College Level

On the college level, offerings in bioethics are a well-established feature. Certain institutions offer, or allow students to construct, an interdisciplinary major in bioethics.

More common is a minor or concentration in bioethics, interdisciplinary in nature or offered through a philosophy, religion, or social-science-based department.

Though most colleges have neither major or minor, they are likely to offer one or more courses in bioethics. A typical course might use one of the standard textbooks of bioethics, either written from a unitary perspective or offering an edited collection of canonical "pro" and "con" articles on bioethical issues. The instructor may choose to supplement this with a collection of cases or to replace it with an assembled course packet of the instructor's choosing.

A number of didactic approaches may be used to help students become experientially involved with the topics. Most popular is the case analysis mode where students grapple with the dilemmas raised by actual or constructed cases. Class debates can provoke spirited dialogue, and a growing library of films and videotapes vividly portrays for students the human impact of these issues. Some professors may bring in, or team-teach with, healthcare professionals, or ask students to visit a healthcare setting as part of the course. Bioethics can lend itself well to a "service-learning" approach, where student service in healthcare-related fields can be used by the instructor as a way to make bioethical issues come alive.

Most bioethics textbooks and many instructors begin from a framework of ethical theories and principles that are then applied to specific issues, such as informed consent, abortion, and euthanasia. However, this "standard approach"—and indeed the "standard issues" of bioethics— have been criticized by professionals associated with fields such as phenomenology, pragmatism, hermeneutics, feminism, casuistry, virtue ethics, and narrative theory. Critics argue, for example, that to base ethical analysis on high-level theory may obscure the richness of particular cases and the complex modes of interpretation that real-life decision makers employ. Moreover, simply to stick to recognized "ethical quandaries" is to risk overlooking the sociopolitical biases and the metaphysics of self and body that have shaped contemporary Western medical systems in ethically significant ways.

Instructors may therefore choose to supplement the medical ethics textbook with other kinds of resources. For example, a brief selection from the seventeenth-century French mathematician and philosopher René Descartes might be used to reflect on the model of body-as-machine that has powerfully influenced the doctor—patient relationship. A literary work such as "The Death of Ivan Ilyich" (1886), by the Russian novelist and philosopher Leo Tolstoy, can render vivid and lucid the experience of illness, the significance of truth telling, and the dilemmas surrounding death and dying. A work of social critique, such as a feminist history of women and medicine, can raise issues concerning the power relations embodied in medical practice and disease categories. The growing diversity of methodologies used within professional bioethics can thus "filter down" to diversify the methods and materials used in college-level teaching.

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