4. IDEAS FOR ASSESSING ESSAYS

Given what we have said about the importance of developing individual, detailed and well reasoned arguments, the best way to assess a student’s philosophical skills is to give them an opportunity to display them in an essay. There is quite a lot of guidance on writing essays, easily accessible to the interested reader, so rather than replicate this material in this section I want to offer a subtle twist to the traditional long essay (by long I mean about 3,000 words plus).

Below is an assessment scheme I developed for students new to ethics who were unaccustomed to writing long pieces of work and could benefit from a gradual introduction to philosophical essay writing skills. The assignment below forms the first part of a Masters degree the Ethics of Cancer and Palliative Care at the University of Keele (the students also had to submit two long essays later on in the year).

Essay tasks

Each ethics essay is different and individual as it reflects the author’s original and critical thoughts. Having said that, we can make some general points about the form of essays, the kinds of tasks you may have to undertake when writing your ethics essay and the kinds of elements which make up a good essay. Your essay will have an introduction, a middle part and a conclusion. In general, the introduction will tell the reader what you are aiming to do in this piece of work, the conclusion will summarize all you have achieved and the middle bit will get all the work done. The work the middle bit has to do is lay out the arguments for the position you are developing. Although each essay will be different there are some general tasks you will undertake for most of the work you will do. These tasks can include (this list is not exhaustive):

1. Critically analysing a concept. Some concepts we use in ethics are difficult to understand and used by different people in different ways (e.g. think of the concept ‘dignity’, many of us would agree that ‘dying with dignity’ is an important aim of palliative care, but explaining what we mean by ‘dignity’ and what it requires in specific situations can be quite a contentious and difficult issue). Part of your task is to question what we mean by these concepts, which in turn informs how we use them and how they affect the arguments we construct to convince others of the validity of our position.

2. Dealing with case studies and examples. As this is a course in applied ethics many of the theoretical ideas we consider will be applied and discussed in the context of particular cases. Case studies are a very good tool for generating discussion in a seminar setting, but can also raise their own challenges when you seek to incorporate particular examples in your own essay. It is important to use the right case study to make your point, and in order to do this you have to correctly identify what the case is about and what you want to say in response to the issues it raises.

3. Comparing and evaluating views in the literature. There is a standing joke amongst philosophers that there is no view so silly that a philosopher hasn’t at some time tried to argue for it! Joking aside, you will find that the suggested readings in your handbook and handouts will represent a large variety of different views. Your task will often be to distinguish which authors are discussing the same topic (this can be more difficult than it sounds), exactly what each author’s position is, then use this to identify any points they agree on with each other and exactly what it is they disagree about, and finally, and most importantly, evaluate their views so that you can construct a convincing argument about who is right. Sometimes you will come across two authors representing two different views, but also look out for one author presenting two or more views. This may be as part of a tactic: e.g. an author may present and reject all alternative views before presenting his own (Peter Singer does this a lot for example), or an author may stage a debate between his view and an imaginary opponent.

For this assignment we will concentrate on these essay tasks, these general study skills which, once gained, can be applied to any ethics essay topic. The aim is to break down (some of) the components of a good essay and focus on them one at a time. You can then take the skills you have gained from this assessment and apply them to other essay assignments.

Word Count for these assignments is

Section A; No MORE than 520, no LESS than 480

Section B: No MORE than 750, no LESS than 650

Section A: No MORE than 1,100, no LESS than 900

For this assignment only the word count refers to the text only, not the references

General Guidance: Complete each task in turn in the order presented, i.e. fist Section A, then Section B and lastly Section C. Since you have three separate tasks think about the time available and how you will use it. Give yourself a deadline for finishing the first task and make sure you stick to it, in order to make sure you have enough time to complete the last task without hurrying. Use your supervisor! For this assignment your supervisor will look at and comment on a draft of the task in Section A (for the essay assignments your supervisor will look at an essay plan/outline of no more than 500 words). Please also note that a large number of readings are suggested for each topic to make sure you have adequate resources. You are NOT expected to read all of them, rather they are available to help you as and when you need them.

Complete THREE tasks, one from each section A, B and C:

Section A: Concepts

Write no more than 520 and no less than 480 words on: What is ‘Palliative Care’?

Guidance: At first this may seem like a very easy question and one that is not very relevant to ethics, but think about it for a moment. Consider some of the answers to this question in the literature and in professional guidelines and you will see that there are competing definitions. If there are competing definitions, already there is contention about what the concept means, so your task is to resolve this. Can you resolve or account for these differences about what the concept means? Can you propose how we should use the concept (i.e. rather than describe the many different definitions, which you don’t have enough word count to do anyway, evaluate the competing definitions and suggest the best one). Once you start evaluating the definitions, i.e. developing a well-thought out and defended argument as to which one is best, do you begin to see the relevance to ethics? Is it possible that the definition of palliative care is intricately linked to arguments about the proper aims and scope of palliative care? If the discussion now is about the proper aims of palliative care, i.e. what the aims of palliative care should be, isn’t this an ethical discussion? In which case you need to develop an argument about what the aims of palliative care should be.

Now the topic is beginning to look quite large and complex which is good as you have something to talk about. However, you only have 500 words to do it in. So you need to be discriminating about what you include in your discussion. Try to avoid long descriptions of other people’s definitions, e.g. no need to quote three different definitions, instead summarize them in your own working notes and present only the points you are interested in (e.g. perhaps only the differences or only the similarities) in the final version of your work. Be concise and avoid lengthy pre-ambles, you have a very limited word count so go straight to the point.

Suggested Readings

Use the internet to track down palliative care definitions by organisations such as the World Health Organisation, the National Council for Hospices and Specialist Palliative Care Services, etc.

Addington-Hall J.M. (1998) Reaching Out: Specialist Palliative Care for Adults with Non-malignant Diseases London: NSHSPCS and Scottish Partnership Agency for Palliative and Cancer Care.

Ahmedzai S.H., et al, “A New International Framework for Palliative Care”, European Journal of Cancer, 2004, 40 (15): 2192-2200

Billings J.A., “What is Palliative Care?”, Journal of Palliative Medicine, 1998, 1 (1): 73-81

Billings J.A., “Definitions and models of palliative care”, IN Berger A.M. et al, Principles and Practice of Palliative Care and Supportive Oncology, Lippincott, Williams and Wilkins, 2006

Chochinov H.M., “Dignity-Conserving Care – A New Model for Palliative Care”, JAMA, 2002, 287: 2253-2260

Davis M.P. et al, “End of Life Care: the Death of Palliative Medicine?”, Journal of Palliative Medicine, 2002, 5  (6): 813-814

Doyle D. et al (eds) (2005) The Oxford Textbook of Palliative Medicine Oxford: OUP

Field D and Addington-Hall J. (1999), “Expanding specialist palliative care to all?”, Social Science and Medicine, 48 (9): 1271-1280

ten Have H. and Janssens R. (eds) (2001), Palliative Care in Europe, IOS Press

Higginson I., “Palliative Care: a Review of Past Changes and Future Trends”, Journal of Public Health, 1993, 15 (1): 3-8

Randall F. and Downie R.S. (2006) The Philosophy of Palliative Care Oxford: OUP

Most palliative care textbooks and handbooks will also include discussions of the definition of palliative care.

Section B: Examples in Ethics

Choose ONE, EITHER:

Write no more than 750 and no less than 650 words on: What is Bernard Williams trying to show with the Jim and the Indians example and do you agree with him?

Guidance: Bernard Williams first introduced the example of ‘Jim and the Indians’ in his half of J.J.C. Smart and B. Williams Utilitarianism: For and Against, a book which sets out a defence of Utilitarianism by Smart and a critique of Utilitarianism by Williams. Williams uses the example to make a very specific point against Utilitarianism, can you identify what it is? To identify Williams’ criticism you will need to be clear about his target, i.e. how does Williams understand Utilitarianism, so that this example shows a problem with this understanding of the theory? Finally, do you agree with Williams? Whether you do or not, try to justify your case, so for example, if you agree with Williams can you further strengthen his case? One way of doing this is imagining a possible response by the Utilitarian and showing why even this more sophisticated version of the theory is still vulnerable to a Williams type argument you have developed. If you disagree with Williams, can you mount a defence on behalf of Utilitarianism, can the theory be modified to address Williams’ problem, or is Williams wrong in thinking this is a problem at all, or a problem for this theory (notice how these are all different strategies, you should adopt the one that works best for what you want to say). Remember the constraints of your word count: given the limited task of this assignment you won’t be able to address all the points you want, so choose a few (or just one or two) and develop them in great detail, rather than mentioning many but very superficially; also remember to use your words wisely, don’t spend 300 words defining every kind of Utilitarian theory out there, pick the one you need to make your argument, summarize the descriptive bit and spend more time on the critical, original part of your discussion (see also notes below on not spending time relating the example as such).

Suggested Readings

Williams’ position is set out in Smart J.J.C. and Williams B. (1973), Utilitarianism: For and Against, Cambridge: Cambridge University Press. Williams expands on these ideas further in:

Williams B., “Utilitarianism and Moral Self-Indulgence” in his Moral Luck, 1981, Cambridge: CUP

Williams B. (1985), Ethics and the Limits of Philosophy London: Fontana, Chs 5 & 6

You may want to start with some general introductions to consequentialism, which can be found in any textbook on moral theory (don’t forget your handout from the relevant session as well), e.g.:

Benn P. (2003), Ethics England: Routledge, Ch.3

Singer P. (ed) (1993), A Companion to Ethics, Oxford: Blackwell, Ch 19 “Consequentialism” by Pettit P.

or the Stanford Encyclopaedia of Philosophy entry on Consequentialism by Sinnott-Armstrong W., http://plato.stanford.edu/entries/consequentialism/

Williams’ example is often referred to as the “Jim and the Indians” example or the “integrity objetion”, for more specific readings see:

Ashford E., “Utilitarianism, Integrity and Partiality”, Journal of Philosophy, 2000, 97 (8): 421-439

Conly S., “Utilitarianism and Integrity”, Monist, 1983, 66: 298-311

Harris J., “Williams on Negative Responsibility and Integrity”, Philosophical Quarterly, 1974, 24: 265-273

Lenman J., “Utilitarianism and Obviousness”, Utilitas, 2004, 16 (3): 322-325

Wenz P.S., “The Incompatibility of Act-Utilitarianism with Moral Integrity”, Southern Journal of Philosophy, 1979, 17: 547-553

OR

Write no more than 750 and no less than 650 words on: What point are Beauchamp and Childress (B&C) trying to make with the ‘physician and the emergency case’ example and do you agree with them?

This example occurs in the first chapter of their classic work Principles of Biomedical Ethics, but oddly enough many readers are unfamiliar with the theoretical claims that underpin Beauchamp and Childress’ later application of the four principles. B&C have a very specific conception of principles in mind, can you identify what it is? What other kinds of principles do philosophers distinguish? How do they differ from each other? Which understanding of principles are B&C defending with this example and how does the example constitute a defence of this kind of principle, i.e. what argument is the example supporting? Are you convinced by this argument? Whether you are or not, can you support your position further, by developing arguments to show why B&C’s position is or is not convincing? Again make sure you don’t spend too long on descriptions, e.g. there is no need to relate the whole of the example in detail (e.g. “B&C present a physician who finds herself in an emergency situation...”), it is fair to assume the reader has read the example. Instead explain what point B&C are trying to make by using this example (this can be contentious as it is a matter of interpretation, so although the reader and you have read the same example, you may have different views on what it is that it is trying to show and will need to illustrate what you think and why).

Suggested Readings

Again most introductory textbooks on moral theories will have something to say about intuitionism and prima facie duties, for example:

Dancy J., “An ethic of prima facie duties” in Singer P., A Companion to Ethics, 1993, Oxford: Blackwell

Dancy J., “Intuitionism” in Singer P., A Companion to Ethics, 1993, Oxford: Blackwell

McNaughton D., “Intuitionism” in LaFollette H., The Blackwell Guide to Ethical Theory, 200, Oxford: Blackwell

On intuitionism/prima facie duties and medicine:

Beauchamp T.L. and DeGrazia D., “Principles and Principlism” in in Khushf G. (ed) Handbook of Bioethics , Kluwer Publications: Philosophy and Medicine, vol.78

Childress J.F., “The Normative Principles of Medical Ethics”  in Veatch R.M., Medical Ethics, 1997, Jones & Bartlett Publishers

Childress J.F. (1997), Practical Reasoning in Bioethics, Indiana University Press, esp. Ch2

Quante M. and Vieth A., “Defending Principlism Well Understood”, The Journal of Medicine and Philosophy, 2002, 27 (6): 621-649 (you may find this article quite demanding).

Thornton T., “Judgement and the Role of the Metaphysics of Values in Medical Ethics” Journal of Medical Ethicsm 2006, 32:365-370

A general collection on intuitionism (you may find this collection quite demanding):

Stratton-Lake P. (ed) (2002), Ethical Intuitionism, Oxford: OUP

Section C: Comparing Views

Choose ONE, EITHER:

Write no more than 1,100 and no less than 900 words on: Do you agree with Mayo (Mayo B., “Virtue or Duty?” in Sommers C. and Sommers F., Vice and Virtue in Everyday Life, Orlando: Hartpury College Publishers, 2001) that we should rely on virtues rather than principles or rules for moral guidance?

Guidance: The first thing to note here is that the terms ‘virtue’, ‘principle’ or ‘rule’ are used in a technical sense, i.e. in a sense determined by the philosophers who use them. Thus, the choice Mayo presents us with is either a moral theory based on principles (or rules) or a moral theory based on virtue. Consider how he understands these two options carefully and you will see that you cannot opt for a theory that relies both on principles and on virtues; the two conceptions are incompatible. So, you have to choose one approach or the other, which one will you choose and why? To decide you need to identify the two positions (what is a principle-based theory, what is a virtue-based theory), what are their claims about the merits of each position, how do you evaluate these merits, what problems are raised by relying on one of the positions (i.e. how does the opposite camp criticise the position you have chosen to defend), can you respond to these criticisms?

Suggested Readings

Any general textbook on moral theories will have a chapter on virtue ethics, e.g.

Benn P., (2003), Ethics England: Routledge, Ch. 7

Oakley J., “ A virtue ethics approach” in Kuhse H. and Singer P. (eds), A Companion to Bioethics, 1998, Oxford: Blackwell

Singer P. (ed) (1993), A Companion to Ethics, Oxford: Blackwell, Ch 21”Virtue Theory” by Pence G.

the Stanford Encyclopaedia of Philosophy entry on Virtue Ethics by Hursthouse R. http://plato.stanford.edu/entries/ethics-virtue/

or the Internet Encyclopaedia of Philosophy entry on Virtue Ethics by Athanassoulis N., http://www.iep.utm.edu/v/virtue.htm

Specifically on rules (or principles) versus virtues see:

Childress J.F., “A principle-based approach” in Kuhse H. and Singer P. (eds), A Companion to Bioethics, 1998, Oxford: Blackwell

Gardiner P., “A virtue ethics approach to moral dilemmas in medicine”JME, 2003, 29: 297-302

Nussbaum M.,  (1990) Love’s Knowledge, Oxford: OUP, Ch 2, Sec II: Priority of the Particular

Roberts R.C., “Virtues and Rules”, Philosophy and Phenomenological Research, 1991, 51 (2) (you may find this article quite demanding).

Solomon W.D., (1978) “Rules and Principles” in Reich W.T. (ed), Encyclopedia of Bioethics, vol.1, New York: Free Press, 407-13

Sherman N., “Character Development and Aristotelian Virtue” in Carr D. and Steutel J.W., Virtue Ethics and Moral Education, 1999, Routledge

Thomasma D., “Virtue Theory in Philosophy of Medicine” in Khushf G. (ed) Handbook of Bioethics , Kluwer Publications: Philosophy and Medicine, vol.78

Toon P., “Setting Boundaries: a virtue approach to the clinician-patient relationship in general practice” in Bowman D. and Spicer J., Primary Care Ethics, 2007, Radcliffe Publishing

Toumlin S., (1981), “The Tyranny of Principles”, Hastings Centre Report, 11 (6): 31-9

Wallace R.J., “Virtue, Reason and Principle”, Canadian Journal of Philosophy, 1991, 21 (4) (you may find this article quite demanding).

OR

Write no more than 1,100 and no less than 900 words on: Is morality relative?

Guidance: The Washburn chapter “Is morality relative?” (Washburn P., Philosophical Dilemmas, New York: Oxford University Press, 1997) sets out everything you need to see two different points of view on this question; that of the relativist (yes, morality is relative) and that of the absolutist (no, morality is not relative). It sets out a short introduction to the topic (written a little bit from an American perspective, but see past that), a defence of relativism in the first person, a defence of absolutism in the first person (including critical questions for both positions) and a discussion which focuses on the exact point of disagreement between the two. This is a really good summary of the debate as it clearly explains what the disagreement is about and provides you with all the tools to make up your own mind. You can’t ‘sit on the fence’ on this one; these two positions are mutually incompatible, if you are a relativist you can’t be an absolutist, if you are an absolutist you can’t be a relativist: so which one are you going to be, and how are you going to convince the reader your position is right?

Suggested Readings

Again most textbooks on moral philosophy will have a chapter on relativism, e.g.:

Benn P., (2003), Ethics England: Routledge, Ch. 1

Blackburn S., “Relativism” in LaFollette H., The Blackwell Guide to Ethical Theory, 200, Oxford: Blackwell (you may find this article quite demanding)

Kuhse H. and Singer P. (eds), A Companion to Bioethics, 1998, Oxford: Blackwell, Ch.3: Bioethics and Cultural Diversity, by Gbadegesin S.

Singer P. (ed) (1993), A Companion to Ethics, Oxford: Blackwell, Ch 39: Relativism by Wong D.

Below are some readings that deal specifically with relativism in a medical context:

Kopelman L.M., “Medicine’s challenge to relativism: the case of female genital mutilation”, Philosophy of Medicine and Bioethics, 1997, 50: 221-237

Macklin R., “Ethical Relativism in a Multicultural Society”, Kennedy Institute of Ethics Journal, 1998, 8 (1): 1-22

Marshall P. et al, “Intercultural Reasoning: the challenge for international bioethics”, Cambridge Quarterly of Healthcare Ethics, 1994, 3 (3): 321-8

Pellegrino E.D., “Some things ought never to be done: moral absolutes in clinical ethics”, Theoretical Medical Bioethics, 2005, 26 (6): 469-86

Turner L., “Medical ethics in a multicultural society” Journal of the Royal Society of Medicine., 2001, 94: 592-594

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