M2 reading objectives

Question 1

divergences within defining death

Answer 1

according to science (objective) vs according to moral/ philosophical stance (value systems)
-cardiopulminary to whole brain to higher brain= conservative to progressive definitions

Question 2

problems with immortality

Answer 2

• disenfranchised youth, societal disruption, individual implications (adding no life to years)
• leads to brutal/ violent deaths (no med accidents)

Question 3

death grounds value by…

Answer 3

1) boredom (pleasure decreases with immortality) and tedium (annoyance increases with immortality)
2) seriousness (don’t take life for granted or put things off)
3) beauty (vulnerability/ transient nature)
4) character/ virtue/ nobility (sacrifice, heroism)

Question 4

illogical loop in immortal desires

Answer 4

human condition is that life IS an innately incomplete process- wanting more years (incompletions) to create a greater complete picture is an inherent contradiction

Question 5

turn to XX as renewal of humanity (mortal coping)

Answer 5

• children/ procreation= renewal of human possibility
• community
• culture

Question 6

quantitative futility

Answer 6

low possibility of survival- doctor should weigh in on success rate of procedure- HC provider can say no

Question 7

qualitative futility

Answer 7

100% survival, but quality of life after is pointless- should be entirely up to the patient

Question 8

physiological futility

Answer 8

clarify how quant and qual interact- patient sets goals of quality std and dr judges if treatment can get there
-problems= 1) doesn’t match everyday use
2) air of perceived certainty
3) doesn’t even address the real moral issue
= real manifestation provides disagreement on who actually makes final call

Question 9

physician autonomy

Answer 9

expertise- not slave to patient

-BUT constrained by the profession bc of code of profession

Question 10

professional autonomy

Answer 10

grounds of medical profession backing- society does intervene in negotiation and dialogue
-problems= 1) don’t need Dr opinion, 2) the only treatment option left, 3) values grounding judgement are intensely personal

Question 11

moral integrity

Answer 11

treatment goes against personal, moral values= conscientiously object
considerations:
1) core to personal values (not superficial)
2) basis in professional norms (med ethics)
3) central to professional identity
4) impact of patient
5) recognition of laws/ competing rights

Question 12

the devils choice

Answer 12

• perversely constrained options
• and no opting out of the decision
• both routes have foresight and intent, but one has DESIRE and this counts

Question 13

double effect

Answer 13

action produces 2 separate effects

-both with foresight, but one has INTENT which provides justification

Question 14

acts and omission

Answer 14

patient succumbs to illness when support is received

-the doctor passively routes to death, but illness actively causes death

Question 15

utilitarianism

Answer 15

hedonistic= decrease pain and increase pleasure
preference= increase choices of patient
=generate greatest good for greatest number
-both support VE

Question 16

Vol euth

Answer 16

prima facie permissible (principle of autonomy)

-very few people mistakenly choose it

Question 17

problems with immortality

Answer 17

1) societal disruption
2) individual incompleteness
3) death grounds value (boredom/ tedium, seriousness, character values, and beauty)
4) adding years to feel complete is illogical
5) turn to children, community, culture for humanity’s renewal

Question 18

futility types

Answer 18

quant- uncertain chance of survival- up to MD

qual- survival is certain, but quality of life is unsure- patient decides

Question 19

problems with physiological futility

Answer 19

1) divergent use of “futility” will lead to mismatched policy
2) air of perceived certainty (who really decides)
3) doesn’t address the real moral issue

Question 20

autonomy as justification for vacation

Answer 20

physician autonomy- not slave to patient; doesn’t work bc constrained by profession
professional autonomy- the profession makes decisions but these are negotiated by society because:
-don’t need MD to decide treat or not
-only treatment option left at this point
-intensely personal decisions

Question 21

conscientious objection

Answer 21

1) core to personal values (not superficial)
2) basis in professional norms
3) central to professional identity (would impede future practice)
- —
4) impact on patient (HUGE deciding factor)
5) competing rights/ laws (contingency)

Question 22

double effect

Answer 22

real weight is carried in INTENT (both courses have foresight)

Question 23

acts and omissions

Answer 23

doctors action was not the true cause of the death; underlying illness was

Question 24

devil’s choice

Answer 24

• no opting out
• both morally perverse options
• real power lies in DESIRE (both routes have intent and foresight)

Question 25

voluntary euthanasia argument

Answer 25

1) both utilitarianism forms support it 2) prima facie permissible because of autonomy 3) mental illness is the same as physical and does not remove autonomy 4) physical illness is reason enough and VE is better than terminal euthanasia 5) slippery slope has no proof (OR / NE)