Medical Ethics - Semester Two

Front 1

According to Brody, in what conditions (if any) is abortion morally justified?

Back 1

No conditions justify abortion

Front 2

According to Benatar, what five “new concepts” should be added to the Declaration of Helsinki to better honor the concepts of justice and integrity in biomedical research?

Back 2

1. Vulnerable groups should be provided with increasing accessibility to research, and this should apply to the vulnerable within all countries.
2. Exploitation of subjects, or their use as mere means to the ends of others, should be explicitly excluded by ensuring that the research is of relevance to the individuals participating in the research as well as their communities.
3. The potential benefits of research should considerably outweigh the potential risks or harms to vulnerable individuals and communities.
4. Research subjects should be encouraged to participate in planning and conducting studies.
5. Research in developing countries should be linked with capacity building in health care, and with economic and educational empowerment that has beneficial effects on the delivery of health care and on progress generally in the host country.

Front 3

In a single sentence, precisely how does the UDDA define the criteria for declaring death?

Back 3

An individual who has sustained either (1) irreversible cessation of circulatory and respiratory functions, or (2) irreversible cessation of all functions of the entire brain, including the brain stem is dead.

Front 4

According to Janice Raymond (Reproductive Gifts and Gift Giving), how do altruistic reproductive exchanges, such as surrogacy, both glorify and reinforce women’s inequality?

Back 4

Altruistic surrogacy glorifies women's inequalities as being morally virtuous, "doing it for love", being selfless and nurturing. At the same time it negatively reinforces the patriarchal tradition of giving women away for sex, marriage and to bear others children, reinforcing duty of women to statisfy needs of others before self.

Front 5

According to Barbara Rothman (Not All That Glitters is Gold), what two main concerns suggest that human embryo diagnosis is not even an appropriate goal?

Back 5

1. Are we looking in the wrong corner, by leaving important areas in relative darkness. We are less likely to find real solutions to our problems.

2. We may find what we are looking for: would not just solve problems at hand, would cause more.

Front 6

According to Mary Mohowald, what are some potential “areas of agreement” on which both pro-choice and pro-life citizens might come to agree?

Back 6

1. That abortion is a bad thing

2. That there are differences between the Right ot terminate a pregnancy and the right to terminate a fetus, and parental responsibility.

3. That disclosure of accurate information is as morally requisite here as in other treatment situations.

4. That Pregnant women have rights at least equivalent to those of non-pregnant people.

5. That viability and sentience of fetuses are morally relevant to abortion decisions.

6. That Legality and morality are related but not equivalent

Front 7

According to Arthur Caplan (Organ Procurement: It’s Not in the Cards), what are the four basic policy options for organ procurement? Which options, in Caplan’s view, can be morally justified?

Back 7

*1. volunteerism
2. creation of a market in cadaver organs
3. presumed consent
*4. Required request

Front 8

According to C. Keith Boone (Bad Axioms in Genetic Engineering), what five “bad axioms” currently influence much thinking about genetic issues?

Back 8

1) Playing g-d
2) Interfering with nature
3) Slippery Slopes
4) The ethical neutrality of science
5) genetics is the answer

Front 9

Briefly, what does Gilbert Meilaender (Abortion: The Right to an Argument) mean by his comment that-
“There is a difference between the characteristics that distinguish the human species, and the qualifications for membership in the species”? p179 (LC)

Back 9

he says that, "it may be that among the distinguishing characteristics of human are features like rationality, self-cautiousness and moral concern. But one can be human without exercising or even having the capacity to exercise them. In order to be human, you just need to be born from another human."

Front 10

Briefly, according to Alexander Capron (Anencephalic Donors: Separating the Dead from the Dying), why should the UDDA not be amended to classify all anencephalic infants as “dead at birth”?

Back 10

Anencephalic infants arent "dead at birth" they're dying and the distinctions between individual cases of anencephalic infants rest on clinical judgment, not moral principle.

Front 11

According to Carol Levine (as quoted approvingly by Ruth Macklin in Artificial Means of Reproduction), what is a good definition of “family”?

Back 11

Family members are individuals who by birth, adoption, marriage, or declared commitment share deep personal connections and are mutually entitled to receive and obligated to provide support of various kinds to the extent possible, especially in times of need.

Front 12

According to Andrea Bonnicksen (Genetic Diagnosis of Human Embryos), what are a few of the big moral and policy issues which will be raised by embryo diagnosis? p407 (LC)

Back 12

1. What needs are met through embryo diagnosis
2. Who's responsible for monitoring this technique and paying for treatment
3. What ethics should be applied to diagnosis & embryo therapy
4. What social implications will be raised

Front 13

According to John Robertson (Resolving Disputes over Frozen Embryos), what is the best way to resolve disputes over frozen human embryos?

Back 13

Look at joint wishes of couple and if not available or unable to agree, look to prior instructions which they give for the disposition of those embryos. If none exist, a comparison must be made on the relative burdens of each party on using or not useing the embryo to see which party should prevail.

Front 14

How does W. French Anderson distinguish “therapy” and “enhancement” in the context of genetic technology?

Back 14

Engineering/enhancement- “supplying a specific characteristic that individuals might want for themselves or their children which would not involve the treatment of disease” (551)
• Therapy- “can be supported by the fundamental moral principle of beneficence: It would relieve human suffering. Gene therapy would be, therefore, a moral good.” (551)

Enhancement- could be medically hazardous (risks could exceed the potential benefits and could cause harm); requires moral decisions to be made that our society is not prepared to make; could lead to increased inequality and discriminatory practices

Front 15

According to Elaine Draper (Genetic Secrets), what ought to be our first priority when thinking about how genetic screening can be used to reduce occupational illness?

Back 15

Health policy could be redirected toward reducing disease without needlessly panelizing individuals and groups perceived to be genetically at high risk.

Front 16

According to Larry Gostin, what ethical principles or guidelines or considerations should help shape our response to bioterrorism?

Back 16

1. Declaration of a public health emergency
2. Emergency planning
3. Surveillance
4. Management of property
5. Protection of persons

Front 17

According to the Nuremburg Code, in what circumstances can non-therapeutic experimentation be preformed without the informed consent of the subject?

Back 17

never

Front 18

Briefly, what are the main conclusions drawn by Shapiro & Meslin concerning medical trials in developing countries?

Back 18

1. We should not exploit the subjects who agree to phase 3 testing in developing countries.
2. Clinical trials in other countries should meet all US standards
3. Voluntary informed consent from all subjects must be obtained.
4. OK to use control group ONLY if the condition being studied is not life threatening.

Front 19

According to Emmanuel & Miller, what would be a “middle ground” in the controversy about placebo-controlled clinical trials?

Back 19

...permitted but only when the methodologic reasons for their use are completting, a strict ethical evaluation has made it clear that patients who receive placebo will not be subject to serious harm and provisions have been made to minimize risks associated.

Front 20

According to the principles Thomson develops in her defense of abortion, in what circumstances do persons have a moral obligation to prevent harm to other persons?

Back 20

nobody is morally required to make large sacrifices to sustain the life of another who has no right to demand them.

Front 21

According to Warren, exactly what are the criteria for moral personhood?

Back 21

1. Consciousness and in particular, ability to feel pain
2. Reasoning
3. Self-motivated activity
4. Capacity to communicate
5. Presence of self concepts and self-awareness

Front 22

In a nutshell, according to Marquis, why is abortion wrong?

Back 22

The moral permissibility of abortion stands or falls on moral status of fetus. Since a fetus possesses a property, the posession of which in an adult human is sufficient to make killing an adult human being wrong which shows abortion is wrong.

Front 23

Just what does Parens mean by “fragility” when he writes of “the goodness of fragility”?

Back 23

Fragility means subject to change and to chance. This is referring to the "genetic hand dealth us by nature"

Front 24

Briefly, according to Parens, what would we do (or not do) if we took behavioral genetics seriously?

Back 24

We could significantly reduce our fragility as humans whose genetics are determined purely by nature.

Front 25

How does Gordon distinguish genetic “enhancement” from genetic therapy?

Back 25

Therapy is considered to be improvement of traits for alleviation of deficiencies or reduction of disease risk, that without intervention would be completely normal. Enhancement is intervention beyond therapy.

Front 26

According to Glover, what lessons from the "Nazi Experience" might be relevant to current bioethics?

Back 26

1. Mistake to let any system of belief become too abstact.
2. Do not think in terms of racial purity or of a lesser racial quality
3. Don't take a group approach: look at those immediately involved.
4. Conclusions about social darwinism can be dangerous.

Front 27

According to Roche & Annas, what would be some of the key elements of a good social policy regarding genetic privacy?

Back 27

1. Recognize individual genetic rights
2. limit parently rights to authorize collection, storage, or analysis of child's DNA sample.
3. Prohibit unauthorized uses of individually identifiable DNA samples
4. Prohibit disclosures of genetic info without individual explicit authorization
5. Strictly enforce laws & institutional policies
6. Provide accesible remedies for individuals whose rights are violated.

Front 28

According to Ross & Moon, what are the most important ethical issues raised by genetic testing of children?

Back 28

1. Diagnostic genetic testing
2. Population based genetic testing
3. Carrier identification

Front 29

According to Buchanan et. Al, what issues of justice are raised by genetics?

Back 29

1. Equal opportunity
2. Morality of inclusion

Front 30

According to Burgess, what are the most important ethical and social issues -other than consent - raised by genetic testing?

Back 30

1. Standard of practice
2. indeterminancy of risks
3. Collective acceptability of risks & benefits

Front 31

According to Capron, why is it a very bad idea to punish mothers for behaviours associated with damage to fetuses?

Back 31

Pregnant addicts wont seek pre-natal care, may seek late term abortion, may seek delivery means outside medical setting putting mother & baby at risk.

Front 32

According to Sherwin, what basic insights does feminist ethics offer regarding in vitro fertilization?

Back 32

They are interested in freedom of choice for women. IVF offers women safe and effective choice to have kids. Though, it is up to doctors to perform procedure as well as you must be approved (based on relations & financial situations).

Front 33

Briefly, according to Kass, what is "the wisdom of repugnance"

Back 33

It is the common repulsion of the thought of human cloning or mass production of humans.

Front 34

According to Brock, what are the main arguments "pro" human cloning?

Back 34

1. a new means to relieve the infertility some experience
2. enables couples in which one party risks giving a serious heriditary disease to offspring to reproduce without doing so
3. can make twin, enabling procurement of organs/tissues
4. to clone someone who had special meaning to them
5. duplication of individuals with great talent/character, etc
6. make possible important advances in scientific knowledge

Front 35

According to Gillon, what are the main arguments anti-human cloning?

Back 35

1. Yuck category - revoluting, unnatural, disgusting
2. Autonomy and personal identity arguments
3. Harm to humans
4. Justice - equality of resources, moral laws of behavior, etc

Front 36

According to David Ozar (The Case Against Thawing unused Frozen Embryos), both the “pro-choice” and the “pro-life” views of abortion should lead to the same moral policy regarding the handling of frozen embryos. What, in brief, is that policy?

Back 36

The responsible parties have an obligation to preserve the frozen embryos in their frozen state until such time as they can no longer survive implantation. They should support implantation of unused embryos in women who volunteer to bear them and make effort to locate such women.

Front 37

According to Lori Andrews (My Body, My Proptery), what main considerations support the conclusion that we should permit people to sell their own body parts? p463 (LC)

Back 37

Should be a market for body parts if can be removed safely, if the donor is no longer living and in all a person should have property rights over their own bodies, but to allow the government or other agencies to.