Ethics

Question 1

Name 4 reasons why ethical reasoning is important?

Answer 1

1. to be able to understand and evaluate moral arguments
2. to know when to challenge people
3. help you make right/better decisions
4. to be able to explain and justify decisions

Question 2

1. what makes an ethical argument valid?

2. What makes an ethical argument sound?

Answer 2

1. if the conclusion follows logically from the premises

2. if the argument is valid, and all the premises are true

Question 3

Define the following:

1. ab hominems
2. appealing to emotion
3. begging the question
4. the straw man fallacy

Answer 3

1. attacking or criticising another person’s view or argument, not on the basis of the quality of their argument but the basis of the character of the person
2. premise in an argument appeals to a person’s emotions so that it seems more persuasive
3. where an argument for a particular conclusion already contains the conclusion within the argument
4. Someone may have presented a strong argument, but another misrepresents that argument in such a way that it is easy to reject the argument and therefore reject the conclusion

Question 4

1. Name 2 arguments supporting assisted reproduction

2. Name 3 ethical objections to assisted reproduction

Answer 4

1. procreative autonomy
   welfare interests of parents
2. involves destruction of embryos
   harmful to those trying to conceive
   unnatural

Question 5

1. What are the interests of the future child?

2. What is the right to an open future?

Answer 5

1. if, as a result of being conceived, a child is likely to suffer serious harm, then it would be hard to justify the provision of treatment as being in the child’s best interests
2. dilemmas should be resolved so as to ensure that children will enjoy the widest possible range of opportunities

Question 6

1. From a legal perspective, when can a woman be provided with fertility treatment
2. what is the counter argument to this?

Answer 6

1. when account has been taken of the welfare of the child who may be born as a result of the treatment (including the need of that child for the father)
2. fertile couples do not need to meet this criterion

Question 7

Name 4 ethical issues raised by mitochondrial replacement therapies

Answer 7

1. health benefits to future child
2. benefit to parents
3. concerns regarding health risks to child
4. does this constitute germ like modification?

Question 8

According to the abortion act 1967, when is an abortion legal

Answer 8

if two registered medical practitioners are of the opinion, formed in good faith, that the termination is necessary to prevent grave permanent injury to the physical or mental health of the pregnant woman.

pregnancy must not have exceeded 24 weeks

Question 9

Describe the pro-life argument

Answer 9

abortion ends the life of the foetus
human foetus has the same moral status as a person
it is wrong to end the life of a person/a creature with the moral status of a human

• therefore, abortion is morally wrong

Question 10

1. When is a doctor allowed to conscientiously object to abortion?
2. What must a doctor do under these circumstances?

Answer 10

1. when it is not an emergency

2. must not be judgemental; refer patient to another professional for the treatment they request.

Question 11

1. If a child under 16 is not Gillick competent, who gives consent?
2. What should be taken into account?
3. What is the principle of parental autonomy grounded in?

Answer 11

1. consent from one person with parental responsibility is sufficient
2. the views of children should be taken into account
3. that they know their children best and will act in the child’s best interests

Question 12

1. At what age is a person presumed competent to consent?

2. What happens if a person under the age of 18 refuses treatment, but a parent approves treatment?

Answer 12

1. 16

2. treatment will be allowed

Question 13

1. what is the argument supporting compulsory immunisation?
2. What is the counter argument for this
3. What is the harm principle?

Answer 13

1. that is brings about a public good - lower disease incidence thereby improved public health
2. threatens autonomy; also risks harms from side effects
3. The only purpose for which power can rightfully be exercised over any member of a civilised community, against his will is to prevent harm to others

Question 14

1. What must be done if there is reasonable concern that child is at risk of abuse or neglect?
2. When can consent of a competent child be broken?

Answer 14

1. the appropriate person or authority must be informed

2. if they are involved in abusive or seriously harmful sexual activity

Question 15

Name 4 types of research that raises ethical concerns

Answer 15

1. human participants v others
2. different disciplines
3. different research subjects - particularly when vulnerable people are involved
4. research in the context of the developing world

Question 16

Name the 6 principles of research ethics

Answer 16

1. usefulness of the research
2. necessity of the research
3. risks of the research
4. has consent been obtained?
5. confidentiality of the data
6. research ethics approval

Question 17

1. What are the 3 criteria of voluntary consent?

2. Name 5 ways in which consent can be facilitated

Answer 17

1. • not putting pressure on participants
   • not offering inappropriate inducements
   • not threatening/imposing sanctions
2. • information sheets
   • careful presentation of information
   • summary of key points
   • give opportunities to ask questions
   • give time to decide

Question 18

why is important to maintain confidentiality in research? (3)

Answer 18

1. respect autonomy
2. promote trust
3. prevent harm

Question 19

What information is included in participant information sheets? (7)

Answer 19

1. purpose of study
2. why patient has been approached
3. what will happen if they take part
4. risks and benefits
5. what if the study stops or something goes wrong
6. how privacy/confidentiality will be respected
7. ethics review

Question 20

Name 6 reasons why research ethics approval is needed.

Answer 20

1. protects participants from harm
2. protects researchers
3. minimises potential for negligence claims
4. maintains integrity of organisation
5. often a requirement for grant funding and publication
6. legal requirement for some forms of research

Question 21

Name the 5 statutory principles of the mental capacity act

Answer 21

1. presumption of capacity (unless proven otherwise)
2. right to be supported to make own decisions
3. right to make unwise decisions
4. decisions must be in the patient’s best interests
5. interventions must be the least restrictive

Question 22

What must a patient have to be deemed to have capacity? (4)

Answer 22

1. understand information given
2. retain information given
3. use or weigh information given
4. communicate decision

Question 23

1. What is an advance statement of wishes?

2. Are these legally binding?

Answer 23

1. a person with capacity may express their wishes and preferences about things such as the medical treatment and care they would like to receive
2. no, but should be taken into account when considering a person’s best interests

Question 24

1. What is the purpose of advance decisions?
2. What do they empower patients to do?
3. When are advance decisions legally binding?

Answer 24

1. relates to autonomy
2. refuse treatment
3. if valid and applicable to patients circumstances

Question 25

1. Name 3 advantages of advanced decisions

2. Name 3 disadvantages of advanced decisions

Answer 25

1. respects autonomy
   encourages forward planning
   less anxiety about unwanted treatments
2. difficulties in verifying that patient’s opinion has not changed
   difficult to ascertain circumstances are what the patient for-saw
   possibility of coercion when making out AD

Question 26

1. What is the argument supporting AD refusing life saving treatment in people lacking capacity but who are happy
2. What argument disputes AD in people with dementia who undergo a severe personality change

Answer 26

1. Experiential v critical interests
   - does the person lacking capacity still have their critical interests? If not, then the AD should be respected
2. Personal identity argument
   - person is no longer numerically identical to the person making out the AD; therefore AD should not be binding