Term
Identify and explain 5 of the 10 patient protections on the Nuremburg Code. |
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Definition
1. The voluntary consent of the human subject is absolutely essential. This means that the person involved should have legal capacity to give consent without force, fraud, deciet, or coercion.
2. The experiment should be such as to yield fruitful results for the good of society, unprocurable by other methods or means of study, and not random and unnecessary in nature.
3. The experiment should be so designed and based on the results of animal experimentation and a knowledge of the natural history of the disease or other problem under study that the anticipated reslts will justify the performance of the experiment.
4.The experiment should be so conducted as to avoid all necessary physical and mental suffering and injury.
5. The experiment should be conducted only by scientifically qualified persons. the highest degree of skill and care should be required through all stages of the experiment of those who conduct or engage in the experiment. |
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Term
Identify and explain the three main principles of the Belmont Report. |
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Definition
1. Respect for persons-individuals should be treated as autonomous agents and persons with diminished autonomy are entitled to protection. In research respect for persons demands that the subjects enter into the research voluntarily and with adequate information.
3.Beneficence-Persons are treated in an ethical manner not only by respecting their decisions and protecting them from harm but alsp by making efforts to secure their well being. Do not harm and maximize possible benefits and minimize possible harms.
3. Justice- Who ought to recieve the benefits of research and bear its burdens? Just ways to distribute are to each person an equal share, to each person according to individual need, to each person according to individual effort, to each person according to societal contribution and to each person according to merit. |
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Term
Identify and explain three of the populations particularly vulnerable in medical research. |
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Definition
populations incapable of giving consent- children, animals, and fetuses.
Children - There are grey areas of defining "child", Role of parental consent or refusal, vulnerability to coersion in academic environments.
Animals- Capacity of animal suffering, cognitive capacity and ability to have preferences conveys moral status.
Fetuses - necessary to benefit prenatal care, tie to abortion debate, necessary to test drug effects.
Populations espacially vulneranle to coersion- children, prisoners, poor populations, terminally ill patients
Prisoners- strong challenge to consent (highly coersive environment)
Poor populaions- Financial considerations impact the decision to volunteer, Research continues to be done at municipal hospitals, which have less affluent patients.
Terminally ill patients- Possibility of a cure is coercive, high patient expectations of success
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Term
Identify and explain two of the three "standards of disclosure" in informed consent. |
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Definition
- Subjective patient standard: Disclosure of all info that the patient views as important opens up liability, patient puts info into own words and explains back.
- Reasonable patient standard: Disclosure of what the average patient would want to know, risks of treatment and common concerns.
-reasonable clinician standard: what the average clinician discloses or reveals. |
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Term
Identify and explain five of the eight normal factors of disclosure in informed consent. |
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Definition
- Diagnosis
- Nature and purpose of treatment
- Risks and outcomes
- Disclosure of skill or status risks
- Alternatives
- Prognosis if treatment or test is declined
- Prognosis with treatment
- Conflicts of interest
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Term
Identify and explain three of the five exceptions to the need to secure informed consent.
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Definition
- Blanket authorizations (questionable justification)- Hey Im sick....do anything to make me better. Removing the information/discussion portion of the consent.
- Emergencies
- Implied Consent (consenting to all steps necessary in treatment)
- Patient waivers (waiving the rights to medical information)
- Therapeutic privilege (questionable justification)- I don't think you can handle all the information so i'm going to withhold it from you. |
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Term
Explain state versus personal paternalism. What are the differences between them?
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Definition
- Paternalism is the interference of a state or an individual with another person, against their will, and justified by tha claim that the person interferes with will be better off or protected from harm.
State paternalism is the control exerted by a legislature, agency, or other governmental body over particular kinds of practices or procedures
Personal paternalism consists in an individual's deciding, on the basis of his own principles or values that he knows what the best is for another person. |
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Term
Identify and explain three reasons why clinicians might not accurately educate their patients. |
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Definition
Valid cosent requires deliberat before we are able to give a "true" consent. Genuine deliberation requires both information and understanding. 1. some physicians have argued that it is pointless to provide relevant medical information about research and treatment because they are so technical and complicated. 2 patients lack a medical background ; they cant be given the information in a form to adequately help them decide hoe they are to be treated. 3. Patients simply dont know what to make of the information being given to them. Obligation is imposed onto physicians to find a way to explain medical matters to their parents.
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Term
| Identify and explain three exceptions to medical privacy. |
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Definition
- Infectious diseases -TBm some STDs (public health concerns)
- Child Abuse
- Assault |
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Term
Why do some people argue for a moral difference between a zygote, fetus, and neonate? |
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Definition
Munsun- attitudes of public opinions, cellular-organismal-psychosocial life
- Zygote- mass ball of cells some argue moral relevance/others life at conception, cellular life.
-Fetus- wide range of development, need to consider developmental stage (2 days from zygote or two days from birth)
-Neonate- considered to have moral status, neonate is born and living on its own outside of the mother and has interactions with people, psychsocial. |
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Term
Why is the question of personhood relevant to the discussion of abortion? |
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Definition
| Do we have a moral right to non persons? If a fetus is not a person then we do not have a moral right to them and abortion could not be considered a case of killing. If however the fetus was a person then we would have a moral right to it just as we would to our neighbor and therefore abortion would be an act of murder. It could be argued that a fetus may not be a person but has the potential to be and thus a significant morally relevant property. |
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Term
Identify and explain viability and the uncertainty surrounding it. |
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Definition
| -Viability can be affected by race, and have certain circumstances. |
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Term
Identify and explain the different efforts to manipulate public perception made by abortion advocates and opponents. |
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Definition
Both abortion advocates and opponents use extremes of the situation to manipulate the public perception.
Advocates concentrate on rape and incest to manipulate public perception to be compassionat to the victim
Opponents concentrate on dialation and extraction and manipulate public perception by calling it "partial birth abortion.
Both extremes are only a small percentage of the abortions that actually occur. |
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Term
Why do deontological thinkers like Kant and Ross face more difficult choices than utilitarians like Mill and Betham on the issue of abortion? |
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Definition
| - Kant and Ross (deontology) attribute to individuals autonomy and self-direction, which includes a woman and her body. If a fetus is a person it has inherent dignity and worth. It is an innocent llife that cannot be destroyed except for the weightiest moral reasons. Provides no clear answer to how thoseare to be weighed. We each have a right to protect our own lives, even if it means taking the life of another person. As long as there is substantial doubt about the status of th fetus, it is not certain that it is legitamate to demand the rights of a fetus to be protected by law |
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Term
Explain the difference between active and passive euthinasia. Provide examples. |
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Definition
- Active Euthinasia: acting/killing, is the direct killing and is anact of commission, to take definate action to end a life. An example of that would be giving a patient that desires to die but is paralyzed an injection of potassium to help him die.
-Passive Euthinasia- withholding/letting die, to take no steps to prolong life when those steps seem callled for, act of omission. An example of passive euthinasia would be failing to administer needed antibiotics that resulted in the death of the patient.
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Term
Explain the differences between voluntary, involuntary and nonvoluntary euthinasia. Provide examples. |
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Definition
-Voluntary euthinasia- cases in which a person takes his or her own life, either directly, by refusing treatment, or by telling the doctor to do it. An example of this would be telling the doctor you want to die and to please help you and the doctor either injecting you with something to do so or providing you with the means to do so.
-involuntary euthinasia- is the ending of someones life contrary to their wishes, without their consent, and even with there expressing the wish live. An example of this would be "Doctor what are you doing with that needle, No please get away, NO NO NO, I dont want to die.
-Nonvoluntary- Includes those cases where the decision about death is not made by the person who is to die. An example of this could be that a patient is in a persistant coma and the family of the patient choses to remove life support. The decision about death was not made by the patient and no explicit consent was given. |
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Term
What is the difference between whole brain death and higher brain death? provide examples. |
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Definition
Whole brain death- is the cessation of functioning of both the brain stem and the cortices. This death is loss of all control of the body including: temp regulation,hormone regulation, etc. and also the ability to speek move or even think aka loss of consiousness.
Higher brain death - is the cessation of functioning of only the higher cortices. The person still continues to breath and regulate all bodily functions only he is unconsious and cannot have any interaction with others.
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Term
What is the difference between living will and a proxy decision maker? |
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Definition
- A living will is a legal document that the patient has put in place that states his desires in the case that he is unable to state his own wishes verbally.
- A proxy decision maker is a person designated by the patient that is to make medical decisions for the patient in terms of what he or she would want in the case that they would not be able to state so themselves. |
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Term
Explain the doctrine of double effect in the context of euthinasia. |
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Definition
| - Double effect makes it morally permissible to give pain medication even if the dosage of medicine to relieve the pain is so high that the risk of dying increases for the patient. an example of this would be a doctor giving a terminally ill patient a high dose of morphine to manage his immense pain when the secondary effects of such a dosage suppresses the patients respiratory system which could result in death. |
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Term
Why do deontological thinkers like Kant and Ross face more difficult choices than utilitarinas like Mill and Bentham on the issue of euthanasia? |
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Definition
Kant does not give absolute reasoning and states that every autonomous rational being has a duty to preserve his own life, therefore making it impossible for one to rightly refuse treatment or commit suicide. Also we have inherent dignity so when it is compromised by severe illness or PVS we may be obligated to put one to death.
Ross says we have an obligation not to kill unless in self defence but we also have an obligation to keep promises so if some one leaves orders to be killed or allowed to die in such a case we would be obligated to do so.
Utilitarians is only conserned with the happiness of the individuals and there for makes it easier hen considering euthanasia. They could be for euthanasia because when suffering is great and there is no hope of recovery then it would be right to let die or kill. Secondly utilitarians could look at the theory that life is a necessary condition for happiness then it may not be permissable to kill or let die cause then that ability for happiness is taken away totally.
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