HLTH 380 Exam - Weeks 2-6 Content

Ethical dilemma

A situation where no option is entirely satisfactory because each violates an important value.

Metaethics

The study of the nature and status of morality itself.

Normative ethics

The study of standards for how one ought to act morally.

Applied ethics

Using ethical theories to address specific moral issues.

Bioethics

Application of ethics to medical, bodily, and technological issues.

Public health ethics

Approach for clarifying and justifying population-level health decisions.

Cultural relativism

Ethical values differ across cultures.

Subjectivism

Moral values are subjective; no universal right or wrong.

Moral realism

There are universal moral guidelines to distinguish right and wrong.

Utilitarianism

Ethical theory that judges actions by consequences and overall happiness produced.

Hedonic calculus

Bentham’s method for calculating pleasure vs. pain to choose best action.

Act utilitarianism

Evaluates each action individually by greatest happiness.

Rule utilitarianism

Says rules that promote overall happiness should guide behavior.

Strength of utilitarianism

Egalitarian and includes all affected beings.

Weakness of utilitarianism

Measurement problems, ignores non-pleasure values, predicts consequences poorly.

Deontology

Ethics based on duties and rules, not outcomes.

Good will

Only thing good without qualification; basis of moral action.

Duty

Actions are moral only if performed because they are one's duty.

Categorical imperative

Universal moral law that applies to all rational beings.

CI universal law test

Act only on maxims you would will to become universal laws.

CI humanity test

Treat others always as ends, never solely as means.

Strength of Kantianism

Emphasizes justice, dignity, and universality.

Weakness of Kantianism

Rigid, conflicting duties, difficult to apply maxims.

Virtue ethics

Focuses on character and being a good person, not rules or outcomes.

Teleology (Aristotle)

Everything has a purpose or goal.

Aristotelian happiness

Living well; flourishing, not pleasure.

Doctrine of the mean

Virtue lies between extremes; achieved through practice.

Strength of virtue ethics

Holistic, considers emotions, context.

Weakness of virtue ethics

Culturally specific virtues; not action-guiding.

Feminist ethics

Critiques traditional theories; emphasizes relationships, care, power, inequality.

Ethics of care

Moral reasoning emphasizing responsibility, relationships, and care.

Relational autonomy

Autonomy shaped by relationships and social context.

Strength of feminist ethics

Highlights marginalized voices, emotions, social inequalities.

Weakness of feminist ethics

May lack clear action guidance; internal disagreements.

Liberalism

Ethical focus on individual autonomy and minimal state interference.

Rawls’ theory of justice

Fairness and equal basic liberties; just society protects autonomy.

Harm principle

Only reason to restrict autonomy is to prevent harm to others.

Strength of liberalism

Respects individual choice.

Weakness of liberalism

Poor fit for clinical settings; conflicts of autonomy.

Distributive justice

Fair distribution of scarce goods, including healthcare.

Macro allocation

Government-level healthcare decisions.

Meso allocation

Hospital/health authority resource decisions.

Micro allocation

HCP decision-making with individual patients.

Inherent needs

Biological essentials needed to sustain life.

Subjective needs

Desires beyond essential needs.

Socially induced needs

Needs created by societal expectations.

Market distribution

Health treated as a purchasable good; creates inequality.

Utilitarian allocation

Maximize population well-being; basic care for all, extra by social worth.

Kantian allocation

First-come-first-served or lottery; universal fairness.

Virtue ethics allocation

Focus on goals of medicine and meaningful care.

Feminist allocation

Examines marginalization in resource access.

Liberal allocation

Emphasizes equal access, transparency, and autonomy.

Callahan natural lifespan

Care should support natural lifespan but not extend life beyond it.

Critique of Callahan

Natural lifespan hard to define and varies culturally.

Life-cycle allocation principle

Invest more in younger people, less in very young/old; egalitarian death.

Daniels prudent lifespan

Allocate healthcare across lifespan to preserve normal functioning.

Nudging

Subtle choice architecture guiding choices without removing freedom.

Features of nudges

Not coercive, preserves choice, minimal incentives.

Ethical issues with nudging

Transparency problems; risk of manipulation.

Engineering model

Physician provides facts; patient decides; no value judgments.

Critique of engineering model

Impossible to avoid value judgments; unrealistic.

Paternalistic model

Physician makes decisions for patient’s benefit; may use deception.

Critique of paternalism

Disrespects autonomy; assumes physician superiority.

Contractual model

Shared decision-making; mutual obligations; autonomy respected.

Critique of contractual model

Doesn't reflect real power imbalances.

Covenantal model

Ongoing partnership; trust-based; rooted in virtue ethics.

Critique of covenantal model

Idealistic, hard to apply broadly.

Moral distress

Knowing the right action but being unable to act due to constraints.

Moral uncertainty

Unclear what the right action is.

Moral agency

Professional responsibility to act ethically.

Moral residue

Lingering guilt after unresolved ethical conflicts.

Autonomy (capacity)

Ability to make an informed, voluntary choice.

Internal autonomy factors

Cognition, mental ability.

External autonomy factors

Social pressures, information access.

Beneficence

Do good.

Non-malfeasance

Do no harm.

Harm principle

Restrict autonomy only to prevent harm.

Informed consent requirements

Provide information, no coercion, ensure understanding, patient competence.

Feminist critique of autonomy

Traditional autonomy ignores oppression and social constraints.

Cultural humility

Recognizing limits of cultural understanding; patient-centered.

Cultural safety

Ensuring healthcare settings address systemic inequalities.

Therapeutic research

Research intended to improve patient's condition.

Non-therapeutic research

Research for knowledge; no benefit to participant.

Tuskegee study

US experiment withholding syphilis treatment from Black men.

Dr. Cameron experiments

Canadian unethical experiments on Indigenous children & psychiatric patients.

Hans Jonas

Research is not essential; protects individuals from exploitation.

John Harris

Moral duty to participate in research for societal good.

Equipoise

Genuine uncertainty about best treatment required for ethical RCT.

Phase 1 trial

Tests toxicity in healthy volunteers.

Phase 2 trial

Determines optimal dosing.

Phase 3 trial

Tests effectiveness vs. control.

Phase 4 trial

Post-approval monitoring.

Pharma manipulation

Suppression or alteration of research results for profit.

Olivieri scandal

Researcher fired after reporting drug harm; pharma interference.

Speciesism

Belief humans are morally superior to animals.

Abolitionist view

Animal research is always wrong.

Reformist view

Acceptable if pain minimized and benefits justified.

Non-malfeasance (public health)

Interventions should not cause unjustified harm.

Beneficence (public health)

Improve population well-being.

Health maximization

Intervention must improve health outcomes.