Bioethics Exam 1

Bioethics

the study of value-laden issues in medicine, health, and the life sciences, and formulating how best to resolve such dilemmas

Tuskegee Syphilis Study

(1930s-1970s), study of untreated syphilis, despite treatment becoming available in the 1940s

WWII Nazi and Japanese medical experiments

(1930s-1940s), forced experimentation on prisoners

Willowbrook experiments

(1950s-1960s), intellectually disabled children given hepatitis to track development of virus

● Justification: children in institutions would ‘get it anyway’

● Parents often agreed because otherwise their children wouldn’t be able to access hospital services

Nuremberg Code

(1947) was developed by American physicians overseeing trials of Nazi physicians involved in experiments

Declaration of Helsinki

(1964) code that focused on clinical

research specifically, and which is periodically updated

Belmont Report

Proposed three principles: respect for persons, beneficence, and justice

Foundation of the Common Rule, which sets out federal guidelines for research followed by IRBs

Normative

analyzing and formulating opinions on the resolution of ethical dilemmas by applying theoretical concepts from philosophy and neighboring disciplines

Empirical

collecting data (quantitative and qualitative) about an ethical dilemma, which can inform how best to resolve it

Principlism

use generalizable principles to guide ethical decision making: beneficence, nonmaleficence, autonomy, and justice

deontology

the morality of an action depends on the action/intention

consequentialism

the morality of an action depends on the outcome

virtue ethics

we need to have certain personal qualities or character traits to be ‘good’; An act is morally permissible if and only if it is one that a virtuous person (acting in character) would do.

paternalism

an authority (physician, family, etc.) limits the autonomy of the patient; the clinician makes a decision on the patient’s behalf (hard & soft)

distributive justice

allocating scarce resources fairly to all people and social groups

consumerism

the physician’s role is limited to providing all the medical information and the available choices for interventions and treatments while the fully informed patient selects from the available choices

capacity

the ability of an individual to make a decision about their own medical care (aka decision making capacity)

informed refusal

a patient’s ability to appreciate the information about a treatment, and freely decline that treatment

Shared Decision Making

clinicians and patients collaborate on treatment decisions for the patient

best interest

what treatment does the medical team believe is the most effective and appropriate course of action given the circumstances, that most patients in the situation would opt for?

Metaethics

Concerned with the meaning and nature of ethical claims (but not with their content)

Normative ethics

Concerned with the discovery (or construction) of general moral principles

Practical Ethics

Concerned with ascribing moral properties to particular actions/policies/outcomes/dispositions

Moral Epistemology

how do we come to know moral truths?

Consequentialism

An action is morally permissible if and only if it produces the best (or sufficiently good) results

Utilitarianism

An act is morally permissible if and only if it maximizes well-being

Non-consequentialism

The deontic status of an action is not just a function of its consequences

Kantianism

An act is morally permissible if and only if its maxim is universalizable (i.e. the motivating principle of the action could be universally adopted)

Social Contract Theory

An act is morally permissible if and only if its maxim is permitted by rules that free, equal, and rational people would agree to live by

Pluralism

An act is morally permissible if and only if it is sufficiently supported by the balance of reasons

Feminist ethics

An approach (rather than a competitor) emphasizing the importance of relationality and other (stereotypically) non-masculine values and perspectives for ethical theorizing.

ex. autonomy as individualistic or relational

Moral Realist

morality exist independently of our thoughts and values

Moral Antirealist

morality depends essentially on our beliefs and values roughly the same kind of way that many people think that etiquette does

Divind Command Theorist

morality is related to divine commands; that is, they think that an action is right or wrong if and only if God says so

narrative medicine

teaches clinicians literary skills to help them elicit and interpret patients’ stories, and to tell their own stories about their work as healthcare professionals, and the values they hold

Voice, character, plot, resolution

elements of narrative ethics

restitution, quest, chaos

Typology of Illness Narratives (3)

mattering map

how do people describe what matters in different social and physical settings?

Ableism

systematic marginalization and stigma of disabled people favoring non-disabled people who represent the cultural norm

Medical Model

disability is caused by some dysfunction or injury to the body, requiring clinical intervention

Social Model

disability is caused by the failure of the environment to meet the needs of diverse bodies/minds

Epistemic injustice

harm against someone specifically in their capacity as a knower (ex. silencing)