Week 6: Ethics Of Transplantation

Question 1

What are the key legal frameworks underpinning organ transplantation?

Answer 1

Human Tissue Act 2004 - enforced by Human Tissue Authority
Consent
Opt out system as of May 2020 (The Deemed Consent act)

Question 2

What are the key points of the Human TIssue Act 2004 regarding organ donation?

Answer 2

Regulates the removal, storage, disposal and use of human tissue for living organ donation and other uses such as cadaveric anatomy.
The act is enforced by the Human Tissue Authority
Emthasises the importance of consent from the donor and the use of the organ for a selected and appropriate purpose.

Question 3

What is the purpose of the Deemed Concent Act 2019 in England?

Answer 3

Law for dead donor organ donation
Assumes an opt out system at time of death - must register on NHS Organ Donor registry to state wish not to become an organ donor of family/close friends must express wish to not donate after death.
This act does not apply to those under 18yrs, people who lack the mental capacity to understand the new arrangements and take necessary action e.g dementia patients
Visitors to England or those not living here voluntarily
People who have lived in England for less than 12 months before their death.

Question 4

What is meant by medical justice>

Answer 4

When deciding if an action in ethical must consider if it is compatible with the law, the patients rights and if it is fair/balanced.

Question 5

What is the principle of QALYs in medical justice?

Answer 5

QALY - Quality Adjusted Life Years
Utilitarian principle that focused on the outcome that will provide the greatest improvement in quality of life for the longer period to time
1 QALY is equal to one year of healthy life expectancy.
Is used as a method of quantifying benefit for cost effective analysis.
Based on Bentham’s theory

Question 6

What is Rawls theory of medical justice? Fair society

Answer 6

Fair society is based on what most rational individuals would choose
Based on veil of ignorance thought experiment - people described many societies and able to pick which one they would choose, some societies have large variation in wealth distribution (Billionaires and less than £2 a day) and ones have even distribution of wealth (e.g all middle class)
Most people would choose the society with the best well off poor.
Therefore justice is an action that results in the best outcome for the most well off.

Question 7

What is aristotles theory of medical justice?

Answer 7

An action is just if it fulfils a persons/objects absolute objective or aim.
You must known an objects telos
For example: most likely to save a life or extend a life.

Question 8

What are the different foundational values for moral reasoning?

Answer 8

Spectrum from individual need concerned to general principles and societal concerned
Indiviudal concerned tend to be more liberal in thinking and think harming another is the greatest evil, focused on interpersonal relationships.
1. Care
2. Fairness
3. Oppression
4, Loyalty
5. Authority
6. Sanctity
Societal focused are more conservative in nature and think the greatest evil is desecation, there is implied protection against sentiment life or objects.

Question 9

What are the different anthropoligies that undermine our ethical views?

Answer 9

Most indivudialism ( you are the product of your own individual choices)

Libertarian
Liberal
Utilitarian
Postmodern

Most collectivism (you are the product of social forces and structures)

Question 10

What is the difference between individualism and collectivism?

Answer 10

Individualism - you are whollly the product of your individual choices

Collectivism - you are wholly the product of social forces and structures

Question 11

What are the principles of libertarian?

Answer 11

Justice is about freedom
Minimal state intervention
Increased individual autonomy
This is fair because everyone had equal chance to make decisions - no one is being limited by anyone else-
Idividualist approach

Question 12

What are the principles of a liberal anthropology?

Answer 12

Justice is about fairness
Equality is important - in terms of access and ability to have an opinion
Views of freedom of speech, religion and press.
Government should protect and promote individual rights and equality

Question 13

What is a utilitarian anthropolgy?

Answer 13

Justice is about happiness
Actions should promote good (happiness) and avoid bad
Produce the greatest amount of good for the greatest amount of people

Question 14

What is the postmodern anthropology>

Answer 14

Justice is about power.
Regocnises the need of cultural institutions to communicate with people and promote engagement of the poorest in society
Just by increasing the power of the poor - even playing field - promotes equity

Question 15

What are the three different perspectives on justice?

Answer 15

Rights
QALYS
Social factors

Question 16

What are the three main different moral theories?

Answer 16

Consequences
Duty - to follow rights and responsibilities
Virtue (character - how would a morally right person behave, what action makes me morally good)

Question 17

What is meant by microjustice in medicine?

Answer 17

Micro-ethics - consequences of individual behaviour, often when there are multiple actions all of which are legal, but have a variety of consequences some which are desirable and others that is not.
Decisions that each individual doctor makes

Question 18

What is meant by macroethics?

Answer 18

Collective social responsibility of a profession or society
In the NHS this could be funding decisions, allocation method of GP appointments.

Question 19

What are the key ethical questions realted to organ donation?

Answer 19

Do we own ourselves? My body, my choice
Can someone be harmed after death?
How should organs be allocated?
Do the benefits or organ transplants outweigh the costs?
Should a trade in bodily organs be prevented?
Should the donation of organs be opt-in or opt-out?