The rapid increase both in our knowledge of genetics and in genetic technology means that we must face a number of profound moral issues. Most notoriously, there is the question raised by the recent cloning of sheep and mice: would it be morally wrong to clone human beings? Related to this is the use of genetic therapy and genetic screening in human reproduction to eliminate disorders such as Down’s and Huntington’s Syndrome. It might also be possible to reduce or even completely prevent the occurrence of serious mental disorders such as schizophrenia. One of the fundamental worries concerning these possibilities is lead to a new era of eugenics, with intolerance of imperfection and difference from cultural norms. In its worse forms, as seen in fascist ideology, eugenics is explicitly racist and sexist. This leads us to the deep question of what kind of human beings we want to exist and what manipulation of human reproduction should be allowed. There are also ethical questions that we are facing, concerning privacy of genetic information. Is it morally reasonable for insurance companies to charge those at greater risk for genetic disease higher premiums? Should an employer be able to refuse a person a job if it knows that person is at a high risk for diseases with genetic components, including alcoholism, mood disorders, and neurodegenerative disorders? Issues to do with genetics are frequently in the news, and the seminar will have the flexibility to turn to any current controversies.

Maybe the most rapidly expanding part of medical ethics is the study of the moral dilemmas posed by genetic technology. Some difficult questions for ethics, law and policy have already arisen. Insurance companies have pressed for access to genetic information; the U.S. Supreme Court has allowed the patenting of genetic codes; and the Clinton administration has banned research into human cloning. Genetic counseling is becoming increasingly common, and there has been considerable discussion of the extent to which counselors should remain morally neutral in the way that they can and should present information to clients. Genetic biotechnology is advancing with astonishing rapidity, so we need to start to address future moral, legal and policy questions now in order for us to be prepared to deal with them when the time comes. These are the questions that have been dramatized in such works of science fiction as Brave New World and movies such as Gattaca. If we place no constraints on the availability of this new technology, will the desires of parents to give their children the best opportunities available lead to even greater separation between the rich and poor? What responsibilities do we have to future generations? If we have the capability to eliminate genetic disorders and defects, should we not attempt to do so? Can we clearly and objectively demarcate disorders from non-disorders? It seems quite likely that we will eventually be able to reduce through genetic manipulation the susceptibility of future people not just to physical disorders but also mental disorders such as schizophrenia, addictions, mood disorders and personality disorders. It may eventually be possible for parents through genetic technology to select their children’s psychological traits, such as courage, intelligence, self-confidence, cheerfulness and freedom from neurosis. Of course, parents have always had some control over their children’s traits though the quality of parenting and ability to provide resources for their children: the essential issue is whether there is something especially troubling about this new way for parents to help their children. Similarly, does this new technology pose special risks of social engineering as seen in visions of dystopian futures?

This is a demanding course since it requires a broad range of skills from students. In order to adequately address these issues, we will have to examine the literature both in medical ethics and political theory. In the course of providing a background in ethical thought, it will be useful to distinguish different approaches to morality and political theory, including libertarianism, utilitarianism, communitarianism, the ethic of care that has grown out of feminist theory, and liberalism. Students also need to learn about some of the history of eugenics and the current sociology of biotechnology, medicine and psychiatry in order to be able to realistically address the moral issues that arise in genetics. Finally they will need to be able to reflect on their own personal experience and that of their classmates to get a sense of how to develop their own ethical outlooks on the issues discussed. Through the combination of these skills, students will learn to critically reflect on the complex interrelation of technological and scientific facts, medical and psychiatric practices, and legal, political and moral views. Students will be expected to do a lot of reading and should engage in active class discussion. Students will form small groups in which they will need to decide on how to apportion responsibility for doing research and prepare presentations to the rest of the class. This requires mutual cooperation and problem solving abilities. Students will then get written feedback both from the professor and their peers, and they will afterwards write a report on both the research that they did and on the process by which they accomplished it, in which they assess themselves and the other members of their group. Students will then chose individual projects related to their group projects and write a final research paper.

Course Outline

(i) We will begin the semester by surveying the basic science of genetics and recent advances in genetic technology. We will then look at a variety of real-life cases where difficult decisions have to be made, and through Socratic dialogue I will tease out a variety of different moral/political approaches that can be taken towards these decisions. We will then take a more formal approach to ethical and political theory, studying nihilism, relativism, utilitarianism, right-based approaches, the ethics of care, contextualism, principlism, liberalism, socialism and communitarianism, paying careful attention to how these different theories apply to the cases that we previously studied.

At this stage, students will start to do presentations to the rest of the class. (They will have chosen their topics and formed into groups of two or three people near the start of the semester.) The presentations will be present more detailed information and then give some discussion of the ethical and social issues that arise for the topic at hand. Depending on the number of students in the class and the size of the groups, each student will do one or two presentations.

We will end the semester with some discussion of some issues chosen by the seminar instructor, possibly focusing on issues that have arisen in the news during the semester, and an overall survey of what has been accomplished.

(ii) Students will contribute to the instructional component of the seminar in several ways in the process of preparing, doing, and writing up their presentations, and evaluating other students’ presentations. They will be able to choose what topics they want to do. They will then get into groups of two or three. Within these groups, they will have to decide who does what, and each student will take complete responsibility for his or her part of the presentation. The class presentation, which should be roughly 20 minutes per student, will be followed by discussion; at the end the other seminar members and the instructor will give written feedback to the presentation, including an evaluation how informative, clear, and interesting it was, what further questions they are left with, and how they might have done the presentation differently. Each student will then write up his or her part of the presentation, including a summary of the feedback he or she received, a response to that feedback, and study questions for readers of the write-up. These write-ups will be made available to the rest of the class, probably through being converted into web pages. The information in the write-ups will form the basis for a final exam.

(iii) Students will take two in-class written tests, one early in the seminar based on the initial background information they have been given, and the second late in the seminar, based on the information they have learned through student presentations. Their presentations will be evaluated on the informativeness, clarity and interest of the performance in class, and the informativeness, clarity, and thoroughness of the subsequent write-ups. The final piece of work will be a 10-15 page research paper, based on a topic and building on the research from the presentation(s) that each student did.