Goldman uses what example to prove the importance of autonomy?
How is the principle of autonomy applied to clincal settings?
Healthcare workers should allow people who are rational to decide what sort of treatement they are to receive
How does the principle of beneficence apply to clincal settings?
Healthcare workers should perform procedures that will heal their patients and prevent their illness
P1: Giving HCW priority care for COVID is the only way to ensure that there are enough HCW to treat future COVID patients
P2: Ensuring that there are enough HCW to treat future COVID patients is the only to ensure that we maximize overall utility
C1: Giving HCW priority care for COVID is the only way to ensure that overall utility is maximized
P3: We should ensure that overall utility is maximized
C2: We should give HCW priority care for COVID
The Utilitarian argument in favor of prioritizing
What does Harris think should be taken into account to determine how to use healthcare resources?
Always save the greatest number of lives
P1: Health care workers (HWC) have willingly accepted some level of personal risk as part of their job
P2: If HWC have willingly accepted personal risks as part of their job , then they should not receive special treatment when they are harmed by those risks
C1: HCW should not receive special treatment when they are harmed by the risks they’ve willingly accepted
P3: Giving HCW priority care for COVID would be giving them special treatment for the risk thye’ve willingly accepted
C2: HCW should not receive priority care for COVID
The known Risk Argument against proritization
How does the principle of utility apply to clincal settings?
When healthcare workers cant help everyone (or harm someone) they should perform those procedures that will maxiize overall well-being as much as possible
Collective-Other Regarding reasons
Reasons you have to do something for the sake of contributing to some collective good even ifothers dont contribute
Blitze rejects the known risk argument by saying what ?
Willingly accepting personal risk doesnt mean that they dont also deserve special treatment when they get sick, especially while helping others
Which moral reasoning does Rieder belives can actually explain why we should social dsitance?
Collective-Other -Regarding Reasons
What are Cullen’s & Klein view on telling patients the truth?
Doctors are morally required to tell their patients the truth & by not telling them the truth disrespects the autonomy of the patient
Invloves restricting the autonomy of a person whose rational abilities are dimished for their own good
Self -Regarding Reasons
Reasons you have to do something for your won sake
What are the two forms of paternalism?
- Weak Paternalism
- Strong Paternalism
How does Harris respong to the argument in favor of QALY?
Just because we can use QALY for a single person doesnt mean that we should do it for everyone
What was Flanigan Analogy?
She compared it to shooting stray bullets in the air
Doctor- Patient Confidentility
Prohibits the disclosure of a patient’s protected health information to parties not involved in that patient’s healthcare
Absolute Moral Principles
Rules that dont allow for any exceptions and so must always be followed
In the case where it may be permissible to act in the patient’s interest even if doing so goes against their own wishes, conflict between what two moral principle arise?
- Principle of autonomy
- Principle of beneficence
Individual -Other regarding reasons
Reasons you have to do something for the sake of others
The principle of beneficenece
We should promote the well-being of other and prevent their harm or injury
QALY attempts to measure the value of a life by taking what into account?
- A person’s years of life
- The quality of those life years
What four ways can autonomy be restricted due to illness?
- Physical Constraints on autonomy
- Cognitive Constraints on autonomy
- Psychological Constraint of autonomy
- Social Constraints on autonomy
What are moral principles?
Moral Principles are general rules that tell us how we should act with respect to morality
Involves restricting the autonomy of a person whose rational abilities are not diminished for their own good
The principle of autonomy
We should allow persons who are autonomous to exercise their capacity of self - determination
What is Chen’s response to the Utilitarianargument in favor of prioritizing?
That there are other ways to ensure there is enough HCW for COVID for exampe trainig new healthe care workersto be able to take the place of the current ones
How does chen respond to the reciprocity argument in favor of prioritizing HCW?
By generalizing the argument to essential workers
Quality life score of 0 represents what?
A quality life score between 0 & 1 represents what?
Less than full health
What three methods are used for calculating Quality of life?
- Time trade-off method
- Standard gamble method
- Visual analogue method
Prima Facie Moral Principles
Rules that allow for the possibility of exceptions when other moral considerations are relvant
What are the arguments for or against Prioritization?
- Known risk argument against prioritization
- The reciprocity argument in favor for prioritization
- The Utiliarian argument in favor of prioritization
What are teh three possible moral reasons for social distancing?
- Self- Regarding Reasons
- Individual -Other regarding reasons
- Collective - Other - Regarding reasons
What two arguments are backwards looking?
- The known risk argument
- The reciprocity argument
What arugment is forward looking?
The Utilitatian arguemnt
What are the forms that medical paternalism can take?
- Treating patients without their consent for their own good
- Lying to or withholding information from a patients for their own good
What is Ackerman view on noninterference?
Belives that its not the same as patient’s autonomy & in some cases its can respect a patient autonomy by interfering with the decisions made by the patient
Why do we have doctor - patient confidentiality?
- Allows for honest communication between patients & doctors resulting in better pateint treatment & care
- Preserves the privacy of the pateint & protec ts them form discrimination against their medical conditions
- Respects the pateint’s autonomy
What are Harris views on allocating scare healthcare resources?
- We should not use QALY to determine how to healthcare resources
- We should not take a person’s life expectancy into account
- We hsould not take a person’s quality of life into account
Rieder belives that we are ________ required to socially distance but ______ to socially distance
Are not morally required, Have moral Reasons
P1: Using QALY to allocate healthcare resources punishes those who have already suffered the misfortune of having a low qualtity of life
P2: Punishing those who have already suffered the misfortune of having a low qualuty of life is unfair
C1: Use QALY to allocate health care resources in unfair
P3: We should not use any allocation methods that is unfair
C2: We should not use QALY to allocate scare health care resources
The double Jeeopardy Argument Against using QALY
How does the principle of nonmaleficence apply to clincal settings?
Healthcare workers should not perform procedures that they know will injure or harm their patients
P1: A shorter, higher quality of life can be better than a longer, lower quality life
P2: If a shorter, high quality life can better than a longer, lower quality of life, then we should take quality of life into account when determining how to treat a single person
C: We should take quality of life into account when determining how to allocate scare healthcare resources between different people
Argument in favor of using QALY
What does QALY stand for?
Quality adjusted life years
Flanigan argues what?
- That it is morally wrong to refuse to be vaccinated
- It can morally permissble to institute laws to make vaccination compulsory under certain conditions
P1: HCW have willingly accepted soem level of personal risk as part of their job to help others
P2: If HCW have willingly accepted personal risk as part of their job to help others, then we should adequately compenste them for taking those risk for the sake of others (Principle of reciprocity)
C1: We should adequately compensat HCW for taking risks for the sake of others
P3: Adequately compensating HCW for taking risk for the sake of others involves giving them priority care for COVID
C2: HCW should receive priority crae for COVID
The Reciprocity arugment in favor of prioritization
The limits of patients autonomy applied to clincial settings
Healthcare workers should allow people who are rational to decide what sort
What is Paternalism?
Paternalistic acts involves the restriction of a person’s autonomy for the sake of their own good
The principle of justice
We should make sure to treat people fairly by mkaing sure that they get what are due
What is Ackerman view on patient;s autonomy?
Belives its important but that physicians should never interfere with the decisions made by the patient
What matters to QALY when allocating scare healthcare resources?
- Quantity of life
- Quality of life
The principle of nonmaleficence
We should not intentionally cause harm or injury to others
A quality life score of 1 represents what?
How do calculate QALY?
Multiply number of years with their quality of life score
P1: The disclosure of certain information can, in at least some instances be harmful to health and wellbeing of a patient
P2: A physican’s top priority is always to protect the health and wellbeing of their patients
C: In some instances, physicians can be justified in withholding certain information from their patients
The Argument in favor of medical paternalism
What are Flanigans four conditions to make vaccination mandatory?
- Vaccination prevents a contagious illness
- Those who are exposed to the illness dont make themselves liable to the risk
- Vaccination is potentially effective at limiting contagion
- Vaccination doesnt limit rights of self-defense or defesne of others
The principle of utility
We should produce the most favorable balance of benefit over harm for all concerned
What is Flanigan four policy proposals?
- Exclusion from public services
- Employment Restricitions
What is Lipkins view on telling patients the truth?
He believes that doctors are not morally required to always tell the truth to their pateints
What are the moral principles in clinical ethics?
- The principle of autonomy
- The principle of nonmaleficence
- The principle of benficence
- The principle of utility
- The principle of justice
What is goldman’s response to the argument in favor of medical paternalism ?
That the protection and wellbeing of patients isnt always the physicians priority
What is the time trade-off method?
It figures out how many years at diminished health you would be willling to trade for one year at full health
In particular lipkins thinks that doctors are not required to tell the truth to their patient if what?
- Their patients can’t understand the truth about their conditions
- Their patients dont want to know the truth about their condition
- Their patients would be harmed by learning the truth of their condition
How is the principle of justice applied to clinical settings?
Healthcare workers should ensure that their patients are given treatments in a way that is equitable and treats each patient fairly
What are the five necessary conditions for a patient consent to be informed consent?
- Patient Competence
- Adequate Disclosure
- Patient Understanding
- Voluntary Decision
- Consent to Treatment
A patient may not be competent if they are what?
- Intellectually disabled
- Suffering from dementia or psychosis
Adequate Disclosure requires physicians to include information about what?
- The nature of the procedure
- The risks of the procedure
- Alternatives to the proposed procedure
- The expected benefits of the proposed procedure
Patient adequately understand the relevant information regarding their condition and the proposed medical treatmnt
A patient’s decision may not be voluntary if they are what?
- Coerced by threat, force, or individual/ social pressure
- Manipulated by misinformation or misleading presentation of information
Actively gives their consent rather than simply refrains from protesting against the procedure
Involves exercising one’s autonomy and assuming personal responsibility for the decision
What the exceptions to informed consent?