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31 Cards in this Set
- Front
- Back
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informed consent
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“To respect a patient’s autonomy, it is not sufficient that the patient be given the opportunity to consent to, or to withhold consent from, medical treatment.
The patient must be given sufficient information to make a meaningful choice”. |
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The barriers that Terrence Ackerman (“Why Doctors Should Intervene”) thinks stand in
the way of patient autonomy and what doctors should do about them. |
Denial
Depression Fear Social Constraints |
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What implications the views of Dworkin, on the one hand, and of Dresser and Robertson
on the other, would have for a dementia patient who had signed an advance directive when competent to decline life-saving medical treatment if demented. |
Dresser and Robertson believe you only look at the patients current interest and who they are at that exact moment. Dworkin on the other hand asks that we take the entirety of the patients life into account, and respect their wishes regarding their decisions for their own futures.
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Under what circumstances, according to Carl Cohen, is a person coerced by an attractive
offer |
Coercive offers flow from the deliberate effort on the part of the offerer of the choice to pressure the offeree into a particular decision. And it must be such that the offer could have refrained from offering but did not refrain. (Prisoners)
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Don Marquis’s “future like ours” argument against abortion (in “Why Abortion is
Immoral”) |
By aborting a fetus, it is denying their right to a future like ours-- in which they are able to create memories, experiences and goals.
They become a victim due to the inability to fulfill their lives like we have been able to-- the future is the true value of life |
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The bodily autonomy (or bodily integrity) argument for the permissibility of abortion,
best known from the work of J.J. Thomson, and discussed by Joel Feinberg in “Abortion” |
-”Abortion can be justified on the basis of bodily autonomy only to save the mother from extreme harm or else to save the mother from a lesser harm where she has no moral responsibility for the pregnancy.”
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The Disability-Rights perspective on the socially created nature of disability and how this differs from the view that disabilities are medical problems
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1) discriminatory against people with disabilities, similar to selective abortion based on sex. It is something created by culture we live in, if our culture was different, “normal” people could be the ones considered disabled; socially constructed
2)disabilities should not be seen as medical problems, rather as differences in the basic human variation. Society has turned being different into a handicap |
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Bonnie Steinbock’s critique of Disability-Rights perspective on the nature of disability
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The way to eradicate the suffering of disabled peoples is not to eradicate disabled people, but to change society’s view of them. But not all disabilities are socially recreated, some are legitimate problems
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The central Disability-Rights objection to abortion
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The argument against selective abortion for disability is similar to argument against selective abortion for sex:
To have an abortion because the embryo or fetus would have an impairment or disability is unethical, because it expresses a negative and discriminatory attitude against people with disabilities |
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How the Disability-Rights objection to abortion differs from a general objection to
abortion (e.g., how it differs from Don Marquis’s account in “Why Abortion is Immoral”) |
The “Abortion is immoral” argument generally refers to the moral status of the fetus and the fact that it is human life whereas the disability-rights objection to selective abortion has to do with discrimination against those who have disabilities.
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Bonnie Steinbock’s main argument for the permissibility of selective abortion
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It is entirely rational for an individual to want to avoid burdens on themselves. A women should not have to terminate her career and/or education for the mothering of a child with special needs if she chooses not to.
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Savulescu on parental duties with respect to genetic therapy and genetic enhancement
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By choosing not to enhance a child you wrong the child by not choosing the best future for them.
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What legal rights parents ought to have (according to Savulescu) with respect to genetic enhancement and why
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“we accept environmental interventions—education, diet, and training—to make our children better behaved, more cooperative, and more intelligent. In doing so, we are trying to improve our children and increase their opportunities in life.” Why not allow for interventions that create genetic improvements as well? If we practice genetic therapy we should practice genetic enhancement - health enables us to live well and genetic enhancement merely does the same.
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Sandel’s central objection to genetic enhancement (the idea of “openness to the
unbidden”) |
““The deepest moral objection to enhancement lies less in the perfection it seeks than in the human disposition it expresses and promotes. The problem is not that parents usurp the autonomy of the child they design. The problem lies in the hubris of the designing parents, in their drive to master the mystery of birth. Even if this disposition did not make parents tyrants to their children, it would disfigure the relation between parent and child, and deprive the parent of the humility and enlarged sympathies that an openness to the unbidden can cultivate”
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How Sandel thinks that genetic enhancement might erode social solidarity (especially
what I labeled the “moral interpretation” of this phenomenon) |
If our genetic enhancements are gifts rather than achievements for which we deserve credit than it is unfair to assume that we are entitled to the full benefits in the market economy. We instead have an obligation to share these benefits with those, who through no fault of their own, weren’t given the same gifts.
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Active Euthanasia
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Actively killing such as lethal injection.
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Passive Euthanasia
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Means of withholding or discontinuing life support or life preserving measures.
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Physician Assisted Euthanasia
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Physician intentionally provides the individual with the means to end their life, but where the patient himself/herself administers the means.
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Voluntary Euthanasia
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Where a competent patient requested to be euthanized or more controversially where a formerly competent patient formally requested to be euthanized.
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Involuntary Euthanasia
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A patient is euthanized against their will or without expressed permission
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non-voluntary euthanasia
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Where the euthanized patient is incapable of giving consent. Ex: an infant or comatose patient
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What is meant by the “sanctity of human life” (as, for instance, in the Congregation for
the Doctrine of Faith, “Declaration on Euthanasia”) |
Life is something sacred and no one may dispose of it at will. Believers see life as the gift of God’s love. Intentionally causing one’s own death is the same as murder and “a rejection of god’s sovereignty and loving plan”.
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What is the Doctrine of Double Effect? What is the difference between an intended and unintended effect?
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Death is not the intention but only the unavoidable side effect. “The “double effect” refers to two kinds of effect an action might have: the effect aimed at and the effect not aimed at but foreseen”.
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For someone who accepts the sanctity of human life, how does the Doctrine of Double
Effect apply to treatments that might kill patients? |
As long as the intention was intended to treat the patient and was the best treatment for the patient, if it kills them that was not the intention, so it is ok. The good effect outweighs the bad effect which justifies the causing of the bad effect as long as the agent exercises due diligence.
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Dan Brock’s central argument for voluntary active euthanasia
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The values supporting euthanasia are the same as the values supporting the patients right to refuse life-sustaining treatment. Values = Autonomy and well-being (beneficence). Euthanasia allows for dignity, and the choice of how one wants to die, and may even prevent cases of abuse or mistreatment.
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The objections to euthanasia (beyond sanctity-of-life objections); at least three
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Deliberate killing is wrong, possible mistakes in prognosis, social pressures to die, role of physician (physician's duty is to make the sick well, or as well as they can become), Palliative care is a better option (refusing treatment, fluids, food), and euthanasia does not offer enough benefits to justify the societal risks.
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Be able to explain both sides of the disagreement discussed by Joel Feinberg as to
whether the fictional paralyzed sculptor Ken Harrison is competent to decide to refuse life-sustaining treatment |
Competence and the catch 22: A competent person would not want to kill him/herself. No suicide. An incompetent person is not allowed to choose suicide because of his/her incompetence. No suicide.
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Considerations Rescher thinks are relevant for deciding who should receive scarce medical
resources |
“Biomedical Aspect”
Relative likelihood of success Life expectancy “Social Aspect” 3. Family Role 4. Potential future contributions 5. Services rendered |
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The significance of chance, according to Rescher
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-prevents life-and-death choices from being made the automatic application of an imperfect selection method
-we are used to our lives being affected by chance -an element of chance makes result easier to accept -element of selection relieves administrators from some of the responsibility of making life-and-death decisions |
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Considerations Harris thinks are relevant for deciding who should receive scarce medical
resources |
a. The anti-ageist argument (and the extent to which Harris endorses it)
“the rest of our lives” everyone values it equally -- the harm of death is equal for everyone → therefore life expectancy should not be used to make allocation decisions b. The fair innings argument (and the extent to which Harris endorses it) requires that everyone should be given an equal opportunity to a fair innings (reasonable life of span of years) -- once reaches the rest of the life is a sort of bonus which may be cancelled when it is necessary to help others reach threshold |
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Rescher's Stages for scarce medical resources
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Basic Screening Stage: Create a pool of candidates who deserve further consideration.
Final Selection Stage: Single out the individuals in this pool who will actually receive the therapy. |
