Loyola University Chicago

Department of Philosophy

Phil 473: Social Health Care Ethics

PHIL 473: Social Health Care Ethics

The Generic Catalog Description

This covers issues such as allocation of funds, hospital management, and ethical review boards.

PHIL 473: Social Health Care Ethics

David Ozar

Health care ethics focused for many years on ethical reflection chiefly in the clinical setting and viewed almost exclusively as the work of individual decision-makers dealing with other individual decision-makers. The extent to which social structures and socially accepted patterns of perceiving, conceiving, reasoning, and evaluating conduct frame and shape the alternatives of such individual decision-makers, not to mention their moral reflections at many levels, received little attention.  But social structures and socially accepted patterns of thought, judgment, and action are themselves deserving of moral examination and judgment, both in principle, and because they are potentially changeable, improvable.  In the last decade, national policy on the allocation of finite health care resources has begun to receive attention from professional ethicists and other scholars, as have some issues of policy regarding biotechnology and research. But there are other, and more fundamental social issues in a health care system that deserve careful ethical reflection, and a method for such social ethical analysis is needed in order to do it well. 

The first step in such a method is learning how to see these social patterns and structures at work. This is not an easy task for many people, because we are so acquainted with them that we don't see them readily.  So increased awareness of some key social structures/concepts/norms in one of the outcomes aimed for in this course.  Another skill is “imagining otherwise” (to borrow a phrase), that is imagining what aspects of these social structures could be realistically changed in order to produce different impacts on individuals and social groups.  That is, sound moral reflection on such accepted items of our lives requires a special kind of imagination (both practical and conceptual) in order to conceive of alternatives to what we identify in practice, and to sort through these from the point of view of strategic possibility.  Enhanced development of that kind of imagination is another intended outcome of this course.  Then, thirdly, once alternatives are available for moral examination, important conceptual tools and the skills of moral reasoning come into play to assist the evaluation of these alternative structures/concepts/ norms in order to come to carefully reasoned judgments, as best we can, regarding them.  The goal, the fourth step, are carefully reasoned judgments about whether any of the imagined alternatives is ethically better than what exists.  I call this four-step method (not very creatively) “social ethical analysis.”  Learning to do this in three areas of the social life of health care in our society is the work of the course; mastering the method so you can apply it to any social health care ethics issue is the outcome of the course. 

(There is a fifth set of skills that pertains to the strategies needed to change accepted social structures/concepts/norms in favor of better ones; learning these skills is not among the aims of this course. Though I wish I could offer them to you in some convenient form, learning them well is not something done conveniently and, for the most part, not done in a classroom; and in any case, I lack both skill and experience in this area myself and can offer at most "lay" advice.) 

The three areas to be studied are: the social construction of the concepts of health, disease, etc., that arguably guide health care practice in our society; the nature of professions and their ethics, especially in the health professions in our society; and the allocation of health care resources.

As in all academic and professional work, failure to properly attribute quotations and close paraphrases of the work of others – i.e. presenting others’ work as if it was one’s own – is a serious ethical failing.  This includes material found on the web as well as print material. The same is true of material written by a student, but submitted for another course.  All students have a special responsibility, therefore, to closely monitor their research and keep track of sources so that materials authored by others (or by the student for another course) do not find their way unattributed into work presented as the student’s own work for this course.  Those who are judged to have failed in this responsibility run the risk of receiving a grade of “F” for the assignment and a grade no higher than “C” for the course, and possibly more serious disciplinary actions if appropriate.