Playing God? Birth and death at the frontiers of medicine

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1 Playing God? Birth and death at the frontiers of medicine Start date 17 October 2014 End date 19 October 2014 Venue Madingley Hall Madingley Cambridge Tutor Dr Anna Smajdor Course code 1415NRX026 Director of Programmes Emma Jennings For further information on this course, please contact Linda Fisher, Academic Programme Manager on Liz Deacon, Programme Administrator on To book See: or telephone Tutor biography Anna is lecturer in Ethics at the University of East Anglia. She developed an interest in the ethics of science, medicine and technology while studying philosophy. Her doctoral thesis (at Imperial College London) explored the ethics of using artificial sperm and eggs in reproduction. Anna is the author (with Ruth Deech) of a book on legal and moral controversies in reproductive technology 'From IVF to Immortality'. Anna is ethics consultant for a local NHS trust, and is an advisory member of the charity Progress Educational Trust.

2 Course programme Friday 17 October 2014 Please plan to arrive between 16:30 and 18:30. You can meet other course members in the bar which opens at 18:15. Tea and coffee making facilities are available in the study bedrooms. 19:00 Dinner 20:30 22:00 Session 1: Technologies of birth Introduction to reproductive technology; the development of IVF and its ethical and legal ramifications; surrogacy; genetic engineering; sex selection. Ethics of the unnatural, and the naturalistic fallacy. Reproductive autonomy and reproductive rights. Foetal surgery. 22:00 Terrace bar open for informal discussion Saturday 18 October :30 Breakfast 09:00 10:30 Session 2: Death before birth: abortion and embryo research 10:30 Coffee Examination of the moral status of the embryo and foetus; maternalfoetal conflict; pro-choice and pro-life perspectives. Judith Jarvis Thomson s violinist analogy. The ethical framework for the research embryo, questions of creation and destruction. 11:00 12:30 Session 3: Prolonging life, hastening death 13:00 Lunch 14:00 16:00 Free 16:00 Tea Discussion about life support and ventilation; when to switch off the machine. Dilemmas over resuscitation; brain death and organ donation. Brain death in pregnancy. Comparison of treatment of the very old and the very young. Terminal sedation; the Liverpool Care Pathway. 16:30 18:00 Session 4: Euthanasia and assisted suicide 18:00 18:30 Free 18:30 Dinner Exploration of the concept of a good death. The moral role of the doctor; the acts/omission distinction and the doctrine of double effect. Advance Directives and their drawbacks. Questions of moral agency and responsibility.

3 20:00 21:30 Session 5: Film: In Vitro 21:30 Terrace bar open for informal discussion Sunday 19 October :30 Breakfast 09:00 10:30 Session 6: Workshops case studies 10:30 Coffee Students will look at case studies that illustrate the issues covered in previous sessions, and formulate their own ethical analysis. 11:00 12:30 Session 7: Feedback and discussion 12:45 Lunch Students will present their analysis of the case studies, followed by general discussion. The course will disperse after lunch

4 Course syllabus Aims: Content: To introduce students to the ethical challenges involved in medicine at the beginning and end of life To explore the concepts and theories related to medical ethics in the context of reproductive technologies, suicide, euthanasia and advance directives To provide opportunities for students to engage in critical reasoning and moral deliberation on issues in medical ethics The course will incorporate two key themes: ethical dilemmas in medicine related to birth, conception and reproductive technologies; and ethical challenges related to abortion, embryo research, the relationship between death and medicine, and euthanasia. Students will learn about controversial possibilities in current medical practice and research, including the use of embryos in research, the ethics of genetic engineering, and reproductive technologies. They will study the ways in which the process of dying can be manipulated to accommodate the possibility of organ donation, and the challenges of defining death. They will look at arguments related to euthanasia and assisted suicide, including questions of personal autonomy, the role of medicine and the interpretation of a good death. The course will cover the main ethical theories relating to abortion and euthanasia, including the distinction between acts and omissions, and the doctrine of double effect. Utilitarian and deontological perspectives will be addressed and applied. Students will be encouraged to develop their skills of ethical reasoning, by working collaboratively to ascertain the relative merits of different moral approaches in the context of real case studies that exemplify the questions being considered. The course is self-contained; no prior knowledge or advance preparation is required, but relevant texts have been suggested for students who wish to explore any of the subject matter in more depth before, during, or after the course. Presentation of the course: The course will be taught partly via lectures accompanied by PowerPoint slides, and partly through facilitated group discussions, where students will be asked to deliberate on specific ethical problems, to apply and evaluate the theories and approaches they have learnt in order to solve an ethical problem. A film will be shown during one of the sessions, and students will be asked to reflect on the questions it raises, and the way in which it answers them. Outcomes: As a result of the course, within the constraints of the time available, students should be able to: understand what sort of ethical problems arise in the context of reproductive technology, abortion and end of life medicine recognise the characteristics of different moral theories, and their applicability to the ethical questions being considered identify, construct and evaluate ethical arguments apply the above skills and knowledge collaboratively, to resolve ethical problems

5 Reading and resources list Listed below are a number of texts that may be relevant to the course. These texts do not need to be bought (or consulted) by participants, but are suggestions for further reading for those who are interested. Author Title Publisher and date J. Savulescu Procreative beneficence: why we should select the best children Bioethics Vol. 15; issue 5-6, pp R. Deech and A. Smajdor From IVF to Immortality Oxford University Press L. Kass The wisdom of repugnance Valparaiso University Law Review Vol 32; issue 2, pp J.J. Thomson In defence of abortion Reprinted in "Intervention and Reflection: Basic Issues in Medical Ethics," 5th ed., ed. Ronald Munson (Belmont; Wadsworth 1996). pp T. Chappell and J. Jung Why Euthanasia is in no-one s interest Philosophy Now. Issue 40, pp D. Oderberg The doctrine of double effect Chapter 41 in A Companion to the Philosophy of Action T. O Connor and C. Sandis, eds. pp J.J. Thomson S.K. Shah, R.D. Truog, and F.G. Miller Physician-assisted suicide: two moral arguments Death and legal fictions Ethics Vol. 109, No 3. pp Journal of Medical Ethics Vol. 37; issue 12, Note Students of the Institute of Continuing Education are entitled to 20% discount on books published by Cambridge University Press (CUP) which are purchased at the Press bookshop, 1 Trinity Street, Cambridge (Mon-Sat 9am 5:30pm, Sun 11am 5pm). A letter or confirming acceptance on to a current Institute course should be taken as evidence of enrolment. Information correct as of: 01 October 2014

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