Biomedical Ethics Final

What are the two main aspects regarding the development and use of informed consent?

Development includes legal standards and ethical debate; Use includes therapeutic and medical research.

What is one element that determines a patient's competence for informed consent?

A patient's ability to assess their interests and determine how to promote them.

What kinds of coercion must be absent for consent to be considered voluntary?

Consent must be free from physical and moral coercion.

What is the Kantian defense of the value of autonomy in informed consent?

Autonomy must be respected as rational agents are self-legislating.

According to John Stuart Mill, what is essential for self-realization?

The principle of autonomy must be respected, as each individual is in the best position to understand their personal interests.

What legal case established that simple consent practices in modern medicine were initially justified by patient cooperation?

Longstanding practice and justification in civil law handled as a case of battery.

What is the Professional Standard in legal standards for informed consent?

Relevant information is determined by what a reasonable and knowledgeable physician would believe is relevant.

What are the elements of disclosure in informed consent?

Nature of the procedure, risks, alternatives or options, and physician-specific information.

Name one exception to the informed consent requirement.

Emergency situations or therapeutic privilege.

What general standard defines incompetence in terms of informed consent?

A patient must have the ability to make decisions evidenced by their ability to understand and appreciate the nature of the decision.

What are some dangers in human research related to informed consent?

Researchers may be motivated by purely utilitarian concerns or self-interest.

What challenges are associated with meaningful informed consent?

Complexity of information conveyed and risks of errant interpretation.

What should be evaluated when critiquing a consent form?

Language clarity, understanding level, and suggestions for revision.

How should medical professionals interact with patients to ensure informed and voluntary consent?

They should ensure accuracy of interpretation and avoid coercive practices.

What historical practices are encompassed under the term 'infanticide'?

Infanticide has a long history including practices such as human sacrifice, sexual selection, and responding to birth defects.

What exception exists regarding the practice of infanticide among historical contexts?

Abrahamic religions serve as an exception to the practice of infanticide.

Under what circumstances is infant euthanasia considered legitimate in the US?

Infant euthanasia is only considered legitimate in cases of medical futility.

What is the incidence of infant euthanasia in the Netherlands based on births per annum?

Out of 200,000 births per annum, 1,000 infants died in the first year, with 600 involving a conscious decision to end life.

How does infant euthanasia differ from adult euthanasia?

Infant euthanasia lacks voluntary judgment that protects autonomy.

What are some considerations if the practice of infant euthanasia is deemed permissible?

Considerations include the medical conditions that justify euthanasia, the quality of life, prognosis, and whether factors beyond the patient’s health should be considered.

What are the five criteria of the Groningen Protocol adopted in the Netherlands in 2002?

1. Diagnosis and prognosis must be certain. 2. There must be hopeless and unbearable suffering. 3. Confirmation by at least one independent doctor. 4. Informed consent from both parents. 5. The procedure must follow accepted medical standards.

What percentage of Americans die in a medical facility?

85% of Americans die in a medical facility such as a hospital, hospice, or nursing home.

What does 'good death' refer to in terms of euthanasia?

A good death includes being peaceful, free from fear and pain, and having lucidity and resolution.

What are the types of euthanasia?

Active, Passive, Voluntary, Nonvoluntary, Involuntary, Assisted, and Unassisted.

Is voluntary passive euthanasia legal?

Yes, voluntary passive euthanasia is legal and often practiced, including do not resuscitate orders and living wills.

What is medical futility?

Medical futility refers to situations where treatment is unlikely to benefit the patient, which can lead to passive euthanasia with surrogate consent.

What is locked-in syndrome?

Locked-in syndrome is a condition where a person is aware and can think but cannot move or speak, except for eye movements.

What is the stance on voluntary active euthanasia in the U.S.?

Voluntary active euthanasia is illegal throughout the United States.

What argument is commonly made against physician-assisted suicide?

The argument against physician-assisted suicide often cites the sanctity of life and the devaluation of life.

Who argues that there's no meaningful distinction between active and passive euthanasia?

James Rachels argues that there is no meaningful distinction between active and passive euthanasia.

What ethical assertion is made regarding the medical community's mission?

The mission of the medical community is to provide treatment and comfort while adhering to the principle of 'do no harm.'

What does the Patient Protection and Affordable Care Act focus on regarding health insurance?

It aims to ensure universal coverage and prevent issues related to experience rating.

What are the two strategies for balancing risks in health insurance?

1. Hike rates for high-risk cases or eliminate them from the pool. 2. Increase low-risk individuals in the risk pool.

What are the components of experience rating as a risk balancing strategy?

Higher rates for high-risk individuals and the elimination of the highest risk cases.

What is universal coverage under the ACA designed to avoid?

Denial of insurance for pre-existing conditions, cancellation of insurance due to chronic illness, lifetime limits, and increased costs based on risk.

What was one significant trouble faced by the ACA in December 2014?

Defunding of risk corridors.

What impact did the repeal of the individual mandate in December 2017 have on insurance coverage?

An estimated 13 million less insured by 2027 and a 10% increase in ACA compliant premiums.

What did the February 2018 proposed regulation aim to change regarding short-term insurance policies?

It aimed to extend the duration of short-term limited-duration policies from a maximum of 3 months to 1 year.

What was the result of the Texas v United States case filed by 20 state Attorneys General?

It sought to either rule the ACA unconstitutional or at least strike down guaranteed issuance and community rating.

What percentage of the US population aged 18-64 has some pre-existing condition according to the KFF study 2015?

27% of the US populace aged 18-64 has some pre-existing condition.

What was the situation regarding pre-existing conditions before the ACA in 2010?

42% of adults aged 50-64 seeking insurance were either denied, faced higher premiums, or had conditions exempted from coverage.

What issues are related to access to health care?

1. Incomplete health insurance coverage. 2. Differential access to medical procedures. 3. Regional access to medical services. 4. Obligations of developed nations to the Third World.

Before 2014, how many Americans lacked health insurance?

Over 40 million Americans.

What were the factors leading to the infeasibility of direct payment for health care in the early 20th century?

1. More frequent use of surgical techniques. 2. More hospitals. 3. New drugs (antibiotics).

What is Blue Cross known for?

Hospital coverage, originally managed by state medical associations.

What year was Medicare established?

1965.

What does Medicaid provide coverage for?

State run insurance program for the poor.

How did the introduction of Medicare and Medicaid impact health insurance coverage?

Greatly expanded coverage but exacerbated the problem of rising costs.

What major problem concerning health coverage increased prior to the ACA?

Over 40 million Americans lacked health coverage.

What is one major research finding related to the utilization of health care by the insured versus the uninsured?

The insured receive 90% more hospital services.

What is distributive justice in the context of health care access?

The just distribution of social goods, where society must ensure adequate health care access.

What are the two rights of property proposed by John Locke?

A. Right of use B. Right of dispensation (exchange, bequeath, etc.)

What is the significance of the Starfield study (1998)?

US ranks low in various health outcome metrics compared to other developed nations.

What is the Oregon Medicaid reform of 1994 known for?

Adding 100,000 to Medicaid rolls and prioritizing treatments through administrative rationing.

Who proposed the concepts of negative and positive liberty?

Kai Nielson.

What is the main critique of the U.S. health care system according to the ethics of access?

Although the US leads in health expenditures and technology, it does not lead in health outcomes.