Bioethics Chapter 2 Short Response

Requests to Die: Terminal patients and nonterminal patients

What was Elizabeth Bouvia’s medical condition when she wanted to die?

Cerebral palsy

What reasoning did Judge Hews use to justify forcing Bouvia to stay alive?

He decided based on the “profound effect on the medical staff, nurses, and administration of the hospital,” as well as the effect her death could have on other handicapped individuals.

Did Judge Hews ever declare Bouvia incompetent? What is the legal significance of this?

No, he acknowledged her reasoning behind her decision. The significance was that, as Bouvia’s competence was acknowledged, it brought attention to how competent individuals have the right to privacy, even if it does not align with the hospital.

According to Paul Longmore, Bouvia’s decision to kill herself was caused by social prejudice and lack of resources for her care. Explain Longmore’s argument.

People with Cerebral palsy have very difficult lives, as they are not able to do anything without the assistance of others. Bouvia herself stated how her quality of life was over due to her condition, and the difficulties of living with the condition only furthered her thoughts into suicide.

The way society treats people with disabilities.

What did the state appellate court rule in Bouvia’s case? How many years before the Cruzan decision was that ruling?

The court held that competent adults could refuse medical treatment. This ruling was 5 years before the Cruzan case.

What’s the Catch-22 situation (circular reasoning) that Bouvia found herself in when she tried to argue that it was rational to kill herself?

Circular reasoning is the situation in which the reasoner begins with what they are trying to end with. Bouvia wanted to establish plausible reasoning as to why she could end her life through the establishment of mental stability, but by wanting to end her life, it alluded to the idea that she could have mental issues.

How did Larry McAfee become paralyzed? How did he exhaust his medical insurance?

He fell off his motorcycle and snapped his head. He remained for over a year at an expensive spinal center

What legal victory did McAfee achieve?

Judge Johnson ruled in McAfee’s favor regarding his right to die.

How did paying for a group home for McAfee become an issue of state/national public policy about allocation of resources?

Federal regulations affected Medicaid, blocking its use for people with disabilities in group homes.

Did Bouvia and McAfee die? If so, how?

Neither killed themselves.

How did Marcus Aurelius and other Stoics argue for the open door?

By stating, “If the room is smoky, if only moderately, I will stay; If there is too much smoke, I will go. Remember this, keep a firm hand on it, the door is always open.” This quote suggests that someone can walk out of a room, but they can also stay in the smoky room, depending on their situation.

How did Socrates die? For him, what was the goal of studying philosophy?

He was sentenced to die by drinking poison. Philosophy translates to “love of wisdom,” so for Socrates, he wanted to determine how to live a life that would allow him to face death with no fear.

Explain the arguments put forth by Immanuel Kant against suicide.

Kant argued that God has a purpose for us when putting us on this Earth, so we should not give it up. To add, Kant viewed suicide as a selfish act, which “can’t justify moral actions,” but rather goes against the rules that God has set in place. “Man not use his freedom against himself to his own destruction.”

Explain David Hume’s arguments on why suicide by terminally ill patients is not immoral or blasphemous.

Hume argued that God made the “law of causality,” so sickness and disease belonged to the world.

How is John Stuart Mill’s principle on harm ambiguous about the morality of suicide?

His principle entailed the idea that as long as others were not harmed, we can do what we want to our bodies. This statement leaves room for debate because suicide is harm to oneself that leads to death, but taking Mill’s principle into account, he states that suicide is okay as long as others don’t get hurt. Clashing statement.

What is Disability Culture, and how has it grown as a force to be reckoned with in medicine over the last two decades?

Disability culture is the lifestyle that is shaped by disabilities. Before WWII, many diseases were quick and deadly, so it was a passive subject, but now in the twentieth century, people live longer but die slowly from different diseases, bringing more attention to different diseases that lead some individuals to want to cut their lives short.

What easy way is there for terminal patients to die without requesting a physician’s assistance with drugs?

Not eating

Anoxia at birth is associated with

Crebral palsy

When did Elizabeth Bouvia win her case?

1985

Godwin’s Law

As online debates progress, the likelihood of participants comparing other to Adolf Hitler or the Nazis increases

Conceptual slope

Exploits the vagueness of a category to argue that there is no difference between things that belong to a category and things that do not.

Empirical slope

Determines what is right or wrong, good or bad, etc. within a bioethical category.

Consequentalism

Results and consequences

Deontology

Motives and intentions

Active euthanasia

Acting

Passive euthanasia

Committing

Legally, is an American patient competent until proven incompetent in

court?

Yes. Adults are legally presumed competent until a court formally adjudicates them incompetent in a legal hearing.

What rights did the Cruzan decision give to competent American patients?

The U.S. Supreme Court's 1990 Cruzan decision recognized that competent adult patients have a constitutionally protected liberty interest to decline unwanted medical treatment, even if withholding or withdrawing that treatment will result in death.

Why is citing the Nazi “euthanasia” program irrelevant to debates about Voluntary physician-assisted dying for terminal patients?

The Nazi "euthanasia" program (Aktion T4) was an involuntary, state-mandated mass murder program targeting disabled and vulnerable individuals without their consent. In contrast, modern voluntary physician-assisted dying requires an autonomous, explicit, and competent request from a terminally ill patient.

What is Godwin’s law?

is an Internet proverb asserting: "As an online discussion grows longer, the probability of a comparison involving Nazis or Hitler approaches one.

How long has physician-assisted dying been legal in Holland? Has it led to terrible abuses? What controversial cases exist on its extremes?

Since the 1970s/80s. Reviews show system adherence to strict procedural safeguards, though debates exist regarding oversight.

Controversial cases involve requests granted for non-terminal conditions, including severe psychological/psychiatric suffering, advanced dementia via advance directives, and cases involving young adults or tired-of-living cases.

How many patients did Jack Kevorkian help die? What were his methods What happened to him?

130 people. He utilized homemade devices, including the Thanatron (an injection machine delivering lethal drugs) and the Mercitron (a canister mask delivering carbon monoxide gas). He was convicted of second-degree murder.

Why was Dr. Anna Pou left in a tough spot by her colleagues at Memorial Hospital?

With what crime was she charged?

How did her defense invoke the Doctrine of Double Effect?

What did the jury decide about her?

Why was the case of Emmet Everett sensational?

Following Hurricane Katrina in 2005, Memorial Hospital lost power, running water, and air conditioning in extreme heat, while communication failed and prompt evacuation was unavailable.

Second-degree murder.

Defense arguments maintained her primary intent was to alleviate severe suffering and pain, even if it resulted in death.

Charges were dropped.

Emmett was overweight and was conscious, asking not to be left behind, but he was deemed to heavy to go up the stairs, so he was given a lethal injection.

Why is hospice care now not usually given in an institution?

Modern hospice care emphasizes comfort and quality of life in the patient's familiar surroundings, making home-based palliative care more patient-centered, personalized, and far more cost-effective than institutional inpatient care.

What different views exist about how the Nazi killings started?

One view attributes the origin to deep-seated ideological, racial hygiene, and eugenic doctrines promoted by the Nazi party. Another view emphasizes a gradual shift where economic pressures, wartime resource rationing, and institutional utilitarianism transformed medical care into state-sponsored killing.

Does the Hippocratic Oath forbid helping terminal patient die? Abortions?

Surgery? Women physicians?

Helping a patient die was forbidden. Abortion was forbidden. Surgery was forbidden, and there is no specific mention about female physicians.

How did Canada legalize physician-assisted dying for terminal patients? What was its name and why did Disability Advocates oppose it?

Canada legalized Medical Assistance in Dying (MAiD) in 2016 following the 2015 Supreme Court ruling in Carter v. Canada. MAID, and it was opposed because allowing assisted dying for non-terminal chronic conditions implies disabled lives are less worth living, often reflecting social neglect and systemic failures in support services rather than a genuine choice.

If someone botches her suicide, people say she was ambivalent about killing herself. Is this always true? Why or why not?

No. A failed attempt does not necessarily mean the individual was hesitant; it frequently stems from a lack of technical knowledge regarding lethal dosages, inaccurate administration, or unforeseen physiological reactions.

Why was it hard for Elizabeth Bouvia to prove her decision to die was rational? What question was begged against her?

Elizabeth Bouvia was severely physically disabled and severely depressed, leading critics and physicians to assert that her request to die was inherently a product of mental illness rather than a rational choice.

Opponents assumed that any decision to end one's life is automatically irrational, assuming the very point that needed to be proven.

Why did Paul Longmore oppose helping Elizabeth Bouvia to die?

What was his overall philosophical objection?

Paul Longmore argued that Bouvia's desire to die was a response to a society that failed to provide adequate home support, financial independence, and social resources.

He maintained that offering assisted dying in a prejudiced and unsupportive society creates an illusory choice, effectively forcing disabled people into death due to systemic discrimination.

How did UAB philosopher James Rachels famously argue that in some cases, killing some patients is more humane than letting die?

In cases of irreversible suffering, actively ending a life quickly and painlessly is more humane than allowing a prolonged, agonizing death.

How do conceptual slippery slopes differ from empirical ones?

Conceptual claims that if option A is permitted, there is no logical or principled boundary to prevent accepting option B.

Empirical claims hat permitting option A will set off a practical chain reaction of social or institutional events leading to option B in practice.

Why was Michael Swango infamous?

He was an American physician and serial killer who poisoned and murdered an estimated 60 patients and colleagues across multiple hospitals while misrepresenting his background.

What scandals happened in America about reimbursement for hospice care?

Fraudulent billing schemes where healthcare companies enrolled non-terminally ill patients into hospice programs to improperly collect higher Medicare and Medicaid reimbursements.