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Ethics > Chapter Nine > Flashcards

Chapter Nine Flashcards

1
Q

For many years, stem cell research was considered quite controversial, especially the use of what?

A

embryonic stem cells and public funding

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2
Q

What reduced the need for human embryos?

A

breakthroughs in stem cell research

  • Scientists have discovered a method in which an individual’s cells can be stimulated to act like stem cells. This reduces the need for donated stem cells
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3
Q

While research of any kind involving genet- ics will always be controversial, this topic is now covered in stem cell is titled what?

A

“Genetic Testing and Engineering.”

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4
Q

In 2003, the Human Genome Project succeeded in what?

A

mapping the human DNA sequence (Human Genome Project Information, 2011

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5
Q

DNA, or deoxyribonucleic acid, is what?

A

the small code contained in all human cells that determines our characteristics

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6
Q

Having a map of our personal DNA allows scientist to complete what?

A

genetic testing for a variety of purposes

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7
Q

Our legal system uses genetic testing to do what? (2)

A
  • To match samples from crime scenes to criminal suspects
  • Courts can use genetic testing to establish paternity and thereby ensure that financial support is provided to mothers and their children
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8
Q

In health care, genetic testing can be used for what?

A

help determine the possibility of developing certain dis- orders and diseases

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9
Q

Burlington Northern Santa Fe Railroad?

A
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10
Q

Genetic testing has a variety of purposes in health care. Give an example and an issue of this

A
  • If a patient has a family history of certain types of cancer, genetic testing might reveal a predisposition for that type of cancer, as well as the potential of passing it along to any biological chil dren.
  • The problem with this type of testing is that it is new and not entirely reliable. Having the predisposition for cancer does not mean a patient will actually develop that cancer.
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11
Q

So, if a woman has a family history of breast cancer and genetic testing reveals a predisposition for that type of cancer, should she take preventive measures by having a mastectomy to remove her breasts?

A

This might seem extreme, but to some patients it might seem like a logical step. If individuals do decide to take such preventive treatments, should health insurance companies be required to pay for them, or should they be considered elective, requiring that patients pay for them out of pocket?

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12
Q

BRCA is an acronym for what? What does normal BRCA do, and what happens when it mutates?

A

BRCA is an acronym that stands for BReast CAncer susceptibility gene . Normally BRCA works to prevent the development of cancer cells . Those with BRCA mutations are not able to suppress the development of tumors, which can lead to breast or ovarian cancer .

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13
Q

What is Title II of the Genetic Information Nondiscrimination Act of 2008

A
  • employers cannotuse genetic information to discriminate against employees or applicants applying for jobs.
  • Genetic information includes the results of an individual’s genetic testing, as well as results of family members.
  • It also extends to family history of genetic diseases.
  • Employers are also prohibited from collecting genetic information or testing for certain genetic traits.
  • Healthcare organizations are prohibited from sharing genetic information to any third party without patient consent.
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14
Q

The potential uses for genetic testing are currently _

A

Limitless

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15
Q

Genetic testing is used primarily for what?

A

to screen for certain diseases, which can provide patients with awareness and understanding

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16
Q

One ethical issue raised by genetic testing is what?

A

screening of children for certain traits—either before birth (in utero) or after birth

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17
Q

The Human Genome Project, as well as basic human rights, request what?

A
  • We not reduce individuals to their genetic characteristics, but rather promote the respect of uniqueness and diversity
  • This does not, however, prevent parents from wanting certain characteristics for their children (e.g., musical or physical ability) or attempting to prevent certain traits or diseases (e.g., diabetes or obesity)
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18
Q

The misuse of genetic information might seem like something out of a science fiction novel, but in our not-so-distant past, _ was practiced by certain societies

A

eugenics

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19
Q

What is known as an effort to improve the genetic makeup of a population

A

Eugentics

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20
Q

Who used Eugentics as a philosphy?

A

Nazi Germany used this philosophy to justify med- ical experimentation and even extermination of non-white and Jewish citizens.

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21
Q

How was Eugentics used in our country? What is an example?

A
  • Certain nonconsenting adults were sterilized in an effort to reduce the risk of continuing the genetic line
  • For example, certain states passed laws requiring the sterilization of patients classified as “mentally ill.” These laws were eventually overturned, but not before thousands of patients were sterilized.
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22
Q

What is cloning?

A

the copying of cells to create copies with similar genetic content

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23
Q

When is cloning considered acceptable?

A

for research purposes only (e.g., the cloning of Henrietta Lacks’s cells) and will not soon be used for any other purposes.

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24
Q

The Uniform Anatomical Gift Act, passed in 1968, allows what?

A
  • anyone 18 years of age or older to donate body parts for the purpose of transplan tation after his or her death
  • also allows next of kin to give permission regarding the donation of body parts.
  • the law further addresses the donation of bodies for medical research or study
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25
Q

In addition to an advance directive, any living person can what?

A

can volunteer to donate organs.

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26
Q

To help simplify and organize the donation of organs, a second law what was passed?

A

National Organ Transplant Act) was passed in 1984. This act created a network for registering and matching organ donor recipients.

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27
Q

The Organ Procurement and Transplantation Network (OPTN) is what?

A

a private, nonprofit organization that contracts with the federal government

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28
Q

Currently, the OPTN is operated by who?

A

United Network for Organ Sharing (UNOS)

29
Q

UNOS was awarded the contract when? What does it focus on?

A
  • UNOS was awarded the contract in 1986 and focuses on sharing organs from deceased donors in an efficient and equitable manner.
  • They also maintain a waiting list of potential organ recipients and work on educational efforts to increase organ donations nationwide.
30
Q

In response to the shortage of organs available for transplantation, UNOS also does what?

A

raises awareness of live donations, in which living donors give organs to those in need of a transplant

31
Q

In the United States, the donation of organs has come exclusively from who?

A

deceased patients or living patients who donate the organs voluntarily without financial benefit

32
Q

T/F: There are significantly more people waiting for donated organs than there are organs available

A

True

33
Q

There are significantly more people waiting for donated organs than there are organs available. This raises what?

A
  • This raises the question of finding new methods of obtaining organs.
  • In some countries donors are paid for organs. Singapore pays donors nearly $36,000 per organ, and Iran has eliminated its waiting list for kidney transplants by paying donors
34
Q

In Israel, if you are not designated as an organ donor, you are placed where

A

at the bottom of the recip- ient list should you need one yourself.

35
Q

Some countries, such as Great Britain, operate under what?

A
  • “presumed consent,” which allows body parts to be taken at the time of autopsy
  • Most organs are no longer viable by the time an autopsy occurs, but corneas can be used, as well as tissue samples for research purposes.
36
Q
A
37
Q

What ethnicity is the highest on the organ waiting list? What organ is need most?

A

.

38
Q
A
39
Q

In the United States, the primary avenue for promoting organ donation has been through what?

A

marketing, education, and certain state laws requiring citizens to designate their organ donation status on driver’s licenses.

40
Q

Ethical issues arise with organ donations when what?

A

Ethical issues arise when considering paying for donated organs.
* For example, would this type of policy prey on lower-income families who might consider selling a kidney to pay off credit card debt? Or would it simply fulfill a need for extra income while meeting the health needs of desperate patients?

41
Q

Recent internet matching services have raised some ethical concerns about what?

A

informed consent
* In these cases, volunteers willingly give an organ to a person who is unfamiliar to them. They are not compensated, except for travel and medical expenses, but some doctors still worry about the ability of the donors to really understand the long-term consequences of their decisions.

42
Q

When an organ becomes available for transplant, a complex process begins. explain

A
  • UNOS maintains a computer database of patients waiting for organ transplantation, and this database is used to find a matching recipient for the donated organ.
  • A variety of factors determine a match, including compatibility, location, and the age and size of both the donor and the recipient.
  • The health condition of both the donor and the recipient is considered as well.
  • Thus, simply being at the top of a waiting list does not guarantee that a patient will receive the next available organ donated.
43
Q

A variety of factors determine a match like what?

A
  • including compatibility, location, and the age and size of both the donor and the recipient.
  • The health condition of both the donor and the recipient is considered as well.
44
Q

For example, a large percentage of donated kidneys come from patients of what?

A

caucasian descent

45
Q

nearly one-third of patients on the waiting list for kidneys are of _ _ descent because why?

A

nearly one-third of patients on the waiting list for kidneys are of African American descent because there is a higher risk of diseases that require kidney transplant in that population

46
Q

T/F: it is not always necessary to match race for kidney transplantation

A

T but there are certain factors that make it easier to match a donor to a recipient from the same race (e.g., similar blood types)
* patients of Caucasian descent often wait a shorter time because there is a greater chance of a match being available.

47
Q

Another issue is health of the patient for organ transplant, explain

A

Some patients have diminished health after waiting a long time for an organ transplant. This might cause them to drop to a lower transplant status

48
Q

there is the issue of geographic location for organ transplant, explain?

A
  • Organs can only survive for a limited time once they are harvested.
  • Therefore, some waiting lists are dependent on proximity to the available organ.
  • Patients with the financial ability to travel on short notice might make arrangements to be on more than one waiting list.
  • For example, Steve Jobs (former CEO of Apple) was able to obtain a liver transplant after placing himself on several waiting lists around the country and using a private plane to jet to the location
49
Q

The conscience clause, a federal regulatory law, protects who?

A

healthcare professionals from discrimination if they refuse to participate in sterilization procedures or abortions, due to religious or personal objections

50
Q

Conscience clause origninal law included what? What changed?

A

The original law included protection for phar- macists and hospitals, but in January 2012, the Obama administration repealed the old law and replaced it with a new one. The new law only protects healthcare professionals who wish to avoid assisting directly with sterilization and abortion procedures.

51
Q

Who is Catherina Cenzon-DeCarlo

A
52
Q

Original interpretation of the conscience clause allowed pharmacists to what?

A

to refuse to fill prescriptions used to prevent or terminate pregnancies
* Some states do not allow pharmacists to refuse to fill prescriptions, while other states allow pharmacists to refuse

53
Q

The conscience clause was tested during the Obama administration as certain components of the Affordable Care were challenged in the supreme court. Explain

A
  • The ACA originally required all insurance policies to provide contraception to patients at low or zero cost.
  • The Catholic Church considered the use of contraception to be a violation of its moral code and therefore did not want to include it in the insurance policies available for thousands of individuals who currently work for hospitals and educational facilities owned and run by the Catholic Church.
54
Q

The Catholic Church does not refuse to allow its employees to use contraceptives. Insteads does what?

A

Instead it refuses to pay for the contraceptives as part of a benefits package.

55
Q

What happened in king v burwell?

A
  • In King v. Burwell, the Supreme Court ruled that employers with a historical reli- gious foundation could be exempt from certain requirements outlined in the ACA, including coverage of birth control and sterilization procedures.
  • The ethical arguments focused on whether or not an employer can force its moral standards on an employee.
56
Q

According to the Patient Bill of Rights, patients have the right to what?

A

decide whether or not to participate in research studies

57
Q

Who is Henrietta Lacks

A
58
Q

It is generally agreed that research should always involve what?

A

informed consent, include only willing and knowing participants, and come at a minimal risk to those involved

58
Q

There are some gray areas, however, in the research world. Give an example

A
  • For example, very few patients are aware that once a blood or tissue sample is given to a healthcare organization, it becomes the organization’s property.
  • When patients give blood and tissue samples, they are required to sign consent forms. But they not fully understand
59
Q

Finally, it is important to note that when experimental treatments are offered to patients for research purposes, it is hard to know what?

A
  • it is hard to know if the patient’s desire to try a new procedure—any procedure that might cure a disease or alleviate suffering— overshadows the risks.
  • For example, if a patient is in the final stages of cancer and has the option to try an experimental treatment option, is it ethical for a doctor to promote this new procedure or better to offer palliative care?
  • In the end, it is best to provide both options to the patient and let the patient choose what he or she thinks is best.
60
Q

Currently, marijuana is considered what?

A
  • a controlled substance, which means that it is heavily regulated and illegal to take across state lines.
  • The federal government bans the sale of marijuana (and other controlled substances), but some states have legalized the use of medical marijuana, while other states have legalized the sale of marijuana, even if not being used for medical purposes.
  • The federal government has not yet challenged the states on this particular issue.
61
Q

Medical marijuana is recommended for what?

A
  • therapeutic use by some medical professionals.
  • Studies have found that it effectively reduces pain, controls nausea and vomiting, and is less addictive than other controlled substances, especially those containing opioids
62
Q

Opponents to legalizing marijuana argue what?

A

the long-term effects of marijuana are not yet fully understood, the drug is not approved by the Food and Drug Administration, and other legal drugs exist that make its use unnecessary

63
Q

Public health issues and concerns are constantly changing. At the time of publica- tion, the American Health Association puts several at the top of their list. Like what?

A

These include, but are not limited to, obesity, gun control, and opioid addiction

64
Q

In the past, states and even cities have tried to regulate the sale of what?

A
  • certain consumer products that are known to promote weight gain (e.g., soda in large quantities)
  • Many of these measures have been unsuccessful because the legislation is either considered a civil rights infringement or the regulation is beyond the scope of the governing body.
  • The same issue exists with gun control. As a country, we are morally divided on the right to own and use firearms.
65
Q

Opioid addiction is currently considered a public health emergency. This designation allows funding to be shifted and utilized more easily under what?

A

Public Health Emergency Act

66
Q

In response to the opioid crisis, the U.S. Department of Health and Human Services is focusing its efforts on five major priorities:

A
  1. improving access to treatment and recovery services
  2. promoting use of overdose-reversing drugs
  3. strengthening our understanding of the epidemic through better public health surveillance
  4. providing support for cutting-edge research on pain and addiction
  5. advancing better practices for pain management
67
Q

The National Institutes of Health (NIH), a component of HHS, is the nation’s leading medical research agency helping solve the opioid crisis by what?

A

discovering new and better ways to prevent opioid misuse, treat opioid use disorders, and manage pain

68
Q

To accelerate progress, NIH is exploring formal partnerships with pharmaceutical companies and academic research centers to develop: (3)

A
  • safe, effective, non-addictive strategies to manage chronic pain
  • new, innovative medication and technologies to treat opioid use disorders
  • improved overdose prevention and reversal interventions to save lives and support recovery

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