Professors:

Syllabus PIDL 3004: Philosophy and Medicine

Spring 2015 10:00 - 11:15 am TR, AH E259

Reynolds Jarvis, M.D. Georgia Regents University. Email: rjarvis@gru.edu Steven D. Weiss, Ph.D., Dept. of History, Anthropology and Philosophy Office: Allgood Hall, E215. Office hours: 11:15 - 12:15 am TR; 2:15-3:15 pm, MW; and by appointment. Office phone: (706) 667-4461 ; dept. phone: (706) 737-1709; fax: (706) 729-2177 E-mail: sweiss@gru.edu

Course Texts: Selected readings will be provided to students from Degrazia, Mappes, and Brand­Ballard, eds. Biomedical Ethics, (McGraw HilI, 2006).

Anatole Broyard, Intoxicated by My Illness (New York: Fawcett Columbine, 1992).

Arthur Kleinmann M.D., The lllness Narratives: Suffering, Healing & the Human Condition (Basic Books: A Member of the Perseus Book Groups, 1988).

Richard Reynolds, M.D., and John Stone, M.D., eds. On Doctoring, New, Revised and Expanded 3rd ed. (New York: Simon & Schuster, 2001).

Course Description: The course reviews basic ethical concepts, principles and theories, focusing on the types of ethical problems and dilemmas encountered in the daily practice of medicine. Students will learn how to apply these concepts and theories to an analysis of clinical case studies. Additionally, Arthur Kleinman's The Illness Narratives will provide a framework for organizing the various ways individuals, culture and society attribute meaning to symptoms and disorders. Kleinman's insights will be applied to various short stories and films to gain a deeper understanding of the existential experience of illness and how illness and suffering alter our perception of the body, our sense of personhood, and Our relationship to others and the world. Students will also prepare an "illness narrative" based on an interview with someone who has undergone a life-altering illness or trauma.

Course Requirements: The success of the course depends on students coming to class prepared to pose questions and discuss the assigned reading for the day. The course is highly interactive and discussion-based, where faculty members will help students navigate through new ideas by asking students for their feedback and insights on the material. Students will also collaborate and share ideas with classmates as they participate in small group activities

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collaborate and share ideas with classmates as they participate in small group activities which will report back to the larger class. Your course grade will be based on the following:

1. In-class ethics exam (1 00 points) 2. Two ethical analyses of clinical cases (S-6 pages, typed, double-spaced): 100

points each. 3. "Illness narrative" interview (6-7 pages, typed, double-spaced): 150 points.

Course Policies: 1. Attendance is required and roll will be taken every class meeting. Students who

arrive late or leave early disrupt the class and may be marked absent at the professors' discretion. Students are furthermore responsible for signing the attendance sheet for each class period: students who miss more than 4 class periods due to unexcused absences will be withdrawn from the course per university policy. An excused absence must be documented (e.g., doctor's note) and approved by the professors. An excused absence from class/exams will be granted only under special circumstances e.g., medical/court appointments. Whenever possible notify faculty beforehand about any anticipated absences. Finally, students are expected to remain within the classroom for the duration of the period since walking in and out of classroom is disruptive. An additional 20 points for perfect attendance will be added to the total course point score.

2. Students are asked to check their university e-mail account prior to class in the event that the professor needs to update students on assignments, class activities or class cancellation.

3. Success in this course requires regular attendance and careful, timely reading of all assignments and good note taking. Hard and intelligent work will be rewarded with good grades and an understanding of ideas that can be used and enjoyed throughout one's life. Mediocre work will be rewarded with half-knowledge and poor grades. Earning an "A" requires consistently excellent work; this is distinctly possible but requires regular attendance, hard work, keeping up with the readings, and the timely completion of assignments.

4. Academic integrity is more important than receiving a good grade in the course. Please review the Academic Conduct Policy (3.1.4) available at http://policy.gru.edul3-1 -4-academic-conduct-policy/

S. Debate and discussion are encouraged in class, but no one has the right to monopolize the discussion and each of us is expected to respond thoughtfully and

respectfully to those who express different points of view. Consistently thoughtful and constructive participation in class will be taken into consideration when determining the final course grade; disruptive or disrespectful behavior that impedes classroom learning may result in course withdrawal.

6. Proper classroom decorum is the standard in higher education. According to university policy, eating i.s not allowed in the classroom; also sleeping is not

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allowed; cell phone use, and texting are not allowed in class. Laptop use is restricted to class-related work. Failure to comply with these rules is disruptive and may result in withdrawal from the course.

7. Students with disabilities who qualifY for services will receive the accommodations for which they are legally entitled. It is the responsibility of the student to register with the Office of Testing and Disability Services and follow their procedures for obtaining assistance. For more information: http://policy.gru.edu/4-I -I -accommodating-students-with-learning disabilities/

Grading Scale: Grades will be calculated according to the following scales: 100-90% .... ....... .. ... A 400-360 points ........ ...... A 89-80% ...... ....... .. ... B 359-320 .. .... ... ... ... .......... B 79-70% ... .. ...... ....... C 319-280 ..... ............ ........ C 69-60% ........ ..... ..... D 279-240 .......... ... ......... ... D Below60% ............ F Below 240 ..................... F

Course Objectives: I. To foster an understanding of basic ethical concepts, principles and theories

within the broader context of medicine. 2. Learn how to apply ethical concepts, principles and theories to a careful analysis

and practical resolution of complex clinical case studies. 3. To develop an understanding of the ethical/philosophical significance of the

experience of illness and suffering for the perception of the body, our sense of personhood, and altered relationship to others and the world.

4. To develop practical interpersonal skills in engaging with and understanding someone who has undergone a life-altering illness or trauma.

Course Schedule:

Week #1 Jan. 6: Jan. 8:

Week #2: Jan. 13: Jan. 15:

Week #3: Jan. 20: Jan. 22:

Week #4: Jan. 27:

Introduction; pre-course assessment. Biomedical Ethics, General Introduction, pp. 1-17.

Biomedical Ethics, General Introduction, pp. 1-17 continued. Biomedical Ethics, General Introduction, pp. 17-27.

Biomedical Ethics, General Introduction, pp. 17-27 continued. Biomedical Ethics, General Introduction, pp. 27-38.

Biomedical Ethics, General Introduction, pp. 27-38 continued.

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Week #5: Feb. 3: Feb. 5:

Week #6: Feb. 10: Feb. 12:

Week #7: Feb. 17: Feb. 19:

Week #8: Feb. 24:

Feb. 26:

Week #9: March 3:

March 5:

Week #10: March 10:

March 12:

Week #11 : March 17: March 19:

Week #12: March 24: March 26:

Week #13 : March 31:

Biomedical Ethics. General Introduction, pp. 38-51 continued. Principles of Medical Ethics: Benevolence, Nonmalefficence, Justice, Autonomy.

In-class ethics exam Case Study; "Context: Backward, Sideways and Forward," Hilde Lindemann Nelson.

Kleinmann, ch. 1, "The Meaning of Symptoms and Disorders," pp. 3-30. Klenimann, ch. 1 continued.

Klenimann, ch. 2, "The Personal and Social Meanings of lllness," pp. 31-55. Kleinmann, ch. 2 continued.

Kleinmann, ch. 3, "The Vulnerability of Pain and the Pain of Vulnerability," pp. 56-74. Kleinmann, ch. 3 continued.

DVD: Decalogue: "Thou shalt not take the name of the Lord thy God in vain. " (Should a doctor lie about the prognosis of a patient to save the life of an unborn child?) (First case study analysis due in class.) Kafka' s "Country Doctor"; Japanese DVD.

David Biro, "An Anatomy ofIlIness" (Article to be provided to students.) Class discussion of Broyard's Intoxicated by My fllness, "The Patient Examines the Doctor," pp. 33-58; "What the Cystoscope Said," pp. 91-132.

In class case studies. From On Doctoring: William Carlos Williams, "The Practice," pp. 52-58; "The Girl with the Pimply Face," pp. 62-73; "The Use of Force," pp. 73-75.

From On Doctoring: Richard Selzer, "Mercy," pp. 213-216; "Imelda," pp.

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April 2:

Week #14: Apri17: Apri19:

Week #15: April 14:

April 16:

Week #16: April 21 :

April 23 :

Week #17: April 28:

Final exam:

217-228; Ernest Hemingway, "Indian Camp," pp. 1020105.

Leon Kass video. (Second Case Study analysis due in class.)

Spring break Spring break.

From On Doctoring: Arna Bontemps, "A Summer Tragedy," pp. 110-118; Zora Neale Hurston, "My Most Humiliating Jim Crow Experience," pp. 119-120. DVD: Worlds Apart: A Four Part Series on Cross-Cultural Healthcare

From On Doctoring: David Hellerstein, "Touching," pp. 254-257; Abraham Verghese, Exceprt from My Own Country, 360-367. K1einmann, ch. 4, "The Pain of Living," pp. 75-87; ch. 9, "Illness unto Death," pp. 146-157.

Course evaluation. (Early bird special: 10 bonus points if interview is turned in on last day of class.)

Thurs., Apri130, 7:00-9:00 am (Absolute deadline for interview; no email copies will be accepted; paper must be submitted during exam period.)

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