PHI4633: Biomedical Ethics

Course Description

PHI4633 Biomedical Ethics applies moral philosophy to the decisions actually made in medicine and the life sciences — about consent, the end of life, resource allocation, research on human subjects, and what may be done to and with the human body.

The statewide inventory records the course at four institutions, including Florida Atlantic University, Florida International University, the University of Central Florida and the University of West Florida. ⚠ Two full descriptions were retrievable and they agree on the structure of the course.

Institution	What the entry says
UWF	"Designed to introduce students to the moral and conceptual foundations of ethics, to various ways of analyzing selected problems in the field, and applications of various theories to the professions." College of Arts, Social Sciences and Humanities, Department of History and Philosophy, 3 sh. ⚠ Meets College-Level Communication Skills Requirement.
FIU	"After examining the foundations of ethics, this course will consider the human and ethical dimensions of current issues in the life sciences, such as the meaning of human living and suffering, ethics of genetic control, death and dying, personal responsibility in the medical and counseling professions."

⚠ Both descriptions have the same two-part shape: foundations first, applications second. That structure is the field's own, and it is not optional — an applied ethics course that skips the theory produces students who can state opinions about euthanasia and cannot defend them.

The foundations half. Consequentialism — the rightness of an act depends on its outcomes; deontology — some acts are required or forbidden regardless of outcome, and persons must be treated as ends rather than merely as means; virtue ethics — what would a person of good character do; the ethics of care, which grew partly out of nursing and is unusually well suited to clinical relationships; and principlism.

⚠⚠ Principlism is the framework the clinical world actually uses, and every student in this course should be able to name its four principles from memory:

• Autonomy — respect for the self-determination of competent persons.
• Beneficence — act for the patient's benefit.
• Non-maleficence — do not inflict harm.
• Justice — distribute benefits and burdens fairly.

⚠ Its usefulness is that it is neutral between the deeper theories, so a committee whose members disagree about ethical foundations can still reason together. ⚠⚠ Its limitation is the more interesting point: the four principles routinely conflict, and principlism supplies no rule for ranking them. Autonomy against beneficence is the standard collision — a competent patient refusing a treatment that would save them — and that is not a defect in the framework so much as an accurate description of why these cases are hard.

The applications half.

• Informed consent and capacity — ⚠ the foundational doctrine, and more subtle than students expect: capacity is decision-specific rather than global, a patient may have capacity to refuse one thing and not another, and the right to refuse treatment does not depend on the reason being one anyone else finds sensible.
• Surrogate decision-making — advance directives, living wills, health care surrogates, and the distinction between substituted judgement (what would this person have wanted) and best interests (what would benefit them).
• End of life — withholding and withdrawing treatment, the doctrine of double effect, palliative sedation, physician-assisted death, and futility disputes.
• Research ethics — ⚠ grounded in the historical cases the field was built on: the Nazi experiments and the Nuremberg Code; the US Public Health Service study at Tuskegee, which ran for forty years and is the reason the American research protection system exists; Willowbrook; and Henrietta Lacks. Then the Belmont Report, institutional review boards, and the ethics of placebo controls and of research in poorer countries.
• Genetics and reproduction — screening, testing, gene editing, embryo selection, assisted reproduction, abortion, and the disability critique of selective technologies.
• Justice and allocation — organ transplantation, triage, access to care, and ⚠ the rationing question, which the field's standard line addresses squarely: every health system rations, and the argument is about the criteria, not about whether.
• Confidentiality and its limits; professional duties; conscientious objection by clinicians.

Learning Outcomes

Required Outcomes

• Explain the major normative theories — consequentialism, deontology, virtue ethics, care ethics — and their strongest objections.
• Explain the four principles of biomedical ethics and apply them to cases.
• ⚠ Explain how the four principles conflict, and reason about which should prevail in a specific case and why.
• Distinguish descriptive, normative and metaethical claims.
• ⚠ Distinguish what is legal from what is ethical, and identify where they diverge.
• Explain informed consent — its elements, its justification, and the conditions that undermine it.
• Explain decision-making capacity, how it is assessed, and why it is decision-specific.
• Explain surrogate decision-making, advance directives, and the substituted judgement and best interests standards.
• Analyse end-of-life cases, including withdrawal of treatment and the distinction between killing and allowing to die.
• Explain the doctrine of double effect and evaluate it.
• Explain the arguments for and against physician-assisted death.
• Explain the historical cases that produced modern research ethics, and what each changed.
• Explain the Belmont Report principles and the function of institutional review boards.
• Analyse ethical issues in genetic testing, screening and gene editing.
• Analyse ethical issues in reproduction and assisted reproductive technology.
• Explain the disability critique of prenatal screening and selective technologies.
• Analyse allocation and rationing problems, including organ transplantation and triage.
• Explain confidentiality, its justification and its recognised limits.
• Explain justice in access to health care and the main positions on it.
• ⚠ Reconstruct an opposing argument accurately enough that its holder would recognise it, before criticising it.
• Analyse a case systematically, identifying stakeholders, values in conflict, options and their justifications.
• Write a sustained argumentative essay defending a position and answering the strongest objection to it.

Optional Outcomes

• Explain neuroethics and issues in brain intervention and enhancement.
• Explain public health ethics — mandates, quarantine, the individual-versus-population tension.
• Explain global health ethics and research in low-resource settings.
• Explain animal research ethics.
• Explain enhancement versus treatment and its boundary problems.
• Explain clinical ethics consultation and how ethics committees work.
• Explain organ procurement policy — presumed consent, donation after cardiac death, markets.
• Explain religious and cultural perspectives on biomedical questions.
• Explain ethics of AI in clinical settings.

Major Topics

Required Topics

• Normative ethical theory.
• Principlism and the four principles.
• Moral reasoning and argument; law versus ethics.
• Informed consent and capacity.
• Truth-telling and confidentiality.
• Surrogate decision-making and advance directives.
• End-of-life decisions.
• Physician-assisted death.
• Research ethics and its historical cases.
• The Belmont Report and IRBs.
• Genetics — testing, screening, editing.
• Reproductive ethics.
• Justice, allocation and access.
• Organ transplantation.
• Professional responsibility and conscientious objection.
• Case analysis method.

Optional Topics

• Neuroethics.
• Public health ethics.
• Global health ethics.
• Animal research.
• Enhancement.
• Clinical ethics consultation.
• Organ procurement policy.
• Religious and cultural perspectives.
• AI in medicine.

Resources & Tools

• Beauchamp and Childress, Principles of Biomedical Ethics — ⚠⚠ the book that created principlism and the single most influential work in the field. If your course uses one primary text, it is probably this one.
• Anthologies: Vaughn, Bioethics: Principles, Issues, and Cases — ⚠ the most widely used undergraduate anthology, with the theory, the arguments on each side, and real cases; Arras, Steinbock and London, Ethical Issues in Modern Medicine; Munson, Intervention and Reflection.
• ⚠⚠ Free and authoritative: the Stanford Encyclopedia of Philosophy — peer-reviewed, written by specialists, free, and better than most textbook chapters; the Internet Encyclopedia of Philosophy; and the Hastings Center, whose Bioethics Briefings are short, current, balanced and free.
• Primary documents you should read rather than read about: ⚠ the Nuremberg Code (one page), the Declaration of Helsinki, and above all the Belmont Report — short, free, and the document that governs human subjects research in the United States. The AMA Code of Medical Ethics and the ANA Code of Ethics for Nurses are free and are what practising clinicians are actually bound by.
• The cases the field is built on: Quinlan, Cruzan and Schiavo for end of life — ⚠⚠ Schiavo is a Florida case, litigated in Pinellas County, and it drew in the Florida legislature, the governor, Congress and the President. It is the most consequential right-to-die case in American history and it happened here; Tuskegee; Henrietta Lacks; Tarasoff for the limits of confidentiality; Canterbury v. Spence for informed consent.
• Readable book-length treatments students actually finish: Rebecca Skloot, The Immortal Life of Henrietta Lacks; Atul Gawande, Being Mortal — ⚠ widely assigned, and the best available account of why medicine handles the end of life badly; Harriet Washington, Medical Apartheid.
• Journals: the Hastings Center Report, the American Journal of Bioethics, the Journal of Medical Ethics, the Kennedy Institute of Ethics Journal.
• ⚠ Florida-specific and worth knowing: Chapter 765, Florida Statutes — health care advance directives, surrogates and proxies; Chapter 766 on medical malpractice and informed consent; Florida's health care surrogate and living will forms, which are free from the Florida Agency for Health Care Administration and from Florida Bar consumer pamphlets. ⚠ Filling one out for yourself is a legitimate and eye-opening course exercise.

Career Pathways

⚠ This course serves two distinct populations and it is worth knowing which you are in: philosophy students taking an applied field, and — usually the majority — pre-health students taking a course they will use.

• Physicians and surgeons (SOC 29-1210s) — ⚠⚠ the MCAT includes a Psychological, Social, and Biological Foundations of Behavior section and medical school interviews probe ethical reasoning directly. Many programmes use multiple mini-interviews built on exactly the case reasoning this course teaches, which makes it unusually good preparation.
• Registered nurses and advanced practice nurses (SOC 29-1141, 29-1171) — ⚠ ethics is a required component of nursing curricula and of the ANA Code.
• Physician assistants (SOC 29-1071), pharmacists (SOC 29-1051), physical and occupational therapists (SOC 29-1123, 29-1122).
• Clinical ethicists and ethics committee members (SOC 19-3099, 21-1099) — ⚠ hospital ethics committees are required by accreditation, and this is normally a graduate-level role.
• Health care administrators (SOC 11-9111) — allocation and policy decisions are ethical decisions made under budget constraints.
• Research compliance and IRB professionals (SOC 13-1041) — ⚠ every research university and hospital system employs these, and the Belmont Report is their working document.
• Health law (SOC 23-1011) — ⚠ a substantial Florida practice area, and this course is strong pre-law preparation for it.
• Public health professionals (SOC 21-1091, 19-1041) — ⚠ CEPH-accredited MPH programmes require ethics content.
• Genetic counsellors (SOC 29-9092) — requires an accredited master's; the ethical content is central to the work.
• Bioethics scholars and academics (SOC 25-1126, 19-3099) — with graduate study.
• Chaplains and palliative care team members (SOC 21-2011, 21-1022).

⚠ Florida employers include AdventHealth, Orlando Health, BayCare, Baptist Health, Tampa General, Moffitt Cancer Center, Mayo Clinic Jacksonville and the academic medical centres — all of which run ethics committees and IRBs.

Special Information

⚠⚠ Gordon Rule — UWF designates this course as writing-intensive

UWF records that this course meets the College-Level Communication Skills Requirement. ⚠ That is UWF's label for the writing half of Florida's Gordon Rule (State Board of Education Rule 6A-10.030):

• ⚠⚠ A Gordon Rule course must normally be completed with a grade of C or higher to count. A C− does not satisfy it at most institutions. Passing is not sufficient.
• ⚠ The designation is institution-specific — FIU's entry for the same number carries no such label, which does not mean less writing is involved.
• The designation normally travels within the Florida public system when the sending institution applied it, but confirm rather than assume.

⚠ Practical consequence: expect substantial argumentative writing, and treat C as the floor. For a pre-health student this is a good place to meet the requirement — the writing is argument about cases, which is more useful practice than most alternatives.

Prerequisites and who takes it

⚠ Neither institution lists a prerequisite, and both descriptions confirm the course builds the ethical theory it needs — "introduce students to the moral and conceptual foundations" at UWF, "after examining the foundations of ethics" at FIU.

• No philosophy background is required. ⚠ An introductory ethics course (PHI2600 or PHI2603 statewide) makes the first third go faster but is not assumed.
• No biology background is required either, though ⚠ students with clinical experience — CNAs, EMTs, scribes, volunteers — bring cases that make the discussion far better, and they generally find the applications half more vivid and the theory half harder.
• ⚠ The 4000-level number reflects placement in a degree, not difficulty of entry. The real demand is writing a sustained argument, which is why the Gordon Rule designation fits.

Course format and workload

3 credits, 45 contact hours — lecture and discussion, three hours per week; discussion-heavy by design, and UWF notes it may not be repeated for credit.

Expect 6–9 hours per week outside class. ⚠ The reading is not long but it is argumentative — a twelve-page philosophy article takes longer than forty pages of narrative, and re-reading is normal rather than a sign of failure.

Assessment normally includes case analyses, argumentative papers (with revision, where the writing designation applies), examinations with essay questions, and participation. ⚠ Some courses run structured debates in which you are assigned a position rather than choosing one — which is the single most effective exercise in the course, and the most uncomfortable.

⚠ Where students struggle

• ⚠⚠ Confusing "what is legal" with "what is right." The most common error in this course. Physician-assisted death is lawful in some states and not others; the ethical arguments do not change at the state line. Law is evidence about a society's settled judgements and it is not the answer to the ethical question.
• ⚠⚠ Asserting a conclusion instead of arguing for it. "I believe life begins at conception" is a position, not an argument. The course grades the reasoning — premises, inference, and a response to the strongest objection. A well-argued paper for a conclusion the instructor disagrees with scores higher than a poorly argued one they share, and good courses say so explicitly.
• Reconstructing the opposing view fairly. ⚠ Harder for the position you already hold than for the one you do not, and it is the skill most transferable out of the course.
• Tolerating unresolved conflict. Students want the framework to produce an answer. ⚠ Sometimes the honest output is that two principles conflict, both readings are defensible, and a decision must still be made — which is the actual condition of clinical ethics, not a failure of the course.
• Slipping into relativism. ⚠ "Everyone has their own ethics" ends the discussion rather than advancing it, and the course tests it as a position rather than accepting it as a ground rule.

⚠⚠ Difficult and personally charged material

This course discusses death, dying, disability, abortion, suffering and the withdrawal of life-sustaining treatment. ⚠ Many students in the room will have made or witnessed one of these decisions in their own family, sometimes recently.

• Contributions are voluntary. ⚠ Personal experience is welcome and never required, and a student who does not wish to speak about their own family is not disengaged.
• Disagreement is expected and is conducted on arguments, not on characterisations of the people holding them. ⚠ The classroom includes people who hold each of the positions being discussed, and a good instructor makes that explicit early.
• ⚠ The disability critique deserves particular care, because it is frequently taught badly. Disabled scholars have argued that prenatal screening for conditions like Down syndrome expresses a judgement about the value of lives like theirs, and the argument is a serious one that reproductive-autonomy defenders must answer rather than dismiss. Disabled students are present in this discussion and it is about them.
• If the material is personally difficult, campus counselling is confidential; Florida 211 connects to local support and the 988 Suicide and Crisis Lifeline is available at any hour.
• ⚠ A practical note that students find grounding rather than upsetting: this course is the natural prompt to complete your own advance directive. Florida's forms are free, the conversation with your family is the point, and the people who most regret not having had it are the ones the Schiavo case is about.

⚠ Florida's own case

The Terri Schiavo case (1990–2005) is the most consequential end-of-life dispute in American history and it happened in Florida. ⚠ Nearly every element of this course appears in it: the persistent vegetative state and what it means; the substituted judgement standard applied without a written directive; conflict between a spouse and parents as surrogates; the distinction between withdrawing treatment and killing; and an extraordinary intervention by the Florida legislature, the governor, Congress and the President.

⚠⚠ The practical lesson the case is normally taught for: the dispute was possible because there was no written advance directive. Florida's statutory scheme in Chapter 765 exists partly in response. If your course covers one case in depth, this is likely to be it — and it is local, documented, and unusually well suited to teaching how law and ethics interact without being identical.

Articulation and transfer

The number PHI4633 is used at the institutions carrying it, so SCNS articulation is clean, and both retrievable titles match.

⚠ The practical question is which requirement it fills. It may serve as a philosophy elective, a humanities general-education course, a pre-health requirement, or an ethics requirement in a health programme — and the answer differs by institution. Check before relying on it, and keep the syllabus. ⚠ The Gordon Rule designation is separately institution-specific.

Prefix note. PHI is philosophy; PHM philosophy of law and society; REL religion; HSC and HSA health science and administration; NUR nursing. ⚠ Biomedical ethics is also taught under HSC, HSA and NUR at institutions that place it inside a health programme — those versions are typically more clinical and less theoretical. Search by subject rather than prefix, and check which version a requirement expects.

⚠ Florida College System institutions widely teach PHI2600/PHI2603 (ethics), which transfer cleanly and are good preparation; this upper-division applied course is normally taken after transfer.

AI Integration

⚠⚠ Medicine is one of the fastest-moving areas of AI deployment, and every application raises a question this course already has a framework for. A current bioethics course should treat it as subject matter, and many now do.

The live issues, mapped onto the four principles:

• Diagnostic and prognostic systems — imaging, pathology, sepsis prediction, deterioration scores. ⚠ Beneficence says use what works; non-maleficence asks about false negatives; and both require knowing the system's error profile in your population rather than the one it was validated on.
• ⚠⚠ Algorithmic bias, which is documented rather than hypothetical. A widely deployed US algorithm used health spending as a proxy for health need and consequently under-identified Black patients for extra care — because less had historically been spent on them. This is a justice failure that arose from a modelling choice that looked technically reasonable, and it is the standard teaching case.
• Informed consent — ⚠ should a patient be told an algorithm contributed to their diagnosis? Can consent be informed if the clinician cannot explain the reasoning? This is a genuinely open question and the course's consent material is exactly the tool for it.
• Responsibility. ⚠ If a clinician overrides a correct system, or follows an incorrect one, who is responsible? Both directions of error are live, and automation bias — the tendency to defer to a machine — is a documented human factor.
• Allocation. Predictive tools already inform triage and organ allocation. ⚠ A model trained on past allocation decisions learns past allocation priorities, including ones the field has since rejected.
• Privacy and secondary use of health data — ⚠ the Henrietta Lacks problem restated in a new form, and the course's research-ethics material transfers to it directly.
• Autonomy and mental health chatbots, and the question of whether a therapeutic relationship can exist without a person in it.

Where AI assistance helps a student in this course: explaining a theory or a concept a second way, mapping the structure of an argument you are reading, and — ⚠ genuinely valuable here — generating the strongest objection to a position you have drafted, which is precisely what the assessment rewards.

⚠⚠ Where it fails, and the failure is unusually well matched to this course's grading:

• ⚠⚠ Trained-in non-commitment. Models are deliberately built to present balanced views on contested moral questions and to avoid taking a position. That is the opposite of the assignment. This course grades a defended thesis with a response to the best counterargument — and a model reliably produces a fluent, balanced, thesis-free essay, which is the standard mediocre bioethics paper.
• Fabricated citations and cases. Invented articles, court decisions and case details. The real cases are documented and free to check.
• Legal error. ⚠ Advance directive law, surrogate hierarchies and assisted-death statutes are state-specific and change. Florida's are in Chapter 765, and model output averages across jurisdictions.
• Flattened positions. The strongest versions of contested arguments get smoothed into their weakest summaries — and the course's core skill is reconstructing the strongest version.

The deeper point, which belongs in this course specifically. ⚠⚠ What this course develops is the capacity to reason under moral uncertainty and to take responsibility for a judgement. That capacity is what a clinician needs at 3 a.m. with a family in front of them, no consensus available, and a decision that cannot wait. It is built by working through hard cases yourself and being wrong in seminar occasionally. A tool that supplies a balanced summary removes exactly the part that builds it — and this is a course whose content some students will be applying to actual patients within a few years.

Academic integrity. Follow the course policy. Submitting generated prose as your own violates every Florida institution's policy — ⚠ and for students heading into health professions, professional programme applications and licensure boards conduct character and fitness review, and academic integrity findings are asked about directly. In a course about professional ethics, the point rather makes itself.