L02 - Moral Concern

Question 1

What is moral status?

Answer 1

Factors that determine:

1 - Who we deem to be worthy of our concern

2 - To whom we owe obligations or duties

Question 2

What are the 6 grounds for moral concern?

Answer 2

1 - Humanity

2 - Autonomy

3 - Sentience

4 - Personhood/sapience

5 - Potentiality

6 - Patient

Question 3

What is humanity?

Answer 3

Belief that all human life is sacred -> sanctity of life

Question 4

What is autonomy?

Answer 4

The mental capacity to make independent decisions based on own thoughts -> free will

Question 5

What is sentience?

Answer 5

Ability to feel painful/pleasurable stimuli

Question 6

What is personhood/sapience?

Answer 6

The notion that being a person is not just a biological matter -> ability to have certain continuous mental states e.g. desires for future, rational thought

Question 7

What is potentiality?

Answer 7

Latent qualities that serve as grounds for moral concern

Question 8

Why is being a patient considered grounds for moral concern?

Answer 8

Doctors have a duty of care to all patients irrespective of philosophical status, grounded in professional duties & obligations

Question 9

Define biological death.

Answer 9

Irreversible cardiopulmonary arrest

Question 10

What is brainstem death?

Answer 10

A state in which the heart continues to beat but there is cessation of vital biological functions:

1 - Respiration

2 - Thermostasis

3 - Brain function

4 - Fluid balance

Question 11

What is a minimally-conscious state?

Answer 11

Severely altered consciousness in which minimal but definite behavioural evidence of self or environmental awareness is demonstrated

Question 12

What is therapeutic nihilism?

Answer 12

General aversion to the idea of keeping someone in a minimally-conscious state alive as a low number in a MCS make a full recovery

Question 13

What are 5 characteristics of humanity?

Answer 13

1 - Language

2 - Reasoning

3 - Ownership of property

4 - Kinship

5 - Self-awareness

Question 14

How does brainstem death differ from biological death?

Answer 14

Brain stem death is considered to be a form of biological death, despite the fact that the heart continues to beat

Question 15

In which state are patients suitable as organ donors?

Answer 15

Brainstem death

Question 16

Define biographical death.

Answer 16

Death of personhood

Question 17

How does brainstem death differ biologically from a persistent vegetative state?

Answer 17

• In brainstem death, the brainstem is non-functional
• In a persistent vegetative state, the brainstem is functional, but the midbrain and cortex are non-functional. This means that all higher mental functions are lost but basic biological functions remain

Question 18

How is a persistent vegetative state diagnosed?

Answer 18

Observe the following clinical signs for 6-12 months:

1 - No awareness of self or environment

2 - No response to visual, auditory, tactile or noxious stimuli

3 - No evidence of language comprehension

4 - Sleep / wake cycles maintained

Question 19

Which imaging techniques can be used to help diagnose a persistent vegetative state?

Answer 19

PET scanning

Question 20

List 3 conditions that might present as a persistent vegetative state.

Answer 20

1 - Minimal awareness state

2- Locked-in syndrome

3 - Guillain-Barré syndrome

Question 21

How do the outcomes of a minimally conscious state compare to that of a persistent vegetative state?

Answer 21

There is more continuous improvement & significantly more favourable outcomes post-injury in a minimally-conscious state when compared with a vegetative state

Question 22

List 4 clinical practices that are made difficult by using humanity as a moral ground for concern.

Answer 22

1 - Abortion

2- Euthanasia

3 - Withdrawal of life-saving treatment

4 - DNARs