(F) L3: Bioethical Principles and Analyses of Bioethical Issues Flashcards
Bioethics is a philosophical discipline that deals with the study of the morality of human conduct in relation to _______ in particular and to _________ in general
- Health
- Human life
What are the 4 BASIC Bioethical Principles?
- Stewardship Principle
- Totality Principle
- Double Effect Principle
- Principle of Cooperation
Basic Bioethical Principles:
This embodies the concept that we have the obligation to take good care of/improve a thing that was entrusted to us
Stewardship Principle
Basic Bioethical Principles:
Refers to how we are going to take care of our responsibilities as healthcare practitioners in supervising our own work
Stewardship Principle
Basic Bioethical Principles:
Humans are entrusted with their bodies and they have the obligation to preserve and develop it
Stewardship Principle
Basic Bioethical Principles:
MTs have the obligation to participate in advancing and developing the vocation
Stewardship Principle
Basic Bioethical Principles:
Means that the parts of the physical entity, as parts are ordained to the good of the physical whole
Totality Principle
Basic Bioethical Principles:
All parts of the human body are meant to exist and function for the good of the whole body and thus naturally subordinated to the good of the entire entity
Totality Principle
Basic Bioethical Principles:
Deals with concerns about mutilation, organ donation, and transplantation while preserving the sanctity of life
Totality Principle
The Totality Principle deals with concerns about mutilation, organ donation, and transplantation while preserving what?
Sanctity of Life
Totality Principle (Summary of Moral Teachings):
The patient should have a serious need that can only be satisfied by __________
Organ Donation
Totality Principle (Summary of Moral Teachings):
Even if a donation reduces “anatomical integrity”, it should not diminish the “______ integrity” of the person
Functional
Totality Principle (Summary of Moral Teachings):
Even if a donation reduces “______ integrity”, it should not diminish the “functional integrity” of the person
Anatomical
Totality Principle (Summary of Moral Teachings):
The risk in donation as an “act of _____ should be proportionate to the good resulting for the patient”
Charity
Totality Principle (Summary of Moral Teachings):
The risk in donation as an act of charity should be _______ to the good resulting for the patient
Proportionate
Totality Principle (Summary of Moral Teachings):
There should be ______ and ________ consent by the donor
Free and Informed
Totality Principle (Summary of Moral Teachings):
It should not be _______ for an individual to participate in the medical intervention to be performed
Mandatory
Totality Principle (Summary of Moral Teachings):
This is one of the important documents that one needs to communicate to a patient with in order to avoid legal issues
Informed Consent
Basic Bioethical Principles:
Contemplates that it is permissible to cause harm as a side effect of bringing about a good result even though it would not be permissible to cause such a harm as a means to bringing about the same good end
Double Effect Principle
Double Effect Principle (Four Conditions):
That the action in itself from its very object be _______ or at least ________
- Good
- Indifferent
Double Effect Principle (Four Conditions):
That the good effect and not the evil effect be _________
Intended
Double Effect Principle (Four Conditions):
That the good effect be not produced by means of the ___________
Evil Effect
Double Effect Principle (Four Conditions):
That there be a proportionately grave reason for ________ the evil effect
Permitting
Double Effect Principle (Four Conditions):
That there be a proportionately ______ reason for permitting the evil effect
Grave
Basic Bioethical Principles:
It differentiates the action of the wrongdoer from the action of the cooperator
Principle of Cooperation
2 Types of the Principle of Cooperation:
Defined as willing participation on the part of the cooperative agent in the sinful act of the principal agent
Formal Cooperation
2 Types of the Principle of Cooperation:
Occurs when the cooperator does not intend the object wrongdoer’s activity but actively participates in the deed by which the evil is performed
Material Cooperation
What are the 4 MAJOR Bioethical Principles?
- Principle of Respect for Autonomy
- Principle of Beneficence
- Principle of Non-Maleficence
- Principle of Justice
Major Bioethical Principles:
Entails that healthcare professionals should honor the autonomous decisions of competent adults
Principle of Respect for Autonomy
Major Bioethical Principles:
Comes from the Greek word “auto-nomos” which means “self-rule or self-determination”
Principle of Respect for Autonomy
Major Bioethical Principles:
Comes from the Greek word “auto-nomos” which means what?
Self-Rule or Self-Determination
Major Bioethical Principles:
The ability of a person to give consent after due information of medical intervention, however if the patient is minor (below 18 years old) then this principle is exercised by the parents
Principle of Respect for Autonomy
Principle of Respect for Autonomy:
This refers to guardian figures agreeing to subject their children to the specific medical intervention
Parental Permission/Consent
Principle of Respect for Autonomy:
Any representative who cares and has custody of a minor
Parent
Elements of informed consent; informing the participants about:
His/her ________
Rights
Elements of informed consent; informing the participants about:
_________ to be undergone
Procedures
Elements of informed consent; informing the participants about:
________ of the study or test to be performed
Purpose
Elements of informed consent; informing the participants about:
Potential _________ of participation
Risks and benefits
Elements of informed consent; informing the participants about:
Participants must participate ________
Willingly
Elements of informed consent; informing the participants about:
These people must receive extra protection
Vulnerable populations (those immunocompromised, old age, and suffering from a life threatening condition)
Elements of informed consent; informing the participants about:
The informed consent document must be written in a ________ easily understood by the participant
Language
Elements of informed consent; informing the participants about:
It must minimize the possibility of _______ or undue influence
Coercion
Elements of informed consent; informing the participants about:
The participant must be given sufficient time to consider ________
Participation
Elements of informed consent; informing the participants about:
The process of consenting is ______ and must be made clear to the participant that it is their right to ________ of the study or procedure at any time not just at the initial signing of paperwork
- Ongoing
- Withdraw or opt-out
Major Bioethical Principles:
Hold that the healthcare system should aim to do good
Principle of Beneficence
Major Bioethical Principles:
The ethical obligation to maximize benefit and to minimize harm
Principle of Beneficence
If there is a conflict between the principle of respect for autonomy and the principle of beneficence, what should prevail?
Principle of Respect for Autonomy
Major Bioethical Principles:
Requires that healthcare professionals should do no harm
Principle of Non-Maleficence
Major Bioethical Principles:
This is found in the instructions of the Hippocratic Oath; “primum, non nocere” (first, do no harm)
Principle of Non-Maleficence
Major Bioethical Principles:
Obligation to prevent undue and deliberate infliction of harm on people
Principle of Non-Maleficence
2 Types of Harm:
Example: Reusing the syringe from an HIV patient to a normal patient
Malicious Harm
2 Types of Harm:
Example: Manifestation of hematoma as a result of poor venipuncture
Negligence Harm
Major Bioethical Principles:
Hold that the healthcare professionals should act fairly when interests of different individuals or groups are in competition
Principle of Justice
Types of Principle of Justice:
Balancing the competing interest of an individual and a group against one another
Example: priority lanes and priority for emergency cases in hospitals
Comparative Justice
Types of Principle of Justice:
The fair distribution of healthcare services to all
Example: first come, first serve policies
Distributive Justice
This is an ethical dispute that requires the application of ethical principle for its resolution
Bioethical Issues
The resolution of every biological issue calls for a complementary standing of LIFE and CHOICE which comes in 2 forms, what are those?
Pro-Life and Pro-Choice
It is a universally accepted principle that every human being enjoys the right to ______
Life
Human rights being grounded on ________ law is inherent therefore not a creation of or dependent upon a particular law, custom, or belief
Natural
Human rights precedes and transcends any ______ or ______ of men
- Authority
- Laws
This demands the respect and protection of life
Pro-Life
This attempts to calibrate the extent of respect and protection due to life
Pro-Choice
This requires the application of ethical principles to a certain ethical inquiry
Bioethical Issues
This is primarily concerned with the interpretation or application of the law, particularly to a certain given fact
Legal Issue
What are the 2 bioethical issues that fall under the category of “destruction of life”?
- Abortion
- Euthanasia and assisted suicide
What are the 2 bioethical issues that fall under the category of “sustaining life”?
- Withholding life support
- Organ transplantation
Abortion
“The State recognizes the sanctity of family life and
shall protect and strengthen the family as a basic autonomous social institution. It shall equally protect the life of the mother and the life of the unborn from conception. The natural and primary right and duty of parents in the rearing of the youth for civic efficiency and the development of moral character shall receive the support of the Government”
What law states this?
Philippine Constitution: Article 2 Section 12 (Declaration of Principles and State Policies)
According to Article 2 Section 12 of the PH Constitution, the state shall equally protect the life of both the _______ and ________
- Mother
- Unborn from conception
Bioethical Issues:
The termination of pregnancy before the viability of the fetus
Abortion
Bioethical Issues:
A willful killing of the fetus in the uterus or violent expulsion of the fetus from the maternal womb which results in death
Abortion
Bioethical Issues:
Removal or expulsion of an embryo/fetus
Abortion
Bioethical Issues:
Can be direct, induced, or even be by natural causes/accidents
Abortion
Reasons for Abortion:
The cause for spontaneous abortions or miscarriages
Natural Causes
Reasons for Abortion:
Can be intentional or unintentional
Overt Acts
Reasons for Abortion:
An example of this is elective abortion; when a person arrogates (claim w/o justification) her autonomy in resulting to abortion
Performed for Personal Reasons
Reasons for Abortion:
For medical reasons; there is an unavoidable result in performing abortion due to conflicting situations between mother and child
Therapeutic Abortion
In therapeutic abortion, when there are conflicting situations between mother and child, the physician must always be obliged to save who?
BOTH
In therapeutic abortion, if saving both the mother and child is impossible, the resulting death to one should not be _______
Deliberate
This is normally invoked by a physician to participate in therapeutic abortion (based on their moral conviction) but may run contrary to the patient rights to receive treatment
Conscientious Objection
The principle of no abortion in the country is embodied in the constitutional protection of ______
Life
Bioethical Issues:
Aka “mercy killing”; practice of painlessly putting to death a person suffering from an incurable disease
Euthanasia (giving assistance to commit suicide, withholding, and withdrawing life support)
Bioethical Issues:
Comes from the Greek words which mean “good death” or gentle/easy death
Euthanasia (giving assistance to commit suicide, withholding, and withdrawing life support)
What does “eu” and “thanatosis” mean in Greek?
“EU” = Good
“Thanatosis” = Death
The ethical issue with euthanasia, whether active or passive, revolves around who has the right to determine the ______ or _______ of a patient
- Death
- Survival
Type of Euthanasia:
Aka “positive euthanasia”
Actions that speed up the process of dying; physician introduces a chemical agent that results in the ultimate death of a patient
Active Euthanasia
T or F: Active euthanasia can be performed even without the consent of the patient
True (with or without, it can be performed)
Type of Euthanasia:
The act of the medical practitioner overrides the autonomy and willingness of a dying patient
Active Euthanasia w/o consent
Type of Euthanasia:
The role of the medical practitioner is to give assistance to a patient who wants to commit suicide in order to end their suffering; therefore they cooperate with the patient
Active Euthanasia w/ consent
T or F: Only active euthanasia w/o consent is prohibited in the country
False (both kinds of active euthanasia are prohibited)
Reasons for why Active Euthanasia is not observed due to ethical and legal complications:
The act of the medical practitioner ______ the right of the patient to self-determination
Overrides
Reasons for why Active Euthanasia is not observed due to ethical and legal complications:
Their act runs contrary to the solemn oath of __________
“Do no harm”
Reasons for why Active Euthanasia is not observed due to ethical and legal complications:
The act is not ______ for the patient
Beneficial
Reasons for why Active Euthanasia is not observed due to ethical and legal complications:
Their act may fail to carry out their duty to ______ life
Preserve
Active Euthanasia:
A physician’s act is _______ and _______ with the full knowledge that it will cause the death of a patient
Willful and Deliberate
A doctor who resorts to mercy killing of their patient without the patient’s consent may be liable for ________
Murder
A doctor who will give assistance to a dying patient,
to the extent of doing the act themselves, is liable for
_________
Giving assistance to suicide
Bioethical Issues:
Aka “negative euthanasia”; there is no heroic measure taken to preserve life
Death is brought about by non-introduction of medical measures to preserve life
Passive Euthanasia
Passive Euthanasia is implied/recognized in healthcare settings with the use of what code?
Clue: 2 possible answers
DNR or No Code Order
This refers to having the rights to waive the procedure of performing CPR as long as there is a waiver
DNR (Do Not Resuscitate)
This refers to having the right to refuse from the procedures included in emergency cases known as “code blue”
No Code Order
Bioethical Issues:
The decision of the patient or representative to refrain from giving permission for treatment or care
Withholding Treatment
Bioethical Issues:
The decision of the patient or representative to discontinue activities or remove forms of patient care
Withdrawing Treatment
The refusal of the patient or their representative to any therapeutic medical intervention despite such disclosure requires what?
A waiver
The balancing interests of medical principles in the autonomy of the patient is a _______ consideration in passive euthanasia
Primordial
This is a written declaration of a patient’s/representative’s last will to stop the pain and to end their (patient) suffering
Waiver
This must be made in writing, documented, and included in the patient medical record as this will exonerate a medical practitioner to both ethical and legal accountability that will arise from the death of the patient
Waiver
Without a waiver for euthanasia, a healthcare provider may be liable for _________
Medical Negligence
Bioethical Issues:
A form of surgery wherein one body part is transferred from one site to another or from one individual to another
Organ Transplantation
Types of Organ Transplantation:
Tissue is transplanted from one part of the body to another in the same individual
Autograph/Autotransplant
Types of Organ Transplantation:
Transplant of an organ or tissue from one individual to another
Allograph/Homograph
Types of Organ Transplantation:
Surgical graft of tissue from an animal is transferred to a human
Xenograph/Heterograph
The practice of organ transplantation is imbued with ________; the state advocates fair distribution and allocation of transplantable organs to the public
Public Interest
Bioethical issues ensue when the concept of fair distribution is hampered by acquiring viable organs, especially through the _______ or through _________
- Black Market
- Illegal Organ Trafficking
What law was made due to the widespread selling of organs, particularly kidneys, in exchange for a measly amount of money?
Clue: Go back to midterms
RA 7170: Organ Donation Act of 1991
Phases of the Lab (Diagram; state what principle is applied):
Pre-Analytical: Informed Consent
Principle of Respect for Autonomy
Phases of the Lab (Diagram; state what principle is applied):
Pre-Analytical: All tests benefit the patient
Principle of Beneficence and Non-Maleficence
Phases of the Lab (Diagram; state what principle is applied):
Pre-Analytical: Access to all tests at reasonable costs
Principle of Justice
Phases of the Lab (Diagram; state what principle is applied):
Analytical: Right to decline specimen examined
Principle of Respect for Autonomy
Phases of the Lab (Diagram; state what principle is applied):
Analytical: Best possible analytical result to patient
Principle of Beneficence and Non-Maleficence
Phases of the Lab (Diagram; state what principle is applied):
Analytical: No discrimination in the examination of samples on the basis of gender, age, or race
Principle of Justice
Phases of the Lab (Diagram; state what principle is applied):
Post-Analytical: Reporting and interpretation of results
Principle of Beneficence and Non-Maleficence
Phases of the Lab (Diagram; state what principle is applied):
Post-Analytical: Residual specimen
Principle of Respect for Autonomy
Phases of the Lab (Diagram; state what principle is applied):
Post-Analytical: Data Access
Principle of Justice
What specific case study was this called?
Syphilis was injected into African-American citizens without them knowing
Tuskegee Syphilis Study
How many participants died in the Tuskegee Study?
128
What specific case study was this called?
A tranquilizer was used for pregnant women to relieve morning sickness; the drug was approved without a license and therefore the babies born after had birth defects (substance was teratogenic)
The Thalidomide Scandal
How many miscarriages, stillbirths, and infant deaths were recorded in Britain after the Thalidomide Scandal?
10,000
What specific case study was this called?
Scientists used chronically ill patients to inject cancer cells into them in order to gauge their immunity
Chronic Disease Hospital in NYC
What specific case study was this called?
They used children with forced informed consent (will only be admitted to school once they agree to the study); the food was contaminated with the virus
Willowbrook State School Hepatitis Study
What specific case study was this called?
Was done for Philadelphian inmates; they gave dermal products and skin injections (with monetary incentives) which caused harmful effects
Holmesburg Prisoner Study
