Ethics Midterm Flashcards

Meta-ethics

The branch of ethics that asks what morality itself means and where moral values come from

Normative ethics

The branch of ethics that examines the content of moral values and judgments to determine what makes actions right or wrong.

Applied ethics

Applies moral concepts and principles to guide practical decision-making in specific domains such as healthcare or public health.

Autonomy

Recognizing an individual's right to self-government and to make decisions about their own medical care without external coercion.

Beneficence

The ethical obligation to act in the best interest of individuals and perform actions that produce positive good.

Nonmaleficence

The ethical obligation to protect individuals from physical, emotional, or financial harm.

Police power

The legal authority reserved for state governments to enact legislation and enforce actions to protect the common health, safety, and welfare of the population.

Supremacy Clause

The constitutional provision establishing that legitimate federal laws take precedence over conflicting state laws.

Jacobson vs Massachusetts Principles

Individual liberty can be limited when reasonably necessary to protect public health and safety.

Cost-Effectiveness Analysis (CEA)

An evaluation method that relates the financial costs of a program directly to its key non-monetary health outcome benefits.

Cost-Benefit Analysis (CBA)

An evaluation method that weighs the financial costs of a program directly against the calculated dollar value of its benefits

Strong paternalism

The practice of overriding the choices or actions of a substantially autonomous individual for the purpose of promoting their welfare or preventing self-harm.

Weak paternalism

The practice of intervening in the choices or actions of an individual who is non-autonomous or substantially lacking decision-making capacity to protect them from harm.

Intervention Ladder

Developed by the Nuffield Council that ranks public health policy options by intrusiveness, from doing nothing to eliminating choice entirely.

Three-step approach to public health ethical dilemmas

Analyzing the ethical issues

Evaluating the ethical dimensions of public health options

Providing public justification for the chosen action.

Justificatory conditions for public health action

Effectiveness, proportionality, necessity, least infringement, and public justification.

All required when public health goals override individual rights or liberties.

What is Public health ethics?

Branch of inquiry that seeks to understand and clarify the principles and values guiding population-level health decisions and policies.

What is the field of practice in Public health ethics?

Application of relevant moral principles and values to guide decision-making, policy creation, and problem-solving in population health.

What is justice in bioethics?

Core principle requiring fair, equitable, and appropriate distribution of health goods, burdens, and resources across society.

What is vulnerability in public health?

A status indicating an individual or group faces conditions that adversely impact their well-being, creating an ethical duty for society to safeguard them.

What is Interstate Commerce Clause?

The constitutional power of Congress to regulate commerce between states.

What is Statutes?

Formal written laws enacted by legislative bodies that confer legal powers onto executive branch agencies.

What are Administrative regulations?

Rules created by executive agencies that carry the force of law and can be updated more rapidly than legislative statutes to respond to emerging challenges.

What is Distributive justice?

Governing the fair allocation of societal benefits, burdens, costs, and health risks across a population.

What is Procedural (fair process) justice?

Emphases fairness, public participation, and transparency in the decision-making processes used to allocate resources.

What is Formal justice?

The traditional principle establishing that equals should be treated equally, and similar cases should be treated similarly.

What is Material justice?

Is concerned with whether people have fair access to the basic resources and material conditions needed for health and well-being.

What is Informational privacy?

The specific dimension of personal boundary concerned with controlling access to and disclosure of an individual's personal data or health records.

What is Confidentiality?

The ethical and legal obligation to keep private information disclosed within a professional relationship safe from unauthorized access or disclosure.

What is Effectiveness (as a justificatory condition) ?

The requirement that an intrusive population health measure must have a high probability of successfully achieving its intended health goal.

What is Proportionality?

The requirement that an intrusive populations health measure must have a high probability of successfully achieving its intended health goal.

What is Proportionality?

An expected public health benefits of an action must outweigh the moral considerations and individual liberties infringed upon.

What is Necessity?

Overriding individual rights/autonomy is essential to achieve the overriding population health objective.

What is Least Infringement?

Using the least restrictive intervention necessary to achieve a public health goal while limiting individual liberty as little as possible.

What is Public Justification?

Giving clear, reasonable explanation for a decision or policy that everyone affected can understand and accept even if they disagree with it.

What is Kass Framework?

A six-step questionnaire designed to evaluate the ethical implications, burdens, and effectiveness of public health programs.

Public Health Code of Ethics (The Noun)

The formal, written set of rules and ethical standards (such as the APHA code) that provides guidance for public health.

Ethical Analysis in Public Health (The Verb)

The formal, written set of rules and ethical standards that provides guidance for public health.

What is Egalitarian (everyone should be treated equally) Justice Theory?

Framework that emphasizes equal access to health resources and equal treatment for all individuals.

What is Libertarian Justice Theory?

A framework of distributive justice centered on individual liberty, non-interference, and reliance on free-market mechanisms.

What is Communitarian Justice Theory?

Prioritizes the shared community values, public good, and social traditions over individual rights.

What is Utilitarian Justice Theory?

Maximizing the overall health outcomes and producing the greatest benefit for the greatest number.

What is Medical Utility?

A resource allocation criterion during crises prioritizing individuals who have the highest likelihood of clinical recovery and survival.

What is Social Utility (do what helps the most people) ?

A triage criterion assessing an individual's value to society, evaluated either broadly (overall societal worth) or narrowly (essential pandemic response roles).

What are the Four Conditions of Fair Process?

Publicity, Relevance, Revisability, and Regulation.

What is Risk Perception?

The subjective evaluation of health hazards by lay individuals, shaped by factors like voluntariness, familiarity, controllability, and fear.

What is the Belmont Report?

Ethical guidelines for conducting research involving human participants.

Which 3 of the 4 tenets are outlined in the Belmont report?

Autonomy, Beneficence, Justice

When does an IRB (Institutional Review Board) step in and why does it do that?

Reviews a study before researchers can start collecting data from human participants. The purpose is to protect the rights, safety, and welfare of research participants.

How does public health infrastructure work?

On a federal, state, and local basis.

What is the federal government bound by and where are its powers and limits outlined?

Bound by the U.S. Constitution.

The Constitution outlines the powers and limits of the federal government, including what the federal government can and cannot do.

What are expressions of the moral values of the public?

Laws and public policies

What are some types of conflicts in research?

Bias, conflicts of interest, and competing interests can influence how research is conducted or interpreted.

What principle in bioethics/medical care is associated with respect for persons?

Autonomy, which is expressed through informed consent.

What is privacy?

A person's right or interest to be left alone and to control access to themselves or their personal information.

What is confidentiality?

The responsibility and legal/ethical obligation to protect information that has been entrusted to you

What is the difference between privacy and confidentiality?

Privacy is the individual's right to control access to themselves or their information. Confidentiality is the duty to protect information that has been shared

What must a person be free from in order to have agency?

Coercion and undue influence

What is agency?

The ability to make one's own decisions and act voluntarily

How does beneficence relate to research ethics?

Beneficence means maximizing benefits and minimizing potential harm to participants in reaserch

What is the difference between the noun and the verb when discussing biomedical ethics?

A noun refers to the ethical principle or concept itself, while a verb describes the action of applying that principle.

What is the difference between strong and weak paternalism?

Weak allows intervention when a person's decision is not fully voluntary or informed

Strong intervention even when the person is making a voluntary, informed decision, because the intervention is considered to be in their best interest

What are the different types of justice?

Distributive justice: Fair distribution of benefits, risks, and resources.

Procedural justice: Fairness in the processes used to make decisions.

Compensatory justice: Fair compensation or restoration when someone has been harmed.

Retributive justice: Fair and appropriate consequences for wrongdoing.

What is equality?

Giving everyone the same resources, opportunities, or treatment.

What is equity?

Providing people with the resources or support they need to achieve a fair outcome.

What is inequality?

A difference or unequal distribution between people or groups.

What is inequity?

An unfair or unjust inequality, often resulting from avoidable or systematic disadvantages.

What is the difference between consequentialism and utilitarianism?

Consequentialism is the broader ethical theory that judges an action based on its consequences/outcomes.

Utilitarianism is a type of consequentialism that focuses on producing the greatest overall good for the greatest number of people.

What are the characteristics of consequentialism?

It focuses on the outcome or consequences of an action. An action is considered morally right or wrong based primarily on its results.

What are the characteristics of utilitarianism?

It focuses on maximizing overall benefits and minimizing overall harms, with the goal of achieving the greatest good for the greatest number.

What is an ethical dilemma?

A situation in which there are two or more competing ethical values or principles, making it difficult to determine the appropriate action.

How do we confront an ethical dilemma in public health?

1. Identify the ethical issue/dilemma.
2. Evaluate the relevant facts, ethical principles, risks, benefits, and competing values.
3. Provide justification for the proposed public health action.

In the practice of public health, how do we provide benefits to participants?

By collecting and using data to improve the health and well-being of individuals and populations while protecting participants' rights and welfare.

What are trade-offs?

When gaining one benefit requires giving up or limiting another benefit, value, or interest.

Why are trade-offs needed in public health?

Resources and options are limited, and public health decisions often involve competing values or interests. Protecting one interest may require limiting another.

Why do trade-offs require justification?

When a public health action limits someone's rights or liberty to achieve a public benefit, there must be a reasonable ethical justification for why the benefits outweigh the costs or burdens.

What should be considered when prioritizing general welfare over individual liberty?

Consider the public health benefit, the restriction on individual liberty, the necessity of the intervention, whether less restrictive alternatives exist, and whether the action is proportionate to the threat.

What is marginalization, and what should public health consider?

When certain people or groups are pushed to the edges of society and have less access to resources, opportunities, power, or decision-making.

How are law and ethics related?

Laws establish legally enforceable rules, while ethics guide what is morally right.

They often overlap, but legal does not always mean ethical.

What is common law?

law developed through court decisions and judicial precedent, rather than being created solely through legislation.

In a court of law, what are decisions based on?

Law, evidence, and legal precedent, rather than personal opinions or moral beliefs.

What is capacity in public health ethics?

Ability of a person to make decisions for themselves.

If they lack it, a trusted person may make decisions on their behalf.

What are civil and political human rights?

Rights such as freedom to vote and protection from torture.

What are economic, social, and cultural human rights?

ESC = work, well-being, and culture.

What is deontological ethics?

Ethical theory focused on duties and rules. Certain actions are inherently right or wrong regardless of the outcome.

Which philosopher is strongly associated with deontological ethics?

Immanuel Kant

What is the veil of ignorance?

A thought experiment where you decide how society should be organized without knowing what position you will have in that society.

According to the veil of ignorance, whose well-being should receive particular attention?

The least well-off members of society

What is moral distance?

The idea that we may feel less moral responsibility toward people who are farther away from us socially, geographically, or emotionally.

What are examples of vulnerable populations?

Pregnant women, children, older adults, people with disabilities, and marginalized groups.

What is marginalization?

A person or group is pushed to the edges of society and may have reduced access to resources, opportunities, or decision-making.

What is a policy?

A law, regulation, procedure, administrative incentive, or voluntary practice used by governments or institutions

What are the main tools used to formally analyze benefits, costs, and risks?

Cost-effectiveness analysis (CEA), cost-benefit analysis (CBA), and risk-benefit analysis (RBA).

What are the steps of risk analysis?

Identify the risks → estimate the risks → evaluate the risks → reduce the risks

What does risk-benefit analysis examine?

The probability and severity of potential harms in relation to the benefits of different options.

What factors can influence how people perceive risk?

Severity of harm, probability of occurrence, voluntary vs. imposed risk, perceived control, whether the risk is new or familiar, and fear of associated conditions.

What is distributive justice concerned with in public health?

How benefits, resources, risks, and burdens are fairly distributed among people in society.

What is procedural justice concerned with?

Whether the process used to make decisions is fair.

What is a framework?

A particular set of rules, ideas, or beliefs used to deal with problems or decide what to do.