PHI FINAL

Necessary condition

a factor that must be present for something to follow (an event to occur, a definition to be met)

Sufficient Conditions

a factor whose presence guarantees that something follows (an event occurs, a definition is met)

IVF

In Vitro Fertilization; the unifying of egg and sperm in a petri dish

ART

Assisted reproductive technology; all procedures that aid reproduction

PGD

Pre-Implantation Genetic Diagnosis; the screening of embyros for genetic traits prior to implantation via IVF

Savior Siblings

children produced by IVF and PGD to serve as donors for ill children

Cloning

the asexual reproduction of genetically identical organism from an existing one

Reproductive cloning

aims to produce a live individual

Therapeutic cloning

creates a stem cell line for medical use in the donor patient

Surrogacy

gestating a fetus for others

Traditional surrogacy

the surrogate is impregnated by sperm from the social father (or a donor)

Gestational surrogacy

Surrogate gestates an embryo that is not from her eggs

somatic

bodily; refers to differentiated, diploid cells in the body (skin, muscle, nerves, etc.)

germline

haploid reproductive cells; eggs (oocytes) and sperm

somatic gene therapy

alters DNA in non-reproductive cells to treat an individual, with changes not inherited

germline engineering

modifies reproductive cells or embryos, making changes heritable for future generations

treatment/therapy

intervention aimed at treating disease and restoring functions and capacities to a baseline

enhancement

intervention aimed at improving functions and capacities that are already adequate

Euthanasia

directly or indirectly bringing about the death of another person for their sake

Active Euthanasia

involves directly bringing about the person’s death

Passive Euthanasia

allowing someone to die

Voluntary Euthanasia

with the consent of competent patients

Nonvoluntary Euthanasia

without the consent of noncompetent patients

Involuntary Euthanasia

without the consent of the competent patients

Physician assisted suicide

when a patient takes their own life with the assistance of a doctor

palliative care

care for patients without seeking to end the cause of their condition

Thompson on abortion

What if we grant that a fetus is a person, does that now make abortion morally impermissible? Famous violinist, rapidly growing child, Henry Fonda (good samaritan vs minimally decent samaritan)

Marquis on abortion

Killing is wrong because you are taking away a future like ours; the category of beings is accidental but the wrongness to kill is essential; at first sight (prima faci) abortion is immoral because it is killing; contraception is fine because it is not depriving an already potential life

English on abortion

the more personlike (more developed) the fetus is, the more murderlike the abortion is

Glannon on genetic enhancement

why enhancement would be morally objectionable

1. unfair advantage

2. if made fair it would be “collectively self-defeating”

3. if fair, everyone gets to baseline - undermine the value of equality

4. if we tried to make the species better it would undermine autonomy

Savulescu on genetic enhancement

1. Parents are obligated to bring about the best states of affairs for their children, so not enhancing is wrong

2. There is no relevant difference between environmental and genetic intervention

3. no difference between treatment and enhancement

Research cloning

creates stem cell lines for research purposes

Autonomy

A person's rational capacity for self-governance or self-determination. It is an individual's power to deliberate about available options, to choose freely among those possibilities, and to act accordingly.

Nonmaleficence

Do no harm.

Beneficence

Benefit others.

Utility

Bring about the most good for the most people.

Justice

People get what is fair or what they deserve.

Normative Ethics

Reflection on moral standards and norms.

Metaethics

Reflection on the foundation and meaning of morality.

Applied Ethics

The practice of applying ethical thinking to real situations.

Utilitarianism

Consequentialist theory in which one should act always to maximize the greatest happiness for the greatest number.

Act Utilitarianism

Act in every situation to maximize happiness for the greatest number.

Rule Utilitarianism

Act according to general rules that will maximize happiness for the greatest number (in the long run).

Kantian Ethics

Categorical imperatives: what one must do, by virtue of being a rational creature.

Categorical Imperative

Act only on that maxim through which you can at the same time will that it should become a universal law.

Principlism

Actions ought to be guided by a number of overlaid principles. Principles are applied prima facie, and can be overridden.

Natural Law

Belief that at least a significant portion of the moral law can be known from nature.

Doctrine (Rule) of Double Effect

Actions with multiple anticipated effects, some of which would be immoral to intend can be nevertheless ethical if: 1) The act we are performing is not unethical for some other reason... 2) The bad effect is not the means by which the good effect occurs ... 3) Only the good consequences are intended ... 4) The good done by the action outweighs the harm it inflicts. 5) We seek to minimize ... unintended harm.

Virtue Ethics

Focuses on the development of character that leads to human flourishing. Not a theory of right action. It is not enough to do the right thing... for the right reasons.

Rawls/Contract Theory

A just society is one that a group of normal, rational, self-interested people would choose from behind a 'veil of ignorance.'

Ethics of Care

Other types of theories go too far in the pursuit of impartiality and downplay healthy emotional attachments... Certain personal relationships ... ought to be governed by special considerations.

Feminist Ethics

Generally seeks to criticize views that devalue women's moral concerns ... and view women as immature and inferior.

Casuistry

Case based ethics... bases judgments on precedent, not principles... Reasons by analogy.

Tuskegee

Throughout the study, deprivation was assumed to be natural...not an isolated case of bad research ethics, but rather a product of racist medical community.

HIV Transmission Trials in the Developing World

Helsinki requires the 'best' current treatment, not the local one... Acceptance of this ethical relativism could result in widespread exploitation of vulnerable Third World populations.

Ontological

Respect is warranted by the way beings are. We respect persons because of their capacities, like sentience, consciousness, reason, etc.

Voluntarist

Respect is grounded in the choice of some authority. For example, persons are respected because society or God says so.

Paternalism

Overriding of a person's autonomy for their own good.

Weak Paternalism

When the patient lacks capacity for autonomy.

Strong Paternalism

Overrides the wishes of otherwise autonomous patients.

Competence

The ability to render a decision.

Informed Consent

When an autonomous, informed person consents to treatment or participation in research. Conditions: Patient competence; Adequate disclosure; Patient understanding; Voluntary decision; Consent.

Equipoise

Condition in which researchers do not know which treatment is better.

Experimental Group

Those getting the treatment being studied.

Control Group

Those not getting the new treatment.

Placebo-Controlled Trial

Tests the treatment against a placebo.

Active-Controlled Trial

Tests the treatment against best existing treatments.

Double-Blind

Neither the patient nor the researchers know who is getting which treatment.

IRB

The Institutional Review Board, a group at each research institution that must approve all research on human and animal subjects.

Coercion

The use of force or other pressure to compel someone to make decisions that may be counter to their preferences.

Exploitation

Taking advantage of a power differential that causes people to decide differently than they would on even ground.

Abortion

The ending of a pregnancy.

Spontaneous Abortion

Miscarriage.

Induced Abortion

Intentional abortion.

Therapeutic Abortion

To save the health or life of the mother.

Viability

The ability to survive (healthily?) outside the womb.

5 Principles of Bioethics

autonomy, beneficence, non-maleficence, justice, utility

3 levels of Ethics

normative ethics, metaethics, applied ethics

Ackerman, "Why Doctors Should Intervene"

The ethics of autonomy are usually reduced to noninterference... autonomy is limited by the realities of life. So, the obligation to respect a patient's autonomy implies a positive duty to interfere in order to address threats to autonomy (physical, psychological, social)

Hellman & Hellman, "Of Mice but Not Men"

The roles of physician and researcher are distinct... A medical trial puts researchers in both roles... This creates an ethical bind... Physicians are said to be in equipoise until such data is available. But, even if your views are speculative, you have a duty to communicate them to your patients

Brandt, "Racism and Research"

Pattern: racism harms people, then explains their condition via more racism... not an isolated case ... but rather a product of racist medical community