Who is Worthy of Moral Concern?

Question 1

Define moral status.

Answer 1

Factors that determine:

1 - Who we deem to be worthy of our concern.

2 - To whom we owe obligations or duties.

Question 2

List the 6 grounds for moral concern.

Answer 2

1 - Humanity.

2 - Sentience.

3 - Autonomy.

4 - Personhood.

5 - Potentiality.

6 - Patient.

Question 3

List 5 characteristics of humanity.

Answer 3

1 - Language.

2 - Reasoning.

3 - Ownership of property.

4 - Kinship.

5 - Self-awareness.

Question 4

Define sentience.

Answer 4

The ability to experience pleasure or pain.

Question 5

Define autonomy.

Answer 5

The ability to make a choice independently.

Question 6

Define personhood.

Answer 6

The ability to have continuous mental states such as desires for the future and rational thought.

Question 7

Define potentiality.

Answer 7

Latent qualities that serve as grounds for moral concern.

Question 8

Why is being a patient considered grounds for moral concern?

Answer 8

Because a doctor has a duty of care over the patient, therefore grounds for concern is founded in a doctor’s professionalism.

Question 9

Define biological death.

Answer 9

Irreversible cardiopulmonary arrest.

Question 10

Define brain stem death.

Answer 10

A state in which the heart continues to beat but there is cessation of:

1 - Respiration.

2 - Thermostasis.

3 - Brain function.

4 - Fluid balance.

Question 11

How does brain stem death differ from biological death?

Answer 11

Brain stem death is considered to be a form of biological death, despite the fact that the heart continues to beat.

Question 12

In which state is most organ donation done?

Answer 12

During brain stem death.

Question 13

Define biographical death.

Answer 13

Death of personhood.

Question 14

How does brain stem death differ biologically from a persistent vegetative state?

Answer 14

• In brain stem death, all of the midbrain and cortex is dead and most of the brain stem is dead.
• In a persistent vegetative state, all of the midbrain and cortex is dead but the brain stem is functional. This means that all higher mental functions are lost but basic biological functions remain.

Question 15

Describe the method of diagnosis for persistent vegetative state.

Answer 15

Observe the following clinical signs for 6-12 months:

1 - No awareness of self or environment.

2 - No response to visual, auditory, tactile or noxious stimuli.

3 - No evidence of language comprehension.

4 - Sleep / wake cycles maintained.

Question 16

Which imaging techniques can be used to help diagnose a persistent vegetative state?

Answer 16

PET scanning.

Question 17

List 3 conditions that might present as a persistent vegetative state.

Answer 17

1 - Minimally conscious state.

2 - Locked-in syndrome.

3 - Guillain-Barré syndrome.

Question 18

Define minimally conscious state.

Answer 18

A condition of severely altered consciousness in which minimal but definite behavioural evidence of self or environmental awareness is demonstrated.

Question 19

How do the outcomes of a minimally conscious state compare to that of a persistent vegetative state?

Answer 19

Minimally conscious states have a more continuous improvement and significantly more favourable outcomes post-injury when compared with a persistent vegetative state.

Question 20

Define therapeutic nihilism.

Answer 20

Aversion to the idea of keeping someone in a minimally conscious state alive.

Question 21

List 4 clinical practices that are made difficult by using humanity as a moral ground for concern.

Answer 21

1 - Abortion.

2 - Euthanasia.

3 - WIthdrawal or life-saving treatment.

4 - DNR orders.