MA Medical Ethics

Programme co-ordinator: Tristan Nash

** Please note that this pathway is closed to new applicants **

Introduction to the Course

Health professionals face perplexing ethical issues of many kinds in their day-to-day work, particularly in the current climate of rapid scientific and technological development and changing public and political expectations of health care services. New technologies raise apparently new problems such as the right use of genetic information and the morality of stem cell research, while more long-standing issues such as euthanasia, resource allocation and informed consent continue to be vigorously debated in new contexts.

This MA is designed for health professionals, health care chaplains, ethics committee members and all whose work brings them into contact with these issues. One core module introduces students to the variety of ethical frameworks that have been articulated by philosophers, and shows how these frameworks can be used in thinking about issues in medical ethics. Another core module helps students to develop the study and research skills necessary for the study of Ethics at postgraduate level. A series of optional modules address particular topics such as euthanasia, health care rationing (resource allocation) and human genetics. A further optional module explores a variety of Christian theological approaches to bioethical issues. A supervised dissertation offers the opportunity to explore a particular area of interest in greater depth.

This course will not offer neatly-packaged solutions to complex ethical issues. It will, however, enable students to gain a clearer understanding of these issues and to develop more consistent and informed ways of addressing them.

The MA can be completed in just over two years of part-time study, and must be completed within five years of initial registration. The Medical Ethics pathway can be taken as a pathway either to the MA in Philosophy or to the MA in Theology. Students taking it as a pathway to the MA in Philosophy must choose the module Writing Philosophy; those taking it as a pathway to the MA in Theology must choose the modules Study and Research Methodology and Christian Theology and Bioethics.

The MA is divided into two parts:

1. The taught element. Students study six modules chosen from the following list:

Compulsory core modules

1. Ethical Theory and Medicine [module code: MAME0120]

This module outlines and critically discusses a variety of theoretical frameworks that have been developed by moral philosophers for addressing moral issues. The relevance of these theoretical frameworks to medical ethics is illustrated by reference to a range of examples, and students have the opportunity to explore further the connections between theory and practice in medical ethics in their module essays. The following topics are covered:

• Philosophy and theory in ethics
• Consequences and moral mathematics
• Facts and values
• Kant and the nature of duty
• Virtue and character
• Double effect, and the distinction between acts and omissions.

2. Writing Philosophy [module code: MATP0620]

Module Tutor: Tristan Nash

The aim of this module is to help people who have had little or no experience of writing philosophy, or writing in related disciplines, to acquire some of the fundamental skills required for this. Many of those skills are ones that are required for good writing in any academic discipline; and for much other writing besides. Philosophical writing does, however, make a range of quite specific demands on the author. By the time students have finished this module they should have acquired a clearer picture of what those demands are, along with detailed practice in meeting them. The practice is a fundamental aspect of the teaching involved in the module: a range of exercises, which students are encouraged to submit for feedback, being a central component of it. The module is intended for people with limited recent academic experience of a form relevant to the MA; and would be of particular relevance to people who intend to go on to further postgraduate work after completing the MA. In some case students may be required, or at least strongly urged, to take this module.

Optional modules

1. Euthanasia [module code: MAME0420]

In this module, we consider such questions as: What does the examination of actual case histories reveal about the attitudes of doctors and nurses towards euthanasia? Is there a morally significant distinction between active and passive euthanasia: between killing someone and letting her die? Is one just as responsible for failing to prevent harm to others as one is responsible for causing harm to others? Is euthanasia morally equivalent to murder? Can the traditional Roman Catholic 'doctrine of double effect' bring out important differences between the ways in which doctors or nurses may be related to the death of a patient? Does the distinction between 'ordinary' and 'extraordinary' means of treatment throw light on our moral responsibilities towards those with life-threatening illnesses? How should the problem of the allocation of scarce health-care resources influence our thought about euthanasia? (The course text for this module also contains material on suicide, which may be of interest as background reading to the study of euthanasia.)

2. Abortion [module code: MAME0220]

What is the relation between feminism and abortion? How should we respond to the suggestion that since the foetus is a person, and killing a person is murder, abortion is murder? How is it to be decided whether or not we should say that the foetus is a person: are all human beings people? Is there any significant moral distinction between abortion and infanticide? How, if at all, might doctrines of the 'sanctity of life' be relevant to our view of abortion? Does utilitarianism - the view that actions are wrong only in so far as they cause suffering or reduce happiness - throw light on the morality of abortion? Is utilitarianism an acceptable doctrine? Even if we have to agree that the foetus is a person from the moment of conception does it follow that abortion is morally unacceptable? Can it be argued that there are important respects - perhaps because of the mother's right to control her own body - in which abortion is significantly different from other cases of killing? What light, if any, does a consideration of the virtues throw on the rights and wrongs of abortion? Can the wrongness or permissibility of abortion depend on the age of the woman who has the abortion, the possibility of disabilities in the child, how developed the foetus is? Is child bearing intrinsically worthwhile? This module attempts to clarify moral thinking about abortion through a consideration of questions such as these.

3. Ethical issues in Resource Allocation (Health Care Rationing) [module code: MAME0620]

This module introduces students to the complex problems associated with the allocation of health care resources at three different levels: micro-allocation (allocation of resources between individual patients), macro-allocation (setting priorities and allocating resources within an institution, a sector or a health care system as a whole) and international (the disparities in availability of health care between nations and regions of the world). The relevance of ethical concepts such as justice and rights to resource allocation is explored. Various criteria and mechanisms for setting priorities, including the quality-adjusted life year (QALY), are critically examined. Students are encouraged to explore the moral issues of resource allocation with reference to their own experience of particular health care systems and to concrete examples referred to in the module study pack.

4. Human Genetics [module code: MAME0820]

This module enables students to explore some of the ethical issues and challenges posed by the use of human genetics in medicine; issues and challenges that have been brought into particularly sharp focus by the Human Genome Project and its applications. The module consists of an introductory topic, the science and technology of human genetics, and five main topics: access to genetic information; genetic diagnosis and screening; human identity, behavioural genetics and mental health; genetic manipulation; the commercial exploitation of human genetics research. Students write short essays (formative assignments, which do not contribute to their formal assessed work) on some of these topics under the guidance of the module tutor, before selecting a further topic from the list for their final 5,000-word assessed essay.

5. Ancient Medicine: myth and practice [module code: MACLA5920]

Scientific' Greek and Roman medicine was based on a mixture of fixed ideas, misconceptions and (sometimes) enlightened thinking. Some people preferred to rely on divine aid or home-made remedies. The module looks at the main medical and pseudo-medical writers and at some of the specific health issues that they faced. It will not give you a complete history of medicine in the Ancient World, but will look in depth at some aspects of it. The period covered will be approximately 430 BC to AD 200, but some later material may be included. Topics covered will include: Hippocrates, Asclepius, women's bodies in Greek medicine, epidemics: Hippocratic doctors in action, miracle cures, Soranus and Galen, surgery and army medicine, family planning, plagues, Aelius Aristides. The module is delivered by handouts, video- and audio-tapes, and through the web.

6. Computer Ethics [module code: MABE0420]

Module Tutor: Dr. James Luchte

This module deals with the rapid advance of information technology (IT) which has introduced 'society' into a new age - the age of the information society.

There is no doubt that the information technology revolution surpasses both the agricultural and the industrial revolutions in social significance. The new reality of the information economy enables people to earn their living by working with words, numbers and ideas. The increasing use of computers and computer networks affects rapidly the way that people live, communicate, work and entertain. Humans and their activities are widely connected to and sometimes totally dependent on computer systems and tools. But as every technological advance has both advantages and disadvantages, likewise computer technology is responsible for creating both benefits and problems.

Within the digital world of the information age human behaviour seems to be underlined by novel moral standards where traditional ethical questions are reexamined and new are emerge. Computers have become the principal tool for political power, authority and propaganda as well as of electronic crime, fraud, surveillance and security. The centralization, distribution and control of information results a different kind of modern discrimination between the 'poor in information' and the 'rich in information'.

Moreover, human relationships are underlined by new parameters of distant and impersonal communication; malfunction and misuse of computer can cause serious problems to individuals and groups; stock markets, banks, businesses and governmental organizations are totally depended on information systems as well as on the reliability and the integrity of digital data; expert systems and artificial intelligence mimic human intelligence sometimes with unpredictable or unreliable results; intellectual property rights cannot be easily defined and protected by the law; malicious viruses and skilful hackers invent computer networks and the rights of personal data, privacy and anonymity are frequently ignored.

The following modules are being developed

1. Ethical issues in Medical Research
2. Ethical Issues at the End of Life

Assessment for the first part of the MA is on the basis of one 5000-word essay or two 2,500-word essays for each module.

Guidelines for submission of postgraduate work are available here.

The dissertation

On passing the first part of the MA, students proceed to Part 2. This involves the writing of a 20,000-word research dissertation on a theme relevant to the MA programme, under the supervision of a member of the teaching staff. You should choose a research topic and prepare a proposal in consultation with a member of the teaching staff. The proposal, when completed, must be approved in writing by the Course Director, who will appoint a supervisor. Your supervisor will give guidance and feedback as you work on sections of the dissertation, and will advise you when it is ready for submission.