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Module Reading List

Current Developments in Health Care Ethics, 2021/22, Semester 1
Dr Sarah Carter-Walshaw
Tutor information is taken from the Module Catalogue

Week One: Ethics Committees and Ethical Expertise

We will reflect on the reasons behind the development of research ethics committees and consider whether there is a need for ethics committees to police clinical practice generally and to advise on policy decisions. What kind of competence are ethics committees supposed to have? Are there moral experts?

Essential Reading

J. D. Moreno, 'Ethics Committees and Ethics Consultants' in A companion to bioethics H. Kuhse and P. Singer (eds.) (Malden: Blackwell, 2009) (available online as an ebook through the library)  

D.W. Brock 'Truth or Consequences, the role of philosophers in policy making' Ethics, 97 (4):786-791 (1987)  

Jukka Varelius, 'Is ethical expertise possible?'. Medicine, Healthcare and Philosophy, 11, 127–132 (2008).  

Further Readings

'Part XI: Ethicists and Ethical Committees', in Helga Kuhse and Peter Singer (eds.) Bioethics: An Anthology, 2nd Edition (Blackwell: 2006). 

Janet E. Fleetwood, Robert M. Arnold and Richard J. Baron, ‘Giving Answers or Raising Questions? : The Problematic Role of Institutional Ethics Committees’, Journal of medical ethics., 15/3 (1989): 137-142. 

R. Gillon, ‘Clinical Ethics Committees - pros and cons’, Journal of medical ethics.., 23 (1997):203-04.

J.G. Thornton and R.J. Lilford, ‘Clinical Ethics Committee’, British medical journal., 311/7006 (1995): 667-669.

Clinial Ethics Committees Supplement, Journal of medical ethics., 27 supplement 1 (2001).

On RECs:

S. Mason and C.Megone (eds.), European neonatal research : consent, ethics committees and law, (Ashgate, 2001).

Watson, J.C. and Guidry-Grimes, L.K. (eds.) (2018) Moral Expertise: New Essays from Theoretical and Clinical Bioethics. Cham: Singer    

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Week Two: The Duty to be a Research Subject

Experimentation has to at some point also involve using people as subjects. In experimenting on people is consent the only ethical issue? What are the difficulties in getting real consent? Is proxy consent a form of consent? Are there circumstances in which experimentation should be allowed although those being experimented on have not consented? Do patients have a duty to help with the advancing of medical knowledge?

Essential Readings

John Harris, ‘Scientific research is a moral duty’, Journal of Medical Ethics., 31 (2005): 242-248.  

Sandra Shapshay and Kenneth Pimple, ‘Participation in biomedical research is an imperfect moral duty: a response to John Harris’, Journal of Medical Ethics., 33 (2007): 414-417.  

Further Readings

Iain Brassington, ‘John Harris’ argument for a duty to research’, Bioethics., 21/3 (2007): 160-168.

Iain Brassington, ‘Defending the duty to research? ’, Bioethics., 25/1 (2011): 21-26.

Margaret Brazier, ‘Exploitation and enrichment: the paradox of medical experimentation’, Journal of medical ethics., 34 (2008): 180-183.

Sarah Chan and John Harris, ‘Free riders and pious sons – why science research remains obligatory’, Bioethics., 23/3 (2009): 161-171.

G Helgesson and S Eriksson, ‘Against the principle that the individual shall have priority over science’, Journal of medical ethics., 34 (2008): 54-56.

Lynn Jansen and Steven Wall, ‘Paternalism and fairness in clinical research’ Bioethics., 23/3 (2009): 172-182.

Sarah Edwards and James Wilson, ‘Hard paternalism, fairness and clinical research: why not? ’ Bioethics. 26/2 (2012): 68-75.

'Part VII: Experimentation with Human Subjects', in Helga Kuhse and Peter Singer (eds.) Bioethics: An Anthology, 2nd Edition, (Blackwell: 2006). 

'Part XI: Experimentation with Human Subjects' in A companion to bioethics, H. Kuhse and P. Singer (eds.) (Malden: Blackwell, 2009).

Don Marquis, ‘An Ethical Problem Concerning Recent Therapeutic Research on Breast Cancer,’ in HB Holmes & LM Purdy (eds.), Feminist perspectives in medical ethics, (Indiana University Press, 1992), 140-153.

‘Your Baby is in a trial’, Lancet., editorial, 345/8953 (1995): 805-806.

Stanley Milgram vs Diana Baumrind, ‘Can Deception in Research be Justified? ’ in Caroline Levine (ed.), Taking Sides, (3 rd Edition), (Dushkin Publishing Co., 1989), 182-201.

Ralph E Kauffman, ‘Drug Trials in Children: Ethical, Legal and Practical Issues,’ Journal of Clinical Pharmacology, 34/4 (1994): 296-299.

Peter Allmark, ‘Should Zelen pre-randomised consent design be used in some neonatal trials,’ Journal of medical ethics., 25 (1999): 325-329.


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Week Three: Use of Animals as Research Subjects

Society has an interest in making brisk progress in medical science. That progress necessitates experimentation. What justifies our using animals before using humans as subjects to experiment upon? Is such research justified provided only that no unnecessary pain or distress is caused?

Essential Reading

TLS Sprigge, ‘Animal Experimentation in Biomedical Research: A Critique,’ in R. Gillon (ed.), Principles of health care ethics ISBN: 0471930334 ISBN: 0471930334, (John Wiley & Sons, 1994), 1053-1065. OCR REQUESTED BY LIBRARY (SRJ 30/10/2017) Available as an Online Course Reading in the VLE   

Bonnie Steinbeck, ‘Speciesism and the Idea of Equality,’ Philosophy., 53/204 (1978): 247-256.  

Further Readings

Part VIII: Experimentation with Animals', in Helga Kuhse and Peter Singer (eds.), Bioethics: An Anthology , 2nd Edition, (Blackwell: 2006). 

'Part XII: Experimentation with Animals' in A companion to bioethics, H. Kuhse and P. Singer (eds.) (Malden: Blackwell, 2009).

DeMello, M. (2012). Animals and society an introduction to human-animal studies . New York: Columbia University Press.

Regan, T. (2004). The case for animal rights (Second edition.). Berkeley: University of California Press.

Singer, P. (1995). Animal liberation (Second edition, with a new preface by the author.). London: Pimlico.

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Week Four: Ethics and Disability

An introduction to some of the ethical issues that arise concerning disability.

Essential Reading

Lennard T. Davis, 'Crips Strike Back: The Rise of Disability Studies', American literary history., 11/3 (1999):500-512.  

Barnes, E (2009). 'Disability, Minority and Difference' Journal of applied philosophy. ISSN: 0264-3758 26 (4): 337 - 355  

Chadwick, R and Levitt, M. 'Genetic Technology: A Threat to Deafness' Medicine, Health Care and Philosophy ISSN: 1386-7423, Vol. 1, 1998   

Further Readings

From Helga Kuhse and Peter Singer (eds.), Bioethics: An Anthology, 2nd Edition (Blackwell, 2006):

Chapter 13: Ruth Chadwick and Mairi Levitt, 'Genetic Technology: A Threat to Deafness'

Chapter 31: Neil Campbell, 'When Care Cannot Cure: Medical Problems in Seriously Ill Babies'

Chapter 33: R.M. Hare, 'The Abnormal Child: Moral Dilemmas of Doctors and Patients'

Chapter 34: Alison Davies, 'Right to Life of Handicapped'

Josh Parsons, 'Why the Handicapped Child Case is Hard', Philosophical studies.., 112/2 (2006): 147-162, Section I. 

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Week Five: Commodification, Exploitation and Bioethics

Organ transplant specialists tell us that there is a shortage of suitable kidneys, cornea, hearts etc. Some economists reply that the best way to deal with suich a shortage would be to pay people for transplantable organs. Is there anything wrong with the buying and selling of human organs? Do we own ourselves? Do we own our organs? Do we own our labour- something we transfer when we get a job?

Essential Reading

Rob Lawlor, “Organ sales needn’t be exploitative (but it matters if they are)”, Bioethics. Volume 25, issue 5, 2011.  

Liberto, H. (2013). Noxious Markets versus Noxious Gift Relationships. Social theory and practice. 39(2): 265-287     Available online 

Further Readings

'Part IX: Organ Donations' in A companion to bioethics, H. Kuhse and P. Singer (eds.) (Malden: Blackwell, 2009).

From Helga Kuhse and Peter Singer (eds.), Bioethics: An Anthology, 2nd Edition (Blackwell, 2006): 

Chapter 7: Laura M. Purdy, 'Surrogate Mothering: Exploitation or Empowerment? ' 

Chapter 8: Susan Dodds and Karen Jones, 'A Response to Purdy' 

Chapter 50: Richard M. Timms, 'Why Give to Strangers' 

Chapter 51: Eike-Henner W. Kluge, 'Organ Donation and Retrieval: Whose Body is it Anyway? ' 

Chapter 52: Janet Radcliffe-Richards et. al., 'The Case for Allowing Kidney Sales' 

Chapter 53: John Harris, 'The Survival Lottery' 

Rob Lawlor (2014) Organ Sales: Exploitative at Any Price?. Bioethics. ISSN: 0269-970228 (4), pp. 194-202

‘Paying Organ Donors,’ J Harvey, Journal of medical ethics., 1990, 16: 117-119.

‘The Case For Allowing Kidney Sales’, J. Radcliffe-Richards et al, Lancet. 1998; 352: 1950-1952.

‘The Kidney Trade: or, the customer is always wrong,’ Bob Brecher, Journal of medical ethics., 1990, 16: 120-123. Note from Rob Lawlor: this paper should not be used uncritically. Perhaps I am not understanding it. As far as I can tell though, it is unclear, incoherent and inconsistent. As such, if you use it uncritically, just presenting the claims, assuming they are coherent, the danger is that your essay will be similarly flawed. See my "exploitative at any price" for more detailed response to this paper.

Further exchanges between Brecher and Buttle in Journal of medical ethics. 1991, 17: 97-99.

Spheres of Justice, Michael Walzer, Basic Books, 1983, Ch 4 ‘Money and Commodities’.

The body as property, Russell Scott, Allen Lane, London,1981.

Bodies for sale : ethics and exploitation in the human body trade, Stephen Wilkinson, Routledge.

Cecil Fabre Whose body is it anyway? : justice and the integrity of the person Chapter 6 – Organ sales (the library has a digital copy of this book)

T.L. Zutlevics (2001) “Markets and the needy: organ sales or aid? ” Journal of applied philosophy. 18, 3.

James Stacey Taylor, “Autonomy, Constraining Options, and Organ Sales” in Journal of applied philosophy.. Or chapter 4 of his book Stakes and Kidneys. (This includes a response to the Zutlevics paper.)

M. Goyal et al. Economic and Health Consequences of Selling a Kidney in India. JAMA 2002; 288(13): 1589 (This isn't a philosophy paper, but is based on empirical research in India. However, you need to be very careful in drawing conclusions from this paper. On the face of it, you might think that it provides strong evidence for the claim that organ sales are an example of harmful exploitation. But does this conclusion generalise to all cases of organ sales, or are they specific to the context, given the particular conditions etc in India? )

Alan Wertheimer “Exploitation” in the Stanford encyclopedia of philosophy [electronic resource]. (online) or Alan Wertheimer Exploitation ISBN: 0691019479 (pbk) : £12.50; 9780691019475, chapter 1. (Note: these are very similar, so there is little value in reading both. One or the other would be fine. Neither is about organ sales though, or even bioethics. However, many of the papers on organ sales and other issues in bioethics work with (what I consider to be) a too simplistic account of exploitation. Wertheimer's account is more sophisticated.)

Alan Wertheimer Exploitation ISBN: 0691019479 (pbk) : £12.50; 9780691019475, chapter 4 commercial surrogacy.

The following readings do not focus on organ sales in particular, or even exploitation, but are very good on the general idea that some things should be valued in a way that isn't obviously compatible with treating them as commodities. 

Ben Rogers (ed.) Is Nothing Sacred? Routledge 2004. (Note: this is available online from the library.) (Note: I'd recommend starting with Ben Roger's short intro. This is very good at spelling out the general philosophical issue (of how we value different things). 

Michael Sandel, What Money Can't Buy, Penguin 2013.

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Week Six: Gene Therapies: Enhancements

What ethical objections might there be to Genetically Modified Babies? Why can’t parents be allowed to improve on nature- for the benefit of their offspring?

The Clothier Committee (1992) declared that ‘profound ethical issues’ would arise if gene modifications were ever allowed for the ‘enhancement of normal human traits’. Was it reasonable of the Committee to take fright at the idea of parents choosing to improve on nature, choosing genetic enhancements for their children? Should genetic alterations be restricted to corrective changes only? If so, why?

Essential Reading

'Part VI: The New Genetics' in A companion to bioethics, H. Kuhse and P. Singer (eds.) (Malden: Blackwell, 2009). (available online as an ebook through the library)  

Further Readings

From Helga Kuhse and Peter Singer (eds.), Bioethics: An Anthology, 1st Edition (Blackwell, 1999): 

Chapter 12: Laura M. Purdy, 'Genetics and Reproductive Risk: Can Having Children be Immoral? ' 

Chapter 13: Deborah Kaplan, 'Prenatal Screening and its Impact on Persons with Disabilities' 

Chapter 14: Mary Anne Warren, 'Sex Selection: Individual Choice or Cultural Coercion? ' 

Chapter 17: John Harris, 'Is Gene Therapy a Form of Eugenics? ' 

From Helga Kuhse and Peter Singer (eds.), Bioethics: An Anthology, 2nd Edition (Blackwell, 2006): 

'Section III: The New Genetics' 

Elizabeth R Hepburn, ‘Genetic testing and early diagnosis and intervention: boon or burden? ’, Journal of medical ethics., 22 (1996): 105-110.

Report of the Committee on the Ethics of Gene Therapy , (London: HMSO, 1992).

Carol A Tauer, ‘The NIH Trials of Growth Hormone for Short Stature,’ Hastings Center report. 16 / 3 (1994): 1-9.

British Medical Association, Human Genetics: Choice and Responsibility, (New York: Oxford University Press, 1998).

Allen Buchanan, Dan W Brock, Norman Daniels, & Daniel Winkler, From chance to choice : genetics and justice, (Cambridge University Press, 2000), Chapter 5.

Harris J. Clones, genes, and immortality : ethics and the genetic revolution. Oxford: Oxford University Press, 1998.

Reindal S. Disability, gene therapy and eugenics - a response to John Harris. Journal of medical ethics. 2000;26:89-94.

Farrelly C. Genes and equality. Journal of medical ethics. 2004;30:587-592

McGleenan T. Human gene therapy and slippery slope arguments. Journal of medical ethics. 1995;21:350-355.

Prusak B. Rethinking ‘Liberal Eugenics.’ Hastings Center report. 2005;35(6):31-42.

Buchanan A. Better than human : the promise and perils of enhancing ourselves. Oxford: Oxford University Press, 2011.

Persson I, Savalescu J. Unfit for the future? : the need for moral enhancement. Oxford: Oxford University Press, 2012.  

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Week Seven: Human Cloning/ Novel Reproduction

The recent advances in genetic research have stirred up the debate about the ethical implications of possible uses and abuses of the information gained. Cloning, for example, might be used in cancer therapy and to repair nerve damage-which seems wholly desirable. But are there other possibilities that would be morally repugnant? What, if anything, is wrong with cloning humans? Should no uses be allowed lest some uses lead to abuses? Are researchers accountable for the applications that others make of their discoveries?

Essential Reading

Carson Strong, 'Cloning and infertility', Cambridge quarterly of healthcare ethics. ISSN: 0963-1801Vol. 7 (1998), 279-293.  

Dan Brock, ‘Is a consensus possible on stem cell research? Moral and political obstacles’ Journal of medical ethics., 32 (2006), 36-42.  

C. Parker, ‘Ethics for Embryos’, Journal of medical ethics., 33 (2007), 614-616 (which is a reply to Brock).  

Michael Sandel, ‘Embryo Ethics – The Moral Logic of Stem Cell Research’, New England journal of medicine., 351:3 (July 15 2004), 207-9 (which is very short and elaborates on something Brock refers to).  

Further Readings

'Pre-Natal Screening, Sex Selection and Cloning', in Helga Kuhse and Peter Singer (eds.), Bioethics: An Anthology , 2nd Edition , pp. 117-178. 

Susan M. Wolf, ‘Why Ban Cloning? Why NBAC is Wrong’, Hastings Center report., 27/5 (1997):12-15

Human Genetics Advisory Commission Papers

Human Genetics Commission Library

John A. Robertson, ‘The Question of Human Cloning’, Hastings Center report., 24/2 (1994): 6-14.

Gregory E. Pence, Who's afraid of human cloning? (Rowman & Littlefield, 1998).

British Medical Association, Human Genetics: Choice and Responsibility, (New York: Oxford University Press, 1998), pp. 201-203.

Sarah Chan and John Harris, ‘Consequentialism without Consequences: Ethics and Embryo Research’ Cambridge quarterly of healthcare ethics. Vol. 19 (2010), 61–74.

Katrien Devolder, ‘Human Embryonic Stem Cell Research’, Bioethics., Vol. 19, No. 2 (2005), 167-186.

Katrien Devolder, ‘Embryo deaths in reproduction and embryo research: a reply to Murphy’s double effect Argument’ Journal of medical ethics. published online first November 8, 2012.

Katrien Devolder and Julian Savulescu, ‘The Moral Imperative to Conduct Embryonic Stem Cell and Cloning Research’ Cambridge quarterly of healthcare ethics. Vol. 15 (2006), 7–21.

Soren Holm, ‘The Ethical Case against Stem Cell Research’, Cambridge quarterly of healthcare ethics., Vol. 12 (2003), 372-383.

A. Kuflik, ‘The “future like ours” argument and human embryonic stem cell research’, Journal of medical ethics., Vol. 34 (2008), 417-421.

TM Murphy, ‘Double-effect reasoning and the conception of human embryos’, Journal of medical ethics. 2012. Published Online First 18 August 2012.

Demetrio Neri, ‘The race toward ‘ethically universally acceptable’ human pluripotent (embryonic-like) stem cells: only a problem of sources? ’ Bioethics. Vol 25, No. 5 (2011),  260–266.

Ingmar Persson and Julian Savulescu, ‘Actualizable Potential, Reproduction, and Embryo Research: Bringing Embryos into Existence for Different Purposes or Not at All’, Cambridge quarterly of healthcare ethics. 19 (2010), 51–60.

Martin Shaw, ‘Moral Qualms, Future Persons, and Embryo Research’, Bioethics., Vol. 22, No. 4 (2008), 218-223.

Lori Gruen, Laura Grabel and Peter Singer (eds) Stem cell research : the ethical issues (Blackwell, 2007).

For an overview of the ethics of abortion and so arguments about the moral status of the embryo which, in some cases, will also apply to embryo research, see The Internet Encyclopedia of Philosophy

Carter-Walshaw (2019) In vitro gametogenesis: The end of egg donation?. Bioethics 33(1): pp.60-67

Mertes, H., & Pennings, G. (2010). Ethical aspects of the use of stem cell derived gametes for reproduction. Health Care Analysis, 18, 267–278.

Suter, S. M. (2015). In vitro gametogenesis: Just another way to have a baby? Journal of Law & the Biosciences3, 87–119.

Notini, L., Gyngell, C. and Savulescu, J. (2020) Drawing the line on in vitro gametogenesis. Bioethics 34(1): pp. 123-134.

This list was last updated on 02/09/2021