Medicine raises a number of questions that can benefit from philosophical inquiry. We strive to understand what health and health care are (medical epistemology) and what they ought to be (medical ethics). In doing so, we engage with scholars from multiple disciplines in health and medical humanities, with patients, and with other community members to advance ethics in health care.
The Department of Philosophy, Michigan State University, in collaboration with the Center for Bioethics and Social Justice, offers a special doctoral concentration in Philosophy and Ethics of Health Care. Besides the usual course work leading to the doctoral degree, the concentration offers special seminars in health care issues; practicum experiences in clinical and policy-making settings; and special opportunities for teaching and research in health care. This concentration is available both to individuals who choose to write a dissertation in this area as well as individuals writing in other areas.
Admission decisions are made by an admissions committee that considers academic record, letters of recommendation, a statement of purpose, a sample of philosophical writing, and any other materials that document capacity for graduate study in philosophy. Admission is usually for the academic year beginning fall semester. Information about how to apply can be found here: http://www.philosophy.msu.edu/graduate/admissions/
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At least one seminar in a topic related to Philosophy or Ethics of Health Care will be offered each year. Seminars previously taught, and planned to be repeated in coming years, include Medical Epistemology and Philosophy of Medical Science; Justice and Health Policy; and Implications of Medical Ethics for Ethical Theory. A one-semester 4 credit practicum will be divided between a clinical and a policy setting. The clinical practicum will be based on a hospital service or in an outpatient clinic; every effort will be made to match the clinical service to the student’s special interests (neonatal, geriatrics, women’s health, etc.). The policy practicum will take advantage of Michigan State University’s proximity to the state government offices in Lansing to locate students in legislative or regulatory offices dealing with health care issues. Supervising the students will be both on-site preceptors and Philosophy or Center faculty who will offer weekly discussion sessions to explore and analyze the students experiences.
Students in the concentration will ordinarily be expected to complete three of these seminars plus the practicum.
Independent study can also be arranged with faculty associated with the concentration.
Michigan State University’s Department of Philosophy has a large faculty with diverse interests and backgrounds. The curriculum covers the standard areas of western philosophy and offers a wide range of seminars each year. The Department emphasizes teaching, and boasts several faculty who have won University teaching awards. Interdisciplinary interests (besides health care) represented among the faculty include Womens Studies, Cognitive Science, Evolutionary Theory, Philosophy of Science, Agriculture, Cultural Studies, and Sociology. Programs of study are offered at the undergraduate, masters, and doctoral levels.
The Center for Bioethics and Social Justice serves as a teaching, research, and public service unit for the Colleges of Human Medicine, Osteopathic Medicine, Nursing, and Veterinary Medicine, besides its ties to the Colleges of Arts and Letters, Natural Science, Social Science, and Agriculture and Natural Resources. Center faculty team-teach courses with health professionals, and offer medical ethics consultations in local hospitals. The Center serves as the headquarters for the Medical Ethics Resource Network of Michigan, operates the networks ethics computer bulletin board, and publishes the networks bimonthly newsletter. The Center also publishes its Medical Humanities Report three times yearly. (Graduate assistants are involved in all aspects of the Centers operations.)
The Center works closely with the Bioethics, Humanities and Society of the College of Medicine. Besides an undergraduate specialization in Health and Humanities, BHS runs an overseas study program in Ethics and History of Medicine, based in London; concentration students may enroll in this course for doctoral credit.
Michigan State University offers a broad range of academic programs, and with guidance committee approval, students in this concentration may take some of their course work from other departments. Depending upon specific student interests, courses in sociology, anthropology, literature, history, psychology, political science, and economics might be pertinent.
Faculty regularly meet informally with students working in this area to provide insights on what it is like to work in this sub-discipline of philosophy. A joint student/faculty journal club in the area provides the opportunity to read and discuss professional writing outside of the classroom setting. A one-credit version of the practicum is available both Fall and Spring semesters — students need to make their own arrangements with an instructor for this one credit version. Numerous faculty are willing to do independent studies in relevant areas.
Earning the Ph.D. requires completion of a minimum of 24 credits at the 400 level or higher, determined by the student’s guidance committee. This includes PHL 801 Teaching Philosophy, a seminar requirement, and a distribution requirement. Part of the distribution requirement is a Minor Field requirement that may be interdisciplinary. Course work usually must be completed by the end of the fourth semester. A 3.0 minimum grade point average must be maintained, with no more than 6 credits falling below a 3.0. Grades below 3.0 will not count towards the degree. Students must demonstrate competence in at least one foreign language in which there is a substantial philosophical literature. Those for whom English is not the native language may use their own language for this requirement if it possesses a substantial philosophical literature.
Doctoral students must work closely with their guidance committee to formulate their plan of study. This includes an annual evaluation by the full guidance committee made up of four faculty members and a meeting with the guidance committee chair each semester to discuss the annual evaluation, progress toward the degree, and professional development. The guidance committee will administer the comprehensive examination by the end of the sixth semester.
The purpose of the comprehensive examination is twofold. First, it ensures that doctoral students have mastered the necessary background material in philosophy to begin their own specialized dissertation research. Second, it provides doctoral students with close supervision and advice in the early stages of their dissertation project. To accomplish these related purposes, the comprehensive examination is divided into three steps: 1) the guidance committee determines the format and topic of a paper or written examination over the area in which the student has chosen to write the dissertation — the format may be, for example, one or more papers or a take-home exam with multiple questions; 2) if the guidance committee approves the paper or the student passes the written exam, then the student will propose a bibliography and prospectus for the dissertation; 3) if the guidance committee approves the bibliography and prospectus, the guidance committee will meet with the student, offer advice on the dissertation, and in consultation with the student set the timetable for writing the dissertation.
Finally, each student must write a dissertation and defend it orally to the satisfaction of the guidance committee.
The comprehensive examination and all course work must be completed by the end of the eighth semester; all requirements for the degree must be completed within sixteen semesters of the time a student first enrolls as a doctoral candidate. Students should consult the MSU Graduate Programs bulletin for University regulations.
Interest in health care ethics is growing and career opportunities are expanding into areas not previously considered by Ph.D. graduates in philosophy. Academic appointments are available both in philosophy departments and in medical or nursing schools. Governmental agencies, multihospital corporations, and large medical centers are increasingly adding ethics consultants to their staffs. A few health care ethicists have even established private consulting firms. Career and employment counseling can be readily obtained as students progress through the doctoral concentration.
Support is provided primarily in the form of graduate assistantships. In 2002-2003 graduate assistants received at least $11,260 for a half-time assistantship, waiver of nine credit hours of tuition each term, health insurance coverage, and waiver of out-of-state tuition rates (where applicable). The Department of Philosophy sets aside several graduate assistantships each year for entering students; in addition, students enrolling in the concentration will receive preferential access to quarter-time graduate assistantships funded through the Center for Bioethics and Social Justice. College fellowships and Affirmative Action Assistantships are also available.
The Center and the Department are working to create a special fellowship program for minority graduate students in health care ethics. Funding from a foundation is currently being sought for such a program. In the meantime, some Affirmative Action funds set aside within the University may be applied toward the support of qualified minority students. We especially invite inquiries from minority students interested in this field of graduate study. Michigan State University has a number of internal programs to provide support and counseling for minority students.
Leonard Fleck, Professor, Ph.D., St. Louis University (Medical Ethics, Health Policy), has published on a broad range of topics in health care ethics, especially issues related to health care justice, health care rationing, and health care policy. More recently he has published a number of articles on ethical issues related to emerging genetic technologies, this in connection with his role as co-principal investigator for two three-year NIH ELSI grants. These grants explored the role of community dialogue (rational democratic deliberation)in addressing controversial issues of ethics and policy related to genetics and reproductive decision making. He is currently completing a book for Oxford University Press under the title “Just Caring: The Moral and Practical Challenges of Health Reform and Health Care Rationing.” This book explores the role of rational democratic deliberation in addressing problems of health care justice. Professor Fleck is a past president of the Medical Ethics Resource Network of Michigan [MERN], and served for three years as chair of the Philosophy and Medicine Committee of the American Philosophical Association.
Fred Gifford, Professor, Ph.D., Pittsburgh (Philosophy of Science, especially biology and medicine, and Ethics, especially medical ethics), has published articles on philosophy of biology, causation, and medical ethics. He is currently serving as a member of the University’s review board on research on human subjects.
Hilde Lindemann, Associate Professor, Ph.D., Fordham University, (Practical Ethics (esp. bioethics), Feminist Philosophy, Moral Philosophy), is the author of Damaged Identities, Narrative Repair, and with James Lindemann Nelson has coauthored both Alzheimer’s: Answers to Hard Questions for Families and The Patient in the Family. She has also edited two collections: Feminism and Families and Stories and Their Limits: Narrative Approaches to Bioethics. Her ongoing research interests are in feminist bioethics, the ethics of families, and narrative approaches to ethics. She is coeditor of a Rowman and Littlefield series, Feminist Constructions, and a Routledge series, Reflective Bioethics.
Jamie Nelson, Professor, Ph.D., State University of New York at Buffalo, (Ethical Theory, Practical Ethics (esp. bioethics)), works primarily in bioethics, but is interested in a number of areas — particularly moral theory (concentrating currently on the realism/antirealism controversy) and the more speculative reaches of the philosophy of language. He attempts to bring to bioethical questions resources from areas of philosophy that the current discussion tends to overlook. This has been rewarding in thinking through questions in reproductive ethics, pondering the just allocation of medical resources, and considering moral issues involved in caring for demented people. He is also interested in philosophical issues that arise from thinking about intimate relationships — particularly families and family-like contexts.
Tom Tomlinson, Professor, Ph.D., Michigan State (Ethics, Medical Ethics) has published widely in the medical and medical ethics literature, and has special interests in resuscitation decisions, competency determinations, empirical studies bearing on ethical issues, and the use of computers in ethics teaching.
Applications for the Ph.D. program can be obtained from the Philosophy Department at the below address.