethical issues in public health policy and public health prevention, treatment, and research. Will include intensive reading and case-based discussions. Evaluation based on class participation, a written exercise and a case analysis.

*Required core course in the Medicine, Society & Culture concentration.

Students enrolled in the course engage in an opportunity for students to attend a variety of talks and events throughout University Circle and the greater Cleveland community. This allows students to engage in learning environments outside of the classroom.

Science, Technology, and Society (STS) is an interdisciplinary field of scholarship that examines how social, cultural, historical, ethical, and political forces impact scientific research and technological development: and, in turn, how our beliefs, values, and perspectives change in response to scientific and technological innovation. This course will take an STS approach to the study of human health and medicine. We will explore how advances in contemporary biomedicine have affected society and culture, and in turn, how society and culture influence medical science, technology, and clinical practice. Topics we will explore include reproductive technologies, genetics, disability, cyborgs and human enhancement, pharmaceuticals, medical practice, and end-of-life care. The course will prepare students to think critically about scientific and medical knowledge, to thoughtfully examine the relationships between science, technology and culture at large, and to consider the ways that new medical technologies shape and re-shape our understandings of illness, health, and the human body. Weekly course meetings will implement a blend of lectures, discussions, and in-class exercises.

This course will focus on both theoretical and practical issues in clinical ethics. Clinical ethics will be distinguished from other areas of bioethics by highlighting distinctive features of the clinical context which must be taken into account in clinical ethics policy and practice. Fundamental moral and political foundations of clinical ethics will be examined, as will the role of bioethical theory and method in the clinical context. Topical issues to be considered may include informed consent; decision capacity; end of life decision making; confidentiality and privacy; the role and function of ethics committees; ethics consultation; the role of the clinical ethicist; decision making in various pediatric settings (from neonatal through adolescent); the role of personal values in professional life (e.g., rights of conscience issues, self disclosure and boundary issues); dealing with the chronically non-adherent patient; ethical issues in organ donation and transplant; health professional-patient communication; medical mistakes; and other ethical issues that emerge in clinical settings.

This course is designed to provide an overview of ethical issues related to current and future neurotechnologies as they are applied clinical and research settings. We will cover many topics related to medical care for patients with neurological disorders, including cognitive vulnerability, neurodiversity, stigma and biases in mental health, brain implants, consciousness, selfhood in neurodegenerative disease, and enhancement. Classroom activities will primarily consist of discussion of selected readings related to a topic in neuroethics, moderated by the instructor. In addition, experts will be invited to visit the classroom to assist in the dialogue. Students will actively participate in discussion, debate, written scholarship and presentation to peers. Evaluation will be based on classroom participation, short writing assignments, and an independent project that will be designed in collaboration with the instructor culminate in both a written and oral presentation.

This course, designed for interprofessional graduate students, will explore the multidimensional qualities of the human experience of pain, including its moral dimensions. Vulnerable populations across the lifespan most subject to unethical pain care will be described (e.g., marginalized populations, those with substance use disorder, chronic pain, mental health comorbidities, cognitive disabilities, and others). Historic and current views of the moral obligation of healthcare providers to treat people with pain will be discussed. Select codes of ethics and pain management policies will be critiqued. Ethical theories will be reviewed for their utility in providing frameworks for determining how ethical, empathetic, effective, and safe pain care can be achieved in the most vulnerable populations.

"Disability" refers to health conditions that fundamentally alter how someone engages in the world around them, including physical, psychological, and developmental illnesses. Everyone will experience disability in their lives, whether temporary or chronic, making it especially important to consider how disability shapes, and is shaped by, society at large. In this course, students will learn about the multifaceted relationships between disability and society, including the impact of ethical, cultural, political, and technological factors on the wellbeing of people with disabilities. We will critically examine representations of people with disabilities in literature, the arts, and popular media in order to interrogate the assumptions and stereotypes about disability that circulate through mainstream culture and how they shape interpersonal and institutional practices. Throughout these topics, students will reflect on the intersections of race, gender, and age with disability through a multi-disciplinary lens, drawing on bioethics, anthropology, sociology, literary studies, and the arts. The course sessions will blend lecture and discussion, and assessments will include written responses and exams.

This course is designed both for people with a deep interest in animals and for those who may have barely considered animals as part of bioethical inquiry. The aims is to provoke a critical evaluation of the relationship between people and other animals by starting from a solid foundation in factual information about animal cognition and capabilities, about animals as research subjects, as food, as targets of conservation, as objects for human entertainment, and in complex, often paradoxical relationships with humans. We will survey philosophical thought and principle based theory about animal ethics, before turning to practical and applied animal ethics. The course will also use art and culture as way to understand the relationship between humans and non-human life.

*Required for Research Ethics Concentration

This in-person seminar course will discuss current topics in biomedical research ethics via recently published articles in both the scholarly literature and the popular science press. For each session, students will choose articles with instructor’s guidance, prepare discussion questions, and lead discussion.

This course examines the complex ethical and other value relationships that exist between science and society. Students will be encouraged to question the simplistic view that science proceeds independently of societal values and contentious ethical commitments. A range of other social factors, such as ethical belief systems, political forces, and large-scale financial interests all influence new scientific and technological developments. In order to illuminate each of these larger themes, this course focuses on three exciting areas of scientific inquiry: stem cell research; synthetic biology; and nanotechnology. Each of these contentious scientific fields provides an excellent view into the challenging ethical, cultural, social, political, and economic issues that will face students, both as scholars and as citizens. No prior technical knowledge is necessary for any of these scientific areas. All relevant scientific information will be provided during the course by the professor.

The focus and content of this course rotates each semester that it is offered. The course provides students with an opportunity to examine in greater depth a particular issue or dimension of bioethics and/or a particular event with significant bioethical implications. Each semester, required readings will include approximately 5 required texts and several journal articles. Previous foci and content for this course include: Bioethics, Bioethicists, and Policy Development; Medicine and Mortality; Queer Health and Bioethics; Capacity and Capacity and Competence Determinations; and Eugenics: Past and Present. 

*Required for Research Ethics Concentration

This course will introduce students to key ethical requirements and issues that arise in the design and implementation of scientific research. Historical developments leading to the establishment of national and international guidelines for ethical conduct in research with human subjects will be addressed. Specific international and national guidelines for ethically responsible research will be explored with attention to their merits and limitations in the conduct of research. Informed consent, a fundamental requirement for ethical research will be examined. The function and role of institutional review boards (IRBs) will be described with attention to challenges faced by investigators in adhering to regulatory requirements. Ethical issues associated with risk assessment and recruitment strategies will be examined. Ethical issues that arise in the implementation of biobanks and stem cell research will be discussed. Challenges associated with the development and production of pharmaceuticals will be assessed. The importance of scientific integrity in the conduct of research will be examined with special attention to conflicts of interest and scientific misconduct such as research fraud. The role of advocacy in promoting research will be addressed. Research ethics and human rights will be explored. The course will end with a discussion of emerging issues in research ethics. Case examples will be used to illustrate ethical complexities surrounding the topics discussed.

This course is previously titled Methods Normative Bioethics.

The purpose of this intensive graduate seminar is to master and to critique core philosophical concepts that are implicit in a wide array of bioethical issues. We will critically examine in a range of contemporary ethical theories beginning with modern conceptions of individual autonomy and concluding with theories of ethical justification. While no advanced knowledge of ethical theories is presupposed, students are expected to come to class prepared with the course readings and to engage in rigorous philosophical discussions with one another and the professor.

Students will explore particular issues and themes in biomedical ethics and medical humanities in depth through independent study and research under the direction of a faculty member.