Midterm #1 Flashcards
___________The study of ethical questions that arise during the practice of medicine and the conduct of research in biological and medical science
Biomedical ethics:
__________: the study of the principles that determines right vs wrong conduct. It usually assumes that our pursuit of self interest ought to be constrained by independent principles of right vs. wrong
Ethics:
_______________ occurs when a physician facilitates a patients death by providing the necessary means and/or information to enable the patient to perform the life ending act.
Voluntary Active Euthanasia:
_________________ “voluntary active” is the admistration of a lethal agent by another person to the patient (at the patients request)
Physician Assisted Suicide:
______________ acting of one’s own free will, patient requests euthanasia
Voluntary:
_____________ an individual can not act of one’s own free will, patient can not consent to euthanasia
Nonvoluntary:
______________: without consent, active disapproval, patient has indicated they do not consent to VAE, but it is done anyway
Involuntary:
_______________ administration of lethal agent by another person to patient
Active euthanasia:
_______________ another word for pulling the plug
Passive euthanasia:
______________ the final act lays with the physician
Euthanasia:
______________ the final act lays with the patient
Physician Assisted Suicide:
Does Placement in the causal chain matter morally?
Euthanasia: the final act lays with the physician
Physician Assisted Suicide: the final act lays with the patient
_____________: the government (state or national) makes it into a law
Legality:
_______________: principles concerning an individual’s ideas of right vs. wrong
Morality:
_______________: not allowed
Impermissibility:
____________: allowed
Permissibility:
_________: Required
Obligatory:
________________ occurs when a physician facilitates a patients death by providing the necessary means and/or information to enable the patient to perform the life ending act.
Voluntary Active Euthanasia:
_____________ “voluntary active” is the admistration of a lethal agent by another person to the patient (at the patients request)
Physician Assisted Suicide:
____________: the failure to act Ex. DNR
Omissions:
______________ taking action, doing something Ex. VAE, PAS
Acts:
_____________ an indivividual can not act of one’s own free will, patient can not consent to euthanasia
Nonvoluntary:
___________ acting of one’s own free will, patient requests euthanasia
Voluntary:
______________: without consent, active disapproval, patient has indicated they do not consent to VAE, but it is done anyway
Involuntary:
___________ administration of lethal agent by another person to patient
Passive euthanasia: another word for pulling the plug
Active euthanasia:
_________________ the power to be self-governing. The ability to make your own decisions
Autonomy:
_____________ the state of being healthy, quality of life
Well being:
Name the two Deontological Arguments Against the Morality of PAS/VAE
- The inherent value of life- There is some moral rule which makes the act of killing an innocent person wrong in and of itself regardless of the circumstances
- It is an Act not an omission- Withdrawing treatment is an omission and does not actively violate the moral rule
Name the three Consequentialist Argument: Against the Legality of PAS/VAE
- Weaken’s patient care- Will alter physician roles, could weaken care to dying patients, threatens rights to withdaw treatment,
- Reduces autonomy- could reduce patient autonomy by increasing options set,
- Slippery slope- weakens prohibition on murder, slippery slope to other forms of Euthanasia
VAE is more morally problematic than PAS because in VAE, the physician acts last.
What are two implications of this statement?
- the last act in a causal chain that leads to a killing is more morally salient (prominent) than earlier acts.
- The last act is actually a form of patient consent.
VAE is more morally problematic than PAS because in VAE, the physician does the killing
What is the claim of this statement? What is the counterargument?
Claim: the last act in a causal chain that leads to a killing is more morally salient than earlier acts
Counterargument: All contributors to a causal chain act together equally from a moral point of view
What are the two values that Dan Brock has in his The Case for VAE and PAS
The value of individual autonomy
The value of individual well being
Autonomy permits people to form and live in accordance with their own conception of a good life
Autonomy allows people to take responsibility for their lives and the kinds of people they become - a central aspect of human dignity lies in people’s capacity to direct their own lives in this way
____________ the set of benchmarks that are used to assess whether or not an individual has been effective or competent
Competency Standard:
Question: What Make Life Good?
Name the two views on what makes life good?
- Life is in itself Good: Physical life itself is an intrinsic value, valued for its own sake
- The quality of life is the relevant good: physical life itself is an instrumental value important in making other valuable things possible
Is Physical Life Itself a Relevant Good?
Stance on VAE/PAS
Life is in itself good and valuable.
Typically against VAE and PAS.
Is Quality of Life a Relevant Good?
Stance on VAE/PAS
The qualities of Life are what make life Good.
Typically Pro-VAE and PAS
____________ Good in Itself
Intrinsic value
______________ Good for what it makes possible
Instrumental value
The Wrongness of the VAE act itself:
Deontological:
Deontological: something wrong about the act of VAE itself that makes is morally impermissible
Although VAE can and oftentimes does promote the value of autonomy and quality of life, there is nevertheless something wrong about the act of VAE itself that makes is morally impermissible
___________ deontology is the normative ethical theory that the morality of an action should be based on whether that action itself is right or wrong under a series of rules, rather than based on the consequences of the action.
Deontological Theory:
The Wrongness of the VAE act itself
Consequential:
The consequences of legalizing VAE/PAS is too great.
Consequential: While individual instances of VAE might prove to be perfectly permissible from the moral point of view, we ought not to legalize it as a public policy because doing so will lead to negative consequences
____________ The rightness of an act is determined solely by a consideration of that acts consequences
Consequentialist Theory:
Potential good consequences of arguments VAE/PAS
Increased self-determination for patients who choose it
Expanded option set insurance for patients who don’t
Reduction of pain and suffering-physical and mental
Availability of a more human death
Potential Negative consequences of arguments against VAE/PAS
Effects associated with altering physician roles
Might weaken optimal care to dying patients
Might threaten rights to withhold/withdraw treatment
Actually reduces patient autonomy: Increased pressure on patients to choose VAE/PAS. Optimal autonomy does not always mean more options
Weakens prohibition on murder
The slippery slope to Non-voluntary and Involuntary Euthanasia
____________: agent, situational context, choices over a number of possible actions
Presumes:
____________: Although VAE can and oftentimes does promote the value of autonomy and quality of life, there is nevertheless something wrong about the act of VAE itself that makes is morally impermissible
Deontological:
_______________: While individual instances of VAE might prove to be perfectly permissible from the moral point of view, we ought not to legalize it as a public policy because doing so will lead to negative consequences
Consequential:
______________: The right act is the act a virtuous agent would choose in the same situation
Virtue Theory:
The trolly problem- what does the consequentialist say? The deontologist?
Flip the switch-consequentialism
Do not flip the switch- deontology
______________: is a theory of what we value
It can include anything as a value; it sometimes incorporates principles of how values relate/compare
A theory of the Good:
_____________: tells us how to react to value
We should honor or instantiate value, we should promote (maximize) value (consequentialism)
What to do with the good things that we have
A theory of right
What moral theory promotes the good
Consequentialism
What moral theory Honors the good/value-____________
deontology
Father of utilitarianism
Jeremny Bentham.
Why should we be deontologists?
A three part argument from simplicity
Consequentialism involves only one method of valuation
Deontology cannot explain without being ad hoc (created or done for a particular purpose), why some values ought to be honored, while others can be promoted
Consequentialism’s structure mirrors that practical rationality
arguments against deontology:
- The hideous recommendations/horrendous deeds objections-consequentialism permits us to do terrible things like murder or kill therefore it is wrong.
- The hideous motivations/state of mind objections: even if, in the end hideous deeds are not actually recommended consequentialism turns us into the sorts of people that will.
- Publicity objection: something is radically amiss when you’re telling agents to act without understanding their true reasons for action, especially in decisions that are of a moral nature. We must understand our reasoning.
The special relationships objection: consequentialism requires us to abandon those we owe most consideration to-like friends and family members - The one thought to many objections: when you tell me to be good to my friends because doing so maximizes the value of friendship overall, you don’t understand what it really means to be a friend. All I have to say is he is my friend nothing more
- The over demanding objection: consequentialism requires us to do too much- there’s always some way I could act differently so as to bring about more good (forego coffee and donate money to charity), but id have nothing left for myself- no objection.
Consequentialism forgets personal autonomy
The negative Responsibility/Dirty hands objection- we don’t want personal responsibility for something bad to stop something bad from happening
______________ the doctrine that actions are right if they are useful or for the benefit of a majority
Utilitarianism:
What is the Theory of the good in consequentialism?
Theory of Good: boils down to pleasure and happiness
What is the theory of value in utilitarianism?
Anything that promotes happiness and pleasure
Arguments for utilitarianism’s consequentialist form (3 positives)
It reflects the nature of human responsibility
It is a theory of equality
It’s simple and can be relatively easily applied
Arguments against utilitarianism
All arguments against consequentialism are arguments against utilitarianism
The experience machine objections
It incorrectly counts animal pleasure
It incorrectly counts immoral or silly pleasures
It ignores the separateness/value of persons
It can’t guarantee equality of rights
What is the experience machine objection
The experience machine or pleasure machine is a thought experiment put forward by philosopher Robert Nozick in his 1974 book Anarchy, State, and Utopia.
__________ The theory of the good is pleasure and the reduction of suffering. The theory of the right: maximizes the theory of the good.
Utilitarianism:
_____________ refers to a theory of the right which maximizes or promotes theory of the good regardless of what value it is. It is a theory of justification not decision making
Consequentialism:
______________How we bring our values into the world
Theory of the Right:
__________ What we actually value or want to see in the world. Can be anything.
Theory of the Good:
What moral theory do these objects use? Are they for or against PAS? Morality/Legality?
There is some moral rule which makes the act of killing an innocent person wrong in and of itself regardless of the circumstances.
Withdrawing treatment is an omission and does not actively violate the moral rule
Deontological Arguments: Against the Morality of PAS/VAE
What moral theory do these objects use? Are they for or against PAS? Morality/Legality?
Will alter physician roles, could weaken care to dying patients, threatens rights to withdaw treratment, could reduce patient autonomy by increasing options set, weakens prohibition on murder, slippery slope to other forms of Euthanasia
Consequentialist Argument: Against the Legality of PAS/VAE
Shelly Kagan’s Definition- The notion of Constraints
How does she feel about deontology?
Deontological Views impose moral constraints on action
Shelly Kagan’s Definition- The notion of Constraints
How does she feel about consequentialism?
Consequentialism leaves something important out of our understanding of moral reasoning- it is just too simple.
Hypothetical case challenge of consequentialism (2)
The organ case
The sheriff and the dangerous mob: Do you release an innocent man to an angry mob in order to stop the violence of the angry mob.
Kagan’s rejection of consequentialism
Consequentialism permits too much
Kagan’s rejection of deontology
Deontology too seems implausible in many cases
Different kinds/types of deontological theory
The ten commandments, contemporary contractualist views, and kantianism
Brock Review: The rule against intentionally killing innocents (2 ideas)
- Wrongful killing is wrong in virtue of lack of consent, motivation of the actor, social role of the actor, or the deprivation of a life of value.
- It is always wrong to actively and intentionally cause an innocent person’s death, but simply omitting life-saving measures is OK.
Kant’s Argument in Groundwork
The concept of intrinsic goodness
Nothing in the world is good except good will- The theory of the good
good will is good because _________
it is good. Not because of what it brings about.
__________ is the only instrumentally/ intrinsically good thing
Good will
_____________ as extrinsically good
Happiness or pleasure
_______________ command an action that would be good only as a means to something else
Hypothetical imperatives:
_______________ commands an action that is good in itself; declares the action to be objectively necessary without referring to any end view
Categorical imperative:
_____________ formulation of the categorical imperative
The universal law
___________ formulation of the categorical imperative
The humanity
The humanity formulation of the categorical imperative
You should be able to endorse all of your actions.
“I ought never to act in such a way that I couldn’t also will that the maxim on which I act should be a universal law.”
__________: the capacity of an agent to act in accordance with objective morality rather than under the influence of desires.
Autonomy:
_________: acting in accordance with one’s desires rather than reason or moral duty
Heteronomy:
_______________ falls obedience to a law that I created myself. It is therefore respect its commitment to compliance with oneself.
Kant defines freedom
Moral freedom is ________ according to Kant
autonomy
Kant believes the value of a human lays in ____________________
Their ability to reason
_________________: freedom from wrongful interference with the way in which decisions are made
Procedural independence :
_________________: means that in the discharge of his/her judicial function a judge is subject to nothing but the law and the commands of his/her conscience.
Substantive Independence:
Dworkin’s “Split-Level” Theory
What is the autonomy equation?
(Autonomy=authenticity+independence)
Requires that out in the moment set of reasons for action be endorsable by our background set of identity giving principles
Dworkin’s “Split-Level” Theory
Beauchamp and Childress’ Approach what are the 3 things required?
Non-control, intentionality, understanding
Type of consent:
_________________ asked for
express consent-
Type of consent:
___________- read from other actions
implicit consent-
Types of consent:
______________- peaceful compliant (not objecting)
tacit consent-
_________________= would you, on reflection, endorse your reasons for acting
authenticity
_____________=freedom from wrongful interference in our decisions
Independence
______________________endorsement of step by step plan, not reactionary
Intentionality=
_______________ has all relevant information and ability to reason through choices
non-control= not being unduly controlled either internally/externally
Understanding=
____________ any medical treatment intended to end a pregnancy
Abortion:
the current status of US abortion law
Abortion must be accessible to a mother before the time of fetal viability
Fetal viability: the fetus has a 50% chance of surviving without the mother. Today fetal viability is considered 23-24 weeks.
States are allowed to attach strings to the accessibility of fetal viability
The purpose of this essay has been to set out an argument for the serious presumptive wrongness of abortion subject to the assump- tion that the moral permissibility of abortion stands or falls on the moral status of the fetus. Since a fetus possesses a property, the possession of which in adult human beings is sufficient to make killing an adult human being wrong, abortion is wrong.
Marquis Method
___________: the property of counting or being valued in our moral decision-making, Possessions of which designates a presumption against being killed. We must consider whether or not it is immoral to harm it.
Moral status:
Marquis’ New Proposal/Argument
Killing is wrong because it takes away __________
It is wrong to kill persons ____________
an individual’s potential
who are rational
Marquis’ New Proposal/Argument
Killing a fetus takes away that fetus’s ________________
potential life
Marquis’ New Proposal/Argument
It is wrong to kill subjects who have a desire to ____________
continue to live
Marquis’ New Proposal/Argument
It is wrong to kill subjects because it is wrong to discontinue the ____________________
experience of the victim
It is not rational
over inclusive: neither are young children or mentally handicap
It is not a social being
Neither are hermits or the socially awkward but we can’t kill them
It looks like a baby
Over inclusive. We would protect baby dolls too
It has a genetic code
So do human cancer cells
The nature of “Sanctity of Life” Position
8 objections
Viability Sentience Actual consciousness Capacity for consciousness Higher cognition/Rationality Potential Personhood Having a valuable future like ours Being a human organism
Thomson’s Thesis
Abortion is morally permissible in certaain situations
The Violinist Example
The violinist is magically connected to your kidneys. The violinist needs your kidneys for the next 9 months. If you unhook yourself the violinist dies.
The Extreme View in Thomson article
Abortion is never morial permissible- the opposing view
The fetus’ right to life trumps all other considerations, and thus that abortion is never morally permissible even in cases where the mother’s life is in danger
Abortion as Self Defense (first person defense)
Active killing is permissible in cases where another person threatens your life, even if that person is innocent
Exploding house. The baby is going to grow and grow inside the mother until the house (the mother) explodes. The mother has the right to eject the baby.
Abortion is permissible when the pregnany threatens the mother’s life if the mother performs the abortion on herself
Abortion as Refusal of Life Support (third person defense)
What can we say about what a third party may die?
May they intervene on the side of one or the other
Thomas justified third party intervention on her behalf because the mother owns her body.
Ownership of one’s body is greater than that of ownership of goods
_______________Morality sometimes requires that we give up some things at a cost to ourselves to help others- in other words, it requires some help
Minimally Decent Samaritanism:
________________ going well above and beyond require help
Good Samaritan
Thomson:
Abortion is not morally permissible (according to this argument) in cases that just require the mother to be a minimally decent Samaritan
Example mother has 2-3 months left and the mother wants an abortion because she doesnt want to postpone travel
Thomson:
Abortion is morally permissible in cases that would require the mother to be a good samaritan
Example mother has 7 months left and a busy life that would be significantly burdened by pregnancy. Violinist Case.
Thomason’s Conclusion:
Abortion is permissible when performed to save the life of the mother
Abortion is permissibile when performed in order to save the mother from significant hardship that go beyond the expectations of the minimally decent samaritan
Is the mother responsible for the fetus in virtue of having consented in some way to the chances of getting pregnant?
Wanton recklessness- _______
Reasonable precautions- ______
maybe
no
Brittney Maynard article gave a person account of ____________________
why PAS was a good option for her and why it should be legalized
Dan Brock alnaylized _______________
both the pros and cons of VAE and PAS. He defined terms and explored deontological and consequential views
Philiip Pettit explained _____________
consequentialism and utilitarianism
Immanuel Kant explained _____________
good will and intrinsic value of human reason
Don Marquis explained ____________
a pro life view focusing on the value of life
Judith Thomas explained ______________
a pro choice view from the perspective that abortion is morally permissible if the fetus causes harm to the mother or if the fetus causes significant trouble to the mother.
