Download Bioethics Final Exam - Medical Ethics (DNSN) | PHIL 148A and more Study notes Introduction to Philosophy in PDF only on Docsity!
Bio Ethics Final exam: Main moral concerns about organ donation and transplantation: One moral concern, specific to post-mortem donations, is whether or not its ethical to artificially keep a brain-dead person from experiencing cardiac death for the sole purpose of preserving desirable organs. Another moral concern involving organ donation and transplantation is determining how to fairly allocate organs between patients. Should there be a market for organs? If not, should there be a selection committee, a lottery, or a first-come, first-serve list? Should the identity of a potential recipient be a factor in determining eligibility? For instance, it is up for debate whether or not a recovering alcoholic should be eligible for a liver transplant. Some may argue that an alcoholic lived life irresponsibly and should not be trusted to take care of a new liver in high-demand. Others may contend that alcoholism is a disease in and of itself, and that a candidate should be rehabilitated and not discriminated against. Due to scarcity of such an “exotic lifesaving therapy”, should the identity of a candidate be considered? For example, a person with a longer remaining life expectancy and a family to support should get precedence over an elderly individual living on his own. Whether or not it should be legal to sell organ’s is another moral concern. Prohibiting the sale of organs creates a “black market”. Organs sold in a black market are often justified by utilitarian thinkers. Utilitarians argue that the life saved as a result of the sold organ is enough to justify breaking the rules. Deontologists, on the other hand, adhere to rule based ethical principals. Therefore, deontologists would oppose black market organs. It is often argued that allowing organs to be bought and sold inevitably leads to exploitation of donors. The autonomy of the would-be donor could not possibly be preserved because the donor is coerced with money. Black market donations also lead to organ theft, providing incentive to murder for an individuals organs. Living donors are often close family or friends with the patient in need of an organ. Although rare, live donors sometimes make altruistic donations to complete strangers, as well. The moral concern here is that many donors are inadequately informed of the risks and hardships of organ donation. Donors undergo major surgery with no possibility of benefiting medically. Studies show that many organ donors come to regret their decision soon after. Donors are supposed to be offered every opportunity to change their mind, but is their
autonomy really protected when another’s life is dependent upon the decision? Such a high-pressure situation can affect a donors ability to think rationally. Organ donation: emphasis on moral issues, developing moral principals a) Live vs. dead Live: can provide consent Dead: a person can’t b) identity of recipient Where should an alcoholic be on a organ donation list? Will he just mess it up again? When the person dies does a person have an entitlement to his organs, does a family have an opinion on who receives the organ? c) prohibition of selling ones organs Issue of profit d) where it is going to be allocated who its going to go, the rational self determination in distributing
- active euthanasia Passive euthanasia a. voluntary Involuntary b. provide two different arguments grounded in different moral principals Active euthanasia occurs when doctors take direct action to end a patient’s life, usually by giving them a lethal injection. Passive euthanasia is failing to provide a medical intervention that might extend dying patients’ lives such as doing CPR or starting a course of antibiotics to treat an underlying infection. These are most commonly differentiated as killing versus letting die. The distinction is an important one as it draws a line that physicians must not cross between “letting nature take its course” and actively ending patients lives. Voluntary euthanasia: a person takes his/her own life, either directly, or by refusing treatment Involuntary euthanasia: ending another person’s life contrary to that person’s wishes Nonvoluntary euthanasia: “the decision about death is not made by the person who is to die.” OPPOSING arguments against euthanasia
- Helping patients die violates the doctor’s duty to save lives
- Human beings do not have a right to take their own lives- this is playing God. Argument #1 is convincing because it can be backed by the ethical
pool and who’s to say that their limitations should provide this boundary of genes? -Need a genetic supermarket Providing a genetic supermarket could in fact create more diversity rather than reducing genetic variety. There would be a limitation to what parents could choose, to be sure that the parents aren’t picking genes to harm their children (ex: for religious reasons). The genetic supermarket could meet the specifications of parents “within certain moral limits.” This argument could positively be supported for therapeutic engineering, as we know parents would not pick out harmful diseases for their children. However, this may also be in an ineffective argument for non therapeutic engineering. It could create an unequal ratio of sexes. Parents could also see children as being less successful if they weren’t completive enough or selfish. This could lead to a shift in genes that could negatively affect the social world and creating unnecessary and unwanted consequences. b. arguments against genetic engineering -less genetic diversity Picking out certain genes for a child is going to create less genetic diversity. This idea is one of the top main arguments against genetic engineering. Would people want to live in a world where everybody looked the same and acted in similar manners? Most would argue no. There is also the idea of natural selection. Most people have accepted genetic change as a result of environmental change. By deliberately trying to change one’s genetic make up, may result in a person who it not necessarily fit to survive the environment. I think this creates a strong argument as I believe survival in life is much more important than vanity reasons of living life. -too risky “We may produce unintended results either because our techniques turn out to be less finely tuned than we though or because different characteristics are found to be genetically linked in unexpected ways” In other words, the results of genetic engineering are still unknown and the consequences could be highly unwanted. Is this risk worth being able to directly manage the makeup of our genes? I think this may only create a weak argument in that clinical trials are performed all the time, and without any failures in science and medicine, one cannot grow. Many positive things have come out of trying out the unknown and testing the untreatable. c) Positive eugenics may cause more of a more issue due to the fact that people are promoting the idea that one gene is better than the other. In addition, with negative eugenics people would usually not object to the use of eugenic policies in efforts to eliminate disorders in their children.
In therapeutic cloning, the goal is to be able to generate cells, tissues, or organs. For instance, if a person needed a bone marrow donation, or a kidney, then the idea is that, with therapeutic cloning, we would be able to grow a perfect fit (like a spare part) that would bring no risk of rejection. In reproductive cloning, the aim is to bring to life an offspring who is genetically identical to the somatic cell donor. This applies to the ‘Dolly the sheep’ case in 1996, where a female domestic sheep was the first mammal to be cloned from an adult somatic cell. a) One argument for reproductive cloning includes a medical need, such as cloning for those who are infertile. Reproductive cloning would provide genetically related children for people who cannot be helped by other fertility treatments. An additional argument for reproductive cloning is that it would allow lesbians to have a child without using donor sperm, and would also allow gay men to have a child that does not have genes derived from an egg donor. Ultimately, reproductive cloning would allow nontraditional couples to have children that are genetically related to one of the parents. I find these arguments to be ineffective because by using reproductive cloning you are not just providing parents with a genetically related child, but rather a genetically identical child. This can create a multitude of problems in the parent-child relationship, such as making the child feel as though he or she is constantly trying to meet or surpass the standards set by the parent he or she is a clone of. Additionally, it would be impossible to extend reproductive cloning to lesbian and gay couples without extending it to the general population, as this would be considered unfair to those who are simply infertile, and not gay. b) The main argument against reproductive cloning is that it would diminish the sense of uniqueness of an individual. Those against reproductive cloning feel as though by using cloning you are threatening identity and individuality, which the human population values extensively. There is fear that clones will be devaluated in society compared to those who are non-clones. Another argument against reproductive cloning is that it is medically risky and inherently unsafe. It is basically an experiment on the resulting children, and many of the mammalian cloning experiments have resulted in miscarriages, stillbirths, and life-threatening anomalies. I feel as though the arguments against reproductive cloning are effective because they are concerned with the wellbeing and healthiness of the resulting children rather than the satisfaction of those being cloned. Both arguments are based on the idea that the cloned children will not be as well off in society as those who are not cloned. I think that when all reproductive technologies are discussed, the main concern should be about the resulting children, which is what arguments against reproductive cloning deal with.
healthcare system. Autonomy demands that each rational, competent person be given the right to make medical decisions that affect his or her life. Just because somebody has aged, does not mean they do not have the right to continue living. He or she has the right to make medical decisions such as what treatments they receive or for how long they wish to be treated. While healthcare is limited, I think that people, no matter their age, should have equal access to resources as long as they wish to extend their lives. Beneficence is the idea that one should “do good” for patients, and that the whole purpose of medical practice is to make lives better, to improve patients’ situations and to make people well again. My beliefs coincide with this principle because by treating people, regardless of age, the ultimate goal is to improve their situations. Usually, ending ones life is not improving their situation or helping to make them well again. While there are exceptions to this idea, patients who still have a chance to live longer should have access to healthcare that will help them do so. The principal of nonmaleficence states that, above all, healthcare providers should “do no harm.” By denying a patient treatments or medications because of their age, healthcare providers are not abiding by this principal. In fact, they could quite possibly be causing harm and suffering. If a patient wishes to be treated and to extend his or her life, a physician should not be able to deny them of treatment because they are elderly. These three principles support my feelings that patients should have equal access to healthcare, regardless of age. c) I feel as though usually, the ends of medicine should include the attempt to extend life. As long as the patient has a desire to continue living and continue undergoing treatment, he or she should have the right to extend his or her life. Only if the patient expresses fatigue from treatment or has lost a will to live, should extending life no longer be the concern of the physician. If the patient will experience a great deal of suffering following methods to extend his or her life, then it is not fair to the patient if he or she has lost quality of life to increase quantity of life.
- I believe that as an illegal immigrant the doctor should take a certain measures in taking care of this women. Many may argue that she has violated a law by entering the US illegally. However, does breaking a law constitute not being able to receive health care. Many people break laws daily, such as working off the books and getting paid without taxes. These people however aren’t punished by not being able to receive health care. One must consider the fact that we have a limited resources, and that taxpayers are feeling the blunt of care for the illegal immigrants. Because of this fact, I believe that there should be a limit to how much, I as a doctor, could help the
women out. There are the extremes of paying for all her bills to receive treatments and medicines to bring her fully back to health, and then there’s refusing to help completely. I believe that there is a happy-medium within these two extremes in which this women could be helped without costing taxpayers too much money. Having to report an illegal immigrant is also a violation of the patient’s confidentiality, which is part of the doctor’s Hippocratic Oath. Having to turn in an illegal immigrant has no relations to that of health care, nor does not require medical expertise. Because of this, I think that one shouldn’t ruin the women’s life and report her as illegal, as it is not a responsibility of a doctor. I believe it to a be a matter of social responsibility as a human to provide the women with a basic human right of health care. Illegal immigrants often come to this country and perform the worst job for the lowest wages. Although they may have voluntarily agreed to this instead of returning home, in most cases it is the better of the two choices. This is why I believe it is our social responsibility to provide health care to those who are opted into our capitalist economy. Although they may be illegal, they are still social members who work hard and participate in different aspects of various communities. Autonomist- needs to be rational and cannot have outside inflictions.
- Direct-to-consumer advertising (DTC advertising) usually refers to the marketing of pharmaceutical products but can apply in other areas as well. This form of advertising is directed toward patients, rather than healthcare professionals. Forms of DTC advertising include TV, print, radio and other mass and social media. There are ethical and regulatory concerns regarding DTC advertising, specifically the extent to which these ads may unduly influence the prescribing of the prescription medicines based on consumer demands when, in some cases, they may not be medically necessary. In general, the advertisements are directed towards patients not doctors. When a patient wants a drug they will rotate through doctors until they get the drug they want. Patients aren't as qualified as doctors to choose what prescription drugs they want also. Arguments for: Without the profits drug companies make from advertising prescription drugs to consumers, those companies would have less money to develop life-saving and life-improving medications. Prescription drug advertisements inform consumers about potential medical conditions they may have and about drugs that could help treat those conditions. A consumer better informed about medical issues is more likely to contact his/her doctor to discuss the condition
ii. Prioritize essential medical and scientific personnel iii. Prioritize health and safety infrastructure iv. Prioritize those with the greatest medical needs v. Prioritize based on life cycle vi. Prioritize the chronically underserved vii. Prioritize early detection and response globally viii. Prioritize transparency and public cooperation Prioritizing early detection and response globally is the most convincing because if nations work together to find diseases and prevent them from an early start, there will be no worries on becoming susceptible to new diseases, etc. There is a conflict between the physician-patient relationship and the duties of a physician during a public health crisis. If there is a pandemic occuring, and the physician knows that a patient could be the root cause of the problem, it is up to the physician to decide whether to report the patient or keep medical histories confidential. In making this decision, it is also important to keep in mind the future of the patient-physician relationship. If a patient is turned in by the doctor, the patient may see this as an act of mistrust and refuse to see the physician again, therefore the physician has a loss of a patient or patients. Also breaking the Hippocratic oath.
