Foundations of Bioethics I and II (8 credits)
Foundations of Bioethics begins with the central question, “what are the foundations of bioethics” by defining the critical interplay of theory, experience, science, social science, law, and community that have influenced and defined bioethics as a field of inquiry. The course continues with an examination of the central philosophical approaches that inform bioethics and assess their core assumptions and underpinnings, beginning with an exploration of the nature and meaning of moral inquiry as applied to the life sciences. Following this introductory unit, the course progresses through critical reading of selections from original texts and commentary during which students gain a critical knowledge base in the major philosophical approaches that have informed bioethics -- and the analytic skills required to both critique and apply these approaches to contemporary challenges in bioethics. Discrete approaches will include consequentialism and various iterations of utilitarianism, deontological theories, virtue ethics, principlism, and “bottom up” approaches such as casuistry.
As students gain a solid foundation in these underpinnings of bioethics, they learn to analyze and critique each approach from the vantage point of the others and also learn to analyze challenges in bioethics from a plurality of perspectives through a series of brief writing assignments over the course of the semester. Building from the philosophical underpinnings, we then turn to a critique of the philosophical concepts through the incorporation of basic and social science research to understand the relative merits and potential shortcomings of each philosophical approach as we consider central bioethics challenges. For example, to the extent that a philosophical approach is grounded in human rationality, how might we reflect on this approach where we identify domains in which human behavior appears anything but rational or even clearly irrational? Similarly, what do our understandings of brain science and neuropsychology contribute to our approach to bioethics theory and analysis?
The course concludes with a revisiting of our original question, “what are the foundations of bioethics” in order to integrate the learning from the course into a multilayered appreciation of the many facets of bioethics inquiry and offer critical reflection on the path forward for the field and its theoretical underpinnings.
Capstone Seminar I and II (4 credits)
Christine Mitchell, RN, MS, MTS, Bizu Gelaye, PhD, MPH, and David Sontag, JD, MBioethics
The capstone experience and seminar is a required component of the Master’s program providing a mentored field placement or project that involves participating actively in applied bioethics work. The Capstone Seminar is intended to help each student reflect upon their own and others’ field experiences, thereby developing an appreciation for the range and complexities of real-world work in clinical ethics, research ethics, or law and/or public policy related to bioethics. Together, the Capstone and associated Seminar focus on acquiring knowledge through experience and linking theoretical knowledge with the technê (craft, skill or art) of bioethics practice. A central feature of the seminar involves consideration of the role responsibilities, professional skills, and virtues of those doing practical bioethics work.
Introduction to Clinical Ethics (4 credits)
Introduction to Clinical Ethics is a core course in the Master of Bioethics program at Harvard Medical School. There are 14 three-hour sessions covering major principles and themes in Clinical Ethics (e.g. futility, physician-assisted suicide, advance directives). Each session includes approximately two hours of interactive case-based lecture and discussion, followed by a one-hour practicum. The practicum is modeled around the experience of a clinical ethics committee with small groups of students working through a case and crafting an interpretation and set of recommendations.
Research Ethics (4 credits)
This 14 week Research Ethics course is organized in a highly innovative manner, designed to provide the student with a comprehensive foundation in research ethics. After taking this course, students will be prepared to manage many of the complex, real-life ethical issues that have attracted public attention in recent years, such as undue influence and coercion of research participants, concerns about privacy and confidentiality of clinical trial data, concerns about unjust research trials in low resource countries, and uncertainty about the value of genetic testing in drug development and study design. The class meets weekly for 3 hours. Each class session is built around a critical discussion of a case study that elucidates the complex interplay of philosophical, scientific, and practical considerations that characterize the field of research ethics.
Health Law, Policy, and Bioethics (4 credits)
This course is an introduction to legal topics in health policy and bioethics. It requires no experience in law, beginning with a brief primer on American law and how it works. Topics covered include legal aspects of the doctor-patient relationship, medical malpractice, privacy issues, health care finance, end-of-life issues, organ donation, disability, mental health, public health, medical product regulation, food regulation, and intellectual property. The course does not cover issues in reproductive ethics or human subjects research regulation, as those are part of other Master’s courses. Students are evaluated via class participation and written work. The reading load is moderate to heavy. Sessions are a mix of lecture and seminar-style, with occasional guest speakers.
Global Health Ethics (2 credits)
This course will examine foundational normative problems and pragmatic ethical challenges facing those who work in some capacity to improve health outcomes for very poor populations living under conditions of severe resource scarcity. We will interrogate basic conceptual ideas such as “what do we mean by ‘global health equity’?” and the nature and root sources of “resource scarcity”, in addition to focusing on specific practical concerns such as 1) how to conduct ethical responsible research on and with socially and economically disadvantaged and vulnerable populations, 2) macro-economic and micro-bedside resource allocation dilemmas, and 3) health care worker “brain drain” from poor to rich locales.
Methods in Bioethics (2 credits)
This 2-credit course will provide students with an introduction to the applied ethics and policy. Applied ethics is defined as the application of research methodologies (both qualitative and quantitative) to ethical issues in the medicine and biomedical research. The results of the applied ethics research are then used to influence the adoption and modification of policies and practices at the national, state or institutional level.
Neuroethics (2 credits)
Paul Ford, PhD
This will be a seminar-style course held during the short January term. Participants will meet weekly for 7 hours for classroom activities, and will be assigned readings and other preparatory activities. Classroom activity will primarily consist of discussion of selected readings related to a topic in neuroethics, moderated by the instructor. Students will actively participate in discussion, debate, role-playing, and presentation to peers. Evaluation will be based on classroom participation, short writing assignments, and an independent project that will be designed in collaboration with the instructor.
We will undertake a survey of the ethical issues related to current and future neurotechnologies as they apply to clinical and research settings. These include such topics as enhancement, vulnerability, mental health biases, Consciousness, and Selfhood. We will cover many topics related to medical care for patients with neurological disorders, including disorders of consciousness, sleep, deciding for others, preclinical imaging and genetic testing for patients with neurological disorders.
Ethics in Reproductive Medicine and Women’s Health (4 credits)
This course will be taught in seminar format; the instructor will facilitate discussion based on each week’s readings. The students will be expected to prepare ahead of class and participate in interactive discussions of cases raised during lecture.
The course will examine ethical issues that arise in reproductive medicine and women’s health. Specifically, we will address ethical questions that arise in the context of providing assisted reproduction services, family planning services, pregnancy care and surgical services to women and their families.
Questions and issues that will be addressed in the course include the following: ethics surrounding the abortion and fetal tissue research debate; multiple cases in assisted reproduction including sex selection, savior siblings, age restrictions in IVF, intra-familial gamete donation, post-humous reproduction; cases at the maternal fetal divide and discussion of the balance of interests in these cases; genetic engineering in assisted reproduction.
Ethics in Genomics (2 credits)
The aim of this course is to offer an in-depth exploration of key ethical challenges and controversies surrounding recent developments in genomics. The course is designed in seven three-hour sessions with each session covering a specific topic. Topics include the appropriate informed consent for genomic testing, direct-to-consumer offers of personal genomic testing, the return of incidental findings etc. For each of the identified challenges we will examine a)how they emerged and why, b)what is the current state of the debate, including the current policies for best practice and c)what are the new directions, if any, in resolving some of the most acute controversies around the challenges. Each session will begin with a lecture, followed by discussion and student-driven projects. Student-driven projects include a variety of formats such as discussion of selected case studies, presentation of a journal article, debate panels. Students will have the option to select their assignment in the first day of class.
Advanced Writing in Bioethics – Year long (2 credits)
Advanced Writing is a full-year 2-credit course open only to students in the Master of Bioethics Program selected by the course instructor and limited in enrollment. The purpose of this course is to provide a year-long writing development and peer-review opportunity for advanced students who have already mastered high-level oral and written communication skills and who have a clearly defined and developed writing project proposal prior to the start of the course. Students will be expected to complete a substantial, publishable manuscript by the end of the course. Towards this end, students will develop, evaluate, and use professional voice, style, investigative rigor, and audience/ publication selection skills appropriate to their projects.
Bioethics Advocacy (2 credits)
This J-Term course seeks to highlight various bioethical issues and dilemmas—especially those that might have relevance in the national discourse about health care—and then develop strategies and ideas for how to research the issues at hand and also promote awareness about them among those in healthcare and, perhaps, the general public as well.
Topics covered during this month long intensive course include the following: US healthcare reform; health disparities and social justice; the impact of social, economic, political, and environmental factors on health; human rights (including healthcare personnel involvement in interrogation and torture); advocacy on behalf of vulnerable populations, and cultural awareness and competency.
The curriculum will be comprised of didactics, workshops, and a research based bioethics/health advocacy project proposal, developed either individually or as a group. It is hoped that after the conclusion of the course students will implement the projects they have developed, tabulate and write about their results, and ultimately present their findings at conferences and/or through publication in the medical literature.
Critical Reading of Contemporary Books in Bioethics (2 credits)
This two-credit elective is intended to expose students to a variety of contemporary books that address various bioethical issues. For each of the four books that will be read in the course, we first conduct a two-hour seminar in which the students and faculty discuss and analyze the book and prepare for the author’s visit. Subsequently, the class attends a 1.5-hour public lecture and forum with the author, followed by a 2-hour session with the author the following morning. Following each book/author, students complete a writing assignment that varying in format throughout the semester. Assignments include mock book reviews and more analytic evaluations of the central argument(s) in the book, with at least one essay intended for a non-academic audience.
Check out the event page for the Contemporary Authors Series here: http://bioethics.hms.harvard.edu/contemporary-bioethics-authors
Frontiers in Bioethics (2 credits)
Jared Silberman, JD
Frontiers in Bioethics is a two-credit course in which students will learn about emerging technologies and the unique moral considerations raised by these advances. In this course, students will gain familiarity with emerging technologies including robotics, artificial intelligence including self-correcting machines, synthetic biology, and cyborgs (humans merging with machines) and both how bioethics informs these advances and the bioethics implications of technology. Finally, the course will explore how bioethics considerations may influence policy towards technological advances. Class will be taught in seminar format with an emphasis on group participation. Evaluation will be based on class preparation and presentations and two writing assignments.
Health and Human Rights (2 credits)
This course is taught in seminar format. The instructor facilitates discussion based on each week’s readings. The course examines health and health care in the context of human rights. Questions and issues addressed in the course include: If we have a right to health, does that include the right to health care or the right to receive medications? If so, what are some of the systematic obstacles to actually obtaining needed care? In addressing these issues we examine some of the social determinants of health, including education, poverty, the social safety net, and the profit driven elements of much of our health care system. We also explore health at the interface of global conflict, including such issues as torture and the oppression of minority groups, vulnerable populations including refugees, and those with mental illness.
Narrative Ethics (2 credits)
This elective course focuses on narrative approaches to ethical issues in clinical medicine. Using literary narratives and poetry as the primary readings, the course methodology emphasizes the importance of particularity, contingency, change, voice, context, and time in recognizing, evaluating, and resolving moral problems. The course aims to develop skills in critical and reflective reading and writing that enhance competence in clinical ethics. Texts include fiction, essays, and poetry. Approximately two hours of reading is assigned for each class hour. The instructor provides necessary philosophic and literary context at the beginning of each class session, the balance devoted to discussion. Students are expected to write five reflection essays that examine such areas as the meanings of illness, the moral role of the physician, and the relevance of emotions, culture, faith, values, social realities, and life histories to ethical patient care.
Religious, Theological, and Cultural Perspectives in Bioethics (2 credits)
This seminar course is designed to reflect on the role and contributions of theological positions and various religious traditions to the interdisciplinary field of bioethics. Attention is given to the unique influence of theological voices on the development of bioethics in the North American context. Moreover, it identifies some of the principles embraced by these approaches and how they guide decisions in health care. Thus, it surveys a few examples of how theology engages the perennial and emerging questions in bioethics. Throughout the course emphasis is placed on how these insights can assist bioethicists in resolving some of the concerns that emerge particularly in clinical bioethics. Reflection also is given to the interplay of religious bioethics and public discourse. The course combines lecture, discussion, and student presentations.
Clinical Ethics Consortium Tutorial – Year-long (2 credits)
Class Days / Times: Monthly on Fridays
The Clinical Ethics Consortium Tutorial enables students to discuss a wide variety of real clinical cases and methods of ethics consultation in health care in order to develop expertise in analyzing ethics cases and consults. In addition to participation in monthly multi-disciplinary clinical ethics case conferences with a variety of clinicians, ethicists and faculty, students subsequently gather as a small group to analyze each month’s case in greater depth, and examine various approaches to ethics analysis and strategies for ethics consultation. Skills in ethical analysis, perspective-taking, logical argument and justification are emphasized.
Health Policy and Bioethics Consortium Tutorial – Year long (2 credits)
Class Days / Times: Monthly on Fridays
This course is based around monthly seminars featuring a moderator and 2 expert discussants each centered around a different topical policy issue with ethical ramifications. The seminars themselves are scheduled from 12:30-2 on the second Friday of every month September-May, except for January (although specific seminars could change based on particular discussants’ schedules). Bioethics masters students will be required to attend the seminar and then be involved in a 60-90-minute small group discussion with the moderator afterwards. There will be pre-reading on the topic ahead of time that could be part of the discussion as well. Topics covered will vary based on current key issues and are currently scheduled to include: FDA regulatory science, international trade and access to medicines, precision medicine, returning results to patients, and patient safety/medical error. Students will be evaluated via class participation and written work. The expert discussants may also join in the small-group session, which is intended to be a continuation of the conversation initiated at the prior public session. Students need not be active discussants in the larger public session—indeed, giving others who are not in the class time to voice their questions so that we can learn from their comments may be preferable—but should be ready to leap into the issues during the following smaller sessions. The reading load will be light to moderate.
Research Ethics Consortium Tutorial – Year-long (2 credits)
Class Days / Times: Monthly on Fridays
The Research Ethics Consortium Tutorial enables students to discuss a wide variety of real research protocols in biomedical and social-behavioral research in order to develop expertise in analyzing research protocols, methods, regulatory requirements, and ethical challenges. In addition to participation in monthly multi-disciplinary research ethics consortia conferences with a variety of researchers, ethicists, institutional review boards (IRBs) and faculty, students subsequently gather as a small group to analyze each month’s protocol in greater depth, and examine various approaches to regulatory ethics analysis. Students learn various approaches to addressing ethical challenges within the regulatory framework of research.
NOTE: students may only enroll in one consortium tutorial: clinical, policy, or research ethics.