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Medical Ethics > unit 3 and 4 > Flashcards

unit 3 and 4 Flashcards

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USMLE® Step 1 flashcards
1
Q

generally, if you have the right to do something then others________

A

have a duty to refrain from preventing you from having or doing that thing

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2
Q

What are the sources of rights?

A

-Governments and institutions (legal rights)
-God (god given rights)
-Humanity and nature (natural/human rights)

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3
Q

What is the issue with scarce resources?

A

how to best distribute resources at both macro and micro levels

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4
Q

The funding for health care comes from ____?

A

YOU!
-it will come from you privately through income
-it will come from you publicly from your tax revenue

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5
Q

Who are the two guys that had the theories of justice

A

-John Rawls
-Robert Nozick

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6
Q

Rawls’s theory of justice

A

Justice requires a fair distribution of resources, such that some members of a society do not appropriately benefit without a net benefit for all members

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7
Q

Nozacks theory of justice

A

No person or government has any right to resource property owned by an individual (earned or inherited)
-justice lies in the defense of property, not equality of distribution

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8
Q

What are exotic life-saving treatments?

A

Any number of life-saving treatments where demand is GREATER than availability

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9
Q

Reschers two stages for selecting

A

-Criteria of inclusion/ exclusion (decides the candidates for the treatments)
-criteria of selection (decides who actually gets the treatment)

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10
Q

What does the consistency factor mean?

A

-A hospital can exclude a patient who isn’t a ‘client’ in some relevant sense of that word (military hospital or children’s hospital ect)

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10
Q

What are the factors in stage one of Reschers stages

A

-Consistency factor
-progress-of-science factor
-prospect of success factor

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11
Q

What does progress of science factor mean?

A

A hospital can include patients based on staff research interests (like if you have cancer, a cancer research hospital could want you)

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12
Q

What is the prospect of success factor?

A

A hospital can exclude those which wont be helped (2 years of treatment v 5 years of treatment)

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13
Q

Whats Reschers stage two factors?

A

-relative likelihood factor
-life expectancy factor
-family role factor
-potential future contributions factor
-past services rendered factor

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14
Q

What does relative likelihood mean?

A

you are individualized

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15
Q

What does life expectancy factor mean?

A

Whether the patient has a long life ahead or not

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16
Q

What does family role factor mean?

A

Is the patient a mom, dad or are they a loner (have no one relying on them)

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17
Q

What does potential future contributions factor mean?

A

will the patient be valuable to society?

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18
Q

What does past services rendered factor mean?

A

Has the patient been valuable to society?

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19
Q

Is ELT a medical decision or a philosophical decision

A

philosophical decision

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20
Q

Two kinds of liver disease

A

-ARESLD (alcohol-related end-stage liver disease)
-ESLD (end-stage liver disease)

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21
Q

What is the HCFA recommendation (and decision)

A

Medicare should cover transplant surgery for those with alcohol who are abstinent
-the decision: treatment approved by HHS secretary, with NO required period of abstinence for those diagnosed with alcohol disease

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22
Q

The initial considerations for liver transplants

A

-Livers are a scarce resource
-more than 50% of ESLD have ARSELD
-Over 120,000 on waitlist
-transplantation requires money and support of public

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23
Q

What is moss/seiglers proposal towards ELT?

A

-proposed a general guideline that patients with ARELSD should not compete equally with other candidates for liver transplantation

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24
Q

What were moss/seiglers reasons for their guidelines?

A

-10-20 years of hard use to develop ARESLD
-alcoholism is a chronic illness, but effectively treatable by programs such as AA ect
-the patient is responsible for developing ARESLD

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25
Q

The one reason to doubt moss/ seigler?

A

-Alcoholism results in a chemical dependence, which is a biological need

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26
Q

What is the definition of ageism

A

Prejudice or discrimination based on age

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27
Q

What does the anti-ageist argument assumption say?

A

-Life has an absolute value to all those who value it
-20 years = 3 years = 4 weeks (all of it equals the same)

28
Q

The premises of the anti-ageist argument

A

-life is absolutely precious to all those who wish to go on living
-life is just as precious (if not more so) to those w/ less time to live

29
Q

Conclusion of anti-ageist argument

A

It would be a great injustice to deny someone in this condition the rest of their life

30
Q

What is the fair innings argument?

A

There is an amount of time which constitutes a reasonable life-span or what is called a “fair innings”

31
Q

What are the premises for the fair innings argument?

A

-Before you reach fair innings, you are entitled to reach it
-Once you reach a fair inning, you are living in bonus time

32
Q

What is the conclusion for fair innings argument?

A

After you reach a fair innings, you can be fairly denied treatment or resources in favor of younger patients

33
Q

What is the ‘time limit’ on your age?

A

70 yrs old

34
Q

What two intuitions does the fair innings aim to preserve

A

-the antiageist intuition that all like is precious to those whom want their lives to continue
-the intuition that the old shouldnt be given endless treatment at the expense of the needful young

35
Q

What are some issues with the fair innings arguement?

A

-According to the argument, a 20 yr old and a 60 yr old are equal
-how do we set a non-arbitrary threshold?

36
Q

What was Thomsons first step?

A

Agrees that the fetus is a person

37
Q

What is the pro-life argument that Thomson attacks?

A

It is always wrong to kill something with a right to life

38
Q

What did Thomson use to prove her point?

A

-thought expirement

39
Q

What was Thomsons reply/opinion?

A

You have the right to defend yourself against fetus threat to your life, even if it kills it
-abortion is permissible to save live of mother

40
Q

What abortions are not unjust killings according to Thomson?

A

-rape
-precautions were taken (IUD)
-threatens mothers life

41
Q

What was Thomsons overall conclusion about abortion?

A

-We have to be at least minimally decent samaritans
-Laws which would outlaw abortion would force women into doing much more than what is morally required of them

42
Q

Morally indecent abortions according to Thomson

A

-abortions of convenience
-late-term abortions

43
Q

What was Tooleys answer to the question “What properties must something have in order to be a person)

A

-Self conscious awareness requirement

44
Q

If you _____ meet the self-conscious requirement, you _____

A

If you do not meet the self conscious requirement, you are not a person

45
Q

What is able to have a right to life? (Tooley)

A

Only persons have a right to life bc only a person possesses the concept of a self as continuing to experience things

46
Q

Where did Tooley draw the line on abortion?

A

If the only things which have a serious right to life are the things which meet the self consciousness requirement, then anything that does not meet this requirement mag be permissibly killed.

47
Q

Implications with Tooleys opinion

A

-Tourture
-Infanticide

48
Q

Tooley says he is not a speciesist, why?

A

Because he puts PERSONS on top, not humans

49
Q

Why does Tooley not say an age for when a person achieves personhood?

A

Because that is not his job, that’s the developmental psychologists job

50
Q

Where does Tooley fall short in Finnis’s argument?

A

persons are nothing more than living human individuals, and this point should be the default
-Tooley tries to get this across but fails

51
Q

What does Finnis say constitutes a human person?

A

Any entity which will develop into a paradigmatic instance of a human person (paraphrased)
-paradigmatic: standard/ ideal type of person

52
Q

How do Finnis and Thomson disagree on the acorn and oak tree analogy?

A

Thomson says acorn does not equal oak tree and Finnis says acorn DOES equal oak tree

53
Q

When does Finnis believe abortion is permissible?

A

NEVER. he believes that a fetus is a person/human at conception (no exceptions)

54
Q

What 4 things does Finnis say about abortion (rules?)

A

1) Direct abortion is ALWAYS wrong
2) Every living human individual is equal with respect to the right to life
3) the unborn are NOT aggressors, nor unjust (no fetus intends to hurt mom)
4) Double effect are permissible however

55
Q

What is the Double effect and what does Finnis think about it?

A

It is permissible to kill a fetus if it were to cause serious harm to the mother
-self-defense vs murder
-hysterectomy vs abortion

56
Q

What are Finnis’ 2 main ethical principles of justice? and who should make ALL decisions based on them?

A

1) Non-maleficence: do no harm
2) Justice: treat like cases alike
Health care workers should make all decisions based upon these

57
Q

What does Finnis say about abortions in the case of rape?

A

No, not permissible once the egg is fertilized because life beings at contraception but you can take contraception (plan B) to try and prevent the pregnancy

58
Q

Is prenatal screening okay in Finnis argument?

A

Yes but only in cases where there is no significant risk to the child or to ensure safe pregnancy, no in cases where the screening is done to view an abortion, because then you have violated the two moral principles

59
Q

How does Finnis feel about the mother/ fetus conflict (mother is going to die bc of fetus)

A

He says it is permissible as long as saving the life of the mother is the SOLE intention and not the direct killing of the fetus

60
Q

How does Finnis feel about embryotic testing?

A

He says it is permissible ONLY if the intention is to benefit the embryo itself but no in virtually ALL other cases

61
Q

Sum up Thomsons, Tooley’s and Finnis argument in a sentence about abortion

A

Thomsons: some abortions are not unjust killings while some are
Tooleys: abortions and infanticide are permissible because only self-conscious persons have a right to life
Finnis: ALL abortions (intentional killings) are inpermissible

62
Q

What were Marquis first steps in starting his argument? what are the general logical constitutes of all other abortion arguments?

A

He first notes the two sides (pro-choice/life) symmetrical strategies and plausible conclusions.
The general constitutes are:
-claims characterizing fetuses (human or not)
-general moral principles
-The arguers then apply the claims to the moral principles and assert their conclusions

63
Q

What is Marquis question that he centers his argument around?

A

What makes the killing of a person always wrong?

64
Q

What was Marquis answer to the main question of his argument?

A

You are depriving the victim of their future

65
Q

In general what was Marquis general argument (2 statements)

A

1) Depriving someone of a future like ours is morally impermissible
2) Abortion deprives someone of a future like ours

66
Q

What are the five reasons that Finnis says to accept his view?

A

1) the view explains why death is considered such a terrible thing
2) the view allows for the wrongness of killing pretty much all non-humans
3) permits active euthanasia
4) does not allow for the killing of infants
5) it avoids personhood

67
Q

How does Marquis feel about contraception?

A

He says it is fine because no subject has lost its future
(egg w/o sperm is nothing vise versa)

68
Q

What was Marquis’s end conclusion on his argument?

A

Since a fetus possess a property (mom), the possession of which in adult beings is sufficient to make killing an adult being is wrong, abortion is wrong
(fetuses have property which makes it unjust to kill them)

Medical Ethics (5 decks)

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