final exam Flashcards
(99 cards)
1
Q
Explain Aristotle’s warning about seeking precision in ethics, that “a well schooled man is one who searches for that degree of precision in each kind of study, which the nature of the subject at hand admits” (Handout8).
A
Every subject demands a different level of precision and it is not right to demand a lot of precision from all of them.
2
Q
- Explain Aristotle’s examples of people learning to “become builders by building houses and harpists by playing the harp” how this applies to learning to be virtuous (Handout8).
A
We become virtuous by being virtuous.
3
Q
- Explain Aristotle’s notion of seeking the “median and the best course” regarding things like “fear, confidence, desire, [and] anger” (Handout8).
A
We can feel emotions in excess, deficiency, and median. By experiencing emotions at the right time, toward the right objects, the right people, and for the right reason, we find the median. This is the mark of virtue.
4
Q
- Explain Aristotle’s point that the virtue of courage is a ‘golden mean’ of the passion of confidence, between the vice of excess (recklessness) and the vice of deficiency (cowardice) (Handout8).
A
If you have too much confidence, you become reckless. If you lack confidence, you become a coward. To be courageous, you need to find a balance between excess and deficiency.
5
Q
- Explain what Aristotle means by the vice of extravagance in contrast to the virtue of generosity (Handout8).
A
When it comes to giving and receiving money, generosity is the mean. Extravagance is the excess and stinginess is the deficiency.
6
Q
- Explain how “apathy” or a lack of anger can sometimes be a vice, according to Aristotle (Handout8).
A
This man is deficient in gentleness. Apathy is his vice.
7
Q
- What are the virtuous mean and the two vices associated with “pleasantness in amusement” (i.e. how fun you are in social settings) (Handout8).
A
The virtuous mean is being witty. The excess is buffoonery and the deficiency is being a boor.
8
Q
- Explain Carol Gilligan’s distinction between a “voice of care” and a “voice of justice” as a matter of two different orientations toward ethics (Carse, 6).
A
The justice orientation recognizes that moral judgements are derived from abstract and universal principles, is dispassionate, and emphasizes individuals rights, equality, and reciprocity in our relationships. The care orientation is not impartial, understands moral judgements as situational, involves empathy and concern, and emphasizes responsibility in our relationships to others.
9
Q
- Explain the feminist critique of detachment and impartiality in moral thinking and the view that an “impartial observer is disqualified rather than legitimated as a competent moral judge” (Carse, 8-9).
A
Detachment and impartiality make it so that we cannot empathize with others or recognize their individual personhood. The care orientation claims that we cannot make moral judgments or moral choices without being attentive to identity and relationship.
10
Q
- Explain the concern that impartiality “cannot always inform us sufficiently about how to respond to others” (Carse, 10).
A
If we are impartial, we cannot understand what that individual needs because thor personhood is not recognized.
11
Q
- Explain critique of an ethics of principles that “Recognizing that a general principle or rule is relevant to the situation at hand, and knowing how it is fittingly to be acted upon, requires a capacity for discernment that is distinct from, and presupposed by, the application of principles themselves” (Carse, 11).
A
You must know how to appropriately apply principles, not just know what it is. Context matters.
12
Q
- Explain the notion of a sensitivity to particular features of the context and to other people and how this calls for a “moral capacity which can be developed and […] is not itself principle-governed” (Carse, 12).
A
Principles require nuance and sensitivity that evolve with experience.
13
Q
- Explain the distinction in the claim that “well-cultivated emotion” is necessary for both “moral discernment” (e.g. discerning the needs of others) and “moral response” (e.g. responding to these needs) (Carse, 13).
A
You have to understand emotions well yourself in order to understand the needs of others and how to respond to them.
14
Q
- Explain the distinction between the motive of an action and the manner of an action, e.g. between acting out of sympathy and acting in ways that express sympathy (Carse, 14).
A
The motive is why someone does it while the manner is how. It is important to be sympathetic but also to behave sympathetically.
15
Q
- Explain the critique that an ethics that presupposes relationships between equals will emphasize “mutual non-interference” that can “threaten us with neglect and isolation especially if we are dependent or relatively powerless, like the very young, the very old, or the sick” (Carse, 16).
A
If someone has a right to something, no one should impede their pursuit of it and vice-versa, leading to mutual non-interference. However, with vulnerable populations, non-interference can threaten them with neglect because they are dependent on others.
16
Q
- Explain the distinction between “the principle of beneficence” and the “care orientation” (Carse, 19).
A
The care orientation emphasized sympathy and compassion. Beneficence emphasizes a love of humanity to promote the welfare of others.
17
Q
- Explain the point that “a full account of the virtues of caretaking would need to spell out conceptions of proper self-regard – or care for oneself – as protection against self-effacement or problematic self-denial and as a precondition of sound caring for others (Carse, 24).
A
You must practice self-care in order to avoid self-sacrifice or self-denial.
17
Q
- Explain the distinction between “technical” errors, “judgmental” errors, and “normative errors” and why the third kind is thought to be worse than the other two (P, 34).
A
Technical error: is when a profession follows their responsibilities conscientiously but their training falls short for the task required.
Judgemental error: when a conscientious profession develops and follows an incorrect strategy.
A normative error: when a professional violates codes of conduct or fails to possess a moral skill.
Technical and judgemental errors are errors made in good faith while a normative error indicates a defect in character.
18
Q
- Explain the example of how a doctor or a nurse could act with the virtues of kindness and loyalty and yet nonetheless be acting unethically (P, 35).
A
A nurse could fail to report a coworker acting unethically in order to be kind and loyal, but puts patients in harm’s way. Virtues need to be accompanied with an understanding of what deserves it.
19
Q
- Explain how the virtue of compassion can lead to “emotional burnout” and how medical and nursing education can counteract this problem (P, 39).
A
Compassion can sometimes cloud judgement and lead to impassioned decisions and emotional burnout rises.
20
Q
- Explain the role of critical thinking in the virtue of conscientiousness, and how “moral indignation and outrage” can have a valuable role (P, 43).
A
To be conscientious, one has to be able to think critically about a situation. Moral indignation and outrage can be virtuous under certain circumstances like a doctor fighting an insurance company to help their patient receive care.
21
Q
- Explain what is meant by “conscientious refusals” and the worry about “banning or greatly restricting conscientious refusals” (P, 43-4).
A
Conscientious refusals are refusing to do something that doesn’t align with your own beliefs. Banning or restricting conscientious refusals raises worries about balancing professionals’ and patients’ rights.
22
Q
- How could a “right action” nonetheless not be a “virtuous action”? What are the three criteria for a virtuous action according to Aristotle (P, 410)?
A
The right action could lack virtue if it is done in the wrong state of mind. To be virtuous, a person must know they are committing a virtuous act, he must decide on the,, and they must do them from a firm and unchanging state.
23
Q
- Explain the point that the “friend who acts only from obligation lacks the virtue of friendliness, and in the absence of this virtue, the relationship lacks the moral quality of friendship” (P, 412).
A
A person who acts out of obligation, and not a desire to be friendly due to valuing friendship, lacks the moral quality of friendship.
24
9. Explain the concern that virtue ethics is not as helpful in encounters between strangers (P, 415).
Virtue ethics is helpful in situations where there is trust, intimacy, and familiarity. With strangers, character plays a less significant role than principles, rules, and institutional policies.
24
8. Explain why many proponents of virtue ethics “do not lament that their approach lacks a clear and precise decision procedure for conflicts and dilemmas” (P, 413).
They believe that theories based on principles, rules, and rights have no advantage over virtue theory in resolving moral dilemmas. In irresolvable dilemmas, virtues can help direct agents to the right responses, attitudes, and emotions.
25
10. Explain the point that virtue ethics is “particularly well suited to help us navigate circumstances of caregiving” and the example that in seeking informed consent from a patient virtues like being caring and discerning can be more important that “merely conforming to institutional rules” (P, 416).
Virtue ethics is well united to help navigate caregiving and delivery of information in health care. When consenting a patient, it is better to be a professional who appreciates dialogout, reassurance, and honesty, than merely conforming to institutional rules of informed consent.
26
1. Explain the distinction between an autonomous person and an autonomous choice (P, 100).
An autonomous person has the capability to self-govern themselves and makes decisions independently. An autonomous choice means that the choice is made without the influence of illness, depression, coercion, or another limiting condition.
27
2. Explain the notion that autonomy as “a second-order capacity of persons to reflect critically upon their first-order preferences” and the critique that “nothing prevents a reflective acceptance, preference, or volition at the second level from being caused by a strong first-order desire,” as in the case of the addict (P, 100-1).
Autonomy requires the ability to oppose one's first order desire using second order desires. First order desires are more basic, animalistic desires while second order desires use higher level thinking. The critique is that first order desires can sometimes overpower second order.
28
3. Explain the three conditions of the authors’ “uncomplicated account” of autonomy (P, 102).
The conditions are intentionality, understanding, and non-control. The person must have a plan and act on it. The person must understand what they are doing. And the person must be free of controls or external sources that take away from autonomy.
29
5. Explain what is meant by having both a “negative” and a “positive” obligation to respect autonomy (P, 105).
A negative obligation is to respect autonomy by not interfering. A positive obligation is respecting autonomy by fostering autonomous decision making.
29
4. Explain one criticism of “autonomy’s prominent role in biomedical ethics” (P, 104).
The model of an independent, rational will is inattentive to emotions, communal life, social context, interdependence, reciprocity, and the development of a person over time.
29
6. Explain the distinction between an “opt-out” and an “opt-in” approach for organ donation as an example of tacit consent and explicit consent (P, 111).
An opt-in approach requires explicit consent from the person. In an opt-out approach, the person’s silence is presumed to be their consent, so it is tacit consent.
29
7. Explain what is meant by “threshold levels” in judging competency for a given task (P, 115).
To determine competency, "threshold levels" are used to determine what abilities a person has that make them incompetent. It uses clear guidelines in determining competence. If you are below the threshold, you are incompetent.
30
8. Explain the notion of a “sliding scale strategy” for determining competence and the critique that this notion rests on a “dubious” thesis (P, 116-7).
Risky decisions require higher competency. Low risk decisions do not require as much, so a person with less competence can still make certain decisions. This is considered a dubious theory because a person's competence does not change with the choices they are presented with. Risk of the decision should not be considered.
30
1. Explain the distinction between the function and the justification for informed consent (P, 119).
There are many functions of informed consent, including providing transparency, allowing control and authorization, promoting concordance with participants values, protecting and promoting welfare interests, promoting trust, satisfying regulatory requirements, and promoting integrity in research. The justification of informed consent is grounded in the principle for respect for autonomy. This justification is compatible with several functions.
30
2. Explain the critique of the understanding of informed consent as the same thing as “mutual decision making” in which the patient and practitioner make a “joint decision” (P, 119).
Informed consent is not the same as shared decision making. By allowing a patient to participate in shared decision making, it ignores their right to consent to and authorize or decline those procedures. It downplays a patient's ethical and legal right to decide. Approval belongs to the patient, not the doctor.
31
3. Explain the distinction between the broad grouping of “threshold elements,” “informational elements,” and the “consent elements” of informed consent (P, 122).
Threshold elements (preconditions), include competence in the ability to understand and decide and voluntariness in deciding.
Information elements include disclosure of information, recommendation of a plan, and understanding of what is disclosed and recommended.
Consent elements include deciding in favor of a plan and authorizing the chosen plan.
31
4. Explain one criticism of the “professional practice standard” of disclosure (P, 124).
The professional practice standard holds that professional custom establishes the amount and type of information to be disclosed to a patient. One criticism of this is that it ignores and subverts patients' rights of autonomous choice. Final decisions for or against medical interventions are nonmedical decisions that belong to the patient, not the provider.
32
5. Explain one criticism of the “reasonable person standard” of disclosure (P, 124-5).
The reasonable person standard holds that the information to be disclosed should be determined by reference to a hypothetical reasonable person. A criticism of this is that it is difficult for physicians to use because they need to hypothesize what a “reasonable patient” would need to know.
33
6. Explain the controversial notion of a “therapeutic privilege” allowing an exception to the duty to disclose information (P, 126).
It allows for doctors to withhold information from their patients if they do not think it is beneficial to them. This is paternalistic and does not respect their autonomy.
34
7. Explain the concern that “information overload” and the use of “unfamiliar medical terms” can also prevent adequate understanding (P, 133).
It can prevent adequate understanding because the patient may be overwhelmed by the amount of information or confused by the medical terms.
34
8. Explained the notion of “informed refusal” and the point that “it is sometimes necessary for clinicians to vigorously challenge patients’ choices that appear to be legally binding” (P, 135).
Sometimes doctors need to challenge what patients want for their own good. For example, if a person with cancer does not want treatment because they don't believe they have it, a physician may urge them to seek treatment. Informed refusal is refusing treatment despite being informed of the need for it.
35
9. Explain the distinction regarding surrogate decision making between the “substituted judgment standard,” the “pure autonomy standard,” and the “best interests standard” (P, 141).
Substituted judgement standard requires the surrogate to make the decision that the patient would want.
Pure autonomy standard emphasizes respecting their prior wishes.
Best interests standard is when whatever is medically best for the patient is done.
36
1. Explain the meaning of the word Primum (“Above all”/“First”) Latin phrase “Primum non nocere” (“Above all/First do no harm”) (P, 155).
It means that while harm may be inevitable, a provider's first thought should be to do no harm.
36
2. Explain the distinction between beneficence and nonmaleficence (P, 156-7).
Beneficence is about doing things that result in a good outcome. Nonmaleficence is avoiding bad outcomes.
37
3. Explain how the case of Robert McFall and David Shimp illustrates the difference between a duty of beneficence and a duty of nonmaleficence (P, 157-8).
Robert McFall needed a bone marrow transplant and David Shimp was a compatible donor, but did not want to donate his bone marrow. McFall argued that he had an obligation to do it out of beneficence. Shimp thought that he had no obligation because he could be at risk of harm, which goes against nonmaleficence.
38
4. Explain what is meant by “due care” and a “standard of due care” (P, 159). Using the example of emergency vehicles, explain how this standard of due care must take into account risks and goals (P, 160).
Medical professionals have a legal duty to provide “due care” to prevent harm (nonmaleficence). While a general “standard of due care” exists, it must be adapted to specific circumstances. Emergency medical services, for example, operate under a different standard due to the urgent need for transport and the limitations of a moving vehicle. This contrasts with the more extensive care possible in a hospital.
39
5. Explain the two types of situations comprising “negligence,” the opposite of “due care” (P. 160)
The act of omission, which is failing to do what a reasonable person would have done. And, the act of commission, which is making an unreasonable choice that leads to harm.
39
6. Explain the argument that giving moral priority of withholding treatment over withdrawing treatment can lead to problematic undertreatment (P, 163).
It does not respect the patient's autonomy. It also protects the doctor more than the patient.
40
7. Explain what is meant by a “double effect” of an action in the “rule of double effect” (P, 167).
It is when an action has both good and bad outcomes, but the good outweighs the bad.
41
8. Explain the idea that in medicine the term “futility” typically expresses both a value judgment and a scientific judgment (P, 173).
It considers statistics and science, but also considers morality of the situation.
42
9. Explain how nonmaleficence can apply to the case of parental requests for treatments for infants using the case of Charlie Gard as an example (P, 179-180).
Parents can think emotionally when it comes to their child so they want all possible treatment options, even if it can cause harm. It is a physician's job to consider whether treatment will actually be helpful or not regardless of the parents emotions.
43
1. Explain the two conditions under which “letting die” is usually acceptable (P, 182).
The first condition is that medical technology is useless. The second condition is that parents or their surrogates have validly refused medical technology.
44
2. Explain the argument that the “validity of authorization – not some independent assessment of the causation of death – determines the moral acceptability of the action” (P, 184).
The presence or lack of authorization by the patient is relevant in deciding whether or not the action is morally acceptable. For instance, if a doctor withdraws treatment from a competent patient who wants and needs the treatment, it is wrong.
45
3. Explain the “slippery slope” argument that if physicians are allowed to intervene to cause death or prescribe lethal drugs abuses of the regulations of this will “grow incrementally over time” (P, 186).
Over time, physicians may begin to abuse their power. Additionally, restrictions on who can choose to die will loosen and unjustified killing may occur.
46
4. Explain the argument that there is a risk a loss of public trust if physicians “become agents of intentionally causing death.” Explain the argument that there is a risk of a loss of public trust if “patients and families believe that physicians abandon them in their suffering” (P, 187.)
If physicians are causing death, patients and families may build distrust towards them. Their vulnerabilities could be taken advantage of, quality of palliative care can decrease, and they could be coerced into requesting physician assisted death. However, if physicians refuse to help patients and families that want to proceed with physician assisted death, mistrust can build because they feel abandoned by their provider.
47
5. Explain the point that “causing a person’s death is morally wrong, when it is wrong, because an unauthorized intervention thwarts or sets back a person’s interests” (P, 189).
Causing death is wrong when it deprives the person of opportunities and goods. However, if a person freely authorizes their death by making an autonomous judgement that dying constitutes a personal benefit rather than a setback, it is not right or wrong.
48
6. Explain the case of Dr. Jack Kevorkian and Janet Atkins as a case of unjustified physician assisted dying. Explain two reasons why even advocates of physician assisted death condemn Kevorkian’s actions in this case (P, 190).
Janet Atkins had Alzheimer's disease and wanted to end her life with Dr. Kevorkian’s help. However, she was in the early years, had several more meaningful years left, and may have been depressed. The doctor also did not confirm her diagnosis, check her level of competence to commit suicide, and lacked the professional expertise to evaluate her medically or psychologically. People have condemned the case due to unconfirmed medical diagnoses and prognoses and because there was no serious assessment of her mental and emotional state.
49
7. Explain the notion of an “advance directive,” and one common practical or moral problem with advance directives (193-4).
An advance directive aims at governing future healthcare decisions through a living will or assigning a person to make decisions for them if they are incapable. A problem with this is sometimes patients change their preferences, but fail to update their advance directive.
50
8. Explain the four qualifications proposed for a competent surrogate decision maker (P, 195).
They must have the ability to make reasoned judgements, adequate knowledge and information, emotional stability, and a commitment to the incompetent patient's interest that is free from conflicts of interest and controlling influence.
51
9. Explain how the case of Mr. and Mrs. Lazarus illustrate problems the need for medical professionals to be vigilant regarding “designated surrogates” (P, 196).
Mr. Lazarus was in a coma and his wife wanted to withdraw care and let him die despite the physicians telling her that he had a good chance of survival. He ended up waking up from his coma. Medical professionals have to be wary of designated surrogates that make bad or harmful choices.
52
10. Explain the notion of “group harm” in addition to “individual harm” in considerations of nonmaleficence (P, 202).
One should try to avoid causing harm to an individual, but also be aware of not causing group harm. This could affect social, cultural, or other groups harm and lead to mistrust of the medical field.
53
1. Explain the idea that beneficence demands more than nonmaleficence and is “at the heart of medicine’s goal, rationale, and justification” (P, 217).
Physicians need to do more than just avoid harm. They must seek to do good.
54
2. Explain what it means that the principle of beneficence in medicine is not identical to the utility principle of utilitarianism (P, 218).
While utilitarians view utility as a fundamental principle of ethics, the principle of beneficence looks at it as equally important to other factors at play.
55
3. Explain the distinction between specific and general beneficence (P, 219-220).
Specific beneficence is directed at specific parties like kids, friends, or patients. General beneficence is directed beyond special relationships to all people.
56
4. Explain the concern that we need to limit the scope of the general obligation of beneficence since too wide an obligation of beneficence may make us less likely to meet our “primary responsibilities” (P, 220).
General beneficence obligates us to benefit people who we do not know or are sympathetic to. It places the same obligation to those individuals as those we have close relationships to. This is overly demanding and makes us less likely to benefit those close to us because we are focused on others as well.
57
5. List the five conditions that have to be met for a beneficent “duty of rescue” (P, 222).
Y is at risk of significant loss of or damage to life, health, or some other basic interest.
X’s action is necessary to prevent this loss or damage.
X’s actions will probably prevent this loss or damage.
X’s actions would not present significant risks, costs, or burdens to X.
The benefit that Y can be expected to gain outweighs any harms, costs, or burdens that X is likely to incur.
57
6. Explain one reason that the case of David Shimp and Robert McFall, discussed earlier, represents a “borderline” situation in which it is unclear whether there was duty of beneficence (P, 222-3).
While McFall’s life was at risk, Shimp was at risk of facing negative consequences, meaning the cost may have been too high to be considered a duty of beneficence.
57
7. Explain what it meant by “expanded access” programs for investigational treatments and how this can follow from an obligation of beneficence (P, 225).
Expanded access programs are programs for patients facing life-threatening conditions with no available treatment, therefore they try investigative treatments as a last resort. This can be considered an obligation of beneficence since the physician has a duty to try and save their patients life, even if it is only through investigative treatment.
58
8. Explain David Hume’s notion of “reciprocity” as the justification for obligations of beneficence (P, 229).
Hume argued that all obligations to good in society are reciprocal. If you give, you receive. Therefore, it is in one's best interest to promote the benefit of society.
59
10. Explain Nellie Bly’s conclusion that the insane asylum she visited was a “human rat-trap” (Handout10).
It was very easy to get into the asylum because patients were assumed to be “crazy” without sufficient cause or evidence. However, it was difficult to get out because the medical staff did not attend to them, hear them out, or provide the right medical treatment. Once “crazy”, they were assumed to always be “crazy”.
59
9. Explain what is meant by a “reciprocity-based” system for organ donation (P, 230).
People are incentivized to donate their own organs by creating a system where only organ donors receive organs if needed.
60
1. Explain the analogy between the “authoritative” figure of the father acting in his child’s best interest with the “authoritative” figure of a medical practitioner (P, 231).
Like a father trying to make decisions that are best for his child, a medical practitioner does the same. In a paternal role, the father acts beneficently and makes all or some of the decisions for his child, rather than letting the child make their own decisions. A medical practitioner is also in an authoritative position to determine the patient's best interest due to training and knowledge.
61
2. Explain the (supposed) distinction between “hard paternalism” and “soft paternalism” (P, 233).
In soft paternalism, someone intervenes in another person's life on the grounds of beneficence or nonmaleficence in order to prevent nonvoluntary conduct such as poorly informed consent or severe depression.
In hard paternalism, interventions are meant to prevent harm or benefit a person even though the person's risky choices are informed, voluntary, and autonomous.
62
3. Explain the example of needing a prescription for a medical device or drug might be a case of paternalism (P, 233).
Requiring a doctor's prescription for a drug or medical device is a form of paternalism because it aims to avoid harm that people may do to themselves whether voluntarily or involuntarily.
63
4. Explain the idea that public health measures like “sin taxes” on cigarettes often have paternalistic goals, and how soft paternalism paved the way for hard paternalism in this case (P, 235-6.)
Putting a tax on cigarettes is meant to discourage people from harming themselves through smoking. However, it started off with disclosure of information and sharp warnings, to harder paternalistic measures like taxes.
64
5. List the conditions necessary to justify hard paternalism in a health professional’s intervention (P, 238).
The patient is at risk of a significant, preventable harm or failure to receive a benefit.
Your action will probably prevent the harm or secure the benefit.
Your action to prevent harm to or to secure a benefit for the patient probably outweighs the risks to the patient of the action taken.
There is no morally better alternative to the limitation of autonomy that will occur.
The least autonomy-restrictive alternative that will prevent the harm or secure the benefit is adopted.
65
6. Explain the notion of “temporary intervention” devised by John Stuart Mill in the case of suicidal persons (P, 240).
If a person does not have a rational mindset to make a decision, someone needs to intervene even if it's temporary.
66
7. Explain how an institutional review board (IRB) considering overall risk employs the utility principle (P, 242).
They make decisions that make the most people happy, even if a few dislike it.
67
8. Explain the argument regarding opioid prescriptions that the FDA should consider not just the product and its effects on the patient but broader considerations about the risks and benefits to others in the patient’s household or community (P, 248).
If someone is taking opioids, it affects more than just them. It affects their family and maybe community, so they must be considered too.
68
2. Name and briefly explain the four traditional theories of justice (P, 270).
The first is Utilitarian theories which emphasizes that to each person according to rules and actions that maximize social utility.
The second is, to each a person a maxim of liberty and property resulting from the exercise of liberty rights and participation in fair free-market exchanges (libertarianism).
The third is, to each person according to principles of fair distribution derived from conceptions of the good developed in moral communities (communitarianism).
The final one is, to each person an equal measure of liberty and equal access to the goods in life that every rational personal values (capability theories).
68
1. Explain what is meant by “material” principles of justice that “identify the substantive properties for distribution” (P, 269).
This refers to how and why resources are used. For instance, the principle of need dictates that materials should be distributed according to who needs it the most.
68
3. Explain Robert Nozick’s libertarian argument for why welfare programs involving the redistribution of wealth through taxation are unjust (P, 273).
Libertarians value the protection of citizens’ liberty and property rights. Nozick thinks that governments act unjustly by taxing the rich. He believes the government should reaffirm individual liberty rights rather than a system that creates patterns of distribution.
69
4. Explain the egalitarian theorists idea about the role of health care in ensuring “justice through fair equality of opportunity” (P, 275).
In order to have adequate levels of functioning so that people can achieve their goals, they must be in good health, so there must be a health care system. Through a good healthcare system, people can have fair equality of opportunity.
69
5. Explain Charles Taylor’s communitarian critique of the idea of autonomous independence ”if developed in the absence of the family and other community structures and interests” (P, 276).
Taylor claims that any theory on autonomy that suggests a strong sense of independence is unacceptable if developed in the absence of the family and community structures and interests.
69
6. Explain Martha Nussbaum’s that things like “bodily health” and “bodily integrity”are “central human capacities” “essential for a human life not to be impoverished below the level of the dignity of a person” (P, 278)
There are certain things like health and integrity which are the minimal level of social justice that should be made available to all citizens. Each criteria is essential for a human to have dignity and forms the basis of human rights.
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7. Explain the “fair opportunity rule” and the argument that even “the willingness to make an effort, to try, and to be deserving in the ordinary sense is itself dependent upon happy family and social circumstances” (P, 282-3).
The fair opportunity rule argues that people should not get social benefits on the basis of undeserved advantages and should not be denied social benefits on the basis of undeserved disadvantages. The willingness to make an effort is dependent on things like family and social circumstances since that will decide what resources and opportunities are available to you.
71
8. Explain how disparities in pain care in the United States as a case of “implicit bias” (P, 284-5).
Medical professionals have biases. For instance, they may believe a white person pain is real and prescribe them medication while failing to believe a black person's pain and dismissing them.
72
9. Explain the worry about involving the economically distressed in research studies and the argument that nonetheless to exclude them would be paternalistic and unjust (P, 287).
Including economically distressed people in studies can be concerning because they may be doing it out of desperation and coercion. However, it would be paternalistic to exclude them because it's deciding what is best for them without letting them make that choice themselves.
73
10. Explain the concern about “undue inducements” for research subjects. Explain the concern about “undue profits” in relation to research subjects (P, 288)
Concerns about undue inducement in research arise when large payments or offers may compromise a participant’s ability to make an informed, voluntary decision. Conversely, concerns about undue profit involve situations where researchers gain disproportionately high benefits compared to what the research participants receive.
74
1. Explain one of the factors that Dr. Murthy blames for driving many health care workers “to the brink,” i.e., resulting in burnout (Handout 11).
One of the factors driving health care workers to the brink is the frequency of physical and verbal assaults at work.
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2. Explain Dr. Murthy’s argument that the “stakes are enormous” in the need to address provider burnout (Handout 11).
If doctors and nurses quit due to burnout, it will affect the public’s ability to receive care, health disparities will worsen where care is more scarce, costs will rise, and it will be difficult to be ready for the next public health emergency. Because of this, it is crucial that burnout in healthcare is addressed.
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3. Explain Dr. Murthy’s argument that society has a “moral obligation” (of justice) to address the problem of provider burnout (Handout 11).
He claims that society has a moral obligation to address provider burnout because we must take care of the people who take care of us. We cannot take their dedication, health, or safety for granted.
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5. Explain the worry that pushing for greater “work-life balance” can jeopardize the approach to medicine in which ‘the patient comes first’ (Handout 12).
By prioritizing themselves, they may not prioritize the patient.
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4. Explain how “paperwork and other bureaucratic demands” adds to the problem of provider burnout (Handout 12).
It makes the job less satisfying because they did not go into healthcare to do paperwork. They went into healthcare to help people.
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6. Explain the idea expressed by Dr. Comfort that working long hours was more acceptable when practitioners were “masters of our own fate” (Handout 12).
Doctors used to have much more autonomy, so they felt more comfortable working long hours and making sacrifices. However, now doctors are treated like any other employee and lack autonomy. Because of this, they are not willing to work like they used to.
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7. Explain the objection to the traditional understanding of medicine as a “calling” (Handout 12).
Some feel that it is offensive to call medicine a calling because it's an opportunity to take advantage of doctors and treat them poorly.
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8. Explain how the concern about sleep deprivation for providers is also a medical concern for patients (Handout 12).
Medical errors increase when providers are sleep deprived.
