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Biology 311D > PHL > Flashcards

PHL Flashcards

1
Q

technological innovation in medicine

A

developments in medical knowledge and techniques have played a major role in reshaping cultural and legal attitudes toward contraception and abortion.

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2
Q

challenges in ethical theory

A

in philosophical bioethics, careful analysis can help make some progress on some issues.

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3
Q

moral nihilism

A

there are no moral facts, moral truths, and no moral knowledge.

  • nothing is right or wrong
  • morality is an illusion that should be abandoned
  • moderate nihilists do not recommend abandoning morality… they offer a theory
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4
Q

theory from moderate nihilists

A

Emotivism- morality expresses our feelings

- author agrees that there is some emotion toward morals, but it does not mean assigning feelings ultimate authority

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5
Q

another form of moderate moral nihilism

A

Ethical Relativism: morality relative to society/culture

  • right or wrong determined by culture
  • not very good theory. not true.
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6
Q

ethical theories

A

they offer one idea as the key to morality and attempt to reduce everything to that one idea

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7
Q

utilitarians

A

right actions are those that promote the greatest happiness of the greatest number

  • if they promote the opposite of happiness, then they are wrong
  • principle of utility: greatest happiness principle
  • actions that promote happiness have positive utility
  • a consequentialist theory
  • can be a violation of ought-> can
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8
Q

kantians

A

right actions are those that can be consistently willed universally

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9
Q

act-utilitarianism

A

primarily concerned with the consequences of specific acts

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10
Q

rule-utilitarianism

A

primarily concerned with consequences of general policies

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11
Q

Kantian ethics

A

argues that consequences can never make an action right or wrong

  • an action that brings a lot of happiness might still be wrong
  • good consequences can never make a wrong action right
  • the ends do not justify the means
  • rejects consequentialism
  • pain is not always bad and pleasure is not always good
  • our rationality is far more important than what we feel
  • we human beings are separated from everything in the world bc of our moral status
  • people have intrinsic worth and must be treated as ends in themselves and not merely as a means to some other end
  • ALL person must be treated equally
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12
Q

Utilitarian approach

A
  • killing one innocent person and using their organs to save 4 other people
  • this would be right since there is a net gain in four lives
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13
Q

Kantian approach

A
  • killing one innocent person and using their organs to save 4 other people
  • here we are treating the innocent person to use their organs as a mere means and could never be justified. this is murder.
  • Kant doesnt say that we should ignore the consequences of actions, they should only be considered after determining that the action is morally permissible
  • if you act right (regardless of consequences), you are not responsible for any bad effects
  • duty should be independent of consequences
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14
Q

social contract theory

A
  • we ought to fulfill obligations that we agreed to
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15
Q

mutual advantage theory

A
  • denies natural duties to others
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16
Q

impartial theory

A
  • people are ends in themselves
  • everyone deserves equality
  • self interests amounts to acting impartially
  • equality… we must guarantee universal access to heath care
  • Veil of ignorance: moral duty to our commitment to others and putting ourselves in their shoes (being empathetic).
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17
Q

Rawls approach

A

Dr. Brody’s dilemma

  • each individual has maximum liberty possible
  • protect weak and vulnerable who cannot bargain for themselves.
  • > approve if it promoted individual autonomy
  • > disapprove if it violated equal respect for persons
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18
Q

Religious ethics

A
  • Not an ethical theory.

- EX: Roman Catholic Church has considerable unanimity (well developed written body of though on medical moral issues).

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19
Q

Natural Law Theories

A
  • we desire things bc they are good. not that things are good bc we desire them
  • focuses on what makes us humans, distinctive: ability to reason
  • suffering is not bad bc bc it allows us to appreciate god
  • do good and avoid evil
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20
Q

Natural law approach

A
  • not to give Lasken the shot bc “life is precious in the eyes of god”
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21
Q

The doctrine of the double effect (DDE)

A
  • useful for justifying an action that has a bad effect
  • created bc an act may. have both good/bad effect
  • doctors job is to ease pain, not kill. giving drugs for pain is not wrong bc the good effect is produced by administering the drug, not by the bad effect (death of patient)
  • critics say that the principle is confusing and difficult to apply.
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22
Q

Ordinary Treatment

A

treatment that is obligatory

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23
Q

Extraordinary Treatment

A

no obligation to provide

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24
Q

“right-based” approach

A
  • people can have rights regardless of the legal system
  • abortion, euthanasia are conflicting moral rights
  • taking goods away from people that earned it , violates their rights// unfair
  • does Mr. Lasken have a right to end his life and to ask his doctor for help?
25
Q

Libertarianism

A
  • right for people to do whatever they want as long as they don’t violate anyone else rights. can be problematic bc it only focuses on individual rights not social consequences.
  • individuals freedom is everything and impact on society is ignored
  • negative rights: rights to be left alone, they do support legitimate taxation
  • positive rights: rights to be helped, not good, infringe on the freedom of individual.
26
Q

Communitarian Ethics

A
  • all four guiding ethical norms, rules, principles, theories, and virtues can be traced to traditions and ways of life.
  • value neutrality
  • look for common good of a community
  • rejects idea to elevate individual above a social group or community
27
Q

communitarian approach on physician assisted suicide

A
  • human life is sacred, prohibit the act, point out traditional commitments, “doctors heal, they don’t kill”
28
Q

progressive marxist communitarian critique

A
  • all ethical principles and virtues grow from historical traditions, not products of reason.
29
Q

hardcore communitarians

A

reject liberal rights

  • limit freedom of individuals (obtain contraceptives, abortions)
  • most learn to respect differences w our cosmopolitan societies
30
Q

Feminist ethics

A
  • concern for welfare of all women.
  • women have been oppressed by patriarchal societies
  • correcting male bias in ethics
  • aware of balances of power between genders and races
  • all forms of oppression must be fought!
  • some feminists believe evil comes from men (wars, violence, racism, destruction)
  • Relativism: female circumcision poses dilemma for feminists bc… is there a way to have feminist ideals without rejecting multiculturalism?
31
Q

Virtue Ethics

A
  • condition for goodness of anything
32
Q

act-consequentalist

A
  • right action is one that produces good consequences
33
Q

contemporary virtue ethicists

A
  • Aristotle: choices we make reveal our conception of the good life
  • one must act noble and good
  • come to understand what is noble and why
  • to perform right action, one must cultivate virtues for oneself and rely on experience and appreciate/judge things for oneself
34
Q

how to exercise virtue goods

A
  1. represent human emotions and intellectual capacities. they’re valuable in their own right
  2. play role in human flourishing.
  3. without virtues one does not understand what makes an action noble/just or appreciate morality
  4. motivation to do right
    - those who lack this will regard actions as painful or trying to gain reward from them
35
Q

Non-moral Dimension

A

Dr. Brody will help Mr. Lasken which means she will break the law. she has to consider the vast consequences.
- hard thing in life is having the wisdom to figure out when non-moral actions are justified .

36
Q

Modes of moral reasoning

A

theories contribute to our search for ethical warrants or reasons that tend to justify our actions.
- utilitarianism, kantianism, rights-based theories, articulate moral behaviors and principles. rules at a high level of abstraction.

37
Q

Principles Approach

A
  • bioethics: it is not clear which ethical theory is best. Theories are too general and capable of generating contradictory answers.
  • Ethical theories are best seen as partial perspective on complex moral reality
  • PRINCIPLES APPROACH: keeping a list of moral duties. they became a mode of doing bioethics in the US.
38
Q

Principles of autonomy, beneficence, nonmaleficence, and justice

A
  1. respect individual autonomy and act accordingly
  2. foster interests and happiness of other people
  3. no harming
  4. be fair, equal, and resolve disputes by means of fair procedures.
    - these principles, unlike theories, weight and balance principles in each moral situation.
39
Q

HOW principals can be applied to AIDS

A
  • doctors violation of confidentiality is violation of beneficence and nonmaleficence
  • must respect patient confidentiality
  • Principlism: cannot invoke a value that always wins. must weigh and balance conflicting values. for example, autonomy outweighs prevention to harm others.
40
Q

objections to principles approach

A
  • inability to provide a rationally defensible framework to settle conflicts between competing principles.
  • Consequences have to be settled through a process of weighing and balancing of principles (not straightforward like utilitarians or realism)
  • its subjective
41
Q

Casuistry or case-based reasoning

A
  • when potential benefits to patients might be great that moral approval may be justified.
  • Casuists insist that weight of principles reside in details.
  • sometimes, need to reject moral bedrock
42
Q

Hippocratic oath

A
  • does not show any patient autonomy bc it was not part of medical practice.
  • overrides self determination rights
43
Q

Refutation (wrong/false) of medical paternalism

A

reasons why the decisions should be left to individuals:

  1. they are their best judges
  2. value of self determination
  3. doctors who want to make special decisions are claiming special authority.
    - doctor must say truth to patient. lying to patients about their illness just to save distress is jeopardizing their right to self determination– doctor is shifting power to themselves and away from patient.
44
Q

case for medical paternalism

A
  • strong role differentiation (more power to doctor)

- paternalistic (overriding rights/freedom of individuals for their own good)

45
Q

Paradigm Cases

A
  • Jane doesn’t wanna get hurt, yet she doesn’t wear a helmet when riding a motorcycle. Here we assume that not wearing a helmet is not acting in light of her own truth long range values.
  • Paternalism can be justified by two considerations:
    1. right of self determination bars assumptions to override their autnomy
    2. rights based on moral theory: autonomy of individual more fundamental than particular goods enjoyed or harms they may suffer.
  • licensing physicians which prevents others from harming, but also limits freedom of choice for their own good. Assuming that a regular person doesn’t want to be treated a “quack”
  • restraints necessary in whatever form
46
Q

Application of the criteria to medical practice

A
  • argument for paternalistic: doctor knows more to treat the life of a patient. person must be acting irrationally or inconsistently with their own preferences.
  • bad prognosis depresses the patient than to serve a medical positive purpose.
  • sometimes, overriding patients right to decide the basis of truth needs to be done by the fundamental medical principle of providing optimal care and treatment.
  • should a doctor inform a terminally ill patient when their gonna die? maybe not because truth will cause direct harm
  • doctors must balance uncertain benefits and risks in trying to provide treatment that will maximize the probability of cure with least damaging side effects. they must assume full responsibility for any resulted harm.
  • person needing care suggests that they’re not capable of being physically autonomous.
47
Q

refutation to medical paternalism

A
  • disclosure of information may cause depression upon patient. can be detrimental to their health
  • health is assumed priority
48
Q

relativity of values: health and life

A

people derive their meaning form their project and accomplishments.

  • quality of life counts, not simply just being alive.
  • Hedonistic theories of value: produce pleasure or avoid pain and depression
49
Q

case study: beneficence today, or autonomy tomorrow

A
  • Monica is a smoker and had dyspnea for many weeks but did not sought medical advice
  • alternative for her case:
    1. withdraw life sustaining measures
    2. continue ventilation and heavy sedation but not treat any complications that arise. persuade surgeon to implant a stent without consulting monica
    3. wake her up so the team can discuss the diagnosis and prognosis with her. (the team does not know if she will be autonomous enough for her decisions.. should she be woken up?
50
Q

commentary about Monica’s case

A
  • principle of autonomy: Monica should have the opportunity to decide. has right to be informed.
  • reducing sedation just to talk about her preferences will cause suffering
  • depends if there are important things she would like to accomplish before she dies
  • not waking her up would be an unjustified form of hard paternalism
51
Q

why doctors should intervene

A
  • doctor not allowed to hold info from patient even if harmful
  • respect confidentiality of the doctor-patient relationship
  • ethicists condemn paternalistic practices in therapeutic relationships but fail to investigate the features that incline physicians to be paternalistic
52
Q

returning control to patients

A
  • doctors should seek to neutralize the impediments that interfere with patients choices
  • 2 duties of the physician to “return control” to patients:
    1. provide competent care
    2. fully inform the patient
  • physicians may need to influence beliefs and attitudes of relatives that limit their awareness of the patients perspective.
  • knowledge of patients psychological and social situation is important to help them act as a fully autonomous person
53
Q

beyond legalism

A
  • values and beliefs of patients may conflict with physicians, noninterference is best
  • a physician-patient relationship is like a parent-child or teacher-student relationship.
  • many positive interventions must be emphasized since task in the therapeutic process is assisting patients to reestablish control over their own lives
54
Q

4 models of physician-patient relationship

A

paternalistic, informative, interpretive, and deliberative model

55
Q

Paternalistic

A

doctors use their skills to determine patients medical condition and try to restore health of patients. doctors act like guardian

56
Q

informative model

A

doctor provides patient with all info for the patient to select the medical interventions they want. their obligation is to provide what the patient lacks which are facts so that they can determine whats best for themselves based on their values. patients make decisions. like a technician

57
Q

interpretive model

A

doctor provides information. they assist patient and articulate their values in determining what interventions are best. they help interpret the patients values. doctor works with patient to reconstruct their goals and aspirations, commitments and character. physician is basically a counselor

58
Q

deliberative modeal

A

doctor basically gives suggestions. both judge worthiness and importance of health related values. they basically act as a teacher or friend. patient autonomy is moral self development.

59
Q

instrumental model (not good)

A

completely ignores patients values. physician is worried about their own goal (Tuskegee syphilis experiment). only model that does not consider patient autonomy at all.

Biology 311D (2 decks)

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