BCMH 1: Introduction to Bioethics & Ethical Theory (1) Flashcards
(82 cards)
1
Q
What are some of the type of questions that bioethics deals with? (5)
A
- Is it morally acceptable to give a terminal patient, who is in terrible pain a drug that will control the pain, but might also lead to death?
- Should a doctor, who is meant to preserve life, respect the wishes of a patient who refuses treatment that could save his/her life?
- Should a pharmacist dispense the morning after pill to a 12 year old?
- SA law allows women in the first trimester the right to terminate a
pregnancy. Should HCP be allowed to refuse to perform abortions? - Is it ethically justified for the State to require parents to vaccinate their children against MMR?
2
Q
What is Bioethics?
A
Bioethics is the exploration of moral and ethical questions surrounding life, health, science, medicine, and the environment.
3
Q
What disciplines does Bioethics encompass?
A
Bioethics encompasses philosophy, ethics, practical/applied ethics, and various fields related to life sciences, medicine, and environmental studies.
4
Q
What is the origin of the term philosophy?
A
Origin: two Greek words meaning “love of wisdom”
5
Q
What are the fundamental questions philosophy is concerned with?
A
- Philosophy is concerned with fundamental questions
– Related to knowledge, existence, reason, values, morals, the mind, language, etc.
6
Q
- Examples of the kind of questions philosophy grapples with: (4)
A
– What is truth?
– Can we prove or disprove the existence of God?
– How can we tell good and bad logical arguments apart?
– What is the value of art?
7
Q
What are the foundational elements of philosophy?
A
Critical thinking and logical argumentation form the foundation of all philosophy.
8
Q
How does philosophy examine reality?
A
Philosophy uses rational inquiry to critically examine reality.
9
Q
Why is it necessary to justify beliefs and assumptions in philosophy?
A
Beliefs and assumptions need to be justified and explained logically and systematically in philosophy.
10
Q
What is the significance of defining important concepts in philosophy?
A
Important concepts in philosophy are clearly defined to facilitate understanding and discussion.
11
Q
How does philosophy engage with important questions?
A
Philosophy engages with important questions through debate, dialogue, and engagement with other points of view.
12
Q
What activities are intrinsic to philosophy regarding arguments?
A
Philosophy involves developing and articulating good and rigorous arguments, as well as the analysis and criticism of counter-arguments.
13
Q
What is a deductive argument?
A
A deductive argument consists of a conclusion and premises meant to provide reasons for believing the conclusion.
14
Q
Define validity in the context of deductive arguments.
A
An argument is valid if the conclusion could not be false if we assume the premises to be true.
15
Q
Define soundness in the context of deductive arguments.
A
An argument is sound if it is valid and all of the premises are true.
16
Q
Assess the deductive argument: Premise 1: Cats are mammals, Premise 2: All mammals are egg-laying animals, Conclusion: Cats lay eggs. Is it valid?
A
An argument is valid if the conclusion could not be false if we assume the premises to be true. (Premise 2 is a false premise)
17
Q
Assess the deductive argument: Premise 1: Cats are mammals, Premise 2: All mammals are egg-laying animals, Conclusion: Cats lay eggs. Is it sound?
A
An argument is sound if it is valid and all of the premises are true. (Premise 2 is a false premise)
18
Q
What is wrong with these arguments?
- That doctor is constantly cheating on his wife and does not take care of his own children. So, you shouldn’t take his views on health policy
seriously.
A
- Ad Hominem fallacy (attack on the person)
19
Q
What is wrong with these arguments?
- Many professors of anatomy claim that testing medication on animals is morally acceptable. Given the expertise of these people, we should accept that such testing is, in fact, acceptable.
A
- Irrelevant appeal to authority fallacy
20
Q
What is wrong with these arguments?
- No-one has disproved the link between the MMR vaccine and increased incidence in autism. Responsible parents should refuse to have their children vaccinated for MMR.
A
Argument from ignorance
21
Q
What is wrong with these arguments?
- Pro-choice activists are murderers. Because their heartless & godless views have the upper hand, genocide is being committed against millions of innocents who are mutilated, poisoned & slaughtered in abortion clinics around the world.
A
- False appeal to emotion fallacy
22
Q
What is wrong with these arguments?
- Either global warming is a natural phenomenon, or it is caused by human activity. All the scientific evidence we have shows that the burning of fossil fuels is not responsible for increased temperatures. So global warming must be natural.
A
- False dilemma fallacy
◦ Fallacy of the missing middle
‣ Lots of other factors play a role
23
Q
What is ethics?
A
Ethics is a branch of philosophy concerned with questions of morality, including concepts of right and wrong, good and bad, virtue, justice, and values.
24
Q
How is ethics characterized by the questions it asks?
A
Ethics is characterized by the kinds of questions it asks about morality, virtue, justice, and values.
25
How does ethics approach moral questions?
Ethics grapples with fundamental, theoretical, and applied moral questions using the same methods as other branches of philosophy.
26
What fundamental questions does ethics ask about morality?
Ethics asks fundamental questions such as: Is it meaningful to talk about morality? Do we have free will? Is what is right relative to one's culture? Is ethics merely personal opinion? This area is known as Metaethics.
27
What theoretical questions does ethics ask about morality?
Ethics asks theoretical questions like: On what basis can we decide what conduct is right or wrong? Is the right action determined by consequences or by respect for persons? Are moral questions best resolved in terms of human rights? This area is known as Ethical Theory.
28
What practical/applied questions does ethics ask about morality?
Ethics asks practical questions such as: Is abortion wrong? Should physician-assisted dying be legal? Is it ethical to share confidential patient information via WhatsApp? Was SA's pandemic tobacco sale ban justified? These questions apply normative ethical theories practically and fall under Applied/Practical Ethics.
29
What is the nature of bioethics?
Bioethics is a type of practical/applied ethics.
30
How long has medical ethics existed?
Medical ethics has existed for centuries in some form.
31
Why have people historically grappled with ethical issues in medicine?
People have historically struggled with ethical issues in medicine due to the nature of healthcare, which deals with matters of life and death, illness and wellness, bodily integrity, etc.
32
Why are ethical considerations always relevant in healthcare?
Ethical considerations are always relevant in healthcare because medicine deals with matters of life and death, illness and wellness, bodily integrity, etc. There are always ethical issues related to these aspects.
33
How long has the importance of ethics been acknowledged in healthcare?
Almost for as long as there have been any kind of healthcare practitioners, there has been acknowledgment of the importance of ethics.
34
By mid-20th Century there was already an emphasis on: (4)
* the need for ethical practices in the health care professions
* the principles of non-maleficence (do no harm) & benevolence (do good)
* the need to respect privacy; uphold confidentiality
* The need to respect professional boundaries
35
What historical events and trends led to the emergence of bioethics?
The confluence of significant historical events, social trends, and medical advances, especially in the decades after WWII, brought the ethical challenges associated with healthcare to the attention of the world. This eventually led to the establishment of a new academic field known as bioethics.
36
What contributed to the exponential growth of medical ethics in the 1960s-1970s?
Medical ethics experienced exponential growth during the 1960s-1970s, becoming a sub-discipline known as 'biomedical' ethics and then 'bioethics', broadening its scope.
37
What event triggered the growth of medical ethics?
The Nuremberg Doctors Trial of 1946-7 played a significant role. It involved 23 doctors, administrators, and others charged with crimes against humanity for experiments and procedures performed on prisoners and civilians by Nazis.
38
What was the outcome of the Nuremberg Doctors Trial?
The trial resulted in an international realization that there needed to be ethical standards for medical experiments using human subjects. It led to the creation of one of the first human rights documents: The Nuremberg Code, which outlined principles including voluntary consent, absence of coercion, properly formulated scientific experiments, and beneficence.
39
What was the Tuskegee Institute's Syphilis Study?
The Tuskegee Institute's Syphilis Study was conducted by the Public Health Service in the USA between 1932 and 1972. It involved 600 mainly poor black American men, 399 of whom already had syphilis.
40
What was the aim of the Tuskegee Institute's Syphilis Study?
The aim of the study was to observe the natural development of syphilis in black men who were left untreated.
41
How were participants misled in the Tuskegee Institute's Syphilis Study?
Participants were told they were being treated for "bad blood" rather than being informed about their actual diagnosis of syphilis.
42
When was penicillin validated as an effective cure for syphilis, and what happened with the study after that?
Penicillin was validated as an effective cure for syphilis in 1947. However, the study continued even after this discovery.
43
How did the Tuskegee Institute's Syphilis Study come to an end?
The study was terminated only after the situation was reported in the media in 1972.
44
What were some of the consequences of the Tuskegee Institute's Syphilis Study?
As a result of the study, 28 participants died of syphilis and more than 100 suffered from related ailments. Additionally, 40 wives were infected, and 19 children were born with congenital syphilis.
45
What did the Tuskegee Institute’s Syphilis Study lead to? (2)
* Led to the National Commission for the Protection of Human Subjects of Biomedical and Behavioural Research in 1976
* Guidelines were drawn up & published in 1979 in what has become known as the Belmont Report
46
What are the 3 main principles of the Belmont Report?
– Respect for persons (grounds need for consent)
– Beneficence
– Justice
47
* So, one reason for the development of bioethics related to concerns about the need for more _______ treatment of human subjects in medical experiments –
* But there were other clinical cases and _______ developments that also contributed to interest in bioethics
ethical
technological
48
Who was Karen Anne Quinlan?
Karen Anne Quinlan was a 21-year-old who collapsed and went into a coma in 1975, suffering brain damage due to extended respiratory failure.
49
What was Karen Anne Quinlan's medical condition?
Karen Anne Quinlan remained in a persistent vegetative state after suffering brain damage from extended respiratory failure. She was kept alive with a respirator and tube feeding.
50
What legal and ethical challenges did Karen Anne Quinlan's family face?
Karen Anne Quinlan's family faced threats of being charged with murder when they requested to remove her from the respirator. The hospital helped them obtain a protection order from the courts.
51
How did the legal case regarding Karen Anne Quinlan conclude?
In 1976, the New Jersey Supreme Court ruled in favor of Karen Anne Quinlan's family, allowing her to be removed from the machines. She lived in a persistent vegetative state until 1985.
52
What ethical questions did the Quinlan case raise?
The Quinlan case raised ethical questions about the distinction between 'ordinary' and 'extraordinary' measures to preserve life, and it highlighted how advances in medical technology give rise to new ethical dilemmas.
53
What impact did the Quinlan case have on medical ethics?
The Quinlan case led to a review of the definition of death, with "brain death" becoming more commonly used instead of "irreversible cessation of circulatory and respiratory functioning."
54
Advances in medical knowledge, practice & healthcare technology in the last 100 years have created new moral questions: (8)
55
* These factors combined to create interest in ethical issues related to medicine, life & death, health, the responsibilities of doctors, etc
* So, bioethics grew into a very important field of practical _____
* One of the tasks of this field was to try to provide theoretical grounds for how to act morally – turned to _____.
ethics
Philosophy
56
What is missing in each argument?
57
What is necessary for an argument that makes value-based claims about how we ought to act?
Such arguments MUST rely on at least one premise that describes the moral value being relied on.
58
How does the moral value premise function in value-based arguments?
The moral value premise serves as a logical bridge between claims about what "is" the case (facts) and a conclusion about what "ought" to be the case (value claims).
59
What is David Hume's "is/ought" problem?
David Hume's "is/ought" problem states that we cannot derive a conclusion about what ought to be from premises about what is.
60
Why do all applied ethics arguments require a transitional premise?
All applied ethics arguments need a transitional premise that describes the moral value because it addresses David Hume's "is/ought" problem and establishes the basis for value-based claims in ethical arguments.
61
What are examples of moral value premises in abortion arguments? 3)
- We should always act in a way that results in the best overall consequences for those affected.
- It is unethical to prevent others from exercising their rights.
- It is wrong not to always act in accordance with God’s laws.
62
What are some additional moral value premises? (3)
- We should respect the considered choices of autonomous patients.
- We are entitled to protect ourselves, even if it entails force.
- Doctors should prioritize the interests of their patients.
63
What is the purpose of moral theories?
Moral theories seek to provide a single moral value premise that enables us to decide what is right and wrong in all situations. This premise is often referred to as a "theory of right action."
64
What is one of the most important theoretical questions in ethics?
One of the most important theoretical questions in ethics is: How do we decide what is the morally right thing to do in any situation?
65
What is the goal when addressing the theoretical question in ethics?
The goal is to develop a theory of right action that can provide the basis for determining whether any and all actions are morally right or wrong.
66
What is Divine Command Theory?
Divine Command Theory posits that we should act in accordance with God's commands. However, this theory may not be practical in a professional context of religious pluralism as it requires prior faith commitments.
67
Why might Divine Command Theory not be suitable in certain contexts?
Divine Command Theory may not be suitable in contexts of religious pluralism because it relies on prior faith commitments.
68
What are the two most influential types of moral theories of right action?
The two most influential types of moral theories of right action are utilitarianism and duty-based (deontology) theories.
69
What is utilitarianism?
Utilitarianism is a type of consequentialism where an action is morally right if the likely consequences of that action are, on aggregate, more positive than negative for all affected. Positivity is measured in terms of pleasure, happiness, well-being, or preference satisfaction.
70
What are duty theories in deontology?
Duty theories in deontology propose that there are certain actions that we have a duty to perform or refrain from performing. Keeping promises is such a duty, as is refraining from lying, killing, or stealing.
71
What is the principle of universalizability in deontology?
The principle of universalizability states that if everybody decided to break their promises to suit themselves, no one would ever believe promises that are made. Contracts would be meaningless. Therefore, for instance, nobody would extend credit to anyone else.
72
The Organ Donor Thought Experiment
Utilitarianism: (3)
* Cannot account for why this act would be wrong
* Lives are seemingly exchangeable
* End justifies means
73
The Organ Donor Thought Experiment
Duty theories (deontology): (4)
* We cannot treat persons just as means to our own ends, we need to respect their inherent value (how you get to the consequence also matters)
* Boils down to ‘respect for persons’
* No life can replace another
* No just ends without just means
74
What is Utilitarianism?
Utilitarianism is a theory of right action where an action is morally right if the likely consequences of that action are, on aggregate, more positive than negative for all affected.
75
How does Utilitarianism assess the morality of an action?
Utilitarianism requires a calculation of all the good consequences minus all the bad consequences of an action for all affected individuals.
76
What challenges does Utilitarianism face?
Utilitarianism faces challenges such as predicting consequences, ensuring consideration of all consequences, and allocating values to different consequences.
77
How does rule utilitarianism address some of the problems of traditional utilitarianism?
Rule utilitarianism, or practice utilitarianism, tests more general moral rules or practices against the requirement of achieving the greatest good for the greatest number.
78
Give examples of rules in rule utilitarianism.
Examples of rules in rule utilitarianism include: "We should generally keep our promises" and "Innocent people should not be framed for crimes they did not commit in order to appease the public’s desire for justice to be served."
79
What is Deontology?
Deontology is a theory of right action where actions that are morally right are those that we have a duty to perform or refrain from performing.
80
How do we determine what rules or duties are in Deontology? (3)
- Common morality suggests that there are moral duties agreed upon by most people worldwide, such as not lying, cheating, stealing, or killing.
- Universalizability requires that these duties or rules apply to everyone equally.
- Immanuel Kant proposed the Categorical Imperative as the key to moral duties, which dictates treating others as ends in themselves and not merely as means.
81
What are the problems with Deontology? (2)
- Deontology can seem rigid and dogmatic, unable to consider consequences (e.g., Kant's stance on lying to save a life).
- It may appear cold and lacking in compassion, advocating for duty even when it's unpleasant or challenging.
82
What has dominated Normative Ethics in terms of rival theories?
Normative Ethics has been dominated by two rival theories: Duty-Based (Deontology) and Utilitarian (Consequentialist) theories, but there are other perspectives as well.
