Health Care Ethics Exam 3 – Flashcards

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Chapter 7: Abortion Key Terms
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Personhood Potential personhood Abortion Induced Abortion Spontaneous Abortion Therapeutic Abortion Viability The Right to Life Autonomy
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Potential Personhood
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The unborn may not be a person now, but its status as a possible future person puts it in the same moral category as any normal adult human being Arguments against this: -Having the potential to vote (once you reach 18 years of age) does not give you the right to vote now -If a zygote is considered a potential person, than so would a sperm or human ovum
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Abortion
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The ending of a pregnancy
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Induced Abortion
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Intentional termination of pregnancy through drugs or surgery
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Spontaneous Abortion
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a.k.a. Miscarriage Abortion due to natural causes
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Therapeutic Abortion
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Abortion performed to preserve the life/health of the mother
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Viability
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The developmental stage when the fetus can survive outside the uterus -fetal brain waves occur
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Abortion: Roe vs. Wade
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Norma McCorvey sought a non-therapeutic abortion in Texas, where only therapeutic abortions were legal -The court ruled the law was unconstitutional, stating that no state can ban abortions performed before viability -upholds the Fourteenth Amendment -balances the woman's right and state interests according to trimester of pregnancy: in the first trimester, the woman has all rights, in the second, the state may limit, but not entirely prohibit and in the third, after viability, the state may regulate the woman's rights and even ban abortion, except when it is necessary to save her life The Court noted that the Constitution does not define "person" and that "the word 'person', as used in the 14th Amendment, does not include the unborn" After the historic case, the Supreme Court made other decisions that circumscribed the right to abortion defined in Roe: 1. a woman can be required to give her written consent to abortion 2. the government is not obliged to use taxpayer money to fund abortions 3. parental consent or a judge's authorization can be demanded of minors under age 18 who seek abortions 4. a state can forbid the use of public facilities to perform abortions (except to save the woman's life) 5. a woman who consents to an abortion can be required to wait 24 hrs before the procedure is performed 6. a state can mandate that a woman be given abortion information
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Moral Permissibility of Abortion
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1. Conservative view: abortion is never morally acceptable (except possibly to preserve a mother's life), for the unborn is a human being in the full sense 2. Liberal view: abortion is acceptable whenever the woman wants it, for the unborn is not a human being in the full sense 3. Moderate view: Some, but not all, abortions may be morally justified -the fetus achieves personhood at a point somewhere between conception and birth-at viability
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Abortion: Judith Jarvis Thomas Article
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Thomas has a moderate view -argues that even if the conservative view is correct that the unborn is a person from the moment of conception, abortion may still be morally justified -A fetus may have a right to life, but this right does not guarantee having either a right to be given the use of or a right to be allowed continued use of another person's body-even if one needs it for life itself -killing UNJUSTLY is wrong Violinist example -analogy to pregnant woman: the violinist represents a fetus -argument that abortion is acceptable in cases of rape or failed contraception People Seeds exampled - House and Expanding Child example -child growing explicitly in a tiny house and it will crush you to death
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Abortion: applying major principles/theories
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Utilitarians argue that abortion is morally permissible because without this option, women (and society) would suffer terrible consequences In Kantian ethics, it depends whether the unborn is to be considered a person -if it is, it has inherent worth and therefore cannot be treated merely as a means to an end, and cannot be killed just for the convenience of the mother or society -But if the unborn is not a person, then abortion would seem morally justified because the woman is a person who has the right to exercise her autonomy over her own body
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The Development stage at approximately 23-24 weeks of pregnancy when the fetus may survive outside the uterus is know as? a. Quickening b. Gestation c. Viability d. Implantation
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c. Viability
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In Roe v. Wade, the Court saw a guaranteed right of personal privacy in a. Ancient law b. The Bible c. Current statutes d. The Fourteenth Amendment
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d. The Fourteenth Amendment
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A key premise in many arguments against abortion is that a. The unborn is not a person b. The unborn is an innocent person from the moment of conception c. Having human DNA does not automatically make one a person d. The unborn becomes a person at birth
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b. The unborn is an innocent person from the moment of conception
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Mary Anne Warren identifies five traits that are "most central" to personhood and declares that a fetus a. Must be a person b. Must be a potential person c. Has none of these traits d. Has most of these traits
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c. Has none of these traits
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Abortion liberals contend that even if infants are not persons, infanticide is a. Always permissible b. Unthinkable c. Rarely permissible d. Encouraged
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c. Rarely permissible
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Almost half of all pregnancies are unintended. a. True b. False
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a. True
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Judith Jarvis Thomson argues that even if the unborn is a person from the moment of conception, abortion may still be morally justified. a. True b. False
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a. True
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Some reject Thomson's argument by contending that it holds only if the woman bears no responsibility for her predicament. a. True b. False
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a. True
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The natural law position on abortion as articulated in Roman Catholicism is that the fetus is an innocent person from the moment of viability. a. True b. False
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b. False
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Some people opposed to abortion argue that the fetus is a potential person and thus has the same right to life as any existing person. a. True b. False
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a. True
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The Hebrew and Christian scriptures denounce abortion. a. True b. False
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b. False
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Almost everyone believes that therapeutic abortion is impermissible. a. True b. False
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b. False
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In Roe v. Wade, the Court balanced the woman's right and state interests according to trimester of pregnancy. a. True b. False
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a. True
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Both liberals and conservatives on the abortion issue agree that murder is wrong and that persons have a right to life. a. True b. False
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a. True
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Most Western industrialized countries have lower abortion rates than the United States does. a. True b. False
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a. True
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The risk of death associated with abortion performed at eight weeks or earlier is _____. a. One death in 100 abortions b. One death per 11,000 abortions c. One death per 1 million abortions d. One death in 3,000 abortions
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c. One death per 1 million abortions -EXTREMELY RARE
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Conservatives on the abortion issue charge that liberals' standards for personhood imply that a. Cognitively impaired individuals are persons b. Infanticide is never morally permissible c. Some infants are persons d. Cognitively impaired individuals are not persons
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d. Cognitively impaired individuals are not persons
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Judith Jarvis Thomson argues that a. Killing a fetus is always wrong b. The unborn's right to life is absolute c. Unjustly killing a fetus is always wrong d. Killing a fetus is always permissible
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c. Unjustly killing a fetus is always wrong
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The Roman Catholic position on abortion incorporates a. A prohibition against indirect killing of the unborn b. The doctrine of double effect c. The doctrine of practical utility d. An endorsement of therapeutic abortion
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b. The doctrine of double effect
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Late-term abortions are a. Rare b. Commonplace c. Uncontroversial d. Impossible
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a. Rare
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Genetic Testing
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Procedures used to check for genetic disorders by looking for changes in a persons DNA Types: -Newborn screening -Carrier Test -Predictive testing -Diagnostic testing -Prenatal testing -Preimplantation Genetic Diagnosis
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Newborn screening
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Uncovers genetic diseases for early treatment
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Carrier testing
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Used to discover whether or not a person is a carrier of a genetic defect that can be passed on to potential children
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Predictive testing
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Used to discover whether or not parson has a high likelihood of developing some genetic disease
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Diagnostic testing
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Used to discover whether or not a genetic disease is the cause of symptoms a patient is experiencing
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Prenatal testing
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Used to uncover genetic abnormalities in the fetus i.e. Down Syndrome, blindness, deafness
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Preimplantation Genetic Diagnosis (PGD)
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Tests embryos developed in IVF for genetic abnormalities
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Stem Cell Research
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What are stem cells? Why are researchers interested in them? What is the scientific difference between adult and embryonic stem cells? Is there a moral difference between adult and embryonic stem cells? What are some arguments for and against the practice of stem cell research? What arguments/reasons are given in this video on embryonic stem cell resaearch? Who is best served by each of these arguments?
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Stem Cells
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Stem cells are found in most, if not all, multi-cellular organisms. They are characterized by the ability to renew themselves through mitotic division and differentiation into a diverse range of specialized cell types
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Adult stem cells
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Adult stem cells are limited to differentiating into different cell types of or their issues of origin
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Embryonic Stem Cells
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Embryonic stem cells are pluripotent stem cells divided from the inner cell mass of the blastocyst, an early stage embryo. Human embryos reach the blastocyst stage 4-5 days post-fertilization, at which time they consist of 50-150 cells. Human embryonic stem cells are currently produced from surplus embryos of in vitro fertilization procedures
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Embryonic Stem Cells: Steinbock vsThe Pontifical Academy for Life (RCC)
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How does Steinbock distinguish between respect for embryos and respect for persons? On what grounds does Steinbock think embryos have a moral value that other bodily tissues lack? On Steinbock's view, what follows from rejecting the claim that embryos are ends in themselves? Are there any circumstances in which the Roman Catholic Church finds it morally acceptable to use/produce embryonic stem cells for research? What reasons do they give for their position? Why does the RCC denounce the use of embryonic stem cells supplied by other researchers? What alternative to using embryonic stem cells does it endorse?
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Steinbock
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Bonnie Steinbock thinks that embryos are morally significant in a way that other human cells are not. Bonnie Steinbock thinks that there is NOT a moral difference between embryos created for research purposes and spare embryos.
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A common charge against genetic testing to prevent birth impairments is that it amounts to disrespect or discrimination against a. People without genetic impairments b. Older people c. People with disabilities d. Minorities
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c. People with disabilities
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The use of genetic information by employers, insurance companies, and others to discriminate against or stigmatize people is known as a. Genetic testing b. Genetic control c. Unauthorized testing d. Genetic discrimination
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d. Genetic discrimination
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Gene therapy in germ-line cells is currently a. Routine b. Not feasible c. Low risk d. Widely accepted
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b. Not feasible -Gene therapy: the manipulation of someone's genetic material to prevent or treat disease
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The deliberate attempt to improve the genetic makeup of humans by manipulating reproduction is known as a. Germ-line therapy b. Somatic cell therapy c. Eugenics d. Gene activation
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c. Eugenics
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Most of the moral controversy over embryonic stem cells has focused on their source, which is mainly a. Adult stem cells b. Umbilical cords c. Blastocysts d. Bone marrow
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c. Blastocysts
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Many gene therapies have been approved for routine use. a. True b. False
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b. False
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Physicians have debated whether they should reveal to a patient the results of a genetic test showing that he or she is at high risk for an unpreventable, untreatable disease. a. True b. False
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a. True
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The core question in public disputes about embryonic stem cells is whether it is morally permissible to destroy human embryos in a search for cures. a. True b. False
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a. True
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Genetic testing is now available for over 1,000 diseases. a. True b. False
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a. True
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Genetic tests almost always yield definitive answers. a. True b. False
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b. False
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Even when genetic tests correctly predict a genetic disorder, they usually cannot foretell how severe its symptoms will be or when they will appear. a. True b. False
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a. True
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Direct-to-consumer genetic tests are reliable, useful, and safe. a. True b. False
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b. False
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Many symptomless people at risk for Huntington's disease decide not to be tested. a. True b. False
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a. True
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Genetic discrimination is prohibited by law. a. True b. False
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a. True
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Some bioethicists have insisted that discrimination or disrespect for persons is not entailed by genetic testing. a. True b. False
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a. True
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Some argue that gene therapy should not be permitted because it amounts to a. Abortion b. Eugenics c. Genetic repair d. Treatment of disease
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b. Eugenics: the deliberate attempt to improve the genetic makeup of humans by manipulating reproduction
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Negative eugenics is widely regarded as a. Permissible or obligatory b. Impermissible c. Impossible d. Prohibited
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a. Permissible or obligatory
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Those who believe that embryos have the moral status of persons are likely to view embryonic stem cell research as a. Moral b. Morally ambiguous c. Immoral d. Amoral
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c. Immoral
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Those who believe that early embryos have less than full moral status but are still deserving of some respect usually regard embryonic stem cell research as a. Morally impermissible b. Morally acceptable c. Harmful d. Permissible without limits
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b. Morally acceptable
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Preimplantation genetic diagnosis (PGD) is a. Inexpensive b. Dangerous c. Common d. Not yet feasible
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c. Common
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Chapter 10: Euthanasia and Physician-Assisted Suicide
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Euthanasia- Active euthanasia- Passive euthanasia- Physician Assisted Suicide-
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Euthanasia
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The intentional termination of a patient's life in order to relieved them of their sake (for the person's sake = in accordance with the wishes of the patient -A person who undergoes euthanasia usually has a terminal (incurable) disease -Derived from the Greek word, euthanatos, meaning "good death" Demonstrates complications with the principles of autonomy and beneficence, as well as our understanding of the meaning and value of human life
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Where is Euthanasia legal?
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Switzerland Belgium Colombia India Luxemborg Ireland Mexico Netherlands US-Washington, Oregon, Montana, Vermont, California
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Active Euthanasia
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Occurs when the medical professionals, or another person, deliberately administer a treatment that causes the patient to die -i.e. administering a lethal dose of some medication, either by bill, injection, or gas "mercy killing"
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Passive Euthanasia
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Occurs when the patient dies because the medical professionals either don't administer a treatment necessary to keep the patient alive or they stop a treatment that is keeping the patient alive -i.e. switch of life support, disconnect a feeding tube, don't carry out life-extending operations, don't give life-extending drugs
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Physician-Assisted Suicide
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Occurs when the patient self-administers some form of euthanasia which has been prescribed by a physician Some physicians argue the PAS should be morally permissible because it allows them to provide a patient with the death they want without having to deal with the difficult moral problems they would face if they directly/deliberately caused the death of the patient
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Active vs. Passive euthanasia
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Many people make a more distinction between active and passive euthanasia -Killing vs. letting die: --> They argue that it is acceptable to withhold treatment and allow a patient to die, but that it is never acceptable to kill a patient by a deliberate act
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Passive euthanasia (both voluntary and nonvoluntary) is a. Unlawful b. Denounced by the medical profession c. Legally equivalent to physician-assisted suicide d. Legal
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d. Legal
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"When Abstract Moralizing Runs Amok"-John Lachs Article pg. 631, right column, selections
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What position on euthanasia is Lachs criticizing? -Lachs is criticizing Daniel Callahan -Callahan contends there are considerations relevant to life and death decisions that severely limit the weight that autonomy should play in those decisions -Callahan argues against any social policy allowing voluntary euthanasia and assisted suicide. He maintains that self-determination and mercy may become separated. When this happens, assisted suicide for any reason and non voluntary euthanasia for the incompetent will become acceptable -What is the gist of the argument that Lachs is critiquing? What is Lach's response to this position? -Lachs claims that Callahan fails to grasp the moral problems leading people to consider euthanasia. They are interested in euthanasia to end pain and a burdensome life, not to escape from the suffering inherent "human condition" -Callahan holds that even if we have the right to kill ourselves, it intrinsically cannot be transferred to others. But Lachs argues that the idea of a right that cannot be transferred makes no sense -On the moral wrongness of transferring certain rights, pg. 632, last paragraph, left column
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Types of Euthanasia
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Active: -direct causing death Passive: -withholding or withdrawing life-sustaining measures Voluntary: -with consent of the patient; consent is either given by competent patient at time of treatment, or in advance via advance directive or surrogate Non-voluntary: -without consent of the patient because patient is non competent; patient's wishes are unknown
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Morally Relevant Details of Euthanasia
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Physician willingness: -do the personal values of the physician permit them to prescribe euthanasia? Physician due caution and sound evaluation: -Did the physician do their due diligence to try to determine if the patient's request for euthanasia is justified? Patient competency and consent: -Does the patient have the capacity (age and mental health) to make an autonomous decision? -Did the patient voluntarily request and consent to the treatment? Patient motivation: -Why is the patient seeking euthanasia? (Terminal illness is usually considered the only morally permissible motivation. Under Death with Dignity laws in the US, patient must have a terminal illness that will lead to death within six months)
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Brittany Maynard Case
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Which type of euthanasia (from the chart) is at issue in this case? What reasons does she give for wanting access to euthanasia? What does Maynard say about autonomy? What would have done had you been in her situation? Does this affect what you think about the morality of euthanasia?
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Terri Schiavo Case
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How does Steinbock distinguish between respect for embryos and respect for persons? -Human embryos do not have full moral status or human moral status. They are a form of human life, and as such, deserve respect. He also uses Kantian ideology saying that people and embryo's are not merely a means to an end On what grounds does Steinbock think embryos have a moral value that other bodily tissues lack? -It is the right to life position on the moral status of human embryos On Steinbock's view, what follows from rejecting the claim that embryos are ends in themselves? -It makes no moral difference whether one creates embryos for reproductive purposes but ends up using it in research or whether one creates an embryo for that specific purpose. Respect for embryos is demonstrated by restricting their use to important ends Are there any circumstances in which the Roman Catholic Church finds it morally acceptable to use/produce embryonic stem cells for research? What reasons do they give for their position? Why does the RCC denounce the use of embryonic stem cells supplied by other researchers? What alternative to using embryonic stem cells does it endorse?
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The strongest argument offered to support active voluntary euthanasia is derived from a. The principle of justice b. Theological considerations c. The principle of autonomy d. Paternalism
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c. The principle of autonomy
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Performing an action that directly causes someone to die—what most people think of as "mercy killing"—is called a. Passive euthanasia b. Voluntary euthanasia c. Active euthanasia d. Involuntary euthanasia
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c. Active euthanasia
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Those who oppose euthanasia often draw a sharp distinction between a. Autonomy and paternalism b. Beneficence and nonmaleficence c. Killing and letting die d. Mercy and negligence
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c. Killing and letting die
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The definition of death that has become the standard in legal and medical matters is called a. The higher brain theory b. The whole brain view c. The traditional view d. The mind-body theory
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b. The whole brain view
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Slippery slope arguments are seldom used in debates about euthanasia or physician-assisted suicide. a. True b. False
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b. False
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Some argue that there is no morally significant difference between mercifully killing a patient and mercifully letting the patient die. a. True b. False
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a. True
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The American Medical Association has denounced physician-assisted suicide as unethical and inconsistent with physicians' duty to promote healing and preserve life. a. True b. False
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a. True
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Some argue against active voluntary euthanasia by advancing a distinction between intending someone's death and not intending but foreseeing it. a. True b. False
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a. True
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Doctors are unanimous in their rejection of physician-assisted suicide. a. True b. False
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b. False
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James Rachels argues that there is no morally significant difference between killing and letting die. a. True b. False
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a. True
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Scientific research on whether policies permitting euthanasia or assisted suicide lead to unjustified killing is a. Scant b. Definitive c. Sufficient d. Abundant
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a. Scant
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Peter Singer views the issue of euthanasia as a. A classic utilitarian b. A natural law theorist c. A Kantian d. A preference utilitarian
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d. A preference utilitarian
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Most agree that the distinction between intending someone's death and not intending but foreseeing can always be clearly drawn. a. True b. False
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b. False
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Some argue that directly intending a patient's death may be permissible because, to the patient, death a. May be a great harm b. May be what the family wishes c. May release physicians from responsibility d. May not be a harm
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d. May not be a harm
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Proponents of active voluntary euthanasia believe that the right to die a. Compels others to help someone die b. Does not compel others c. Justifies involuntary euthanasia d. Applies only to the nonreligious
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b. Does not compel others
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In the Cruzan case, the Supreme Court recognized a. The right of patients to commit suicide with assistance b. The constitutional right to physician-assisted suicide c. The right of patients to refuse treatment d. The right of active euthanasia
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c. The right of patients to refuse treatment
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RECURRING THEMES
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Respect for Human Life vs. Respect for Persons -when does life/personhood begin? -what is the criteria for personhood? -what makes someone a person? Preserving All life vs. Preserving Quality of Life -should we valued all life or only certain quality of life? -is there a point at which life is no longer worth living? ---> terminal illness, intense suffering, genetic defects, etc. Patient Autonomy vs. Beneficence -which treatments should be withheld for the benefit of the patient? ---> when is paternalism appropriate? -what are the proper boundaries of patient autonomy? ---> when should the patients confidentiality or privacy be overridden in the interest of preventing harms to others? Justice -who has access to treatments? -will limiting access to treatments disproportionately harm those of a lower socio-economic status?
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