Ethics of Medicine

Paper 13_4 in the BBS Major Subject History and Philosophy of Science and Medicine

Lectures are held in the Department of History and Philosophy of Science.

This course provides students with the opportunity to explore core concepts in medical ethics and bio-ethics, ranging from the ethics of reproduction to resource allocation. It also provides an introduction to some of the broader social and political forces which shape the provision of care, and provides tools for thinking about how these forces might influence not only the use but the production of medical knowledge. This course provides students for thinking critically about the challenges medicine raises for society, and the ways in which society structures medicine.

Aims and learning outcomes

• to acquaint students with debates around the ethical implications of new technologies, and the role of ethical concerns in shaping new technologies;
• to provide students with an understanding of the ways in which medical and scientific knowledge more generally is, can be and should be shaped by broader social and political concern;
• to encourage students to place contemporary debates about the ethics and politics of medicine within broader historical and sociological contexts;
• to facilitate students' critical understanding of developments and uses of medicine.

Lectures

Ethics and Politics of Technology

Tom McClelland (4 lectures, Michaelmas Term)

Technology plays an integral role in society and has the power to bring about both huge benefits and terrible harms. Focusing on the development of Artificial Intelligence, this course explores the ethical and political ramifications of technology. How, if at all, can technology be evaluated normatively? When technology causes harm, who should be held responsible: the designers, the user or society as a whole? Can AI be used to overcome the blight of human prejudice or do algorithms themselves encode societal biases? What ethical principles should be encoded into AI, and can an artificial system ever really be ethical? Should we take seriously the idea of AI one day destroying humanity and, if so, what should we be doing about it? Under what conditions would an artificial system deserve our moral consideration? If moral worth is bound to consciousness, how should we go about assessing whether an AI is conscious? And if we can't be sure whether an AI is conscious, what is the most responsible policy to adopt?

Ethics and Politics of Science and Medicine

Stephen John, Ahmad Elabbar (12 lectures, Michaelmas & Lent Terms)

This course considers two important sets of questions. In the first eight lectures, we look at some of the central questions of bio-medical ethics, focusing on different issues from different stages of the life-course: ranging from whether you should be vaccinated, to whether you should be allowed to get drunk, to when you should have children, and, finally, whether you should be allowed to choose how you die. Through this approach, we show how our individual choices are wrapped inside larger social and political structures. In Lent Term, we turn from thinking about ethical issues raised by medical technologies to consider the broader question of how ethical and social values do and should shape science. Many philosophers now hold that science is ineliminably laden with ethical, political or other 'non-epistemic' values. Does that imply that science isn't objective and, if so, what does that imply for the place of science in society, or should we change our view of what counts as objective?

Science and Communism

Dmitriy Myelnikov (4 lectures, Lent Term)

The rise of governments that used the term 'Communist' to describe themselves in the 20th century involved a variety of new understandings and practices of science and technology. During the Cold War, science took on a variety of forms and meanings across the Eastern Bloc and its sphere of influence, from the emergence of Lysenkoist genetics in the Soviet Union to promotions of mass science in the People's Republic of China. These lectures discuss the meanings that Marxist and related political theories attributed to science, as well as science and technology in policy and practice in the Soviet Union, People's Republic of China, Cuba and other Communist-aligned states. Topics covered include the roles of technical expertise and the place of techno-science in global Cold War politics.

Ethical Issues in Psychiatry

Tom McClelland (4 lectures, Lent Term)

It is commonly reported that we are living through an epidemic of mental illness. Psychiatric treatment has never been more widespread, but the ethical issues raised by psychiatry run deep. When, if ever, should a pattern of mental behaviour be regarded as a medical condition? Does the pathologisation of suffering serve the interests of the patient or the interests of industry? How might psychiatric disorders complicate the possibility of informed consent? Should a patient be free to choose how to address their condition, even if it causes them harm? When, if ever, is it ethical to impose compulsory psychiatric treatment on a patient? How does society discriminate against those diagnosed with psychiatric disorders and what implications does this have for the practice of psychiatry? How is diagnosis and treatment biased by gender, age, race and their intersections? Might issues of discrimination be improved or exacerbated by the increased use of AI in psychiatry? Should therapists always be human, or could a patient form an effective therapeutic relationship with an AI?

Preliminary reading

• Bernal, J.D., The Social Function of Science (London: Routledge, 1939)
• Buchanan, Allen, Dan W. Brock, Norman Daniels and Daniel I. Wilker, From Chance to Choice: Genetics and Justice (Cambridge: Cambridge University Press, 2000)
• * Collins, Harry, and Trevor Pinch, The Golem: What Everyone Should Know about Science (Cambridge: Cambridge University Press, 1993)
• Collins, Harry, and Trevor Pinch, The Golem at Large: What You Should Know about Technology (Cambridge: Cambridge University Press, 1998)
• * Douglas, Heather, Science, Policy and the Value-Free Ideal (Pittsburgh: University of Pittsburgh Press, 2009)
• Everson, Michelle, and Ellen Vos (eds), Uncertain Risks Regulated (Abingdon: Routledge, 2009)
• Fox Keller, Evelyn, and Helen E. Longino (eds), Feminism and Science (Oxford: Oxford University Press, 1996)
• * Graham, Loren, Science in Russia and the Soviet Union: A Short History (Cambridge: Cambridge University Press, 1993)
• Jasonoff, Sheila S., Science at the Bar (Cambridge, MA: Harvard University Press, 1995)
• Kitcher, Philip, The Lives to Come (London: Penguin, 1996)
• * Kitcher, Philip, Science, Truth and Democracy (Oxford: Oxford University Press, 2001)
• Latour, Bruno, Science in Action (Cambridge, MA: Harvard University Press, 1987)
• Pielke, Roger, The Honest Broker (Cambridge: Cambridge University Press, 2007)
• Winner, Langdon, The Whale and the Reactor: A Search for Limits in an Age of High Technology (Chicago: University of Chicago Press, 2020)

Resources for Ethics of Medicine on Moodle