I teach Bioethics at Marist College in Poughkeepsie. I have been teaching this course for about 6 years.
Marist College has offered this course for a number of years now. It is available as a required core course toward graduation.
The Bioethics curriculum that I have developed has fairly standard content for a course of this type. What I found after the first year of teaching this course, however, is that I needed to rethink my general approach to this course because not only do I rarely have philosophy majors taking this course, but those who do tend to overwhelmingly come from either biology or biomedical technology majors. Most of my students plan to attend medical school or nursing school. As a result, I now see the class as providing a few major things for these students: 1) helping them to identify where the major moral dilemmas tend to arise in their fields of study, 2) how traditional ethics perspectives could help understand the nuances of these and 3) what contemporary practitioners think about these issues. Furthermore, given that most of my students come to this course without having had a lot of formal training in humanities writing, I have designed the course to touch on a few different types of writing so that I can help improve their argumentative writing.
Non-philosophy majors will probably forget the names of the authors of particular articles, major theories, or moral principles (like me, most of them struggle to pronounce the word “supererogatory”). However, if they are able to retain the core values at stake in different moral positions, and the implications they carry into other dilemmas, this course could aid them in actual practice. The course thus prioritizes an applied ethics perspective and downplays memorizing names and some of the subtle nuances found within major theories.
Two areas specifically important in bioethics are worth mentioning here. The first is the fact/value distinction. Given my students’ majors and the insane pace of technological advancements in the field, their instincts very often lead them to look for empirical facts to answer moral questions. As a result, we spend a lot of time disambiguating these. The other that must be handled for a class like this involves the fact that it deals so intimately with contemporary political issues. In fact, the link is so intimate and pressing that it can be a challenge to stay current, as many large-scale changes in areas like abortion or genetic engineering change almost daily. My way of straddling this issue is to first of all emphasize the difference between the political and the partisan. It’s inappropriate for me to be partisan in class, but politics is about the process of coming to a compromise about community values. In this vein, we do talk about current events with an eye to what they imply about moral questions. Relatedly, the issue of law has to be dealt with. There is obviously always a large gap between the legal and the moral. However, we do look at legal trends and changes as a way of tracking what the national community is concerned about.
The course covers most of the major areas of bioethics, including paternalism and patient autonomy, truth-telling and confidentiality, informed consent, human research, abortion, reproductive technology, genetic engineering, biohacking, euthanasia, disability ethics, race and bioethics and justice of different health care institutions. The recent pandemic obviously also fuels a great deal of discussion on almost every topic we cover. The fact that it’s intimately connected to everyone’s connection to school, family, politics, individual autonomy, and other topics helps make the class less abstract; the students have literal experience of most of what we cover.
Some questions we explore:
- In a pandemic, when is it morally acceptable to coerce certain behaviors like vaccines or masks?
- In cases where dementia patients exhibit different levels of rationality at different times of the day, how can we act respectfully regarding their autonomy?
- How can we identify areas in which what appear to be disabilities are actually areas of social discrimination?
- When is it appropriate to include race in medical practice?
- What does it mean to suggest that a practice such as resource allocation might be both equal and unfair?
- Do individuals have moral obligations to their own health and/or lives?
- Is there inherent moral value in something like a family lineage?
- Do people have either a moral obligation to have or to avoid having children?
To train the students in academic writing, the course employs three essays. The first essay is a very traditional and very focused essay wherein they are expected to use textual evidence to make an argument concerning two articles from a chapter that take contradictory positions on the same question. This essay demands a fair amount of work in class to prepare them for writing it. The second essay asks them to identify a dilemma and then take the perspective of a hospital administrator and develop protocols to deal with some of the nuances. This essay emphasizes the reasoning behind their choices. Finally, the final exam (in addition to short answer questions) asks them to analyze a case study that they’ve never seen before and to use moral theories and principles to make an argument.
Finally, the way the course is structured aims to first develop a common vocabulary that we can use throughout the term. This vocabulary covers moral theories and principles. The class also begins by looking at the least contentious issues first so that we can develop a Community of Inquiry and trust before getting to areas where there is genuine contention and disagreement. Almost no one ever thinks that Kant’s inquiring murder conclusion is correct, but there is also very little agreement.
The biggest challenges with this course involve the size (25), just big enough for some students to have a very hard time participating. This is made worse by the fact that many of the topics are controversial. When students are asked as part of their final exam to write about their participation in the class, it has become more common, but especially post-Covid more common for them to share that they are deeply anxious to participate in this class due to the content of the class; this class literally surveys areas of the greatest and most contentious social debates in our society. Students are very worried to speak up for fear of being “canceled” or looked down on. One way I have developed to help with this involves a whole host of alternative ways of participation.
The students’ backgrounds tend also to have them push for more lectures with slides than discussion. Putting them in small groups and using a lot of case studies goes some way towards mitigating this, but not fully. An interesting contrast can be seen in the version of this course I teach at Oakwood Friends School, a Quaker secondary school. In this class, the students all want to discuss much more. The class has a more exciting dynamic as a result, but we are able to cover much less ground. I have also had the students really stress how much it helps to have a number of different media in a class (conversation, lecture, small groups, videos of current events, readings, etc…).
Like everyone else, I also have a new challenge: AI. For pedagogical purposes, I introduced a chance for more creative and personal writing in the class a few years ago. By January of 2023, it became clear that some of the dialogues that students had written for the class which surprised me for being more engaged than those students had shown previously probably had been written by AI. I’m still looking for ways to fine-tune the second essay to make it personal enough and specific enough to what actually happens in the classroom that AI would be less likely to be helpful.
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Stephen Kekoa Miller
Stephen Kekoa Miller is a Humanities Department chair at Oakwood Friends School and Adjunct Professor of Philosophy at Marist College, has taught Philosophy for the past 20 years in Poughkeepsie NY. Stephen has developed a wide range of courses from middle school philosophy through upper-level college courses, and a philosophy series for parents and community members. Stephen’s research interests lately have included pre-college philosophy, philosophy of education, virtue ethics, and philosophy of emotion. Stephen serves on the Board of Directors for the Philosophy Learning and Teaching Organization (PLATO). Stephen is also the Chair of the APA's Committee on Pre-College Instruction in Philosophy. Stephen served on the Teachers Advisory Council of the National Humanities Center and the Ethics Board of the Town of Poughkeepsie.He is the editor of Intentional Disruptions(Vernon, 2021).smiller@oakwoodfriends.org stephen.miller@marist.edu
I teach using Vaughn’s “Bioethics: Principles, Issues & Cases” currently, also. So cool to see how someone else has implemented the same textbook! I love the alternative methods of participation you have implemented. Thank you so much for sharing!!