Medical ethics

Question 1

How did Fletcher define a person?

Answer 1

Self control, self awareness, concern for others, a sense of past and future, the ability to relate to others, communication and curiosity.

Question 2

How is personhood important in medical ethics?

Answer 2

It’s at the center of many ethical debates, most would consider it wrong to kill a person- but not a non person. How do we define an ex-person, someone who is brain damaged, a fetus, someone with dementia?

Question 3

What is the quality of life argument?

Answer 3

The overall well being of the person is the defining factor in life or death situations. Life is not intrinsically sacred.

Question 4

What is the sanctity of life argument?

Answer 4

Traditional Christian view, all life is sacred and we never have the right to end it.

Question 5

What is signer’s position of the QOL and SOL arguments?

Answer 5

He rejects SOL as outdated and absolutist, he argues against the idea that humans are in any way special and sees animals as our equals.

Question 6

What does glover argue in ‘causing death and saving lives’?

Answer 6

A universal moral system is impossible to achieve- most of us would agree that killing is wrong, but may make an exception for fetuses and brain dead people.

Question 7

What did Glover think of the pro life stance on abortion and euthanasia?

Answer 7

It is untenable, modern science can keep us alive when we would have previously died- but in some cases the QOL is too poor to justify. Broad legislation on euthanasia is difficult and we need to make a careful assessment of each case.

Question 8

Give the three stages of the embryo

Answer 8

Conception-14th days=pre embryo. 14 days-8 weeks=embryo. 8 weeks onward=fetus.

Question 9

Give five opinions on when life begins

Answer 9

1. Conception. 2. Implantation. 2. When brain activity begins. 4. When it becomes viable. 5. At birth.

Question 10

What is the dualist perspective?

Answer 10

People are made from body and soul, the soul is implanted by god and takes place from conception.

Question 11

What are stem cells and embryonic stem cells?

Answer 11

The building blocks of life. Embryonic stem cells are found in the blastula (an early embryo of under 100 cells, which can’t survive unless implanted into the womb.)

Question 12

What is the UK law on embryos?

Answer 12

Testing can only take place up to 14 days after fertilization.

Question 13

Give the two opposing arguments on embryo research

Answer 13

1. They have none of the psychological, physical or emotional properties of a human and unless implanted into the womb, the blastula won’t survive. We need them for medical progress. 2. Destroying the blastula to harvest stem cells is destroying an unborn child, the embryo is a potential person.

Question 14

Give three reasons why we need to create embryos

Answer 14

1. Stem cell research can aid us in finding cures for genetic illnesses. 2. In IVF, an embryo is grown in a lab and then transferred to the womb. More embryos then necessary are created and those with the highest potential for survival are implanted. 3. PGD involves creating an embryo in a lab and removing a cell from it at 5 days to check for genetic conditions.

Question 15

Why do we need embryonic stem cells?

Answer 15

Cord blood from the placenta and umbilical cord is an adult stem cell, this can only differentiate into a limited number of cells, embryonic stem cells can differentiate into any type of cell, so are more useful.

Question 16

What is the catholic view on embryo research and organ donation?

Answer 16

1. Embryo research is completely rejected, it involves procreation outside of marriage and fertilization does not happen as god intended it. 2. Organ donation is supported, as is the therapeutic use of stem cells, as long as no embryonic life is destroyed.

Question 17

What is the current debate over cord blood?

Answer 17

How should it be made available? Should couples keep it for their own future use, or should it be donated to a blood bank for all to use?

Question 18

What three criteria are there for an abortion in the UK?

Answer 18

1. Has to be agreed by 2 doctors. 2. Can take place up to 24 weeks. 3. Can only be done after 24 weeks if there is substantial risk to the mother or the child will be severely disabled.

Question 19

Give three catholic views on abortion

Answer 19

1. Only god can decide when someone dies. 2. All life is sacred and should be protected. 3. Life is god given, once one form of life taking is legalized, all life is under threat.

Question 20

What does Islam say about abortion?

Answer 20

It is wrong, but not punishable if performed in the first 120 days, if life is at risk or is the fetus is unviable.

Question 21

What does the pro choice argument say?

Answer 21

Women are free to decide to have abortions- the fetus is part of her body until it is capable of independent life and she can decided if it lives as its life is potential, not actual. Giving brith must be viewed in her overall financial, social and familial circumstances.

Question 22

How does personhood link to abortion?

Answer 22

Is the fetus a potential person, or actual person? Does the fetus have rights and how do we balance these against the mother’s?

Question 23

What thought experiment is used by Judith Jarvis Thomson to support abortion?

Answer 23

You wake up one morning to find the circulatory system of a famous violinist has been plugged into yours- he has a kidney ailment and your system is being used to extract toxins from his blood. If you unplug now, he will die, but in 9 months, he will be cured.

Question 24

What does Thomson say about unplugging?

Answer 24

You are allowed to, the right to life is not the right to use another’s body. The fetus’s right to life is not violated by abortion as it merely denies it the right to use the woman’s body, something it has no right to anyway.

Question 25

Give three objections to Thomson

Answer 25

1. There is a moral difference between killing and allowing to die. 2. A woman has a special obligation to sustain her offspring. 3. If she has voluntarily engaged in sex, the woman is responsible for the fetus having to use her body.

Question 26

What does don Marquis say about abortion?

Answer 26

It is wrong as it denies the fetus a future like ours. This removes the idea of weather or not a fetus is a person, it is wrong to kill a child as it deprives them of a future, the same applies to a fetus.

Question 27

What is the issue with Marquis’ argument?

Answer 27

It suggests abortion is only right if the fetus is disabled or would not be able to have meaningful future experiences.

Question 28

What is the difference between euthanasia and assisted dying?

Answer 28

Euthanasia allows doctors to end the lives of their patients. Assisted dying is when a patient controls their death with the help of a third party, both are illegal in the UK.

Question 29

What is voluntary euthanasia and what is the problem with it?

Answer 29

It’s carried out at the request of the patient. Opponents say the patient may not to be thinking clearly, they may be depressed, in pain etc. legalizing it could lead to a slippery slope where people are pressured into euthanasia by family members.

Question 30

What is non voluntary euthanasia and what is the problem with it?

Answer 30

The patient is not able to understand the choice between life and death (baby, someone with severe dementia) the choice is made for them in their best interests. Just because they don’t understand the choice, doesn’t mean they don’t have a quality of life.

Question 31

What is the role of Michael Wilcockson?

Answer 31

In ‘euthanasia and doctors’ ethics’ he looks at issues surrounding the blurred lines of euthanasia such as autonomy, the slippery slope, QOL and SOL, acts and omissions and the interpretation of the law.

Question 32

How does Wilcockson consider euthanasia?

Answer 32

Looks at it from a medical ethics perspective and considers why it is illegal in the UK. The BMJ distinguishes between ending someone’s life (active euthanasia) and allowing someone to die (passive euthanasia) they support the latter.

Question 33

Give two case studies for euthanasia

Answer 33

1. Tony nicklinson had a stroke in 2005 and was paralyzed from the neck down. He wanted his treatment withdrawn, but medical institutions refused, saying he still had QOL, he lost his court case in 2012 and died 6 days later after refusing food. 2. Charlie Gard had a rare life limiting condition, doctors at GOSH said it was in his best interests to withdraw treatment, his parents disagreed but lost their court case and his medical ventilation was withdrawn, he died aged 11 months in 2017.

Question 34

Explain ‘acts and omissions’

Answer 34

They stem from the Hippocratic oath. An act is performed by an agent who intervenes to bring about an outcome- active euthanasia. An omission is a failure to act with an awareness of what the outcome will be- passive euthanasia. Wilcockson says a failure to act does not absolve you from responsibility and the Catholic Church sees no distinction between the two.

Question 35

Explain the doctrine of double effect

Answer 35

It allows a distinction between foreseeing an outcome and acting to bring about said outcome. Ergo, giving a patient a potentially lethal dose of drugs to ease their pain is legal as long as the intention is not to kill them. Wilcockson criticizes this, it could be easily abused and there is no difference between intending to act and foreseeing an outcome.

Question 36

Explain ‘ordinary and extraordinary means’

Answer 36

In most circumstances, we have a duty to accept healthcare, but need not go to extraordinary lengths to keep ourselves alive. Extraordinary means are any treatments that are not going to work in the long run and whose burdens outweigh any benefits.

Question 37

What is the catholic perspective on ordinary and extraordinary means?

Answer 37

Natural law- refusing food/water is committing suicide and is wrong. But refusing life prolonging treatment when there is no chance of recovery is simply letting nature take its course and is moral.

Question 38

What does Wilcockson say about proportionate and disproportionate means?

Answer 38

A better criteria then ordinary/extraordinary means as it allows doctors to decide on as case by case basis what it best for each patient.

Question 39

What is the difference between proportionate and disproportionate means?

Answer 39

1. Disproportionate- any treatment that offers no reasonable hope and whose burdens outweigh its benefits. 2. Proportionate- any treatment which offers reasonable hope to the patient and whose benefits outweigh its burdens.

Question 40

When does the distinction between proportionate and disproportionate means become difficult?

Answer 40

When the patient is non competent- an ill baby, in this case, the QOL would say the doctor must make the baby as comfortable as possible without prolonging its suffering.

Question 41

What is the law based upon and what implications does this have?

Answer 41

Mill’s harm principle, suicide is legal, but helping someone to commit it is not. I have the right to make my own decisions about my treatment owing to the principle of personal autonomy.

Question 42

What is the difference between law and morality?

Answer 42

Law- rules prescribed by the state to protect society, we have a moral duty to obey them. Morality- deals with issues of right and wrong. There is public morality, which is a matter of law, but the law should have no say on what we do in private. Law should be divorced from morality to avoid a tyranny of the majority.

Question 43

What does Wilcockson say about avoiding a tyranny of the majority/

Answer 43

It may not be possible as the law takes into account the general moral feeling and laws are decided on the basis of how the majority of society feels.

Question 44

Explain the thin end of the wedge argument

Answer 44

Legalized euthanasia would lead to other forms of killing beings accepted and legalized. Singer disagrees, in countries like the Netherlands where euthanasia has been legalized, this has not occurred.

Question 45

Explain ‘undermining personal autonomy’

Answer 45

The BMA is worried that legalizing euthanasia to respect personal autonomy could undermine it if the individual is vulnerable. The trust between a patient and doctor would be broken and the attitude of society to disability and illness would change.