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Behavioral > Bioethics > Flashcards

Bioethics Flashcards

1
Q

Non-Hippocratic Codes

A

Codes were Hippocratic until the 1970s, were written by not medical ppl but came about by liberal politics

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2
Q

Nuremberg Code (1946 after WW2)

A

Informed consent came about from the Nuremberg trials

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3
Q

Universal Declaration on Bioethics and Human Rights

A

International standard for ethics (2005)

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4
Q

Moral Standing

A

Is the moral status of a being, can have “full standing” (humans) or “limited standing” (corpses, egg/sperm, fetuses, non-human animals)

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5
Q

Cardiac-Oriented View of Death

A

Individual dies when there is irreversible cessation of circulatory/resp function

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6
Q

Whole-Brain View of Death

A

Individual dies when there is irreversible cessation of all functions of the entire brain (including brain stem)
- this is current law except in Japan, NJ and NY

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7
Q

Higher-Brain View of Death

A

Individual dies when there is an irreversible loss of “higher” brain function; consciousness usually considered critical

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8
Q

Abortion 3 Views

A
  • acceptable until capacity for higher brain function exists (~ 24wks)
  • acceptable until capacity for any brain function exists (~ 8-12wks)
  • acceptable until capacity for cardiac function exists (conception)
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9
Q

Capacity

A

Actual ability to carry out function

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10
Q

Potential

A

Genetic program to develop the capacity to carry out the critical function

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11
Q

Non-Human Animals

A

Western thought: sharp division btwn humans and other animals
Eastern thought: connections closer btwn humans and animals

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12
Q

Speciesism

A

Belief that membership in a species per se is relevant to moral standing

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13
Q

Principle

A

General characteristic of actions that makes them morally right

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14
Q

Virtue

A

Character trait of a person

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15
Q

Beneficence

A

Do good

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16
Q

Nonmaleficence

A

Don’t do harm

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17
Q

Utility

A

Measure of net good by taking into account both benefits (beneficence) and harms (nonmaleficence)

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18
Q

Objective vs. Subjective Judgments

A

Hippocratic: clinician subjective judgment of facts/therapy
Modern: strives for objectiv judgment of facts, medical science can tell which therapy is best
Postmodern/contemp: pt’s values should take precedence

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19
Q

Medical vs. Other Benefits

A
  • if health is goal, pt math want to trade health off for other goods
  • if total welfare is goal, physician’s skills are inadequate
20
Q

Conflicting Medical Goals

A
  1. Save life
  2. Cure dz
  3. Relieve suffering
  4. Promote health
21
Q

Conflicts over Relating Benefits to Harms

A

Hippocratic formula (arithmetic or geometric combining), Primum non nocere (“first of all, do no harm”)

22
Q

Fidelity (respect for persons)

A

Duty of loyalty
Confidentiality: hippocratic principle justifies breaking confidence to benefit pt
- fidelity supports duty to keep promises of confidence EVEN IF pt would benefit from breaking it

23
Q

Autonomy (respect for persons)

A
  • Informed consent
  • negative rights: liberty rights (right to be left alone)
  • positive rights: entitlement rights (right to some good or service)
24
Q

Veracity (respect for persons)

A

Truth-telling and lying

25
Q

Avoidance of killing (respect for persons)

A

euthanasia

26
Q

British Medical Association

A

Abandoned hippocratic paternalistic exception for breach of confidence and replaced with:

  • exception of pt agrees, or formal public policy
  • 1971
27
Q

American Medical Association

A

Abandoned hippocratic paternalistic exception for breach of confidence and replaced with:

  • exception of threat of serious bodily harm, or applicable statute/ordinance
  • 1980
28
Q

Therapeutic Privilege

A

Clinician’ privilege of withholding info that he/she believes will be harmful to the pt
(re: autonomy)

29
Q

Professional Standard (for informing)

A

What competent physician similarly situated would disclose

30
Q

Reasonable Person/pt Standard (for informing)

A

What reasonable pt would want to know or would find important in decision making

31
Q

Subjective standard (for informing)

A

What specific pt would want to know

32
Q

Consent

A

Autonomy requires the use of the reasonable person standard modified by what the clinician knows or should be expected to know about the pt’s unique subjective interests

33
Q

Veracity (for informing)

A

From 60s to 80s there was radical change from non-disclosure to disclosure of the dx
(Veracity - truth-telling and lying)

34
Q

Active Killing vs. Letting Die

A
  • consequences of active killing may be worse (wrong ppl may die)
  • autonomy can require clinician not to treat but does not require physician to actively kill
  • active killing is simply inherently wrong
35
Q

Stopping vs. Not Starting Tx

A

Feels diff to clinicians but they are ethically equivalent actions

36
Q

Direct vs. Indirect Killing

A 
Direct = intended (active or passive)
Indirect = unintended (active - anesthesia; passive - forgoing life support)
37
Q

Ordinary vs. Extraordinary Means

A 
Ordinary = proportionally beneficial
Extraordinary = benefits do not exceed burdens (turning an old woman over to prevent decubitus ulcer but it breaks her bones, etc.)
38
Q

Formerly Competent Pt

A

Have expressed wishes about terminal care while competent

  • moral: “autonomy extended”
  • legal: substituted judgment
39
Q

Never-competent Pt (w/o fam)

A

No one w/ standing to speak for the pt

- “best interest” standard is the legal principle, and usually best option

40
Q

Never-competent Pt (w/ fam)

A

Fam given standing to speak for pt (normally next-of-kin, until proven malicious, unreasonable, or unwilling)
*limited familial autonomy: fam has autonomy w/in reason

41
Q

Principle of Social Utility

for allocating scarce resources

A

Action is justified if it produces as much net good in aggregate as possible considering all who are affected
- problems: quantification and inequity (mainly equity)

42
Q

Principle of Justice

for allocating scarce resources

A

Action is justified if it strives for an “end-state pattern” of the distribution of the good (may not do as much good as principle of social utility)
- modern “end-state pattern”: effort or need

43
Q

Clinician’s Role in Allocating Resources

A
  • let clinicians abandon their pt’s @ the margin

- give clinicians exemption from principles of social ethics

44
Q

Duty proper

A

.

45
Q

Prima facie

A

.

46
Q

Duty proper

A

.

47
Q

Prima facie

A

.

Behavioral (11 decks)

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