Graduate Ethics Education

This program includes an extensive curriculum in bioethics education. Students are introduced to the ethical issues that arise in genetics counseling in a seminar series on Ethical Responsibility of Genetic Counselors. Later they participate in two semester-long seminars, Professionalism and Ethical Issues in Clinical Research, and either CLR0720 Theories in Bioethics (Bioethics, Policies and Cases) or MPH0006 Public Health Ethics/Medical Ethics.

MGC1101 - Ethical Responsibility of Genetic Counselors

Course Directors:  Randi Zinberg, MS, CGC and Rosamond Rhodes, PhD

This course introduces students to the concept of professional responsibility and professional codes of ethics with a focus on the genetic counselor code of ethics.  The importance of confidentiality and truth-telling in genetic counseling are explored, and controversial topics such as conscientious objection and testing children for adult onset conditions are discussed.

MGC1105 - Clinical Research Ethics in Genetics Counselling

Course Directors:  Randi Zinberg, MS, GCG and Rosamond Rhodes, PhD

This seminar will explore the complex issues raised by human subject research. The seminar will begin with a review of some of the history of eugenics. In that light, we shall examine the policies that shape our current understanding of the ethical conduct of research and the mechanisms for research oversight that have been instituted. Through reading a broad selection of seminal articles and papers from the recent literature, we shall engage in a conceptual analysis of a number of controversial and pressing issues. We shall be discussing the moral and public policy aspects of topics such asresearch design, risk-benefit assessment, informed consent, research with “vulnerable” subjects, research without consent, confidentiality, inducements, conflicts of interests, disclosure of researchfindings, and biobank research.

Among the core competencies the Clinical Research program develops is the ability to explain, assess, and employ research ethics. All students are required to study research ethics.

CLR0700 - Professionalism and Ethical Issues in Clinical Research

Course Directors:  Karin Meyers, MA and Rosamond Rhodes, PhD

This seminar will explore the complex issues raised by human subject research. The seminar will begin with a review of some of the landmark cases of unethical use of human subjects in research; the policies that shape our current understanding of the ethical conduct of research, and the mechanisms for research oversight that have been instituted. Then, through reading a broad selection of seminal articles and papers from the recent literature, seminar presentations, and discussion, we shall engage in a conceptual analysis of a number of controversial and pressing issues.

We shall be discussing the moral and public policy aspects of topics such as research design, risk-benefit assessment, informed consent, the use of “vulnerable” subjects, research without consent, confidentiality, inducements, conflicts of interests, disclosure of research findings, tissue use, vaccine development, and international research. In addition to exploring the moral landscape of this rich and provocative domain, the seminar should clarify and inform participants’ understanding of basic moral concepts such as autonomy and justice. It should also serve as a model for approaching other issues in applied ethics.

This seminar is required for students in the Masters and PhD degree programs in Clinical Research. It is an elective for medical and Public Health students.

CLR0720 - Theories of Bioethics (Bioethics, Policies and Cases)

Course Directors: Rosamond Rhodes, PhD and Ian R. Holzman, MD

Most people who consider the ethical rules that should govern the practice of medicine assume that the ethics of medicine is no different from the rest of morality. For that reason, people who write about medical ethics draw on the classical sources of ethical insight. They discuss autonomy in Kantian terms, allocation of scarce resources in utilitarian terms, access to health care in terms of rights, and professionalism in terms of virtues. This dominant view was articulated by K. Danner Clouser in his Encyclopedia of Bioethics article on “Bioethics” where he explained that “bioethics is not a new set of principles or maneuvers, but the same old ethics being applied to a particular realm of concerns.” This strategy is most prominently expounded by Beauchamp and Childress in the six editions of their Principles of Medical Ethics and further explained by Gert, Culver, and Clouser in Bioethics: A Return to Fundamentals. The authors of those volumes identify the common features of morality, and show how to apply them to the practice of medicine. This course will explore the major theoretical approaches to bioethics, including principlism, common morality, virtue theory, casuistry, and constructivist bioethics. We shall read and discuss this literature in the context of cases from the practice of medicine. Our study will be guided by two goals. First, we shall try to understand how these theories inform our thinking about medical ethics. Second, we shall try to assess whether these theories are actually appropriate to the practice of medicine. Do any of them actually identify an appropriate framework for the ethical practice of medicine? Do they provide a useful guide to the ethical practice of medicine? Do they offer helpful tools for resolving controversies within medical practice?

MPH0006 - Public Health Ethics/Medical Ethics

Course Directors:  Stefan Baumrin, PhD, JD and Daniel A. Moros, MD

This course examines "classic" and emerging issues in biomedical ethics paying particular attention to the history of medicine and the nature of scientific thought as it relates to medical 39 ethics. While many issues in biomedical ethics seem timeless such as our concerns about the withholding of treatment, abortion, truth-telling - others have arisen out of the development of an increasingly scientific medicine beginning in the 1700s. It is the availability of well confirmed effective treatments that forces us to wrestle with such questions as the propriety of medical intervention over the objection of the patient, the treatment of children over the objection of their parents, the right of all citizens to health care, the regulation of the sale of body parts for transplantation, and numerous circumstances arising out of assisted reproduction. In the not too distant past, it would have seemed bizarre to consider the adjudication of competing rights when one woman contracts to rent the uterus of a surrogate to bear through in vitro fertilization the embryo formed from the egg of a third individual. The current revolution in biotechnology, microelectronics and nanotechnology continuously produces new issues. What is the meaning of confidentially in a world where an enormous amount of information about each of us can be extracted rapidly from numerous searchable databases? What is the moral status of the embryonic stem cell derived from a discarded embryo, or a non-human animal? How are we to regulate cloning and our ability to shape and alter the human genome? We now implant electrodes into the brains of patients with Parkinson's disease and essential tremor. Soon we may be treating depression, disorders of impulse control, anxiety and phobias electronically. Does such technology present different issues as compared with today's drug and surgical therapies? We will also be challenged by the products of bioengineering. We already have prosthetics that remarkably link the brain directly to external mechanical devises and further alter the meaning of disability. In medical ethics both the past and the future need to inform out vision of proper behavior and decision making. In our world of rapidly advancing technology, much medical ethics policies misread and mishandle the present and construct rules with an eye towards an idealized past, while failing to consider a fast approaching future. An aim of this course is to prepare philosophers to enter into medical institutions with the preparation necessary to be helpful additions to the provision of health care in ethically acceptable ways. 

MPH0007 - Social Justice, Public Health and Medicine

Course Directors: Rosamond Rhodes, PhD, and Ethan Cowan, MD

Justice is a major concern in theoretical ethics and political philosophy and a huge literature is devoted to trying to explain just what it entails. In this course our aim is to examine a broad spectrum of issues in medicine, medical research, and public health that raise questions about justice. In light of these critical examples, we review and critique an array of philosophical views on justice. Throughout the seminar we engage in two activities: (1) using clinical dilemmas and health policies as touchstones for developing a clear understanding of justice, and (2) developing an understanding of how theories of justice apply in different public health and medical contexts. By going from practice to theory and from theory back again to practice we are able to advance our understanding of the theoretical literature as well as the requirements of justice in public health, medicine and other areas of the social world.

This course begins with an examination of the allocation of medical resources that raise questions about justice.  It then moves on to examine contemporary work on justice and review of some theoretical work by authors who focus their attention on justice in medicine (Norman Daniels & Paul Menzel).  As the seminar progresses, we develop an understanding of how the U.S. happens to have developed the mechanisms that we now have for the delivery of health care.  We examine how medical resources are actually distributed here, elsewhere, and globally, and in various contexts.   We consider ways in which those allocations do and do not express justice. We also explore some of the problems that become apparent when you attend to the special needs of social groups (e.g., the poor, children, women, the elderly, African-Americans) and examine dilemmas and conflicts that are raised by issues such as the treatment of premature and compromised neonates.

Our Masters of Bioethics program offers a number of elective courses within several other ISMMS graduate degree programs, to enhance those programs and to provide opportunities for students interested in expanding their understanding of bioethics issues.

The Biomedical Sciences program conducts an annual series of seminars on Responsible Conduct of Research for PhD students. Topics include professional norms, codes of conduct, misconduct, and working with animal and human subjects.

BSR1021 - Responsible Conduct of Research

Course Director:  Nada Gligorov, PhD

This course is required for all first-year graduate students, following NIH mandates.  
Specific topics for the eight 1 hour sessions: (i) Research Misconduct (ii)  Experimental design anddata management practices (iii) Mentor and Trainee Responsibilities; Collaborative Research (iv) Conflicts of Interest; Intellectual property (v) The Protection of Human Subjects (vi)The Welfare of Laboratory Animals (vii) Publication, authorship, and peer review (viii) Peer Review, the Grant Process, and Fiduciary Responsibility.