Autonomy

Question 1

J.S. mill was a defender of _________. What does this mean?

Answer 1

Liberty = the notion that people should be able to defend for themselves

Question 2

1. What are exceptions to autonomy?
2. what are the 3 exceptions and give examples
3. what about self harm?

Answer 2

1. exceptions to autonomy describe situations when it is okay to intervene with someone’s free will/right to choose for themselves. the 3 exceptions are:
2. 1) they don’t understand what is happening = we can intervene to educate them. Ex: someone is crossing a bridge we know is about to break, we can tell them not to cross and it is up to them to decide if they want to take the risk

2) they are going to harm you = people are trying to interfere with our autonomy by harming us either mentally or physically (even reputations)

3) they are going to harm others = people are trying to harm another person’s autonomy

3. mill doesn’t see this as something we should be intervening with

Question 3

what are the 4 aspects of autonomy?

Answer 3

1. free action
2. effective deliberation
3. authenticity
4. moral reflection

Question 4

Answer based on free action:
1. what is free action. What are the 2 limits?
2. autonomy is not _________. we must demonstrate our ability to self-_____
3. Explain how other’s evaluate our free action?

Answer 4

1. free action = the idea that we choose our actions but they could be limited by internal and external forces.
   a) internal = an internal factor affects our free will. Ex: like a medical condition where we cannot speak
   b) external = external forces make decisions for us through coercion
2. automatic, self-rule
3. although we have the right to choose for ourselves, how we decide to act can be evaluated from others based on if it was good self judgement. Society sets standards and limits by establishing what is good or bad self-rule

Question 5

Answer based on effective deliberation
1. what is effective deliberation?
2. good = _________
3. what are 3 reasons for ineffective deliberation?

Answer 5

1. effective deliberation = when we make decisions, we put thought into it through reason
2. reasoned
3. 1) misinformation from others –> lies/deceptions
   2) missing information –> other’s forget to give info
   3) mental/cognitive issues –> the receiver of the info has a hard time mentally processing

Question 6

Answer based on authenticity:
1. what is authenticity?
2. being authentic means we are free from ________ and ________ constraints

Answer 6

1. authenticity = each of us should be living an authentic existence where we do what we actually want to and other people who have an influence should be cut out
2. internal and external

Question 7

Answer based on moral reflection:
1. what is moral reflection
2. What are some moral reflective questions?

Answer 7

1. moral reflection = make choices based on what YOU want but before and after you morally reflect if this is right based on your VALUES
2. do you know what you would choose X? Or is it something you have adopted unconsciously and uncritically

Question 8

What did Janet storch say about respect for autonomy?

Answer 8

that we should only respect people’s autonomy enough to do whatever we can to keep them in command of themselves.

Question 9

What are the 3 parts to being fully informed in medical matters?

Answer 9

1. be reasonably informed
2. be allowed to make our own decisions
3. have those decisions respected

Question 10

Why is “fully informed” not a real thing for some people?

Answer 10

• because there is no set standard
• there is a threshold that we cross where the other person knows enough

Question 11

What are the 4 health care consent act elements of consent?

Answer 11

consent must:
1. relate to the treatment
2. be informed
3. be given voluntary
4. not be obtained through misinterpretation

Question 12

what information should be given to patients to evaluate before they give their consent? (checklist for consent)

Answer 12

1. nature of treatment
2. expected benefits
3. material risks
4. material side effects
5. alternative
6. consequences

Question 13

“the physician has the primary responsibility to ensure that such communication (for consent) occurs” Explain this statement

Answer 13

• primary responsibility is the doctor
• there is no stated limit to how much effort should be put in so patients understand what procedure or treatment they are going to grant or decline consent to

Question 14

1. What is the noble lie? Does it apply to yourself?
2. community members lied in ___% of their social interactions, students lied ____%
3. T/F: lying was more common in face to face chats than phone calls
4. ____% of lies were discovered
5. T/F: 60% of lies were exaggerations and 10% were deceptions
6. T/F: less than 70% of liars would NOT tell their lies again
7. T/F: subtle lies (ex: of omission) were most common

Answer 14

1. noble lie = lying to benefit the deceived person. lying to save ourselves is not noble
2. 20%, 33%
3. F. more common in phone calls
4. 14%
5. 10% were exaggerations, 60% deceptions
6. F. more than 70% would lie again
7. T.

Question 15

1. what are the 2 types of lies? Explain both with an example
2. which type of lie is more common. how many more times common?

Answer 15

1. false positives = lying to have a positive effect on the other person. ex: telling someone their food is good even though it sucked so they do not feel bad
   false negatives = lying to have a negative effect on the other person. ex: spreading rumours about someone so people think badly of them
2. false positives are 20-30x more common

Question 16

Explain lying by commission and omission

Answer 16

commission = to commit to a lie
omission = to leave something out intentionally to create the wrong image in a person’s head

Question 17

T/F: in lying by omission, everything said was factually not true

Answer 17

F. everything said could be factually true, but you don’t mention one part

Question 18

What are 3 reasons why autonomy has become such a strong concern in health care?

Answer 18

1. history of patient misuse and abuse
2. rise of individualism and commercialization
3. rise of informed patient

Question 19

1. the health care industry has grown from a more __________ model to a more ___________ patient model
2. the traditional view of medicine was to emphasize __________ and truth was dependent on __________ __________.

Answer 19

1. paternalistic model to a more autonomous patient model
2. beneficence, patient welfare

Question 20

what drawbacks exists for the 4 aspects of autonomy?

Answer 20

1. free action = none
2. effective deliberation = limits effectiveness because we cannot know what the decision is really
3. authenticity = we are never free of outside control
4. moral reflection = we can think about what we could have done differently but we do not know if we were being lied to in the first place

Question 21

What did the supreme court say about the 1 exception to truth telling?

Answer 21

that we don’t have to tell the truth to a person who has an emotional condition if the truth will cause them harm. Ex: if bad news could put them in a state where they cannot mentally recover or if they cannot handle the truth

Question 22

1. What does the 4 principle ethics checklist allow for?
2. What 2 polar dangers does it help us avoid?

Answer 22

1. • systemic analysis of real bioethical problems
     - for people who have no expertise in bioethics
2. avoids moral relativism (any ethics will do) and imperialism (this is the only right way)

Question 23

_______ and _______ are required for a full moral life and a full moral theory
a) rules and nobility
b) principles and objectives
c) objectives and virtues
d) virtues and principles
e) principles and morals

Answer 23

d)

Question 24

______ are need to decide which actions are morally obligatory or forbidden and to decide which are morally commendable, undesirable or neutral

Answer 24

principles

Question 25

1. virtues are morally ___________ dispositions of character
2. T/F: there is one way to do ethics
3. T/F: the 4 principle checklist must be used the same across all cultures
4. the most important of the 4 principles of ethics checklist is _________ for ___________

Answer 25

1. desirable
2. F.
3. F.
4. respect for autonomy