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Euthanasia
Directly or indirectly brining about the death of another person for that person’s sake
Active euthanasia
Performing an action that directly causes someone to die;”mercy killing'.’
Passive euthanasia
Allowing someone to die by not doing something that would prolong life
Voluntary euthanasia
Euthanasia performed when competent patients voluntarily request pr agree to it
Nonvoluntary euthanasia
Euthanasia performed when patients are not competent to choose it for themselves and have not previously disclosed their preferences
Involuntary euthanasia
Bringing about someone’s death against her will or without asking for her consent while she is competent to decide
Active voluntary
Directly causing death (mercy killing) with the consent of the patient
Active nonvoluntary
Directly causing death (mercy killing) without the consent of the patient
Passive voluntary
Withholding or withdrawing life-sustaining measures with the consent of the patient
Passive nonvoluntary
Withholding or withdrawing life-sustaining measures without the consent of the patient
Physician-assisted suicide
A patient’s taking her own life with the aid of a physician
AMA has denounced PAS
Many people (including some physicians) support its use
Legal in Washington D.C., California, Colorado, Hawaii, Oregon, Vermont, Washington, Montana
Managed care
A system for providing health care to a particular group of patients (members of the system) using restraints to control costs and increase efficiency
Distributive justice
Justice regarding the fair distribution of society’s advantages and disadvantages
Libertarians theories of justice
Doctrines holding that the benefits and burdens of society should be distributed through the fair workings of a free market and the exercise of liberty rights of noninterference
What matters most is individual freedom and a person’s right to direct their own life for themselves
Utilitarian theories of justice
Doctrines asserting that a just distribution of benefits and burdens is one that maximizes the net good (utility) for society
What matters most is not individual liberty but the common good, what’s best for the community as a whole
Egalitarian theories of justice
Doctrines affirming that important benefits and burdens of society should be distributes equally
Triage
The sorting and allocation of treatments to patients in an emergency to maximize the number of survivors in medical emergencies
Epidemic
The phenomenon in which a disease occurs in larger numbers than expected in a particular population and geographic area
Pandemic
An epidemic that has spread worldwide
Quarantine
The separation from others of people who have been exposed to disease
Self-isolation
the practice of asking people who are sick with a contagious disease or have symptoms to stay home and go out only in an emergency
Racism
The belief that some races are inferior in important ways or are otherwise deserving of dislike or hostility
Individual racism
Person-to-person acts of intolerance or discrimination
Institutional or structural racism
Unequal treatment that arises from the way organizations, institutions, and social systems operate
Racial prejudice
Antipathy towards a racial group based on a faulty view of that group
Racial discrimination
Unfavourable treatment of people because of their race
Implicit bias
A negative attitude toward a group of people that operates unintentionally or unconsciously
Rachels claims that since physicians withhold treatment during passive euthanasia, and are therefore responsible, this situation is open to moral assessment. Callahan disagrees with Rachels on this point. Explain both of their respective positions.
Callahan proposes that ‘unbearable suffering’ is not enough on its own to justify active euthanasia. What is his argument? Do you agree with his position? Defend your answer.
What moral distinction does Thomson rely on to argue that we do not always have an obligation to keep even a person alive in certain situations? Does this distinction always help her position, or does it sometimes hurt her position?
Warren has to provide an argument displaying why infanticide is morally wrong, since her position on abortion seems to sanction such an act.Explain her argument.Do you agree with her argument?
Active vs. Passive euthanasia
Active euthanasia is killing
Passive euthanasia is letting die
AMA has sanctioned the distinction
Some argue that there is no morally significant difference between mercifully killing a patient and mercifully letting the patient die
Traditional view of death
Cessation of breathing and heartbeat
Standard in law and medicine view of death
Whole brain view: An individual should be judged dead when all brain functions permanently stop
Alternative notion view of death
Higher brain standard: individuals are dead when the higher brain functions responsible for consciousness permanently close down
Active voluntary euthanasia: arguments for autonomy
Respecting people’s inherent right of self-determination means respecting their autonomous choice about ending their lives
Active voluntary euthanasia: arguments for beneficence
If we are in a position to relieve the severe suffering of another without excessive cost to ourselves, we have an obligation to do so
Active voluntary euthanasia: arguments against - moral difference between killing and letting die
Killing is worse than letting die, so giving a patient a lethal injection to effect an easy death is wrong, but disconnecting his feeding tube may be permissible
Active voluntary euthanasia: arguments against - moral difference between intending someone’s death and not intending but foreseeing it
The former is wrong; the latter is permissible
Coronaviruses
cause respiratory illness in humans, (SARS, MERS, the common cold, and COVID-19)
COVID-19 (SARS-CoV-2)
Causes mild symptoms in most people but severe illness and death in others
Ezekiel J. Emanuel et al.’s four fundamental values that should govern resource allocation
Maximizing the benefits
Treating people equally
Promoting and rewarding instrumental value
Giving priority to the worst off
Criteria should not be used to decide who has access to a limited or scarce resource
Wealth
Fame
Political power
First-come, first-served
Moral worth
Social utility
Allocating pandemic resources, unreasonable assumptions might bias decisions, including:
Health status: disability does not always indicate compromised health
Quality of life: disabled people do not necessarily have lower quality of life
“Social utility”: disabled people are no less valuable members of society
Misinformation
A falsehood, a statement that is factually incorrect
Disinformation
A deliberate falsehood, a statement that is factual incorrect on purpose (a lie)
Deliberate deceivers
Knowingly traffic in lies to score partisan points, show support for their tribe, troll the opposition, exact revenge, or make a buck
Self-deceivers
Motivated to hold false beliefs despite contrary evidence
Bullshitters
Don’t care whether what they say is true or false, but intend to deceive their audience about their motives
Read critically
Accept claims hat are supported independently by reliable authorities, evidence, or claims that you know to be true
Accept claims that are adequately supported by the source itself through citations to other credible sources (experts, research, reports, etc.) or through references to supporting facts
Reject claims when there is good reason for believing them false
Suspend judgment on claims that you are unsure of, for it is unreasonable to accept a claim without good reasons, and the only cure for uncertainty about a source’s claims is further research ad reflection
Racism involves:
Inherency
Inferiorization
Racial antipathy
Inherency
The notion that certain traits of mind, character, and temperament are inescapably part of a racial group’s nature
Inferiorization
The treatment of certain groups as inferior to other groups
Racial Antipathy
General racial bigotryy, hostility, and hatred
Racism is empirically wrong
The consensus among scientists and scholars is that the traditional view of races- that there are distinct groups of peoples sharing significant biological characteristics- is false
Race has no physical scientific bases
Race is a social construction, an idea we endow wth meaning through daily interactions
Scientific Racism
The attempt to prove there are spirit races, race explains basic differences among people, some races are superior to others
Scientific Racism Discredited
Based on obvious biases, faulty assumptions, methodological errors, and motivated reasoning
Why not discard the concept of race?
Race-based social grouping has led to real differences in resources, opportunities, and well-being
The concept of race must be conserves in order to facilitate race-based social movements or policies
Racism is morally wrong: Respect for persons
Persons posses inherent worth and have rights- the rights of free expression, choice, and privacy, the right not to be coerced, enslaved, cheated, or discriminated against
Racism is morally wrong: Principle of justice
Equals should be treates equally unless there is a morally relevant reason for treating them differently- and racial difference is not morally relevant
Racism is morally wrong: Utility
We should produce the most favourable balance of beneefit over harm for all concerned and racist beliefs, words, and actions can do harm or lead to harm that is magnified when operating through institutions, corporations, governments, and the law.
Health disparities and race: Infant mortality
The number of infants who die before their first birthday per 1000 live births
In 2013, the infant mortality rate among African Americans (11.1 per 1000 live births) was double the rate among whites (5.06 per 1000 live births)
American Indians/ Alaska Native and Puerto Ricans also experienced higher infant mortality rates (of 7.61 and 5.93 per 1000 live births, respectively) than whites
Health disparities and race: Life expectancy
A measure of the overall health of a population, typically expressed as the average number of years a newborn would be expected to live
In 2014, the life expectancy for white males was 7.65 years, African American makes was 72.0 years, Latino males was 79.2 years
In the same year, life expectancy was 78.1 years for African American females, 81.1 years for white females, and 84.0 years for Latina females
Health disparities and race: Age-adjusted death death rates
Sum of deaths in a population from all causes except old age
The age-adjusted death rate per 100 000 (for the years 2012-2014) was 729.1 for whites and 858.1 for African Americans
The death rate due to heart disease was 165.9 deaths per 100 000 for whites and 206.3 deaths for African Americans
For cancer the death rate was 161.9 for whites but 185.6 forAfrican Americans; for diabetes, 19.3 for whites, 37.3 for African Americans
Reasons for Race-Based health disparities
Laying the blame on socioeconomic status (SES) is too simplistic:
Chronic exposure to racial discrimination has deleterious effects on the physical and mental health of individuals
Residential segregation can exacerbate the rates of disease among minorities and reduce the sense of urgency about the need to intervene
Implicit bias and prejudice leads to widespread differences in health car by race and ethnicity
Race-Based Medicine
Using race as a factor in determining appropriate treatment for patients
Problems:
Drug treatment based on a population-level study ignores interracial differences
It assumes that race is the best predictor available, but the rate at which a drug is metabolized varies as a result of many factors, including environment and lifestyle
There is no reason to treat race as an independent variable that causes or explains differences in treatment response
Preference utilitarians
Holding that rights actions are those that satisfy more of a person’s preferences overall
Doctrine of double effects
Permits actions that have unintentional results
Kant’s theory on euthanaisa
Suicide is prohibited because it treats the persons as mere thing and obliterates personhood (it degrades human nature below the level of animal nature and so it destroys it)
Competent persons must not killed or permitted to die
Recommendation in COVID-19 resource allocation
The value of maximizing benefits is most important
Testing, PPE, ICU beds, ventilators, therapeutics and vaccines should go first to front-line health care workers and others who care for ill patents and who keep critical infrastructure operating and are difficult to replace
Of similar prognoses, equality should be invoked and happen through random allocation
Prioritization guidelines should differ by intervention and should respond to changing scientific evidence
People who participate un research to prove the safety and effectiveness of vaccines and therapeutics should receive some priority for COVID-9 interventions
There should be no difference in allocating scarce resources between patients with COVID-19 and other medical conditions
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