Ethical Issues in Healthcare Final

What is the average waiting time for a kidney transplant in the U.S? 

679 days 

How many people in the U.S. die every day waiting for an organ? 

18 people 

What did the U.S. government do in 1986 to increase the number of organs available for transplantation by 10%? 

Enacted a law in which hospitals identify patients most likely to be organ donors and tell the families about the legal options when it comes to organ donation after death 

What is the name of the organization which establishes rules for organ distribution in the US? 

United Network for Organ Sharing (UNOS) 

According to Veatch and Ross, what percent of Americans are registered as organ donors? 

43%

Countries associated with which branch of Christianity have a higher rate of enacting organ transplantation policies of routine salvaging and presumed consent? Name three countries which use this model. 

Catholicism. Singapore, Poland, and Czech Republic 

Countries which replace donation with routine salvaging and presumed consent normally have what percent of an increase in organ procurement, according to Abadie and Gay? 

25-30% 

Name three countries where organs were being purchased and sold which shut down that practice in the 1990s. 

India, Bangladesh, Pakistan, and China 

Which country promised to stop using organs from the bodies of executed prisoners by mid-2014? 

China 

Does Jacob Appel support or reject paying for death row inmates to have access to kidney transplantation? What were two of his arguments? What is the viewpoint of Carl Cohen and colleagues on the subject of the appropriateness of doing liver transplants on people who have suffered from alcohol use syndrome (formerly known as alcoholism)? 

Appell supports paying for death row patients to receive kidney transplants. His arguments are that transplantation overall costs less than dialysis and the accuracy of the state’s determination are questionable. Carl Cohen believes that alcoholics should be taken care of because they are still people too and it is a disease. 

Janet Radcliffe-Richards and Kishore Phadke/Urmila Anandh have a disagreement about which issue related to obtaining organs for transplantation? What were their respective arguments? 

Janet and Kishore/Urmila believe respectively that organ selling should be regulated and that organ selling is immoral. Janet believes that the best option for vendors, low risk, reliable means of protection. Kishore/Urmila believe that people are exploited if they are poor, discouraged from altruistic giving, and commercialize the body and undercut human dignity. 

What does Hilde Lindemann say in “The Woman Question in Medicine” about female patients and female physicians? 

Female patients emphasize the need for healthcare providers to recognize and address gender biases and stereotypes that may affect the quality of care. Female physicians’ barriers and discrimination that women encounter explore gender inequality in medical education, limited opportunities for career advancement, and prevalence of sexism and harassment. 

What is the difference between one’s “sex” and one’s “gender?” What does it mean to be “cis gender” or “transgender?” 

Sex refers to the anatomical parts that develop during gestation. Gender refers to how one chooses to present themselves within the sliding scale of the gender concept. Cis gender means someone has remained the same gender they were born as. Transgender means you eventually identify as a different gender than the one assigned to you at birth. 

In my class presentation on sexual orientation, I noted that James Nelson proposes that there are four ethical approaches to homosexuality. What are they? 

Punitive condemning, non-punitive condemning, qualified acceptance, and full acceptance. 

What are the concerns expressed by Tia Powell and Edward Stein in their article “Legal and Ethical Concerns about Sexual Orientation Change Efforts”? What is “queer theory” and how has it changed the ethical discussion about sexual orientation and gender? 

Some concerns raised include lack of efficacy (no evidence supporting the efficacy of SOCE in changing an individual’s sexual orientation), potential harm to patients, violation of autonomy, professional ethics. Reflect bias and harmful. Queer theory is an interdisciplinary field that encourages one to look at world through new avenues. Helps with greater acceptance. 

In Dr. David Ansell’s book THE DEATH GAP, what are three factors he notes which contribute to African Americans living shorter lives than white Americans? (See The Death Gap Power Point.) 

Social and economic inequalities, structural racism and discrimination, and healthcare access and quality. 

What was the infamous experiment conducted on African American men which has been named as an important factor in many African American patients’ distrust of the American medical system? When did it take place? What was the major point of Patricia King’s essay on this medical experiment? 

Tuskegee syphilis study. 1932-1972. The main point of King’s essay revolves around ethical violations and betrayal of trust by medical establishment and exploitation of vulnerable men. 

Explain two inequalities of health outcome experienced by African-Americans beyond longevity, according to our textbook. 

Infant mortality rate is twice that of European Americans. Black women are three times more likely to die during childbirth. 

In Susan Wendell’s article, “Who is Disabled? Defining Disability,” she distinguishes among the categories of “impairments,” “disabilities” and “handicaps.” What is the difference, she claims, between a “disability” and a “handicap?” 

Disability is any restriction or lack of ability to perform an activity. Handicap as a function is the relationship between disabled persons and their environment. 

What is Thomas Szasz’s argument about the ethics of mental illness? 

Mental illness is a myth, and the term is used to justify the control and coercion of individuals whose behaviors or beliefs deviate from societal norms. 

What are two key rulings on the commitment of individuals to a psychiatric facility made in the 1970s? (See “The Ethics of Mental Illness” Power Point.) 

1972 – Wyatt vs sticker: committed mental health patient must either receive treatment or be released. 

1975 – O'Conner vs Donaldson: two conditions must be met for involuntary commitment suffering from mental illness to point where not sane and being a danger to others or oneself. 

Name five major reasons why medical care is more expensive in the United States than in other countries in the world, according to our textbook and the class presentation. 

Drug costs, administrative costs, advanced technologies, aggressive medicine, and competitive limits on managed care. 

What are two key points made by Mr. Steve Edwards in his presentation on health care? 

The two key points made were 1)   2) 

What are the four theories of justice which we considered in our discussion of health care funding and distribution? Which philosopher is associated with each theory? Briefly, what do the theories say? 

Robert Mozilla – entitlement theory-one is entitlement to what one possesses provided it’s acquired justly. 

Bentham/Mill - utilitarian tradition – greatest good for greatest number 

John Rawls – Justice as fairness veil or ignorance. 

Bernard Williams – egalitarianism – all people should be honored 

What are the five major characteristics of the Canadian health care system as presented in my Power Point on this topic? 

• Universality: every citizen is covered 

• Portability: people can move to another province, change jobs, etc., and still be covered 

• Accessibility: everyone has access to physicians and hospitals 

• Comprehensiveness: medically necessary care must be covered 

• Public Administration: publicly operated and accountable 

What do Kai Nielsen and Norman Daniels argue respectively about a just way to deliver and fund health care? 

Neilsen argue for universal healthcare based on principles of equality and social justice while Danial’s proposes system that prioritizes equal access to healthcare services while also ensuring fair opportunities for individuals to achieve good health outcomes. What are the key features of the system now commonly referred to as Obamacare? 

What are the key features of the system now commonly referred to as Obamacare? 

Extends dependent healthcare to the age of 26, develops uniform coverage for “apples-to-apples" comparisons of insurance, provides assistance to those who are uninsured due to pre-existing conditions, prohibits pre-existing condition exclusion for children, and requires coverage for preventative service. 

What is the main point of Hall and Lord’s article on Obamacare? What are two “misconceptions” about the Affordable Care Act which Mark Hall and Richard Lord challenged in their article on this controversial subject? 

The main point is to challenge misconceptions about ACA and provide nuanced analysis of its provisions and implications. Myth of government takeover of healthcare and misunderstanding of individual mandate. Budget buster and idea that socialized medicine. 

What is Avik Roy’s recommendation for the best way to fix America’s health care challenges? 

Remove mandate to buy insurance and other regulatory mechanisms of the ACA, market-based reforms prioritize consumer choice competition and innovation. 

If you were going to make a recommendation for the most just way to deal with health care funding and distribution in the United States, what would you propose? 

Universal coverage, single payer system, progressive financing, promotion of health equity 

If you were asked to make ethical recommendations related to organ transplantation, what would you say? 

Informed consent, avoiding exploitation, minimizing harm, transparency, education, and equitable allocation. 

If you were asked to make three changes to enhance the way in which medicine responds to the diversity of patient and health care worker identities, what would you recommend? 

Cultural competency training required education about socioeconomic classes and ability to tailor healthcare policies and practices. 

What was the major point made by Michael Moore in his film, “Sicko,” about health care in America during the first decade of this century? 

The major point made was that America’s healthcare is inaccessible and keeps sick people sick so they can spend more money.