Course List & Schedule

In contemporary bioethics, we find ourselves grappling with practically important, and at the same time, philosophically fundamental questions such as: When does someone’s life begin and how should it end? What is the proper role of physicians, nurses and other health care providers and what are the rights of their patients? What is a just and fair way to provide access to health-care services and resources? Which potential uses of new genetic and reproductive technologies would represent a legitimate advance in medicine and which would signify the beginning of a humanly degrading "brave new world"? Indeed, in a society committed to protecting a diversity of lifestyles and opinions, how can citizens resolve significant policy controversies such as whether there should be public funding of human embryonic stem cell research, or a legally protected right to physician assistance in ending one’s life?

The aims of this course are to identify the fundamental ethical questions that underlie contemporary biomedical practice; develop skill in analyzing and clarifying key concepts such as autonomy, justice, health and disease; critically assess the healthcare implications of different ethical outlooks; explore how citizens can reasonably address controversial bioethical issues in a mutually respectful and constructive way.

The course meets once a week online for an hour and a half. Live-session interaction and post-session discussion forums play a key role as students explore, in a give-and-take spirit, the pros and cons of each position.

This course is designed for medical students, nursing students, and other healthcare professionals, as well as for students at the graduate or advanced undergraduate level in biology, philosophy, political science, public health, law, and related fields.

This course introduces students to selected legal and policy texts that have addressed issues in bioethics and shaped their development. Students will explore and contrast legal reasoning and bioethical analysis, often of the same issues. By the end of the course, students will understand the legal or regulatory status of selected issues and have begun to independently navigate major legal, regulatory, and policy texts. Individual sessions will be focused around particular issues or questions that have been addressed by (usually) American courts and/or in legislation, regulation or policy, and that have been the subject of scholarship and debate within bioethics.

The course begins with a theoretical look at the relationship between law and ethics, and includes a brief introduction to legal decision-making and policy development. We then survey a range of bioethics issues that have been addressed by the courts and/or in legislation, regulation, or significant policy documents, contrasting and comparing legal argument and reasoning with arguments utilized in the bioethics literature.

While this course is designed to introduce students to the fundamentals of clinical ethics and the basic terminology and framework of ethical analysis in biomedical ethics, it offers a more sociological perspective, putting the contemporary clinical issues into a broader context. We will look briefly at the development of clinical ethics and its impact on hospital care and doctor-patient relationships, on the prevailing autonomy norm and its critique. The course then focuses on issues encountered in clinical practice such as informed consent, patient capacity, decision-making, end of life, advance directives, medical futility, pediatrics ethics, maternal-fetal conflicts, organ transplantation, cultural competence and diversity of beliefs and others. The course will examine the role of the clinical ethics consultant (CEC) and assignments will mimic the work that CECs may perform in the hospital setting.

Over the span of the semester, students become familiar with the ethical questions surrounding major topics in the clinic with a practical case-based approach toward ethics dilemmas and ethics consultation. During the semester, students in New York attend a meeting of the adult or pediatric ethics committees of New York Presbyterian and Morgan Stanley Children's Hospital or another area hospital, as well as ethics lectures given at the medical center.

Students are expected to complete five case write-ups using a template that will be given by the instructor. Students will be using these cases to refine and hone their ethical analysis skills and to show their knowledge of law, policy and ethical principles and how they might apply to each situation

Increasingly, issues of medical research and clinical care are posing complex ethical issues not only in the United States, but in other countries in both the industrialized and the developing world. Yet varying economic, political, social, cultural, and historical contexts shape these issues. In diverse contexts in Asia, Africa, Europe and North and South America, practices and policies, along with cultures and moral values, differ enormously. Yet ethical issues are arising not in isolation, but as part of global communities and discourses. In research, multinational pharmaceutical companies are increasingly conducting studies in both industrialized countries and the developing world, posing numerous ethical tensions. In clinical care, uses of reproductive technologies differ across national borders, leading to “reproductive tourism”. End of life care varies widely, reflecting in part differing attitudes toward death and dying. This course examines the political, economic, social, cultural, philosophical, medical, and historical roots and implications of these issues.

The course meets once a week online for an hour and a half, and offers extensive live-session interaction and post-session discussion forums to explore the various bioethical issues contemplated throughout the semester.

In recent years, many crucial issues have arisen concerning research ethics. Scientists in biomedicine, social science and other areas, as well as policy makers face rapidly evolving challenges. In recent years, violations of research ethics have attracted attention from the public, the media, the government, and the scientific community, which have all responded in varying ways. Issues arise in deciding how best to protect human subjects, obtain informed consent, protect privacy and confidentiality, finance research without biasing results, and avoid “misbehavior” among scientists. Questions arise concerning the professional responsibilities and rights of scientists, the rights of study participants, and the appropriate role of the state in these matters.

The course meets online once a week for an hour and a half, with extensive interaction between students and the professor both during class and on post-class discussion forums. It can fulfill the requirements for Responsible Conduct of Research that the NIH and other funders currently mandate for training programs that they support.

On a daily basis clinicians and consultants encounter conflicts and often the best way to resolve them is through negotiations and other forms of conflict resolution. Some of these conflicts are simple, often grounded in factual misunderstandings, and are easy to resolve, while others are medically or structurally complex and may require the support of an advisor who is skilled and trained in both bioethics and mediation. In this course we will explore mediation from several points of view and problem-solving approaches. We will work to bring mediation into focus both conceptually, as you expand your knowledge of the field, and practically, as you further develop your skills as bioethics mediators. We will examine the use of mediation in the private sector and how it is similar and different in the field of bioethics.

Artificial Intelligence has become ubiquitous. There are few if any aspects of our (Northern and industrial) daily lives in which AI has not elicited interest, excitement, curiosity, concern, and, perhaps most importantly, debate. Health care and biomedical research are sources of and inspiration for much of that debate. As is often the case with new medical technologies, the efforts of scientists and engineers has outstripped that of those working in law, public policy, and ethics.  Computer scientists, coders, and engineers best understand the development and use of Machine Learning, but often lack training in ethics, law, and public policy. There is an increasingly urgent need for ethicists with an understanding of AI and machine learning to help steer AI use in safe and productive ways. This course aims to help train future ethicists to fulfill that role.

Students will first learn about different types of Artificial Intelligence and Machine Learning software and associated algorithms. Thereafter, key themes and issues will be addressed, with special regard to real-world uses and applications.

The course is primarily designed for bioethics masters students; no formal background in Artificial Intelligence or Machine Learning is assumed. Students should have completed one semester of MS Bioethics Core Courses to gain a foundation in Bioethics prior to enrolling in this elective.

This is an elective course intended for students to take in the latter part of their graduate training; it is not suggested for first-semester students, as we assume a foundation in bioethics principles and frameworks. Students will leave the course better able to evaluate applications of Artificial Intelligence and Machine Learning in health care and society. The course aims to provide students with the knowledge and skills to support careers in policy development and ethics support

 

As human beings, we have a rich history and complex relationships with non-human animals. We consider some animal species companions who live in our homes as part of the family, we regard many animal species as pests, others we admire as examples of natural beauty, and still others we use as food sources.

Ethical issues arise in the use of non-human animals as subjects of biomedical research, potential sources of organs and tissues for human beings and other emerging technologies. We also consider the ethics of the relationship between animal and human health and of non-human animal medical care.

Along with biomedical scientists, lawyers, philosophers, and activists, bioethicists have been significant voices in the evolving ethical analysis and debates surrounding the use of animals in a biomedical context. This course situates the debate on animals as subjects of biomedical research within the broader context of bioethics. Your previous knowledge of the history and philosophy of bioethics, as well as of research ethics and the Institutional Review Board (IRB), will provide a foundation for our coursework.

Prerequisites: Introduction to Philosophical Bioethics and Research Ethics

Infectious disease pandemics have emerged with often devastating morbidity and mortality since the beginning of recorded history. In the current era, COVID-19 has provided a multitude of examples of bioethical questions and challenges, including government preparedness, drug and vaccine development and legal approval, sufficient efficacy of prevention and treatment, resource allocation, and what information people give credibility to and which determine their behaviors. While COVID-19 was unique, many of the bioethical and policy concerns had precedent.

This course will explore examples of how bioethical and policy decision-making can have different effectiveness in the context of modern pandemics, although illustrative and unique aspects of some pre-19th century and multi-era pandemics will be examined. Modules will explore how ethical, policy, legal and social challenges are responded to in the context of different pandemics and how they differ from similar decisions and processes in “peace time”. Bioethics and related policy responses predictably arise before, during and in the aftermath of a pandemic. 

In addition to bioethical concerns, including social justice, pandemic response raises policy, legal and social challenges, including: individual preference versus societal benefit, risk and opinion of individual harms, and changes in local and national laws. Policy response occurs at every level of government and within institutions: international organizations such as the World Health Organization and the World Organization for Animal Health (WHO, WOAH), national governments, state and local governments, health care and other institutions, healthcare providers and others. The impact of misinformation and disinformation on personal and political decision making will also be explored. 

This course discusses important issues at the nexus of bioethics and the environment, including climate change, ozone shield depletion, soil erosion, ocean pollution, diminishing biodiversity-all among the environmental factors with adverse consequences for the health of both human and non-human beings. Even the technologies employed in health-care have environmental impact harmful to health.

Among the challenges to be addressed: How can healthcare be made “green”?  What do present generations “owe” to future generations? What is environmental justice in the relations between developed and developing societies? How should humans relate to the other inhabitants of this planet?

This course is designed for those students who have successfully completed the Clinical Ethics course. This course is intended as a primer to Clinical Ethics Consultation. It is geared toward students who already have clinical experience in the healthcare or legal setting and students planning postgraduate study in a clinical or health policy discipline. Clinical Ethics Consultation (CEC) concerns itself with addressing value-laden questions and ethical dilemmas that arise in patient care, in the hospital in particular. The CEC course provides a case-based, insider’s view of CEC practice, introducing the core knowledge and skills required to perform CEC on an advanced level. The semester will include a mix of lecture/discussion, mock consultation with role-play based skills practice, and case-based exercises around formulating and documenting CECs. Course materials, presentations and exercises will address a range of topics and skills needed to effectively apply bioethics knowledge and clinical consultation skills to common value-based dilemmas that arise in the clinical setting. Examples include but are not limited to: moral dilemmas in advanced illness, end of life care, medical decision-making for the unrepresented patient, conundrums in caring for the incapacitated patient, refusal of treatment, dilemmas in discharge planning, surrogate decision-making, conflicts among parties to a case, value-laden decisions in pediatrics, and more. Additionally, process skills such as mediation, conducting a high-stakes family meeting, and consultation etiquette will be addressed. We will frame the course in the emerging context of the field of Clinical Ethics Consultation, as the practice has proliferated but the credentialing process is just now in development.

The goal of the Clinical Ethics Practicum is to give selected students experience leading or co-leading clinical ethics consults and writing or co-writing chart notes. During the Practicum, students will shadow, work closely with, and be supervised by, a clinical ethicist at various local hospitals.

The Practicum is a very special opportunity to gain the necessary experience to apply for Quality Attestation for Clinical Ethics Consultants; each student should lead/co-lead and author/co-author a total of six (6) consults, the number required for application.

Because the need for clinical ethics consults arises based on when a patient requests a consult, the timing of these consults cannot be predicted. Students should be prepared to make themselves available most of the time, on most of the days, of their involvement with the Practicum. We expect that students should be able to complete their six consults in one to two months.

Application

Interested students should email Patricia Contino with a brief two-paragraph summary of their interest in the Practicum, and a summary of their prior relevant clinical experience or previous work with clients. Because there are limited spaces available for the Clinical Ethics Practicum, we will give priority to students who have already taken Introduction to Clinical Ethics and Clinical Ethics Consultation in the program.

Preference will be given to those students with relevant prior experience. Participants will also need to register as an Administrative Visitor (or the equivalent) at the medical center where they are assigned, which will require them to undergo a physical exam/medical clearance.

This course will explore how medical decisions at the end of life regarding both curative and palliative care are influenced by medical, legal and philosophical principles and social norms. We will explore how the development of clinical practice standards for patients with advanced disease have evolved in response to advances in treatment and societal assertion of consumerist rights of self determination. This work will assist students in the Bioethics Masters Program to develop the consultation skills needed to interact effectively with patients, even under difficult circumstances. We will build on the knowledge base established in the Introduction to Clinical Ethics course (BIETPS5400) to develop the specific insights and skills needed by clinicians and other professionals to support patients and caregivers who confront dilemmas in end of life care management. Students will develop the analytic and communication techniques needed to advise treating clinicians who seek guidance on management of end of life care for patients, and communicating prognosis and treatment options to their patients’ families. The skills developed in this course will be useful to students who will confront ethical dilemmas in their roles as treating clinicians, health care administrators, ethics committee members, compliance officers, and patient advocates. This course will also provide a valuable foundation for students who intend to pursue more advanced training in clinical ethics consultation, in order to prepare for a career as an institutionally based Ethics Consultant.

This course offers students a context from which to examine "disability" and "disability studies" from the perspectives of bioethics. What can we learn when we put these two ever-broadening disciplines into conversation? Throughout the course, we will endeavor to connect academic texts and theories to real-world dilemmas, with a focus on lived experience and the social contexts of disability. Our aims are not only to read, analyze, and communicate in academic styles but also to identify, understand, and communicate the relevance of both bioethics and disability studies as they apply to broader societal structures, including medicine, public health, law, politics, and beyond.

Clinical medicine and research are undergoing rapid changes, due to technological, digital, and genetic advances that allow for unprecedented amounts of data collection and individual monitoring. Likewise, capabilities to store, transfer, and query private health information have also increased. Technologies also allow different mediums for patients to interact with providers and health data, including patient portals, direct texting, health-related apps, and video conferencing. These powerful technologies will certainly result in health benefits on individual and public health/societal levels, but they also raise ethical concerns.

For students in the Master’s of Bioethics program, it is important to keep up with these changes, and identify and analyze the ethical issues raised by new e-health, digital health, and telemedicine technologies. In this course, students will engage with speakers, assigned readings, and writing assignments to formulate recommendations on how our society can productively harness the power of these tools while simultaneously upholding the principles of autonomy, beneficence, non-maleficence, and justice. Specifically, students will evaluate concerns about quality and delivery of care, privacy/confidentiality, control and use of data, and access, and propose best practices for the use of e-health technologies from patient/consumer, clinical care, research, and public health perspectives.

This elective course complements the Core Courses in the M.S. in Bioethics Program by exploring how bioethical issues arise as a result of rapidly changing technological capabilities in e-health, m-health and telemedicine.

This three-credit course will meet for twelve online sessions, 1.5 hours each time, for lecture and discussion, each aiming for in-depth analysis, debate, and discussion of topics at the intersection of e-health and ethics. The class format is a combination of lecture and seminar. Students should come to each session prepared to engage with each other and with the instructor and to offer their questions, comments, insights, and analyses.

This course will provide an introduction to the theory and practice of empirical research in the social and behavioral sciences. The focus will be on learning to frame questions in bioethics that can be answered using empirical research methods and on building familiarity with the array of logics of inquiry, research designs, and data collection and analysis techniques that can be applied to answer these questions. The course will emphasize the practical importance of maintaining epistemological consistency across research question and purpose, logic of inquiry, research design, and data collection and analysis techniques.

The development of a new drug is a long and expensive process, involving thousands of discrete processes and decisions. Most of these processes reflect some level of ethical diligence and may even be governed by local law. There is a range of formal mechanisms in place in the complex drug development industry (e.g., regulatory requirements, Institutional Review Boards, internal bioethics committees, and legislative requirements) to ensure that ethical issues are considered and that best ethical practices are applied throughout the process. And yet, ethical challenges and considerations persist and evolve.

This online 13 week, 3-credit course will examine some of the major components and drivers of the drug development process from an array of perspectives and analyze the ethical issues surrounding these constituent steps, stages, and components. This course is an elective in the Master of Science Bioethics program and is open, space permitting, to cross-registrants from other fields and/or Columbia University programs. The course is designed for anyone with an interest in the ethics of pharmaceutical product development and the research required to enable it. Registrants should have a foundational understanding of clinical research and development to be successful in the program. This course aligns with programmatic goals in that it gives students an opportunity to develop expertise in a specific area of bioethics through an analysis of the pharmaceutical industry while also demonstrating critical thinking skills and the application of ethical frameworks.

The ethics of medicine, biology, and psychology deeply influence our ideas about gender and
sexuality and how we establish what is “normal” about our sexed bodies. Even the most basic
questions about gender identity, for example, or how we distinguish male from female (or that
we distinguish at all), have been shaped by the culture of science and medicine.

In this class, we will examine traditional gender and sex binaries, including how they have been
prescribed and enforced throughout American medical history, up to the present day. For
example, since the 19th century, physicians typically sought to eliminate and redirect same-sex
desire. Not until 1973 was homosexuality decreed, officially, to be “normal,” not a mental
illness. Even today, the medical understanding of sexual desire, gender identity, and the sexed
body are often contested in the clinic, for example, when transgender people seek medical
intervention to live authentically in a gender other than the one assigned at birth. We need only
look at the recent anti-transgender laws spreading across the country to see how bioethics,
gender, and sexuality are intertwined, enmeshed in politics, and clash with physicians’ ethical
mandate to “do no harm.” The class will thus illuminate key bioethical questions, including
tensions concerning individuals’ rights; the benefits and harms of the choices people face; and
the broader social and cultural contexts in which people make decisions related to gender and
sexuality.

This course will present key ethical, legal, and societal issues raised by psychiatric, neurologic and behavioral genetics (PNB) in clinical, research, and non-clinical settings. Genetic information is increasingly available in clinics, research initiatives and a growing number of daily-life contexts, including judicial, recreational, and educational settings. For bioethicists to engage in PNB-related genetic conversations, there is a need to be knowledgeable about the scientific landscape of PNB genetics, and to develop an in-depth understanding of the myriad of bioethical dilemmas that arise, taking into account racial, ethnic and cultural diversity in PNB genetics.

A policy-oriented course, we will interrogate and review the leadership, governance, legal, ethical and systems’ dimensions of the global response to, mitigation of and recovery from, catastrophes. We will cover natural, accidental and deliberate risks, threats and hazards, including nuclear and radiological, chemical and environmental, biological and infectious disease, and extreme weather events. We will spend time on 21st century infectious disease outbreaks such SARS, H1N1, Ebola and Zika and especially on the current pandemic caused by the SARS-COV2 coronavirus. Students will be immersed in the risk assessment metrics collected by the Global Health Security Agenda/World Health Organization Joint External Assessment and the Global Health Security Index (Johns Hopkins University, Nuclear Threat Initiative and the Economist Intelligence Unit).  High end science experts from Columbia University and elsewhere will give guest lectures in each of the technical risk domains.

This course introduces students to how healthcare policy is created and implemented in the United States and abroad, while also raising critical ethical issues surrounding healthcare policy for the US, and other industrialized as well as poorer nations. Through lectures, discussions, and readings from the current literature, we will explore the political processes and concerns which produce our current policy; examine the major issues being debated surrounding the creation and delivery of healthcare, including ethical issues; explore the process by which we induce biomedical progress and development; explore barriers to sound healthcare production and delivery in various countries, and examine the recent reforms wrought through the Affordable Care Act (Obamacare). In addition, we will spend a few units looking, in detail, at the unusual challenges posed in delivering healthcare to the poor and the elderly.

This course is an introduction to the historical roots of the field of bioethics. It will be through an investigation of history that scholars, practitioners, and clinicians can frame the issues facing bioethics today -- thereby ensuring that we are learning. Despite the discipline’s recent origins, physicians have long been concerned about the ethical treatment and interactions with patients. This course will begin in the 19th century and end with contemporary studies, in order to examine and analyze the changing practices of bioethics and human experimentation over the past three centuries. Through reading and research, students will explore how contemporary medical practices and ethical debates have emerged from a set of historical processes. In particular we will pay attention to the social, cultural, political, and medical contexts that helped shape the discipline over time.

This course is for students with an interest in developing the skills to see and hear how the physical, emotional and spiritual aspects combine and impact bioethics interactions; to explore the ways in which elements of pastoral care can be integrated into the field of bioethics in order to inform decision-making concerning issues of illness and end-of-life. Through reading, discussion and practical application this course will investigate how spiritual and existential perspectives can impact the process of health care decisions and how they can inform and animate the bioethical understandings and practices in consultation and other endeavors. The syllabus is designed to provide students with a basic understanding of the practice of pastoral care, the responsibilities of pastoral caregivers, and definitions of spirituality; and an introduction to the influences of spirituality in decision-making around end of life, goals of care, pain, organ donation, family conflict, sharing and withholding of health related information, conflict among the medical team; and provider compassion fatigue.

IRB Internship

The IRB internship program allows students to gain hands-on and administrative experience in an Institutional Review Board setting. The internship is a wonderful foundational opportunity toward pursuing work in the field of human subjects’ protections, and gaining valuable work experience and making important connections. 

Institutional Review Boards (IRBs) at academic research centers, hospitals, and universities across the U.S. remain at the heart of a federal oversight system created nearly forty years ago to safeguard the rights and well-being of research participants. Within this system of “research protections,” institution-based ethics review boards (i.e., IRBs) provide ongoing review and approval of research involving human subjects. The IRB promotes an institution’s application of the core ethical principles related to research and supports compliance with federal, state, and local research regulations. The IRB internship is designed for those students who are interested in the possibility of obtaining a job as an IRB administrator, rather than in seeking further education (e.g., going to law school or medical school) when they complete their master’s in Bioethics degree. 26 

We established this program to provide students with experience as IRB interns that will help them in seeking such jobs. 

Potential topics covered during an IRB internship are IRB metrics (what types of metrics can be used to demonstrate whether IRBs are achieving or falling short of their mission); assessments of possible harm(s); ethical challenges encountered in specific applications including drug abuse research and randomized controlled psychopharmacology studies involving minors; the limits of confidentiality with respect to internet-based research; and crafting of informed-consent documents. 

Students selected for the IRB internship will be assigned to a mentor at one of various affiliated medical centers. Students will be required to complete a ‘scholarly project’ during their internship, the parameters of which will be determined collaboratively in conjunction with the Program Director, IRB mentor, and student. 

Prerequisites: Philosophy of Bioethics and Research Ethics (recommended courses for the internship; can be taken concurrently). Once selected, students should register for a 3-credit Independent Study on SSOL for the semester in which they will complete the internship. 

The instructor may waive the prerequisite requirements on a case-by-case basis. In order to obtain instructor permission, please submit a two-paragraph description of your prior research ethics work to the Program Director. 

Application: Interested students should email Robert Klitzman (rlk2@cumc.columbia.edu) and Sameer H. Ladha (shl2159@columbia.edu) with a two-paragraph summary of prior relevant course and work experience, and interest in the Internship. As limited spaces are available in the Internship program, the program leadership and IRB mentors will make final decisions about acceptance to the program. 

Voices in Bioethics Internship

Students interested in completing an internship with the Voices in Bioethics online journal should contact Dr. Robert Klitzman at rlk2@cumc.columbia.edu or Sameer Ladha at shl2159@columbia.edu.

Other Internships

Related internships can be arranged. Interested students should contact Dr. Robert Klitzman at rlk2@cumc.columbia.edu or Sameer Ladha at shl2159@columbia.edu.

The Internship in Industry course offers students the preparation to excel in the marketplace with hands-on experience within an organization. The ideal internship will provide students an opportunity to gain tangible and practical knowledge in their chosen field by taking on a position that is closely aligned with their coursework and professional interests.

This course is structured around the internship experience. In the first assignment, students will author learning objectives to complete in their internship and review these learning objectives with their site supervisor. Students should also expect that after completing this course they will be able to:

• Discuss the application of program content and theory in a professional context (LO1)
• Define a plan for assessing and building their professional competencies (LO2)
• Describe an organization’s culture and assess their cultural “fit” (LO3)
• Make recommendations for the types of behaviors, structure, and culture they would want to see in a future workplace setting (LO4)

Before registering for this course, students must secure an appropriate graduate-level internship, complete the Internship Application Form and receive approval from the academic program. It is highly recommended that domestic students complete at least 12 points (credits) prior to completing an internship. International students must have completed at least two terms before completing an internship and apply for & receive CPT approval through the ISSO Office unless they completed their undergraduate degree in the U.S. and enrolled in graduate school immediately after obtaining their undergraduate degree.

To receive approval, the internship must:

• Provide an appropriate opportunity for students to apply course concepts
• Fit into the planned future program-related career path of the student
• Provide a minimum of 210 hours over the semester
• Internship dates must coincide with the start and end of the term you are enrolling in the course. You may not complete this course for a previous internship or for an internship you plan to take in the future. The internship and course must be done at the same time. 

Availability

On Campus: Fall and Spring
Online: Summer

News outlets have always been key portals for the dissemination of bioethics news and thought. This course will acquaint students with the various ways in which traditional and novel publications shape national ethical opinion and discourse. Students will also learn the internal approaches to the ethics of medical coverage. The course will also examine the feedback systems that allow journalism to affect the practice of bioethics, medicine and public health policy. Students will learn how to analyze coverage and how to understand the manner which news culture helps shape medical and ethical articles. The course emphasizes the myriad ways in which ethical experts can improve the coverage of health and medicine and how to navigate influential organizations in order to do so.

This course will introduce students to both “classic” and emerging topics that exist at the intersections of Bioethics and broad topics of mental health and illness. We will survey topics within four themes: Stigma, Narrative, & Lived Experience; Medicine & Psychiatry; Policy & Law; and Social Contexts & Justice.

The course takes a theoretical look at historical concepts of mental illness, long-standing psychiatric diagnostic systems and emerging genomics-based diagnosis, and a consideration of treatment modalities including pharmaceuticals and neurotechnology. We will survey historical and legal dimensions of mental health policy, including psychiatric institutions and deinstitutionalization, questions of capacity, and definitions of dangerousness.

In this course, students will examine ethical, social, legal, and philosophical issues related to developments in the neurosciences, sometimes referred to as neuroethics. This field includes both the ethics of neuroscience (e.g, applied topics, such as the responsible conduct of neuroscience research or the acceptable limits of using new technologies) and the neuroscience of ethics (the use of neuroscience to inform theoretical questions, e.g., regarding moral reasoning or justifications for punishment).

Sessions will be organized under three main themes: “In the Clinic,” “In the Courtroom,” and “In Society.” “In the Clinic” will discuss medical applications of neuroscience, such as new varieties of pharmacologic enhancement, the use of brain imaging to diagnose mental illness, and the development of neuromodulatory therapies that directly alter brain function. “In the Courts” will address the legal implications of neuroscience, from concrete applications such as the admissibility of brain imaging in court proceedings to abstract questions regarding criminal responsibility and theories of punishment. “In Society” will review broader applications of neuroscience, including commercial ventures (such as “neuromarketing”), military uses, and the place of neuroscience in society.

This course meets once a week for a lecture and discussion. Course activities include in-class exercises, formal writing assignments, briefer written exchanges, and a final written project.

Like most advances in medical technology the advent of organ transplantation has produced both anticipated and unanticipated benefits and dilemmas. This course will explore the clinical and ethical history of organ donation and transplantation, as well as the ethical challenges we will face as we contemplate ways to expand the availability of transplantable organs. Topics will include: the relevance of death; appropriate criteria for determining death, the importance of respecting the decisions of donors for donation after death, the moral justification for the presumption against donation and the risk of reversing that presumption, the value of financial and non-financial incentives for living donation and donation after death, the ethics of an organ market and directed donation, the moral status of potential donors who are minors or parents, and critical examination of the clinical basis for allocation of organs.

This course will explore the influence of institutional policies on the ethical practices of clinicians, researchers, and healthcare administrators. We will examine the ways in which rules and practices related to operational and financial performance shape the ability of practitioners, advocates for patients/research participants, and the public to advance organizational goals. We will evaluate internal and external sources of institutional direction and values. The exercise of authority by different stakeholders produces a cumulative impact on organizational ethics and compliance. At the end of the course students will have a working knowledge of the various institutional influences that impact the sometimes-conflicting obligations of compliance with financial regulations and clinical performance improvement. 

While the ethical issues faced in pediatric healthcare share many similarities with those confronted in other arenas, pediatric ethics has clearly become a fully differentiated and distinct field. In this course we will: explore the moral and legal status of children and parents in American society and beyond; fully break down and frame the ethical standards and foundations of medical decision-making in pediatrics from the earliest stages to the adolescent; comprehensively discuss the most paradigmatic cases and issues faced by experts in pediatric bioethics; distinguish the ethical standards guiding pediatric research from those guiding clinical care; and begin to develop the skills needed to both analyze pediatric bioethical issues conceptually as well as address them clinically in healthcare ethics consultation.

This course will explore the uses of coercion and persuasion in public health. To prevent and control the spread of disease, public health professionals choose from a continuum of possible approaches ranging from persuasive to coercive. At the former end of the spectrum, public health seeks to induce certain actions or behaviors by cajoling, admonishing, pleading, tempting, and frightening; at the latter end, it compels people to take actions or refrain from taking actions through the use of laws and legal penalties. In the middle lies an ethical and pragmatic gray area of manipulation, psychological and emotional pressure, and threat—what is sometimes known as manipulation or quasi-coercion. Some of the most challenging ethical and practical decisions in public health require confronting the question of what degree of coercion, if any, is warranted given the magnitude and nature of the problem at hand.

The field of bioethics has a complicated history with the concept of race. As in many other fields, bioethics is a context in which the activities, contributions, and experiences of people of color are often overlooked or ignored. Racial disparities affect every moment in the history of medicine, yet the canon harbors many lacunae regarding people of African and aboriginal descent. This course will offer a definition of “ethics” that broaches related (though often overlooked) fields of inquiry relating race and bioethics, such as public health, medical interdependence, research practices, and justice. Although it is focused on the concept(s) of race, this is a course on the methods, participants, ends, and objections, of ethical reflection. Of particular emphasis will be the United States, but the course will also cover some key issues from the Global South: South America, Africa, and parts of Asia. It will use the COVID-19 pandemic as an entré into conversations about medicine, subsuming under bioethics the concepts of sustainability, finance, regulation, and efficacy.

This course is intended to introduce clinicians and academic bioethicists to critical issues at the intersections of religion and bioethics. It will serve to supplement other, related course offerings in bioethics by providing a dedicated treatment of the various bioethical and religious principles developed within select world religions. We will examine how religious frameworks inform notable bioethical cases - both past and present. We will also discuss specific medical interventions, such as those occurring at the beginning of life, during periods of critical illness and suffering, and those occurring at end of life. Additionally, the course will offer both a historical survey of the roles religion has played in the development of bioethics generally, as well as a treatment of how religion is shaping bioethics today and will likely do so in the future. Its goals, though, are practical: aiding clinicians and bioethicists in their attempt to further clarify and discuss medical issues and their relationship to religious values with patients, policy-makers, and colleagues. This elective course will function similarly to a “seminar” class, in which various guest speakers who are experts in the field of religious studies or bioethics will provide their expertise and insights in select modules. In addition to these presentations, there will be class sessions dedicated to class discussion and debate.

This course will examine critical ethical issues posed by developments in assisted reproductive technologies (ART), such as /in vitro /fertilization (IVF); buying and selling human eggs and sperms; hiring "gestational surrogates" (i.e., "renting wombs"). These practices have helped millions of people to have children, but also raise serious moral concerns: e.g., about the scope of procreative autonomy, the status of the human embryo, the limits of legitimate state authority.

This course will explore the extent to which citizens with different points of view can nevertheless address these challenging issues in a mutually respectful way and thereby arrive at clearer and deeper understandings of what is at issue.Wherever possible, we will also strive to uncover significant (but sometimes not immediately apparent) common ground, in the hope of thereby reducing the areas of disagreement.

Drawing upon the rich array of preeminent scientists, physicians, and scholars working at Columbia University, this course takes an inter-faculty approach to explore the scientific underpinnings of some of the major challenges in bioethics. Should we regulate advances that allow for manipulation of genetic outcomes? How do we balance respect for persons, beneficence, non-maleficence, and justice, in light of a changing scientific and medical landscape? Students will be better equipped to understand the scientific foundations underlying some of the most prominent issues in bioethics; become acquainted with research and scholarship in the field; be poised to consider and analyze enduring bioethical issues in a new light; and become familiar with a set of new ethical challenges emanating from some of the science and clinical research explored during the course.

This course will conduct an in-depth examination of specific structural ethical differences in challenging areas of medicine such as the Intensive Care Unit, the Emergency Room, and the Labor Floor. These are areas of medical care where the physical plant, the use of technology, and the pressure of time may change the ethical decision-making framework in particular ways. This course is ideal for all those who work directly with patients and some clinical experience will be helpful.

Prerequisites: Clinical Ethics

This course is designed to afford students significant opportunity to explore fundamental bioethical issues in a philosophically searching way. For example, it is generally thought that health matters. But then what is health? And how does it matter? What is justice in respect to health-care and the other social determinants of health? Do competing theories of justice (e.g., liberal, libertarian, utilitarian) offer incompatible solutions to the question of healthcare justice? Or can a workable “overlapping consensus” at the public policy level nevertheless be achieved? 

Should a healthcare professional be permitted, on grounds of conscience, to refuse to provide a healthcare service to which people are lawfully permitted? Indeed, what should count as “conscience”? In the aftermath of the recent Supreme Court decision concerning abortion, some have argued for a right to conscientiously insist on providing reproductive services that have been legally prohibited. How are we to sort through and resolve this complicated set of issues?

Could a meaningful personal understanding of what it means for someone to have died nevertheless not be suitable as the basis for a legal declaration of death? Why not? Should there be a “conscience clause” option whereby someone can specify in advance the conception of death to be applied in that individual’s own case? Would every possible criterion be available or would certain criteria have to be excluded? Which? Why?

The population in this and many other societies is aging and putting increasingly significant demands on the healthcare delivery system. Should healthcare be rationed according to age? Would it be unfair to young people not to give weight to that factor—lest they lose out on a fair chance to live as long as society’s seniors already have? What is healthcare justice across the generations?

As researchers gain a fuller understanding of the aging process, it may soon be possible to genetically engineer a significant extension (even doubling?) of human life-span. Is this an appropriate objective for healthcare science to be pursuing? Is the point of healthcare to extend human life as far as possible by whatever means? Is aging a kind of “disease” in its own right? Would life so dramatically extended be beneficial or burdensome?

The topics for this course have been selected in view of (i) how fundamental they are to bioethical thinking (e.g., What is health? What is justice? What is death? What is conscience?) and (ii) how they give rise to some of the most significant practical policy decisions a society must make. 

In Ethical leadership decisions regarding drug development, regulation and delivery is a multi-dimensional process with varied stakeholders, each having their own objectives. This course will provide students with a look at how leaders in health care faced with real-life decisions utilized ethics to determine an outcome. 

The course is designed as a one week intensive in-person course, with two guest lecturers per day from industry, government, funding organizations, HCPs and patient organizations to help students gain a greater understanding of all stakeholders involved in health care decision making. 

Through posted and classroom discussion, speakers will address and students will be challenged to consider the following questions:

• Who are the relevant stakeholders?  What are their preferences and do they conflict? If so, how is this conflict best resolved?
• How do we apply a bioethical framework – the principles of beneficence, nonmaleficence, autonomy and justice -- to this problem? 
• When understanding how a new medicine is developed, how are the long and short term risks, large and small, weighed and evaluated against potential benefits?
• Does industry consider justice– such as access and affordability – when deciding what products to develop?
• What would you advise if you were an ethics consultant?
• What do you think about the actions taken to address the issue?
• How are ethical questions handled within organizations?  Are consultants used formally or informally to ensure outside perspectives?

This course is for anyone with an interest in learning from leaders in the field and exploring real-life cases of bioethical decisions that impact all of us.

The master's thesis provides an opportunity for students to expand their understanding of the complexities of the issues involved in a specific topic within bioethics. They work closely with the core faculty member to whom they are assigned, and often with an additional faculty affiliate as well, depending on their interest. They identify and focus on a topic and conduct a rigorous review and analysis of the relevant theoretical and/or empirical literature. Students are encouraged to choose a topic that draws on their specific interests, past experiences, and/or future professional or academic goals.

The Thesis Workshop is designed to help students turn their thoughts into organized, structured writing. It is useful whether you are still choosing between potential topics or already have an outline and abstract completed and are beginning to write. First year and second year students are strongly encouraged to take the course.

Students will learn how to (a) select a suitable thesis topic (b) access the appropriate resources for researching that topic (c) narrow the scope and improve the focus of the topic selected. Students will also be provided—both by the instructor and by one another—with constructive feedback and positive support in their initial effort at (d) formulating an abstract and (e) working out a tentative outline. Finally, students will explore various strategies for (f) making a cogent, all-things-considered case for whichever conclusion(s) might be warranted by their research.

In recent years, many crucial issues have arisen concerning research ethics. Scientists in biomedicine, social science and other areas, as well as policy makers face rapidly evolving challenges. In recent years, violations of research ethics have attracted attention from the public, the media, the government, and the scientific community, which have all responded in varying ways. Issues arise in deciding how best to protect human subjects, obtain informed consent, protect privacy and confidentiality, finance research without biasing results, and avoid “misbehavior” among scientists. Questions arise concerning the professional responsibilities and rights of scientists, the rights of study participants, and the appropriate role of the state in these matters.

The course meets online once a week for an hour and a half, with extensive interaction between students and the professor both during class and on post-class discussion forums. It can fulfill the requirements for Responsible Conduct of Research that the NIH and other funders currently mandate for training programs that they support.

In contemporary bioethics, we find ourselves grappling with practically important, and at the same time, philosophically fundamental questions such as: When does someone’s life begin and how should it end? What is the proper role of physicians, nurses and other health care providers and what are the rights of their patients? What is a just and fair way to provide access to health-care services and resources? Which potential uses of new genetic and reproductive technologies would represent a legitimate advance in medicine and which would signify the beginning of a humanly degrading "brave new world"? Indeed, in a society committed to protecting a diversity of lifestyles and opinions, how can citizens resolve significant policy controversies such as whether there should be public funding of human embryonic stem cell research, or a legally protected right to physician assistance in ending one’s life?

The aims of this course are to identify the fundamental ethical questions that underlie contemporary biomedical practice; develop skill in analyzing and clarifying key concepts such as autonomy, justice, health and disease; critically assess the healthcare implications of different ethical outlooks; explore how citizens can reasonably address controversial bioethical issues in a mutually respectful and constructive way.

The course meets once a week online for an hour and a half. Live-session interaction and post-session discussion forums play a key role as students explore, in a give-and-take spirit, the pros and cons of each position.

This course is designed for medical students, nursing students, and other healthcare professionals, as well as for students at the graduate or advanced undergraduate level in biology, philosophy, political science, public health, law, and related fields.

This course introduces students to selected legal and policy texts that have addressed issues in bioethics and shaped their development. Students will explore and contrast legal reasoning and bioethical analysis, often of the same issues. By the end of the course, students will understand the legal or regulatory status of selected issues and have begun to independently navigate major legal, regulatory, and policy texts. Individual sessions will be focused around particular issues or questions that have been addressed by (usually) American courts and/or in legislation, regulation or policy, and that have been the subject of scholarship and debate within bioethics.

The course begins with a theoretical look at the relationship between law and ethics, and includes a brief introduction to legal decision-making and policy development. We then survey a range of bioethics issues that have been addressed by the courts and/or in legislation, regulation, or significant policy documents, contrasting and comparing legal argument and reasoning with arguments utilized in the bioethics literature.

Increasingly, issues of medical research and clinical care are posing complex ethical issues not only in the United States, but in other countries in both the industrialized and the developing world. Yet varying economic, political, social, cultural, and historical contexts shape these issues. In diverse contexts in Asia, Africa, Europe and North and South America, practices and policies, along with cultures and moral values, differ enormously. Yet ethical issues are arising not in isolation, but as part of global communities and discourses. In research, multinational pharmaceutical companies are increasingly conducting studies in both industrialized countries and the developing world, posing numerous ethical tensions. In clinical care, uses of reproductive technologies differ across national borders, leading to “reproductive tourism”. End of life care varies widely, reflecting in part differing attitudes toward death and dying. This course examines the political, economic, social, cultural, philosophical, medical, and historical roots and implications of these issues.

The course meets once a week online for an hour and a half, and offers extensive live-session interaction and post-session discussion forums to explore the various bioethical issues contemplated throughout the semester.

Clinical medicine and research are undergoing rapid changes, due to technological, digital, and genetic advances that allow for unprecedented amounts of data collection and individual monitoring. Likewise, capabilities to store, transfer, and query private health information have also increased. Technologies also allow different mediums for patients to interact with providers and health data, including patient portals, direct texting, health-related apps, and video conferencing. These powerful technologies will certainly result in health benefits on individual and public health/societal levels, but they also raise ethical concerns.

For students in the Master’s of Bioethics program, it is important to keep up with these changes, and identify and analyze the ethical issues raised by new e-health, digital health, and telemedicine technologies. In this course, students will engage with speakers, assigned readings, and writing assignments to formulate recommendations on how our society can productively harness the power of these tools while simultaneously upholding the principles of autonomy, beneficence, non-maleficence, and justice. Specifically, students will evaluate concerns about quality and delivery of care, privacy/confidentiality, control and use of data, and access, and propose best practices for the use of e-health technologies from patient/consumer, clinical care, research, and public health perspectives.

This elective course complements the Core Courses in the M.S. in Bioethics Program by exploring how bioethical issues arise as a result of rapidly changing technological capabilities in e-health, m-health and telemedicine.

This three-credit course will meet for twelve online sessions, 1.5 hours each time, for lecture and discussion, each aiming for in-depth analysis, debate, and discussion of topics at the intersection of e-health and ethics. The class format is a combination of lecture and seminar. Students should come to each session prepared to engage with each other and with the instructor and to offer their questions, comments, insights, and analyses.

In this course, students will examine ethical, social, legal, and philosophical issues related to developments in the neurosciences, sometimes referred to as neuroethics. This field includes both the ethics of neuroscience (e.g, applied topics, such as the responsible conduct of neuroscience research or the acceptable limits of using new technologies) and the neuroscience of ethics (the use of neuroscience to inform theoretical questions, e.g., regarding moral reasoning or justifications for punishment).

Sessions will be organized under three main themes: “In the Clinic,” “In the Courtroom,” and “In Society.” “In the Clinic” will discuss medical applications of neuroscience, such as new varieties of pharmacologic enhancement, the use of brain imaging to diagnose mental illness, and the development of neuromodulatory therapies that directly alter brain function. “In the Courts” will address the legal implications of neuroscience, from concrete applications such as the admissibility of brain imaging in court proceedings to abstract questions regarding criminal responsibility and theories of punishment. “In Society” will review broader applications of neuroscience, including commercial ventures (such as “neuromarketing”), military uses, and the place of neuroscience in society.

This course meets once a week for a lecture and discussion. Course activities include in-class exercises, formal writing assignments, briefer written exchanges, and a final written project.

While this course is designed to introduce students to the fundamentals of clinical ethics and the basic terminology and framework of ethical analysis in biomedical ethics, it offers a more sociological perspective, putting the contemporary clinical issues into a broader context. We will look briefly at the development of clinical ethics and its impact on hospital care and doctor-patient relationships, on the prevailing autonomy norm and its critique. The course then focuses on issues encountered in clinical practice such as informed consent, patient capacity, decision-making, end of life, advance directives, medical futility, pediatrics ethics, maternal-fetal conflicts, organ transplantation, cultural competence and diversity of beliefs and others. The course will examine the role of the clinical ethics consultant (CEC) and assignments will mimic the work that CECs may perform in the hospital setting.

Over the span of the semester, students become familiar with the ethical questions surrounding major topics in the clinic with a practical case-based approach toward ethics dilemmas and ethics consultation. During the semester, students in New York attend a meeting of the adult or pediatric ethics committees of New York Presbyterian and Morgan Stanley Children's Hospital or another area hospital, as well as ethics lectures given at the medical center.

Students are expected to complete five case write-ups using a template that will be given by the instructor. Students will be using these cases to refine and hone their ethical analysis skills and to show their knowledge of law, policy and ethical principles and how they might apply to each situation

The Thesis Workshop is designed to help students turn their thoughts into organized, structured writing. It is useful whether you are still choosing between potential topics or already have an outline and abstract completed and are beginning to write. First year and second year students are strongly encouraged to take the course.

Students will learn how to (a) select a suitable thesis topic (b) access the appropriate resources for researching that topic (c) narrow the scope and improve the focus of the topic selected. Students will also be provided—both by the instructor and by one another—with constructive feedback and positive support in their initial effort at (d) formulating an abstract and (e) working out a tentative outline. Finally, students will explore various strategies for (f) making a cogent, all-things-considered case for whichever conclusion(s) might be warranted by their research.