HAP 416 Final

Job

A position based on specialization from background and qualifications.

Profession

Def 1: A body of knowledge shared by a group of individuals with a specialized education and training and common value

Def 2: A disciplined group of individuals who adhere to high ethical standards. Uphold themselves to, and are accepted

Vocation

A calling or way of thinking.

Ignatian Vocation Discernment

“spiritual interpretation and evaluation of feelings.. particularly in the direction to which they move us”

Desire

primary way God leads people to discover their purpose

Discernment

recognizes and responds to one’s vocation(s)

i.e., Gods call through desires

Consolation

admits discernment - naturally a sense of peace, trust your gut

• perfect happiness or perfect peace

• imperfect peace

Desolation

life movements signaling that you’re on the wrong path

• anything that moves you toward hopelessness

Indifference

Freedom from bias or impartiality.

Nonmaleficence and negative duty

no harm

• duty to do no harm

Beneficence and positive duty

do good

• positive duty in or out of compassion

What is the relationship between values, principles, and norms?

ethics and professionalism are intertwined and the standards are shaped by value, principle, and norm

Principles

Articulated concepts reflecting human dignity.

What is the purpose of Ethical and Religious Directives (ERDs)?

the purpose is to help guide the audience on some specific moral issues facing Catholic health care

Who is the audience of Ethical and Religious Directives (ERDs)?

the audience are those involved in Catholic institutions and services

What is the background of the Belmont Report?

Goes back to the 1979 Tuskegee study

• DHHS adopted the Belmont Report as a statement of its policy

• The content of the Belmont Report was incorporated into federal regulation that govern research on human beings

Principles of the Belmont Report

respect for persons (informed consent), beneficence (assessment of risk), and justice (giving what’s due).

Individual versus social good of research — Panicola et a. topline summary

The desire to pursue scientific inquiry must never be allowed to trump the interests and inherent value [dignity] of the irreplaceable human beings who enroll in such research… humans must never be treated as a means to an end

Triple Bottom Line

Focus on people, planet, and profit in decision-making.

• for-profit healthcare maximizes economic profit

• nonprofit healthcare bodies the Triple Bottom Line “posits firms commit to social and environmental impact — in addition to other financial performance rather than solely focusing on generating profit or std bottom line”

Externality

Costs or benefits affecting third parties rather than the producer

How does the Catholic Social Teaching measure economic justice?

Catholic Social Teachings reject the notion that a free market automatically produces justice

• state and subsidiarity

Economic Justice

Giving what is due through rights and duties.

Personal Position

Belief that personhood begins at conception.

• implication for abortion = the right to life establishes an absolute obligation never to intend the destruction of innocent human life

• implication of IVF ethics = “unused” embryos are human persons with legal and moral rights

• stem cell research = “to call cloning for this purpose ‘therapeutic’ is little misleading.. it is not therapeutic for the embryo, which has to be destroyed for its stem cells to be obtained”

Nonpersonal Position

View that personhood does not start at conception.

• implications for abortion = right to autonomy is absolute “my body, my choice”

• implication of IVF ethics = none

• stem cell research = using embryos for research are beneficial for future healthcare treatments

Principle of Double Effect

Criteria for morally permissible actions with unintended consequences.

What are the four criteria for the Principle of Double Effect?

1. The primary action [object, intention, and circumstance] itself is good or indifferent

2. “The good effect is not produced by the means of the evil effect”

3. “The evil effect is not directly intended”

4. “A proportionate reason supports causing or tolerating the evil effect”

Issue Stance

Judging problems, diagnosing causes, and proposing solutions.

Ethical Standards for Critically Ill Newborns

Medical indication, best interest, and quality of life criteria.

medical indication standard

standards are decisions based exclusively on data

• any treatment judged to be medically beneficial

best indication standard

standards are decisions based on the “best interest” of — and only of — the newborn

relational quality of life standard

standard says life is good but must be protected “insofar" as it offers hope in striving for other goods”

Physicalism

Actions conform to physical laws.

Personalism

Actions promote the flourishing of persons.

Stem Cells

Differences between Embryonic and Adult stem cells.

Medical Futility

Continuing treatment unlikely to succeed or lack of reproducible benefits.

Values

Intuitive, experiential importance – experience the worth of a human person

Norms

Rules that guide action to protect/promote values/principles

Public Service

Altruism as “sacrificing oneself for the public good”

Self-Regulation

“Ability to govern or monitor oneself”

Autonomy

Ability to independently organize work, make decisions, and take action

Direct abortion

Primary purpose is ending the life of the fetus for a goal other than saving the mother's life

Indirect abortion

Fetus dies as a side effect of actions primarily to save the mother's life

Foreseen effects

One good and intended, one evil and unintended

Morally obligatory treatment

“One is only morally obligated to use medical means that offer a proportionate hope of benefit without imposing an excessive burden or an excessive expense on one's family or the community” (281)

Killing

you’re culpable for withholding or withdrawing morally obligatory treatment

Letting die

you are not culpable for foregoing treatment that is not morally obligatory

two types of stem cells

ESCs: embryonic stem cells obtained from five- to seven-day-old embryos called blastocyst

ASCs: adult stem cells are found in the human body once it has developed beyond the blastocyst stage… adult stem cell term is misleading

“Bridge cells” Embryonic Germ Cells (EGCs)

potency of two types of stem cells

ESCS are pluripotent - can become different types of cells and potentially more readily available

ASCs and EGCs are multipotent - believed to be limited to becoming only the type of cell the tissue found in

Formal Cooperation with Evil

One foresees and intends that an action will advance the moral evil of another | Active

Never permissible

Material Cooperation with Evil

One “foresees but does not intend that his or her action will” advance the evil of another | Passive

Permissible under some circumstances

criteria of Medical Futility

continue treatment when [A] highly unlikely to succeed in achieving its desired ends or [B] when its rare, beneficial exceptions cannot be systematically explained or reproduced

• [A] is subjective: likely futile given circumstances. e.g., chemotherapy to a non-cancer patient

• [B] is objective: not standard of care due to lack of replicable scientific research. e.g., this worked once so…