biomedical ethics

GENERAL GUIDELINES – FINAL (RESEARCH) ESSAY
• The Research Essay: Again, students are required to develop a 6 TO 8 PAGE investigative
essay on the basis of possible topics in the field of biomedical ethics found at the end of this section.
The final research paper applies ethical theories studied in class to a concrete biomedical issue. Here are
some of the theories that qualify for the project: natural law theory, social contract theory, utilitarianism,
Kantianism (deontology), and virtue theory. Examples of topics that qualify for the paper are listed
below. You are not limited to these topics. However, run topics outside of these past the instructor
before beginning work.
Drawing upon those theories, the student will prepare a written (6 to 8 page typed MLA, APA or CMSstyle
pages) paper that addresses these current moral problems. Of particular importance is the
student’s ability to use ethical reasoning to formulate reflective positions on some of the more
pressing moral problems in contemporary society. Papers without this element tend to score at best a
low B or C. The paper is graded for the following sections:
I. Composition (15 points): Composition (15 points): Tell me in ONE sentence what your
paper will discuss. The introduction may be composed of more than one sentence but your
thesis statement can only be one sentence long and has to be identifiable as such. For
example this sentence might read like: “This paper examines the topic of abortion from
both a utilitarian and a deontological viewpoint and assesses the strengths and
weaknesses of both approaches.” The grade in this section also reflects whether the
paper was written well with attention to syntax, consistent paragraphing indents and proper
citation style.
II. History of topic (15 points): set the context for the moral issue from 1960 onward. Do
NOT go back earlier without checking with the instructor first.
III. Pro/Con (20 points): what are the conflicting sides around the issue? Please note: using
websites like procon.org to set up this issue generally reduces the grade in this section. Look
for journal and newspaper articles that summarize the positions. These are better and more
nuanced treatments of the conflicting sides.
IV. Application of ethical theories (30 points): I am looking for TWO treatments of the issue
from two ethical approaches studied during the term. These should be in depth because this
section is worth thirty points.
V. Personal Conclusion (20 points): In this last section argue for your personal analysis and
thoughts on the issue. Make sure this section receives the treatment and development it
deserves!
YOU MUST TITLE THE SECTION OF YOUR ESSAY WITH THE FOLLOWING FIVE SECTION
TITLES. THUS, EVERY ESSAY WILL HAVE SECTION HEADINGS WITH THESE TITLES:
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COMPOSITION, HISTORY OF TOPIC, PRO/CON, APPLICATION OF ETHICAL THEORIES,
PERSONAL CONCLUSION
Timeline for essay:
Final Essay due by start of class week 6 (see syllabus schedule on page 6 for precise due date).
• There exists a TREMENDOUS wealth of bibliographical research resources at the end of
each chapter of our text.
Here is the rubric you will receive with your final paper:
15/15: Composition: Is paper written well with attention to syntax, grammar, clear thesis statement,
consistent paragraphing and proper citations style or are there recurring problems with any of these?

15/15: History of topic: Does paper develop historical context for the moral issue from 1960 onward in
a clear and chronologically coherent manner or does the paper fall short of doing this in specific ways?

20/20: Pro versus Con: Does paper spell out clearly conflicting sides of the issue or does it only show
one side or is it entirely missing a pro/con section?

30/30: Application of ethical theories: Does author treat issue with two ethical approaches studied
during the term in depth (or analyzes the issue with unusual and sustained depth from the standpoint
of one theory)?

20/20: Personal Conclusion: Does author develop a concluding personal analysis that expresses their
standpoint on the subject in a thorough and clear way or does it sum up the issue superficially or is
the paper missing a genuine personal conclusion?

POSSIBLE TOPICS
• Possible topics for the research paper include, but are not limited to the following. Please feel free
to adapt a topic to suit your interests.
1. Human tissue. Who owns bone, sinew, corneas, and other saleable body parts? Who can consent to
its post-mortem removal? What do state statutes say about the nonconsensual removal of human tissue? Why
does federal law prohibit the sale of solid organs but permit the sale of other human tissue (and blood, sperm,
and ova)? Do the rules that govern these activities sufficiently protect the interests that need to be protected?
Or do they go too far and discourage an efficient market?
2. Physician-assisted suicide (PAS). Oregon is the only state to have legalized the practice. The Supreme
Court has ruled that considerations of neither due process nor equal protection compel states to allow the practice
and that the Department of Justice may not prosecute Oregon physicians who participate in PAS. Your paper can go
in lots of different directions. Should other states follow Oregon’s lead? Is there an equal-protection argument
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that once a state has legalized PAS, it must also legalize active euthanasia? What can we learn from the
practices of other countries?
3. Patentatibility of genetic code. Should genetic researchers be able to obtain patents on “raw” genetic
code? What should the Patent and Trademark Office’s policy be on demonstrating “utility” in order to
obtain a patent for a snippet of DNA?
4. Is “brain dead” really dead? All 50 states and the District of Columbia have rules that define death in terms
of the irreversible cessation of all neurological functioning. This notion of “brain death” has been around since
1968, when the Harvard Medical School Report on “irreversible coma” (now regarded as something of a
misnomer) was issued. Yet, just as soon as we as a nation seem to have become comfortable (more or less) with the
concept, it is coming under increasing scrutiny and criticism. Is it internally inconsistent? Is it a snow job by the
transplant community? Are the NY and NJ variations the way of the future? Is neocortical death preferable to
whole-brain criteria for determining when death occurs?
5. Charity Care. Texas requires its not-for-profit hospitals to provide charity care as a quid pro quo for
tax-exempt status. A dozen or more states do the same, and more states are jumping on the charity-care
bandwagon every month. The federal government used to require charity care as a prerequisite for taxexempt
status, but it dropped that requirement in 1968. Should it resurrect the charity-care requirement? If
so, what should it look like? What are the pitfalls illustrated by various state experiments in this field? Is
there a better way to deal with the problems of providing health care for the indigent and uninsured?
6. Anecephalic newborns. Medical texts usually refer to anencephaly as a condition that is “incompatible
with life” or to anencephalic newborns as “born dying.” Despite this, a few yearsa go, the Florida Supreme
Court said the organs of a baby born with no neo-cortical hemispheres could not be donated because the baby
was still alive under Florida law. (The AMA once opined that anencephalics should be regarded as an exception to
the requirement that organ donors be dead and then turned around at its next session and revoked its own ruling.) A
few years later, the 4th Circuit Court of Appeals said that a Virginia emergency room had an obligation under
federal Medicare law to treat the respiratory distress of an anencephalic infant who was brought to the ER from a
local nursing home. Do we need to rethink the law’s response to anencephaly? Or are anencephalic
newborns entitled to the same level of protection as any other member of
society?
7. Demands for futile treatment. Surrogate decision makers often ask that “everything be done” for
a patient. Sometimes they are more specific. Occasionally this request is for treatment deemed by
the medical team to be “futile.” Should physicians be able to withhold or withdraw nonbeneficial
interventions? If so, under what circumstances? What process values should be respected?
8. Should the U.S. Congress ban all human cloning (“reproductive” and “therapeutic” cloning)? The
distinction between types of cloning activity is driven by the desire of many to create new sources of
embryonic stem cells by creating new embryos. What are the arguments for and against both types of cloning?
Which do you find persuasive and why? Note: the President’s Commission on Bioethics has weighed in on this topic
with its first report.
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9. Ethics of third-world drug research. Drug companies have been accused of running drug-testing
protocols in third-world countries that would be unethical and impossible to run in the U.S. Other times, they
have been criticized for testing drugs that will eventually be marketed at a price the third-world countries
won’t be able to afford. What should the rules be for such research?
10. Medical decision making for minors. What should the standards be for reviewing and overruling parental
medical choices? You might focus on one set of such decisions (end-of-life decisions,decisions by Christian
Scientists, etc.) for your analysis.
11. Sex selection (and other genetic manipulations). What limits, if any, should be placed on the ability of
prospective parents to guide or alter the genetic makeup of their offspring?
12. Medicine and capital punishment. Should physicians be allowed to medicate prisoners to make them competent
for trial? For execution? The AMA has opinions on this; are they correct? Are they even coherent? And are they on
a collision course with the Eighth Amendment’s prohibition of cruel and unusual punishment?
13. Human tissue. Who owns bone, sinew, corneas, and other saleable body parts? Who can consent to its
post-mortem removal? What do state statutes say about the nonconsensual removal of human tissue? Why
does federal law prohibit the sale of solid organs but permit the sale of other human tissue (and blood, sperm,
and ova)? Do the rules that govern these activities sufficiently protect the interests that need to be protected?
Or do they go too far and discourage an efficient market?
14. Access to experimental drugs. Do terminally ill patients have a constitutional right to get access to
experimental drugs without enrolling in a clinical trial? A divided panel of the DC Circuit said yes in a May
2, 2006, opinion. In fact, they concluded that the constitutional right is fundamental and that the appropriate
test of any rule limiting access is strict scrutiny. This is an opinion of potentially far-reaching consequences
for patients, health care providers, payors, and the future of clinical drug trials in this country.