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Theological Bioethics > Midterm > Flashcards

Midterm Flashcards

1
Q

ethics

A

a field of study that reflects on human morality; sustained and intentional reflection on morality and the moral life with analysis, discernment, reasoning, and argument

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2
Q

bioethics

A

an interdisciplinary field of applied ethics that engages the complex moral problems emerging from developments in medical science, biotechnology, and health care

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3
Q

utilitarianism

A

greatest good for the greatest number of people; consequences, not intentions

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4
Q

deontological ethics

A

humans can reason for themselves, moral rules should be articulated and binding for everyone regardless of context
few moral dilemmas, deductive
Kantian

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5
Q

categorical imperative

A

Kant’s unbreakable moral rules

  • Universal maxims guide actions (moral rules should be able to be applied to others
  • Use people as ends, not means
  • No suicide, must save other people if you can, no lying ever, no killing the innocent
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6
Q

natural law

A

moral standards are embedded in nature, all reasonable people can discover and affirm them; nature is teleological; universal moral principles
only way morality exists (to these theorists)

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7
Q

rights theory

A

people have justifiable claims for or from something; protects individuals from government and larger communal society
anything legal is inherently ethical; based on norms

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8
Q

casuistry/ethical pragmatism

A

focuses on actual examples and cases instead of abstract concepts; use precedents to determine morality in other situations

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9
Q

divine command

A

God gives shape of morality as an expression of his will; dominant for religious people
considered binding for everyone, no extenuating circumstances

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10
Q

revelation

A

God communicates plan for human flourishing socially and spiritually

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11
Q

covenant

A

God formed covenant with Jewish people to bring flourishing to human societies. God and humans have rights and responsibilities.

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12
Q

prophets

A

humans who received and communicated word of God to rest of the world

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13
Q

Torah

A

first five books of Bible; only recognized “constitution” for Jews

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14
Q

Talmud

A

fundamental core of Jewish tradition

compilation of Mishna (written texts and oral traditions), Rabbinic commentary and decisions

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15
Q

halakhah

A

Jewish law as applied to Jewish living, used to apply to new circumstances

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16
Q

divine body ownership

A

Body is on loan from God, does not belong to oneself. In Judaism, humans have responsibility to look after their bodies through good hygiene and protection from injury and illness.

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17
Q

Jesus of Nazareth

A

In Christianity, considered the Son of God, died to pay for human sins. In Judaism, has not arrived yet. In Islam, was just another prophet.

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18
Q

creation

A

process where God created planet, sun, nature, and all living beings

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19
Q

redemption

A

Humanity is inherently flawed and in need of redemption in the form of connection with God through the Holy Spirit. Under Christianity, must accept Jesus as Lord and Savior to be redeemed and saved from Hell.

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20
Q

image of God (imago dei)

A

Christian idea that humans are created in God’s image, have ability for reflection and creation and are given authority over other living beings.

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21
Q

human dignity

A

Christian idea that dignity comes from concept that God created us. Cannot be taken away, regardless of individual sins.

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22
Q

graced self-transcendence

A

God’s original intention for people. Always planned for humans to join him in supernatural afterlife and transcend our human bodies.

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23
Q

Islamic five pillars?

A

Shahadh, Salat, Zakat, Ramadan, and Hajj

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24
Q

Shahadh

A

Islamic declaration of faith

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25
Q

Salat

A

daily prayers

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26
Q

Zakat

A

Islamic charity

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27
Q

Ramadan

A

Islamic fasting

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28
Q

Hajj

A

Islamic pilgrimage to Mecca

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29
Q

Qur’an

A

God’s final commands under Islam, dictated to Muhammad

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30
Q

Shari’a

A

Islamic law governing behavior; Qur’an + Sunnah + qiyas + ijma

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31
Q

fiqh

A

human judicial decisions of Islamic scholars

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32
Q

Islamic Juridical Council’s bioethics fatawa

A

Council that discusses critical issues in medical ethics and publishes fatwas and studies in journal
Under Organization of Islamic Countries

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33
Q

the common morality

A

commonly accepted, abstract moral rules irrelevant to particular subgroups; applicable to all people in all places, rejects relativism

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34
Q

moral dilemma

A

when moral obligations demand that a person adopt two or more alternative but incompatible actions, so that they cannot perform all required actions; not practical conflicts with self interests or generally hard decisions

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35
Q

balancing/weighing

A

reasoning about which moral norms should prevail when two or more conflict

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36
Q

prima facie commitments

A

commitments that must be fulfilled unless they contradict with an equal or stronger obligation

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37
Q

moral residue

A

regret when a prima facie obligation overrides another commitment

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38
Q

moral divergence

A

when moral people come to different conclusions about the same situation due to differences in balancing

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39
Q

autonomy

A

when individuals act freely to a self-chosen plan with intentionality, understanding, and without controlling influences that determine their action

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40
Q

types of autonomous consent

A
  • Express/explicit
  • Implicit/implied - based on actions
  • Tacit - based on lack of objection
  • Presumed - form of implicit consent based on info about individual’s choices
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41
Q

nonmaleficence

A

principle that one should not harm others

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42
Q

standards of due care

A

taking appropriate care to avoid causing harm

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43
Q

negligence

A

intentional or careless departure from standards of due care

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44
Q

beneficence

A

all norms, dispositions, and actions with the goals of benefiting or promoting the well being of others

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45
Q

obligatory beneficence

A

necessary beneficence to maintain morality; not extreme

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46
Q

ideal beneficence (“the Good Samaritan”)

A

beneficence that exceeds ordinary morality, extreme generosity

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47
Q

medical paternalism

A

the intentional overriding of one person’s preferences or actions by another person, where the overrider justifies the action by appeal to goal of benefiting or preventing harm to the overridee

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48
Q

soft medical paternalism

A

paternalistic agent intervenes to prevent nonvoluntary conduct (ex. poorly informed consent or refusal)

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49
Q

hard medical paternalism

A

paternalistic agent intervenes, even when a person’s choices are informed, voluntary, and autonomous

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50
Q

stigmatization effects

A

targeting of acts or people who engage in certain conduct; can lead to discrimination against people

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51
Q

antipaternalism

A

opposition to hard paternalistic interventions; belief that rightful authority resides in individuals, not states or groups; usually coincides with strong rights theorists

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52
Q

suicide intervention ethics

A

Failure to intervene communicates lack of communal concern. Many suicidal people are mentally ill. Many suicidal people fantasize about rescue.

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53
Q

antipaternalist stance on suicide prevention

A

temporary restraint, but nothing more; shouldn’t assume suicidal people are without their autonomy

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54
Q

nudge theory

A

idea that choice architecture should be beneficially arranged to encourage people to make choices they want to make without coercion or mandates; argues about existence of value and action gap

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55
Q

individual cognitive heuristics

A

grids in which people encounter the world; 7 reasons people are not individually good decision makers
includes anchoring, remembrance, confirmation, individualistic, framing, implicit, and group mentality heuristics

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56
Q

value/action gap

A

difference between stated values and ideals and what actually occurs

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57
Q

mandatory seat-belt laws case study

A

When the seat belt laws were being considered, the majority were against them because they were considered antidemocratic.
From the autonomy perspective, they argued that wearing a seat belt should be a person’s decision. They thought a law enforcing them would violate constitutional rights.
From the beneficence perspective, the decision to wear seat belts does not just protect individuals. Others are affected in the crash, including other passengers, doctors, paramedics, lawyers, and insurance systems. The autonomous decision is overriden because people want to be safe during a crash; they just didn’t know it. The autonomous decision is overriden on basis of cumulative social benefit. They performed studies proving how seat belts reduced the harm during car crashes and prevent deaths.

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58
Q

veracity

A

honesty, connected to respect for autonomy

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59
Q

staged/limited disclosure

A

disclosing medical truths slowly, over the course of several sessions, instead of immediately

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60
Q

justification of nondisclosure

A

violation of obligations to beneficence and nonmaleficence (ex. anxiety, prompting suicide, destroying hope), fear of legal consequences, concerns about harming patients or public trust, lack of genuine patient desire to know truth

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61
Q

medical error

A

leading cause of death in US hospitals, leads to responsibility to disclose promptly with specificity (does not occur often)

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62
Q

privacy

A

state or condition of limited access to a person; includes informational, physical, decisional, proprietary, and relational
Griswold v. Connecticut led to right that shields info from others and protects decisions from government intervention

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63
Q

confidentiality

A

prevents redisclosure of information within relationship where confider expects confidant to not further disclose without authorization; subset of informational privacy
compromised through systematic medical care

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64
Q

virtue ethics

A

teleological subset of ethics of care that originated in feminist writings; argues that morality of actions is partially dependent on moral character; traits valued in intimate personal relationships, including sympathy, compassion, fidelity, and love; emphasis on emotional responsiveness

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65
Q

eudaimonia

A

happiness or flourishing holistically; includes virtues necessary for a satisfying life

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66
Q

moral habits

A

patterns of disposition entrenched in moral actor; part of existential way of being in the world

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67
Q

compassion

A

attitude of active regard for another’s welfare combined with sympathy, tenderness, and discomfort at another’s misfortune or suffering; expressed in acts of beneficence that try to alleviate misfortune or suffering
can be a weakness when it prevents impartial reflection and blinds reason

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68
Q

trustworthiness

A

quality of warranting another’s confidence in one’s character and conduct

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69
Q

integrity

A

soundness, reliability, wholeness, and integration of moral character; objectivity, impartiality, and fidelity in adherence to moral norms

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70
Q

conscientiousness

A

mental faculty of and authority for moral decision making

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71
Q

moral excellence (heroes/saints)

A

exceptional virtue in altruism and benevolence to the point of realizing a moral ideal consistently or by accepting extraordinary risk
characterized by
- worthy moral ideal
- motivational structure allowing them to forgo advantages in service of moral ideal
- exceptional moral character
- great integrity

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72
Q

supererogatory acts

A

a morally praiseworthy, but optional act that exceeds the demands of common morality and intends to promote the welfare interests of others

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73
Q

principle of qasd

A

Muslim principle that intention of actor, not action itself, is important; means don’t justify the ends

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74
Q

principle of yaqin

A

Muslim principle of certainty; argues all medicine is permissible unless certainly haram; need compelling evidence (not just doubt) to disregard “known” facts

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75
Q

principle of darar

A

Muslim principle that injury should be relieved; justifies medical intervention; harm should be avoided and must be outweighed by the good

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76
Q

principle of darura

A

allowance to override haram actions to save a life

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77
Q

principle of ‘urf

A

Muslim reference to custom and predominant cultural consensus when actions are not otherwise specified

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78
Q

exoticist bioethics

A

bioethical attitude that focuses on specific and unusual cases, ignoring the mundane

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79
Q

heroic ordinary/everyday

A

mundane actions of medical providers are more important than actions in extreme, unusual cases

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80
Q

ethics of care

A

theory modeled on maternal caring, not masculine mode; places moral weight on mutual interdependence and emotional responsiveness; argues humans have a natural capacity for empathy; heavily influential in nursing, way to fight against exoticist bioethics; argues caring is a moral response

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81
Q

processes of ethics of care

A

moral attention, sympathetic understanding, relationship awareness, and harmony and accommodation

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82
Q

empathy

A

complex of emotional and conditioned responses to suffering and proactive constraint on behavior that would inflict harm; central emotion in care ethics

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83
Q

maternalism

A

attempt to collaborate and participate to push someone towards a good end, even if it contradicts with their stated desire, referenced in ethics of care

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84
Q

moral attention

A

attention paid to the situation in all its complexity; awareness of all details that allow a sympathetic response to a situation

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85
Q

sympathetic understanding

A

openness to sympathizing and identifying with persons in a situation; attempt to be aware of how the people in the situation would like them to respond and what’s in their best interests

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86
Q

relationship awareness

A

awareness of network of relationships that connect humans, care for preserving and nurturing these relationships

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87
Q

accommodation

A

consideration of the needs of all involved with hope of preserving harmony

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88
Q

special relations

A

considers the moral actions and adjustments it take to make relationships flourish, referenced in ethics of care

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89
Q

Black Church

A

historically independent, organized institution under total Black control; typically Protestant in belief and personal ethics, but progressive socially; sects of Christianity blended with traditional African spiritual practices; Established by Free African Society of 1787 during revivals of First Great Awakening in 1730s-1750s; grew rapidly after Civil War; not consulted in bioethical deliberation;

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90
Q

structural racial discrimination

A

form of discrimination with roots in Aristotle’s scala naturae, Malthus’s arguments on population control, and Herbert Spencer’s social Darwinism; all of which led to elimination and forced sterilization based on strict categories

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91
Q

medical tacit racial bias

A

unconscious racial biases among physicians that results in extra paternalism, negative emotional tones, less patient-centered care, and subsequent distrust by AA patients

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92
Q

Henrietta Lacks

A

Black woman with cervical cancer whose immortal cells were taken without informed consent

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93
Q

Chester Southam experiments

A

Dr. Southam injected patients unknowingly with HeLa to see how their systems would react to cancer. Justified with paternalism and utilitarianism. Reported by 3 Jewish residents. Convicted of fraud and unprofessional conduct, but was elected president of American Association of Cancer Research later

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94
Q

“HeLa bomb”

A

when Stanley Gartler claimed that many scientific experiments were compromised because HeLa cells were spreading unintentionally

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95
Q

Michael Rogers’ Rolling Stone essay (1976)

A

first public explanation of Henrietta Lacks’s identity; discussed her Blackness, how she didn’t consent, how white cultures were “contaminated” by Black ones, how uncredited HeLa became one of most important medical tools

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96
Q

Moore v. University of California case (1990)

A

Moore sued to legally claim the cell line that had emerged from his cancerous tissues. Judge used HeLa as precedent.
Utilitarian decision that patients cannot stake a claim in their own tissue once they’ve agreed to treatment

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97
Q

medical establishment treatment of Lacks family

A

Did not explain that they were not testing them for cancer, but that they were snooping around their genomes to solve the HeLa bomb problem

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98
Q

medicalization of death

A

traditional understanding that some patients were “overcome by their illness” and additional treatment is pointless

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99
Q

“clinical gaze”

A

empirical analysis of the human body allows identification and treatment of pathologies, but brackets issues of personhood, community, and meaning

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100
Q

hospice movement

A

advocates accepting death as part of cycle of life; could be used to further euthanasia

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101
Q

In Re Quinlan case (1976)

A

court case ruled that refusal of treatment is located in individual autonomy, no ethical or meaningful difference between withdrawing or withholding treatment
Catholics told parents they weren’t morally required to continue with respirator or feeding tube, but parents kept feeding tube

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102
Q

Cruzan v. Missouri Health case (1990)

A

controversial Supreme Court ruling affirmed Quinlan; ruling allows individuals to write end of life wishes
Nancy Cruzan was in permanent vegetative state, parents wanted to withdraw treatment but hospital refused; allows proxies to decide at state level; after ruling, was forced to let her die

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103
Q

Principle of Double Effect

A

natural law concept that an attempt to do good is morally permissible, even if the outcomes are negative

Action with good and bad effects is morally justified if act itself is not wrong, bad effect must not cause good effect, actor must not intend bad effect, and bad effect doesn’t outweigh good effect.

Applied by Catholics to end of life, abortion, mutilation, sterility, etc.

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104
Q

killing v. letting die distinction

A

moral correctness depends on authorization; must know motive, circumstances, patients’ preferences, and consequences; pointless distinction based on convention

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105
Q

killing

A

causal action that brings about death; widely viewed as morally wrong; act of people, not natural conditions

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106
Q

letting die

A

intentional avoidance of causal intervention so that disease, system failure, or injury causes a natural death; acceptable if medical technology is useless or if patients or surrogates validly refuse treatment

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107
Q

medically assisted nutrition & hydration ethics

A

placed under same standards as other medical treatments by US courts, but some individuals distinguish

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108
Q

medical futility

A

when irreversibly dying patients cannot be improved by further treatment; makes treatment hopeless and morally optional
restricted to when patients or surrogates request interventions that simply cannot achieve intended physiologic goal; good clinical and ethical judgement not to provide them

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109
Q

slippery-slope concerns

A

serious abuses won’t occur immediately, but will grow incrementally over time; could lead to unjustified killing and manipulation of the system; should not embark on path because of potential consequences of allowing physician-assisted death
could be deadly elderly or disabled people; could lead to low-income families allowing death rather than suffer financial burdens, could cause palliative care for all patients to suffer, potential loss of public trust

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110
Q

surrogate decision-making

A

usually closest family member; must have ability to make reasoned judgements, adequate knowledge and information, emotional stability, and commitment to patient’s interests, free of conflicts of interest and control by 3rd parties

monitored by physicians, ethical committees, and judicial system

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111
Q

Oregon’s Death with Dignity Act (1994)

A

physicians write prescriptions for lethal medications at patient’s request; patient consciously decides to use drug; physicians are not determinative step in patient death, so are not culpable
usually older white people with cancer; only 66% actually take pills

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112
Q

Eluana Englaro case

A

woman in permanent vegetative state for 17 years; father wanted feeding and hydrating tubes withdrawn because she didn’t want to be kept alive artificially
Supreme Court of Cassation upheld request (made her go to private, clinic), but Catholic Church, Health Minister, Episcopal conference, Prime Minister, and conservatives strongly opposed

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113
Q

virtue of prudence

A

practical knowledge imbued by life of grace

dependent for its reasoning on the analysis of contingent
events (not faith)

more flexible decision making than casuistry

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114
Q

principles of prudence

A

memoria, docilitas, and solertia

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115
Q

memoria

A

memory that is true to being (remembering events as they happened)
prudence principle

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116
Q

docilitas

A

open-mindedness

prudence principle

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117
Q

solertia

A

acumen, ability to act well in the face of unexpected events

prudence principle

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118
Q

Islamic death

A

loss of integrated personhood in Islam; process altered state of being; part of journey of return to God

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119
Q

stable life

A

presupposes continuation of blood circulation and or respiration because of movement and pulse

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120
Q

unstable life

A

rate of blood flow lower than level of viability, inconsistent cardiac function; heartbeat is a conclusive indication of death

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121
Q

whole brain death

A

breathing through artificial life support mechanisms that allow maintenance of heart function and breath; replacement of brain stem; considered adequate marker of death

122
Q

ethics of post-comatic unresponsiveness (PVS)

A

if considered dead, would prevent slippery slope for terminally ill patients with active cortical brain function
justifiable to remove feeding and hydration tubes if case is irreversible (let die)
no cortical function, patient cannot see or hear, but can breathe and digest unaided; can respond to painful stimuli

123
Q

withdrawal of treatment

A

stopping treatment that has already started; avoided by physicians because they feel as though they’re actively killing patients

124
Q

Vacco v. Quill case (1997)

A

Dr. Quill challenged laws prohibiting physician-assisted death. Argued patients have “equal protection” right in asking for help to hasten own death by withdrawal. SCOTUS unanimously ruled there is no “right to die.”

125
Q

physician-assisted dying

A

patient request for physician to withdraw treatment; ruled illegal by Vacco v. Quill

126
Q

surrogate euthanasia

A

passive non-voluntary death; when people cannot choose for themselves whether they want to be supported with machines and their wishes; their decisions are made by a surrogate
assumes there’s good faith basis for the surrogate’s decision

127
Q

involuntary euthanasia

A

when a physician actively decides a patient should die; “mercy killing”

128
Q

“right to die” movement

A

people who support physician-assisted death under the right circumstances

129
Q

human personhood

A

according to pro-lifers, something all people begotten to human parents have for the duration of their existence, regardless of capacities; term is currently used to describe set of capabilities and does not describe all living human beings; people have the right to have their life protected

130
Q

punctualist accounts of personhood

A

fetuses are people the moment they are conceived, when the sperm fertilizes the egg

131
Q

gradualist accounts of personhood

A

fetus becomes a person after conception

132
Q

Roe v. Wade case (1973)

A
  • landmark 7-2 decision overturning absolute state laws restricting abortion
  • gives women fundamental right to decide on abortions in first trimester
  • based on protection of “personal privacy” extended to include right to bodily integrity
133
Q

pro-life feminism

A

in line with first wave feminists who believed abortion was infanticide; motivated by empathy fo child and for women driven to abortion by powerless position and by male sexual selfishness; driven out of feminist movement in 1960s

134
Q

communitarianism

A

view of personhood situated within our relationships with communities; relationships come with obligations that are necessary for the survival of individuals in the community

often pushes back on individualist, Western bioethics

135
Q

species membership

A

tracks human potential closely; animal with active or internally directed potential to exhibit distinctively human ways of behavior and thinking is a person and, therefore, entitled to rights when it first comes to be; concept makes abortion homicide

136
Q

conscientious refusal

A

the right of physicians to refuse to perform a procedure based on conscience, argued on coherent, rational grounds
used in abortions

137
Q

animation/quickening

A

idea that fetus becomes person when it moves during pregnancy

138
Q

traditional formed embryos

A

Aristotelian biological idea of when embryos take on human personhood

139
Q

traditional unformed embryos

A

Aristotelian biological idea that an embryo is not a person yet (hasn’t hit the threshold)
similar to Islamic ensoulment

140
Q

Jewish “breath of life” view

A

babies become human when they breathe air through their lungs after being born

141
Q

“fellow fetuses”

A

pro-life Christian idea that all humans have no achievements they can boast about before God; to Him, the difference between being born and having fetal potential is negligible

142
Q

life-at-conception view

A

the moment an egg is fertilized and a fetus is conceived, that fetus is alive and has independence; argument for pro-life movement

143
Q

gestating motherhood prochoice view

A

belief that pregnancy is beginning of unique, gestational stage of motherhood (not precursor to motherhood) during which the mother should have moral authority to decide to abort or keep the baby; only pregnant women and mothers have authority to make motherly decisions based on obligations

144
Q

motherly fetal authority/power

A

because the gestational mother alone has the obligation thrust upon her to
decide whether to continue the pregnancy or not, she therefore has the primary
authority to decide

145
Q

prochoice Marian interpretation

A

Mary’s choice was free of all male authority; she was not forced to give birth to Jesus, but decided to cooperate in her own redemption (was not a passive object); did not immediately accept, but spent time considering the ramifications before deciding to proceed → affirms women’s decision making about their bodies

146
Q

the Wa’d paradigm

A

when Arabs buried their baby girls alive, right after birth to avoid disgrace or poverty; before Islam was introduced - prohibited several times in Quran

147
Q

Islamic ensoulment

A

moment soul enters fetus, 120 days in this religion

148
Q

Islamic jurisprudence schools on abortion

A
    • Maliki and Hanbali - abortion only permitted up to first 40 days with consent of both parents
    • Shafi and Hanbali - kahhara payment is obligatory for abortion
    • Hanafi and Maliki - kahhara payment is optional act of devotion, not obligation
149
Q

Simone Landrum’s narrative

A

Black woman pregnant with 3rd child. Complaints of pain and swelling brushed aside. Told to calm down, didn’t report hypertensive episode during appointment. Pre-eclampsia caused abruption, baby was stillborn. Almost bled to death
When pregnant with 4th child, enlisted help from a doula who stood up for her rights in face of callous and mocking medical practitioners.

150
Q

Black maternal/infant mortality crisis

A
  • US currently ranks 32 out of 35 wealthiest nations in infant mortality; driven by deaths of Black babies
    • Black infants are more than 2x more likely to die than white infants
      • Wider disparity than in 1850, during slavery
      • Not impacted by education and income
  • Mother mortality - Black women are 3-4x more likely to die from pregnancy-related problems than white women
    • US one of only 13 countries in the wold whee rate of maternal mortality is worse than it was 25 years ago
    • Preventable near deaths rose 200% between 1993 and 2014
  • most exacerbated in lower class Black women, but even college-educated, married Black women are 2x more likely to have infant mortality
  • Dr. Arline Geronimus - weathering theory that stress of living under white supremacy damages Black women’s bodies
    • Greatest experiences of racism → higher levels of preterm births
    • Accumulation of persistent insults and traumatizing life experiences → frequent flood of stress hormones → wear and tear on cardiovascular, metabolic, and immune systems → increased vulnerability to illness and early death
151
Q

a field of study that reflects on human morality; sustained and intentional reflection on morality and the moral life with analysis, discernment, reasoning, and argument

A

ethics

152
Q

an interdisciplinary field of applied ethics that engages the complex moral problems emerging from developments in medical science, biotechnology, and health care

A

bioethics

153
Q

greatest good for the greatest number of people; consequences, not intentions

A

utilitarianism

154
Q

humans can reason for themselves, moral rules should be articulated and binding for everyone regardless of context
few moral dilemmas, deductive
Kantian

A

deontological ethics

155
Q

Kant’s unbreakable moral rules

  • Universal maxims guide actions (moral rules should be able to be applied to others
  • Use people as ends, not means
  • No suicide, must save other people if you can, no lying ever, no killing the innocent
A

categorical imperative

156
Q

moral standards are embedded in nature, all reasonable people can discover and affirm them; nature is teleological; universal moral principles
only way morality exists (to these theorists)

A

natural law

157
Q

people have justifiable claims for or from something; protects individuals from government and larger communal society
anything legal is inherently ethical; based on norms

A

rights theory

158
Q

focuses on actual examples and cases instead of abstract concepts; use precedents to determine morality in other situations

A

casuistry/ethical pragmatism

159
Q

God gives shape of morality as an expression of his will; dominant for religious people
considered binding for everyone, no extenuating circumstances

A

divine command

160
Q

God communicates plan for human flourishing socially and spiritually

A

revelation

161
Q

God formed covenant with Jewish people to bring flourishing to human societies. God and humans have rights and responsibilities.

A

covenant

162
Q

humans who received and communicated word of God to rest of the world

A

prophets

163
Q

first five books of Bible; only recognized “constitution” for Jews

A

Torah

164
Q

fundamental core of Jewish tradition

compilation of Mishna (written texts and oral traditions), Rabbinic commentary and decisions

A

Talmud

165
Q

Jewish law as applied to Jewish living, used to apply to new circumstances

A

halakhah

166
Q

Body is on loan from God, does not belong to oneself. In Judaism, humans have responsibility to look after their bodies through good hygiene and protection from injury and illness.

A

divine body ownership

167
Q

In Christianity, considered the Son of God, died to pay for human sins. In Judaism, has not arrived yet. In Islam, was just another prophet.

A

Jesus of Nazareth

168
Q

process where God created planet, sun, nature, and all living beings

A

creation

169
Q

Humanity is inherently flawed and in need of redemption in the form of connection with God through the Holy Spirit. Under Christianity, must accept Jesus as Lord and Savior to be redeemed and saved from Hell.

A

redemption

170
Q

Christian idea that humans are created in God’s image, have ability for reflection and creation and are given authority over other living beings.

A

image of God (imago dei)

171
Q

Christian idea that dignity comes from concept that God created us. Cannot be taken away, regardless of individual sins.

A

human dignity

172
Q

God’s original intention for people. Always planned for humans to join him in supernatural afterlife and transcend our human bodies.

A

graced self-transcendence

173
Q

Shahadh, Salat, Zakat, Ramadan, and Hajj

A

Islamic five pillars?

174
Q

Islamic declaration of faith

A

Shahadh

175
Q

daily prayers

A

Salat

176
Q

Islamic charity

A

Zakat

177
Q

Islamic fasting

A

Ramadan

178
Q

Islamic pilgrimage to Mecca

A

Hajj

179
Q

God’s final commands under Islam, dictated to Muhammad

A

Qur’an

180
Q

Islamic law governing behavior; Qur’an + Sunnah + qiyas + ijma

A

Shari’a

181
Q

human judicial decisions of Islamic scholars

A

fiqh

182
Q

Council that discusses critical issues in medical ethics and publishes fatwas and studies in journal
Under Organization of Islamic Countries

A

Islamic Juridical Council’s bioethics fatawa

183
Q

commonly accepted, abstract moral rules irrelevant to particular subgroups; applicable to all people in all places, rejects relativism

A

the common morality

184
Q

when moral obligations demand that a person adopt two or more alternative but incompatible actions, so that they cannot perform all required actions; not practical conflicts with self interests or generally hard decisions

A

moral dilemma

185
Q

reasoning about which moral norms should prevail when two or more conflict

A

balancing/weighing

186
Q

commitments that must be fulfilled unless they contradict with an equal or stronger obligation

A

prima facie commitments

187
Q

regret when a prima facie obligation overrides another commitment

A

moral residue

188
Q

when moral people come to different conclusions about the same situation due to differences in balancing

A

moral divergence

189
Q

when individuals act freely to a self-chosen plan with intentionality, understanding, and without controlling influences that determine their action

A

autonomy

190
Q
  • Express/explicit
  • Implicit/implied - based on actions
  • Tacit - based on lack of objection
  • Presumed - form of implicit consent based on info about individual’s choices
A

types of autonomous consent

191
Q

principle that one should not harm others

A

nonmaleficence

192
Q

taking appropriate care to avoid causing harm

A

standards of due care

193
Q

intentional or careless departure from standards of due care

A

negligence

194
Q

all norms, dispositions, and actions with the goals of benefiting or promoting the well being of others

A

beneficence

195
Q

necessary beneficence to maintain morality; not extreme

A

obligatory beneficence

196
Q

beneficence that exceeds ordinary morality, extreme generosity

A

ideal beneficence (“the Good Samaritan”)

197
Q

the intentional overriding of one person’s preferences or actions by another person, where the overrider justifies the action by appeal to goal of benefiting or preventing harm to the overridee

A

medical paternalism

198
Q

paternalistic agent intervenes to prevent nonvoluntary conduct (ex. poorly informed consent or refusal)

A

soft medical paternalism

199
Q

paternalistic agent intervenes, even when a person’s choices are informed, voluntary, and autonomous

A

hard medical paternalism

200
Q

targeting of acts or people who engage in certain conduct; can lead to discrimination against people

A

stigmatization effects

201
Q

opposition to hard paternalistic interventions; belief that rightful authority resides in individuals, not states or groups; usually coincides with strong rights theorists

A

antipaternalism

202
Q

Failure to intervene communicates lack of communal concern. Many suicidal people are mentally ill. Many suicidal people fantasize about rescue.

A

suicide intervention ethics

203
Q

temporary restraint, but nothing more; shouldn’t assume suicidal people are without their autonomy

A

antipaternalist stance on suicide prevention

204
Q

idea that choice architecture should be beneficially arranged to encourage people to make choices they want to make without coercion or mandates; argues about existence of value and action gap

A

nudge theory

205
Q

grids in which people encounter the world; 7 reasons people are not individually good decision makers
includes anchoring, remembrance, confirmation, individualistic, framing, implicit, and group mentality heuristics

A

individual cognitive heuristics

206
Q

difference between stated values and ideals and what actually occurs

A

value/action gap

207
Q

When the seat belt laws were being considered, the majority were against them because they were considered antidemocratic.
From the autonomy perspective, they argued that wearing a seat belt should be a person’s decision. They thought a law enforcing them would violate constitutional rights.
From the beneficence perspective, the decision to wear seat belts does not just protect individuals. Others are affected in the crash, including other passengers, doctors, paramedics, lawyers, and insurance systems. The autonomous decision is overriden because people want to be safe during a crash; they just didn’t know it. The autonomous decision is overriden on basis of cumulative social benefit. They performed studies proving how seat belts reduced the harm during car crashes and prevent deaths.

A

mandatory seat-belt laws case study

208
Q

honesty, connected to respect for autonomy

A

veracity

209
Q

disclosing medical truths slowly, over the course of several sessions, instead of immediately

A

staged/limited disclosure

210
Q

violation of obligations to beneficence and nonmaleficence (ex. anxiety, prompting suicide, destroying hope), fear of legal consequences, concerns about harming patients or public trust, lack of genuine patient desire to know truth

A

justification of nondisclosure

211
Q

leading cause of death in US hospitals, leads to responsibility to disclose promptly with specificity (does not occur often)

A

medical error

212
Q

state or condition of limited access to a person; includes informational, physical, decisional, proprietary, and relational
Griswold v. Connecticut led to right that shields info from others and protects decisions from government intervention

A

privacy

213
Q

prevents redisclosure of information within relationship where confider expects confidant to not further disclose without authorization; subset of informational privacy
compromised through systematic medical care

A

confidentiality

214
Q

teleological subset of ethics of care that originated in feminist writings; argues that morality of actions is partially dependent on moral character; traits valued in intimate personal relationships, including sympathy, compassion, fidelity, and love; emphasis on emotional responsiveness

A

virtue ethics

215
Q

happiness or flourishing holistically; includes virtues necessary for a satisfying life

A

eudaimonia

216
Q

patterns of disposition entrenched in moral actor; part of existential way of being in the world

A

moral habits

217
Q

attitude of active regard for another’s welfare combined with sympathy, tenderness, and discomfort at another’s misfortune or suffering; expressed in acts of beneficence that try to alleviate misfortune or suffering
can be a weakness when it prevents impartial reflection and blinds reason

A

compassion

218
Q

quality of warranting another’s confidence in one’s character and conduct

A

trustworthiness

219
Q

soundness, reliability, wholeness, and integration of moral character; objectivity, impartiality, and fidelity in adherence to moral norms

A

integrity

220
Q

mental faculty of and authority for moral decision making

A

conscientiousness

221
Q

exceptional virtue in altruism and benevolence to the point of realizing a moral ideal consistently or by accepting extraordinary risk
characterized by
- worthy moral ideal
- motivational structure allowing them to forgo advantages in service of moral ideal
- exceptional moral character
- great integrity

A

moral excellence (heroes/saints)

222
Q

a morally praiseworthy, but optional act that exceeds the demands of common morality and intends to promote the welfare interests of others

A

supererogatory acts

223
Q

Muslim principle that intention of actor, not action itself, is important; means don’t justify the ends

A

principle of qasd

224
Q

Muslim principle of certainty; argues all medicine is permissible unless certainly haram; need compelling evidence (not just doubt) to disregard “known” facts

A

principle of yaqin

225
Q

Muslim principle that injury should be relieved; justifies medical intervention; harm should be avoided and must be outweighed by the good

A

principle of darar

226
Q

allowance to override haram actions to save a life

A

principle of darura

227
Q

Muslim reference to custom and predominant cultural consensus when actions are not otherwise specified

A

principle of ‘urf

228
Q

bioethical attitude that focuses on specific and unusual cases, ignoring the mundane

A

exoticist bioethics

229
Q

mundane actions of medical providers are more important than actions in extreme, unusual cases

A

heroic ordinary/everyday

230
Q

theory modeled on maternal caring, not masculine mode; places moral weight on mutual interdependence and emotional responsiveness; argues humans have a natural capacity for empathy; heavily influential in nursing, way to fight against exoticist bioethics; argues caring is a moral response

A

ethics of care

231
Q

moral attention, sympathetic understanding, relationship awareness, and harmony and accommodation

A

processes of ethics of care

232
Q

complex of emotional and conditioned responses to suffering and proactive constraint on behavior that would inflict harm; central emotion in care ethics

A

empathy

233
Q

attempt to collaborate and participate to push someone towards a good end, even if it contradicts with their stated desire, referenced in ethics of care

A

maternalism

234
Q

attention paid to the situation in all its complexity; awareness of all details that allow a sympathetic response to a situation

A

moral attention

235
Q

openness to sympathizing and identifying with persons in a situation; attempt to be aware of how the people in the situation would like them to respond and what’s in their best interests

A

sympathetic understanding

236
Q

awareness of network of relationships that connect humans, care for preserving and nurturing these relationships

A

relationship awareness

237
Q

consideration of the needs of all involved with hope of preserving harmony

A

accommodation

238
Q

considers the moral actions and adjustments it take to make relationships flourish, referenced in ethics of care

A

special relations

239
Q

historically independent, organized institution under total Black control; typically Protestant in belief and personal ethics, but progressive socially; sects of Christianity blended with traditional African spiritual practices; Established by Free African Society of 1787 during revivals of First Great Awakening in 1730s-1750s; grew rapidly after Civil War; not consulted in bioethical deliberation;

A

Black Church

240
Q

form of discrimination with roots in Aristotle’s scala naturae, Malthus’s arguments on population control, and Herbert Spencer’s social Darwinism; all of which led to elimination and forced sterilization based on strict categories

A

structural racial discrimination

241
Q

unconscious racial biases among physicians that results in extra paternalism, negative emotional tones, less patient-centered care, and subsequent distrust by AA patients

A

medical tacit racial bias

242
Q

Black woman with cervical cancer whose immortal cells were taken without informed consent

A

Henrietta Lacks

243
Q

Dr. Southam injected patients unknowingly with HeLa to see how their systems would react to cancer. Justified with paternalism and utilitarianism. Reported by 3 Jewish residents. Convicted of fraud and unprofessional conduct, but was elected president of American Association of Cancer Research later

A

Chester Southam experiments

244
Q

when Stanley Gartler claimed that many scientific experiments were compromised because HeLa cells were spreading unintentionally

A

“HeLa bomb”

245
Q

first public explanation of Henrietta Lacks’s identity; discussed her Blackness, how she didn’t consent, how white cultures were “contaminated” by Black ones, how uncredited HeLa became one of most important medical tools

A

Michael Rogers’ Rolling Stone essay (1976)

246
Q

Moore sued to legally claim the cell line that had emerged from his cancerous tissues. Judge used HeLa as precedent.
Utilitarian decision that patients cannot stake a claim in their own tissue once they’ve agreed to treatment

A

Moore v. University of California case (1990)

247
Q

Did not explain that they were not testing them for cancer, but that they were snooping around their genomes to solve the HeLa bomb problem

A

medical establishment treatment of Lacks family

248
Q

traditional understanding that some patients were “overcome by their illness” and additional treatment is pointless

A

medicalization of death

249
Q

empirical analysis of the human body allows identification and treatment of pathologies, but brackets issues of personhood, community, and meaning

A

“clinical gaze”

250
Q

advocates accepting death as part of cycle of life; could be used to further euthanasia

A

hospice movement

251
Q

court case ruled that refusal of treatment is located in individual autonomy, no ethical or meaningful difference between withdrawing or withholding treatment
Catholics told parents they weren’t morally required to continue with respirator or feeding tube, but parents kept feeding tube

A

In Re Quinlan case (1976)

252
Q

controversial Supreme Court ruling affirmed Quinlan; ruling allows individuals to write end of life wishes
Nancy Cruzan was in permanent vegetative state, parents wanted to withdraw treatment but hospital refused; allows proxies to decide at state level; after ruling, was forced to let her die

A

Cruzan v. Missouri Health case (1990)

253
Q

natural law concept that an attempt to do good is morally permissible, even if the outcomes are negative

Action with good and bad effects is morally justified if act itself is not wrong, bad effect must not cause good effect, actor must not intend bad effect, and bad effect doesn’t outweigh good effect.

Applied by Catholics to end of life, abortion, mutilation, sterility, etc.

A

Principle of Double Effect

254
Q

moral correctness depends on authorization; must know motive, circumstances, patients’ preferences, and consequences; pointless distinction based on convention

A

killing v. letting die distinction

255
Q

causal action that brings about death; widely viewed as morally wrong; act of people, not natural conditions

A

killing

256
Q

intentional avoidance of causal intervention so that disease, system failure, or injury causes a natural death; acceptable if medical technology is useless or if patients or surrogates validly refuse treatment

A

letting die

257
Q

placed under same standards as other medical treatments by US courts, but some individuals distinguish

A

medically assisted nutrition & hydration ethics

258
Q

when irreversibly dying patients cannot be improved by further treatment; makes treatment hopeless and morally optional
restricted to when patients or surrogates request interventions that simply cannot achieve intended physiologic goal; good clinical and ethical judgement not to provide them

A

medical futility

259
Q

serious abuses won’t occur immediately, but will grow incrementally over time; could lead to unjustified killing and manipulation of the system; should not embark on path because of potential consequences of allowing physician-assisted death
could be deadly elderly or disabled people; could lead to low-income families allowing death rather than suffer financial burdens, could cause palliative care for all patients to suffer, potential loss of public trust

A

slippery-slope concerns

260
Q

usually closest family member; must have ability to make reasoned judgements, adequate knowledge and information, emotional stability, and commitment to patient’s interests, free of conflicts of interest and control by 3rd parties

monitored by physicians, ethical committees, and judicial system

A

surrogate decision-making

261
Q

physicians write prescriptions for lethal medications at patient’s request; patient consciously decides to use drug; physicians are not determinative step in patient death, so are not culpable
usually older white people with cancer; only 66% actually take pills

A

Oregon’s Death with Dignity Act (1994)

262
Q

woman in permanent vegetative state for 17 years; father wanted feeding and hydrating tubes withdrawn because she didn’t want to be kept alive artificially
Supreme Court of Cassation upheld request (made her go to private, clinic), but Catholic Church, Health Minister, Episcopal conference, Prime Minister, and conservatives strongly opposed

A

Eluana Englaro case

263
Q

practical knowledge imbued by life of grace

dependent for its reasoning on the analysis of contingent
events (not faith)

more flexible decision making than casuistry

A

virtue of prudence

264
Q

memoria, docilitas, and solertia

A

principles of prudence

265
Q

memory that is true to being (remembering events as they happened)
prudence principle

A

memoria

266
Q

open-mindedness

prudence principle

A

docilitas

267
Q

acumen, ability to act well in the face of unexpected events

prudence principle

A

solertia

268
Q

loss of integrated personhood in Islam; process altered state of being; part of journey of return to God

A

Islamic death

269
Q

presupposes continuation of blood circulation and or respiration because of movement and pulse

A

stable life

270
Q

rate of blood flow lower than level of viability, inconsistent cardiac function; heartbeat is a conclusive indication of death

A

unstable life

271
Q

breathing through artificial life support mechanisms that allow maintenance of heart function and breath; replacement of brain stem; considered adequate marker of death

A

whole brain death

272
Q

if considered dead, would prevent slippery slope for terminally ill patients with active cortical brain function
justifiable to remove feeding and hydration tubes if case is irreversible (let die)
no cortical function, patient cannot see or hear, but can breathe and digest unaided; can respond to painful stimuli

A

ethics of post-comatic unresponsiveness (PVS)

273
Q

stopping treatment that has already started; avoided by physicians because they feel as though they’re actively killing patients

A

withdrawal of treatment

274
Q

Dr. Quill challenged laws prohibiting physician-assisted death. Argued patients have “equal protection” right in asking for help to hasten own death by withdrawal. SCOTUS unanimously ruled there is no “right to die.”

A

Vacco v. Quill case (1997)

275
Q

patient request for physician to withdraw treatment; ruled illegal by Vacco v. Quill

A

physician-assisted dying

276
Q

passive non-voluntary death; when people cannot choose for themselves whether they want to be supported with machines and their wishes; their decisions are made by a surrogate
assumes there’s good faith basis for the surrogate’s decision

A

surrogate euthanasia

277
Q

when a physician actively decides a patient should die; “mercy killing”

A

involuntary euthanasia

278
Q

people who support physician-assisted death under the right circumstances

A

“right to die” movement

279
Q

according to pro-lifers, something all people begotten to human parents have for the duration of their existence, regardless of capacities; term is currently used to describe set of capabilities and does not describe all living human beings; people have the right to have their life protected

A

human personhood

280
Q

fetuses are people the moment they are conceived, when the sperm fertilizes the egg

A

punctualist accounts of personhood

281
Q

fetus becomes a person after conception

A

gradualist accounts of personhood

282
Q
  • landmark 7-2 decision overturning absolute state laws restricting abortion
  • gives women fundamental right to decide on abortions in first trimester
  • based on protection of “personal privacy” extended to include right to bodily integrity
A

Roe v. Wade case (1973)

283
Q

in line with first wave feminists who believed abortion was infanticide; motivated by empathy fo child and for women driven to abortion by powerless position and by male sexual selfishness; driven out of feminist movement in 1960s

A

pro-life feminism

284
Q

view of personhood situated within our relationships with communities; relationships come with obligations that are necessary for the survival of individuals in the community

often pushes back on individualist, Western bioethics

A

communitarianism

285
Q

tracks human potential closely; animal with active or internally directed potential to exhibit distinctively human ways of behavior and thinking is a person and, therefore, entitled to rights when it first comes to be; concept makes abortion homicide

A

species membership

286
Q

the right of physicians to refuse to perform a procedure based on conscience, argued on coherent, rational grounds
used in abortions

A

conscientious refusal

287
Q

idea that fetus becomes person when it moves during pregnancy

A

animation/quickening

288
Q

Aristotelian biological idea of when embryos take on human personhood

A

traditional formed embryos

289
Q

Aristotelian biological idea that an embryo is not a person yet (hasn’t hit the threshold)
similar to Islamic ensoulment

A

traditional unformed embryos

290
Q

babies become human when they breathe air through their lungs after being born

A

Jewish “breath of life” view

291
Q

pro-life Christian idea that all humans have no achievements they can boast about before God; to Him, the difference between being born and having fetal potential is negligible

A

“fellow fetuses”

292
Q

the moment an egg is fertilized and a fetus is conceived, that fetus is alive and has independence; argument for pro-life movement

A

life-at-conception view

293
Q

belief that pregnancy is beginning of unique, gestational stage of motherhood (not precursor to motherhood) during which the mother should have moral authority to decide to abort or keep the baby; only pregnant women and mothers have authority to make motherly decisions based on obligations

A

gestating motherhood prochoice view

294
Q

because the gestational mother alone has the obligation thrust upon her to
decide whether to continue the pregnancy or not, she therefore has the primary
authority to decide

A

motherly fetal authority/power

295
Q

Mary’s choice was free of all male authority; she was not forced to give birth to Jesus, but decided to cooperate in her own redemption (was not a passive object); did not immediately accept, but spent time considering the ramifications before deciding to proceed → affirms women’s decision making about their bodies

A

prochoice Marian interpretation

296
Q

when Arabs buried their baby girls alive, right after birth to avoid disgrace or poverty; before Islam was introduced - prohibited several times in Quran

A

the Wa’d paradigm

297
Q

moment soul enters fetus, 120 days in this religion

A

Islamic ensoulment

298
Q
    • Maliki and Hanbali - abortion only permitted up to first 40 days with consent of both parents
    • Shafi and Hanbali - kahhara payment is obligatory for abortion
    • Hanafi and Maliki - kahhara payment is optional act of devotion, not obligation
A

Islamic jurisprudence schools on abortion

299
Q

Black woman pregnant with 3rd child. Complaints of pain and swelling brushed aside. Told to calm down, didn’t report hypertensive episode during appointment. Pre-eclampsia caused abruption, baby was stillborn. Almost bled to death
When pregnant with 4th child, enlisted help from a doula who stood up for her rights in face of callous and mocking medical practitioners.

A

Simone Landrum’s narrative

300
Q
  • US currently ranks 32 out of 35 wealthiest nations in infant mortality; driven by deaths of Black babies
    • Black infants are more than 2x more likely to die than white infants
      • Wider disparity than in 1850, during slavery
      • Not impacted by education and income
  • Mother mortality - Black women are 3-4x more likely to die from pregnancy-related problems than white women
    • US one of only 13 countries in the wold whee rate of maternal mortality is worse than it was 25 years ago
    • Preventable near deaths rose 200% between 1993 and 2014
  • most exacerbated in lower class Black women, but even college-educated, married Black women are 2x more likely to have infant mortality
  • Dr. Arline Geronimus - weathering theory that stress of living under white supremacy damages Black women’s bodies
    • Greatest experiences of racism → higher levels of preterm births
    • Accumulation of persistent insults and traumatizing life experiences → frequent flood of stress hormones → wear and tear on cardiovascular, metabolic, and immune systems → increased vulnerability to illness and early death
A

Black maternal/infant mortality crisis

Theological Bioethics (2 decks)

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