Medical Ethics

Question 1

Buddhist beliefs

Answer 1

Samsara: Trapped in a cycle of suffering (Dukkha) until they gain enough good karmic energy to track Nibbana

The 8 fold path -> morality section -> skillful action based on 3 root goods -> positive karma -> closer to enlightenment

5 precepts -> aids them in making skillful actions

Question 2

Catholic beliefs

Answer 2

Clear unchanging rules and beliefs. Deontological approach, is right or wrong, no emotions. Teleological, reason/purpose and design.
All teachings are from:
Magisterium: teaching authority (pope and bishops of church)
Tradition: Beliefs, teachings, behaviour of a group, may include scripture, oral teachings, law and ritual practices
Scripture: Peice of writing of religious significance (bible, catachisms)

Question 3

What is sanctity of life?

Answer 3

A catholic belief, that all human life is sacred and thaf everyone has the right to life, which should be protected and valued at any stage

Question 4

Utilitarian beliefs

Answer 4

Consequentialist theory: judges the rightness or wrongness of an action by looking at the result.

Hedonistic: focused on pursuit of happiness as the goal of life, it’s the only thing with intrinsic value, opposite of happiness is suffering.

Equity principle: every beings happiness should matter equally but they realistically don’t, this is determined by their ability to experience happiness and suffering

Question 5

Difference between act and rule utilitarianism?

Answer 5

Act: based on individual situations

Rule: range of rules that cover many situations

Question 6

Utilitarians personhood beliefs

Answer 6

Peter Singer says moral worth is not intrinsic in humans, it is based on having certain qualities and the more you can experience the more morally valuable we are. Qualities: consciousness, self-awareness, ability to communicate, preferences about continued existence.
(Babies only have moral worth when they’re born)

Question 7

Humanist beliefs

Answer 7

We should be free to decide how we live as long as we don’t hurt others, we should seek happiness and support others to do the same. You don’t have to live by traditions or expectations, you should be empathetic, use logic and reason and respect everyones human rights. The golden rule “Do not do to others what you would not like for yourself”

Question 8

Facts about embryos

Answer 8

It is a clump of cells in the earliest stages of human life, the word is used from conception. Week 8 = foetus. The human fertilisation and embryology act 1990 explains embryos must be used within 14 days of creation.

Question 9

What is the process of IVF? (What does it stand for)

Answer 9

In vitro fertilisation

1) natural menstrual cycle stopped with meds
2) egg supply boosted with meds
3) ultrasounds to check egg maturity
4) eggs collected from ovaries
5) eggs mixed with sperm, fertilisation, forms embryo
6) one or two embryos places in womb

Question 10

Guidelines to get IVF

Answer 10

-Under the age of 43
-Trying for at least 2 years
-Have tried other treatments

Question 11

What are the moral issues raised by reproductive uses of embryos?

Answer 11

-Leftover embryos
-Playing God
-Eugenics
-Cost

Question 12

What is the moral issue of leftover embryos? (Reproductive)

Answer 12

Is about what happens to the fertilised eggs that aren’t implanted in the womb, because only 1 or 2 are implanted.
The options are:
-frozen and kept for later
-donated to other couples
-donated for research
-destroyed

Question 13

What is the moral issue of playing God? (Reproductive)

Answer 13

Religious ppl argue that having children is a natural process, if you are unable to conceive you should just accept it, because if you interfere you’re playing God.
Others argue that intellect given to humans should be use to help ppl in this way.
Some think God is irrelevant cause he doesn’t exist.

Question 14

What is the moral issue of eugenics? (Reproductive)

Answer 14

Is when favourable traits in offspring are selected so they or future races have a “better” genetic composition. IVF is not being currently used for this purpose but some ppl argue embryos being created outside the womb could lead to more experimentation with morally questionable implications.

Question 15

What is the moral issue of cost? (Reproductive)

Answer 15

1 round of IVF can cost £5000 or more, NHS works on a budget, which means money that could be direted to other treatments is instead being used for IVF. Some may argue it’s better to put money into treatments with higher success rates. But some say the right to a family overrides the cost and if only available through private healthcare would be unjust.

Question 16

What are the moral issues of Therapeutic uses of embryos?

Answer 16

-Supply of human eggs
-Embryos as a comodity
-means to an end
-slippery slope

Question 17

What are the moral issues of Research uses of embryos?

Answer 17

-Supply of human eggs
-Embryos as a comodity
-means to an end
-slippery slope

Question 18

What is the moral issue of supply of human eggs? (Therapeutic/research)

Answer 18

In a natural cycle women only produce 1 or 2 eggs, the meds given to increase supply can cause harm, the surgery isn’t complicated but has risks. It’s putting health at risk create embryos.

Question 19

What is the moral issue of embryos as a commodity? (Therapeutic/research)

Answer 19

Embryos shouldn’t be sold like a product, this risks vunerable ppl being exploited because women are recruited and paid for their eggs.

Question 20

What does the catholic church say about IVF in general? (Reproductive)

Answer 20

-It takea intimacy/closeness out and focuses on reproduction
-Child has the right to be raised as they are by bio parents
-If one is infertile -> 3rd member involved betrayal to sanctity of marriage
-It’s a trial/test should adopt and become closer to God
-Discarding/mistreating embryos is unjust
-A child is a gift from God
-Masterbation for sperm is a sin (lol)

Question 21

What does therapeutic uses of embryos mean?

Answer 21

It means medicine or medical treatments used for healing diseases, it helps ppl currently by helping with skin grafts or diseases.

Question 22

What is a hESC?

Answer 22

A human embryonic stem cell. They have unique properties, which are they can become any kind of cell and they continue dividing for a long time. They can be used to treat leukaemia, heart disease and Parkinson’s disease.

Question 23

What are saviour siblings?

Answer 23

They can be created with IVF and are a genetic match to someone who needs cells/blood, it can be used to help their older sibling that has a disease. The placenta and umbilical cord are immediately taken, they start having things taken as soon as they’re born. 1 in 4 siblings are an immunological match. (But they can’t consent)

Question 24

What is the moral issue of means to an end? (Therapeutic/research)

Answer 24

Creating human embryos for therapeutic use and to harvest hESCs is means to an end. The embryo is not considered important, is it worth using them to possibly save a human life?

Question 25

What is the moral issue of human cloning/slippery slope? (Therapeutic/research)

Answer 25

The cloning of cells may lead to human reproductive cloning, this brings ethical concerns. Fallacy -> believing one action leads to an undesirable chain reaction. Screening embryos may lead to cloning, can clones consent? Are they human?

Question 26

What does research uses of embryos mean?

Answer 26

Using embryos for increasing knowledge and understanding of diseases (e.g. what causes them possible cures), it helps ppl in the future

Question 27

What is informed consent?

Answer 27

-If you want to donate your organs at some point before death you must inform the government by joining the organ donor register -If not on register organs can't be taken

Question 28

Difference between soft opt-in and hard opt-in?

Answer 28

Soft: famipies can update your decision after death Hard: if you're not on the organ donation register then you can't donate

Question 29

What is presumed consent?

Answer 29

When unless they have specifically opted out then their organs will be donated after death

Question 30

What is the difference between soft opt-out and hard opt-out

Answer 30

Soft: Family can express the dead person's opinions so that their organs don't get donated, unless they're registered to donate Hard: If they haven't opted out they're getting donated anyway no matter what the family thinks

Question 31

Moral issues raised by consent? (Only need about 4)

Answer 31

-Vunerable in society -Autonomy -Rights -Medical Integrity -Giving -Supply (of organs)

Question 32

What is the moral issue of medical integrity? (Consent)

Answer 32

Organ donation as a possibility, may change the relationship between a dying patient and the doctor. Some may worry that the patient will only be treated as an organ bank, and not as a human being. Since doctor's are under a Hippocratic oath, this would be breaking it. Dr's in the past have expressed the wish to can consent from the family first, so to respect medical integrity.

Question 33

What is the moral issue of vulnerable in society? (Consent)

Answer 33

This questions whether it is fair to change legislations if there are people who may not understand the change in law or the need to act to opt out of donating organs. Scotland's soft opt out system takes this into account by leaving out people who are under the age of 16, do not have the capacity to understand this law or have been living in the UK for less than 12 months before their death. But is this enough?

Question 34

What is the moral issue of autonomy? (Consent)

Answer 34

Autonomy is being able to make decisions for yourself, by having an opt out system it can be argued that your autonomy is more limited, because the system is making that choice. Also that people who do not wish to donate now have to make the decision to tell the NHS, which they didn't have to do before.

Question 35

What is the moral issue of Human rights? (Consent)

Answer 35

Either consent system affects your right to privacy, because if you wish to not donate your organs in an opt-out system, you must inform the NHS of your decision. If you choose to not donate your organs this could also be seen as selfish because of other patient's right to life and right to medical care.

Question 36

What is the moral issue of giving? (Consent)

Answer 36

When there is informed consent system, giving your organs after death is considered an act of generosity but any presumed consent system this last act of kindness is taken away because it's just that you're not objecting from your organs being taken.

Question 37

What is the moral issue of supply (of organs)? (Consent)

Answer 37

Sometimes countries wish to switch to a presumed consent system so that there is a higher chance of organ donations. This however doesn't always work, Brazil in 1997 tried switching to a presumed consent system, but they did not have the infrastructure to keep track of all donors and patients needing transplants so they had to switch back. So it may not always work.

Question 38

What is a beating heart donor?

Answer 38

An organ donor who is brain stem dead, organs are thought to be in better condition, ventilator used to pump oxygen into lungs so organs stay alive, the brain can never recover from brain stem death, it is not the same as a coma

Question 39

What is a non beating heart donor?

Answer 39

The heart stops beating and organs begin to shut down (circulatory death) limited amount of time to harvest organs. Person is clearly dead

Question 40

What are controlled non beating heart donors?

Answer 40

Happens in hospital, life sustaining care is withdrawn, organ donation team is ready/on standby

Question 41

What is uncontrolled non beating heart donation?

Answer 41

E.g. cardiac arrest or attempts to bring them back have failed, can be dead on arrival to hospital, unexpected

Question 42

What are the moral issues raised by beating heart donors?

Answer 42

Dead donor rule Personhood Respect/medical integrity

Question 43

What is the dead donor rule? (BHD)

Answer 43

Is brain stem death actually death or is it harvesting the organs that kills them? Brain stem is the control centre of the brain, when it is gone it is only matter of time because all body functions stop. Is removing organs death, or just quickening a gradual process?

Question 44

What are the moral issues of living donors?

Answer 44

Coercion Risk Organs as a commodity

Question 45

What is the moral issue of personhood? (BHD)

Answer 45

Whether a brain stem dead patient is considered a person or not determines if BHD are morally acceptable. If they are considered a dying person harvesting their organs treats them as dead and dehumanises them

Question 46

What is the moral issue of medical integrity? (BHD)

Answer 46

Shortage of organs can lead to doctors seeing brain stem dead patients as spare parts. Respect for the dying patients family is necessary. BHD's look like a they're sleeping so saying goodbye can be traumatic/difficult for family

Question 47

What is the moral issue of coercion? (Living donors)

Answer 47

This is when someone is being blackmailed/bribed/threatened. If someone is not giving altruistically or because they want to but instead are being pressured then they are not being treated well. You shouldn't force someone to donate

Question 48

What is the moral issue of risk? (Living donors)

Answer 48

Undergoing surgery creates risks (infection/blood loss). Is it morally okay for you to put yourself in harms way to help someone else. Which would risk causing you problems in the future.

Question 49

What is the moral issue of organs as a commodity? (Living donors)

Answer 49

(black market) Is it morally okay to buy and sell organs or is this misusing someone and not treating them with dignity or as a person. Are they being viewed as a product?

Question 50

What is euthanasia?

Answer 50

Roughly translates to "good death" from greek. It's the act of allowing an individual to die either at their own request or dr/next of kin. The aim is to give a painless death when suffering unbearably from an incurable disease/illness.

Question 51

What is voluntary euthanasia?

Answer 51

Where a person's life is ended at their own request in order to relieve them of suffering

Question 52

What is non-voluntary euthanasia?

Answer 52

When the person is unable to make a meaningful choice and an appropriate person makes the decision on their behalf

Question 53

What is passive euthanasia?

Answer 53

Intentionally letting a patient die bu witholding artificial life support such as a ventilator/feeding tube

Question 54

What is active euthanasia?

Answer 54

Death is brought about by an act, for example the patient is given an overdose of pain killers

Question 55

What is assisted dying?

Answer 55

It's a form of euthanasia, they want to die and ask someone to help them. This is illegal in England and Wales under the suicide act of 1961, in Scotland it's not specifically a crime but you could be charged with murder. Physician assisted dying involves a doctor giving the patient the necessary drugs to end their life

Question 56

What is assisted suicide?

Answer 56

The government doesn't recognise the difference between this and assisted dying however this is when someone who does not have a terminal illness wishes to end their life

Question 57

What is the Ian Gordon case study?

Answer 57

He smothered his wife with a pillow but she had lung cancer and a fear of hospitals. He was devoted to his wife, she didn't want to get diagnosed with lung cancer, she was screaming in pain in the hours before she died. He was cleared of murder after being in jail for 3 years, as this was afterwards considered active voluntary euthanasia.

Question 58

What is the case study of Richard Selley?

Answer 58

He has motor neurone disease and was advocating for assisted duing before going to Switzerland to die peacefully. He chose to take medicine that would kill him (assisted dying) this gave his death more dignity, his wife supported his decision, it costed £10,000

Question 59

What are at least 3 moral issues of euthanasia/assisted dying?

Answer 59

- Autonomy - Compassion - Dignity - Control - Vulnerable in society - Burden

Question 60

What is the moral issue of autonomy? (Euthanasia)

Answer 60

It means being able to make your own decisions. If humans can control every aspect of their lives such as how we live, spend our money or what job we do. Then shouldn't w also be able to choose how and when we die.

Question 61

What is the moral issue of compassion? (euthanasia)

Answer 61

It means showing sympathy and concern for those who are suffering. What is the most compassionate thing to do for someone who is ready to end their life and is experiencing unbearable pain, should you let them die or try to help them live for as long as possible?

Question 62

What is the moral issue of dignity? (Euthanasia)

Answer 62

It means people being valued and respected, this is a complicated issue. Having to rely on others to feed them, shower them, take them to the toilet may be unimaginable for many, this loss of dignity is why assisted dying should be legalised. Many terminally ill patients would rather die before this point of their bodies shutting down.

Question 63

What is the moral issue of control? (Euthanasia)

Answer 63

Whether laws can control an issue that isn't black and white but in the shades of grey. Would legalising one form of euthanasia lead to more of them becoming acceptable. (Slippery slope)

Question 64

What is the moral issue of vulnerable in society? (Euthanasia)

Answer 64

Those who many not be able to look after themselves without support. Could non-voluntary euthanasia lead to the killing of vulnerable people based on "compassion" and "dignity"

Question 65

What is the moral issue of burden? (Euthanasia)

Answer 65

People at the end of their lives need lots of care both financially and time and effort. If euthanasia was legal would it lead people to end their lives as to not be a burden, and could families push for it to get rid of obligations

Question 66

What is palliative care?

Answer 66

This is for people in the last few months of their lives and helps them live well before they die, it is a holistic approach because it helps you as a whole not just your illness, it also provides support to family and carers.

Question 67

What is covered by the holistic approach? (Palliative care)

Answer 67

Physical needs (medication) Spiritual needs (meditation, connecting you to a religious leader) Psychological needs (mental health, setting up support groups) Family needs (advice for after death procedures, bereavement support)

Question 68

What environments can palliative care be given in?

Answer 68

In hospitals, in care homes, in hospices and at home

Question 69

What is palliative care like in hospitals?

Answer 69

Delivered over a short peiod of time by specialised palliative care team, provided by NHS, a plan is made with patient about where they'll go next (care home, hospice, patient's home)

Question 70

What is palliative care like in care homes?

Answer 70

Specially trained staff, calmer environment than hospital, most are privately run and can be very expensive

Question 71

What is palliative care like in hospices?

Answer 71

Designed for terminally ill patients to recieve care and see loved ones, can spend weeks there or just for the day, families can stay overnight, funded by charities

Question 72

What is palliative like at the patient's home?

Answer 72

Depending on individual situations, palliative care nurse arranges visits during the day, can stay overnight or move in full time

Question 73

What are the moral issues of palliative care?

Answer 73

Cost, virtue/compassion, mental health and wellbeing (MHWB)

Question 74

What is the moral issue of cost? (palliative care)

Answer 74

Should palliative care be free? Private care homes must be paid for by the patient/family, this causes a divide among those who can and can't afford it. Assisted dying is cheaper and quicker. Should the money be spent on something else like cures or research

Question 75

What is the moral isse of virtue/compassion? (palliative care)

Answer 75

Palliative care is more compassionate because it is more holistic which helps the patient on a personal level and supports family by giving bereavement counselling whereas assisted dying is only for the patient's pain. Palliative care is less compassionate because forcing it on someone who doesn't want it restricts their autonomy and shows a lack of compassion, because their being forced to live.

Question 76

What is the moral issue of mental health and wellbeing (MHWB)? (palliative care)

Answer 76

Palliative care provides best care for patients to support them including psychological care. However forcing people to live on with no option could be detrimental to their mental health and draws out their suffering until they eventually die.