Medical Ethics Exam 2

Resource Allocation

How to best distribute resources at both the macro and micro levels

Sources of rights

1. The goverment

2. God

3. Just being human

Justice protecting entitlements/ Libertarian view

1. The people John Locke and Robert Nozick

2. The idea is others cant cant take property owned by you( public healthcare is stealing your labor)

3. The implication is that healthcare is privilege not a right and you don’t have the right to use someone else’s resources to pay for it

Justice as fairness/ equality

1. Justice requires a fair distribution of resources

2. A just society could consider healthcare as a right

The political dimension

Relay on your reflection and training, not on rhetoric and pre justice

What are exotic life saving treatments

The number of life-saving treatment need are greater than the availability

Two major questions for ELT

1. Who gets selected

2. Who get to make the selection

Reacher to stages

1. Criteria for inclusive/ exclusion

2. Criteria of selection

( Rescher) Process of selection

1. Simple

2. Plausible

3. Rationally defendable

Stage 1- Inclusion/ Exclusion

1. The constituency factor

2. The progress of science factor

3. The prospect of success

Stage 2- Criteria of Selection

1. Relative likelihood of success

2. Life expectancy factor

3. Family role factor

4. Potential future contributions factor

5. Post- services render factor

Rescher’s conclusions

They suggest a point system plus randomness with those with equal point totals

HCFA recommendation

The recommendation is medicare should cover transplant people with end-stage alcohol disease who quit alc

Initial considerations

1. Livers are a non renewable resource

2. +50% are ESLD are ARESLD

3. Over 120l people on current waitlist

4. 6k people will die this year

5. Transplant needs $ and support, w/o public support procedures might be taken away

6. Cause of ARESLD will disqualify them from other organ transplants (heart)

Moss/siegler proposal

Patients with ARESLD not = with other candidates for liver transplants

Prioritizing allocation

1. To each an = share of treatment

2. Each similar treatment for similar cases

3. Treatment acc to personal effort

4. Treatment acc to ability to pay

(They reject all but #3)

Moss/siegler cons

Alch is a result of personal choice but results in chemical dependency and biological need on it. So is it really a free choice?

Anti agist argument assumption

1- life has an absolute value to those who value it

2- all life is =

(Regardless of age)

Premises of anti-ageist argument assumption

1- life is precious for those who wish to live

2- life is precious, if not more so, to those with limited time

Conc: its great injustice to deny someone in this condition the rest of their life

Fair innings argument

Created by harris

A reasonable life span is 70 and anything after is bonus time

Conc: if you reach 70 then you are denied resourced in favor of younger patients

Two institutions of fair innings

1- anti ageist institution (life is precious for those who want to continue there)

2- the old should not be given endless treatment at the expense of the young

Justifying fair innings

Always a misfortune to die when they want to live, it is not a tragedy to die of old age

Argument might be salvageable if used as a guiding principle in easier cases

Harris’ conclusions

• respect wishes of those who want to live if not past fair innings

• Only one suffered further injustice of being deprived a fair innings

Thompson’s first step

The fetus is a person

Thompson’s basic arguments

1- every person has a aright to life

2- the fetus is a person from moment of conception

3- the fetus has a right to life

4-it’s always wrong to kill something that has a right to life

5- abortion is the killing of a fetus

6- hence, abortion is always morally wrong

Thompson’s philosophy

Classical liberalism

Thompson’s classical liberalism

1- have a right to control what happens to and inside your body

2- generally this right overrides the violinist’s right to use your body

Both are assumed not argued for

Thompson’s reply to extreme anti-abortion

You have a right to defend yourself even if it kills the fetus

Abortion permissible to save the life of the mother

Thompsons view on: Does the fetus have the right to the mother’s body if she was raped?

NO, she did not give the right to use her body

Thompson’s view on: If the mother had voluntary sex with precautions, but still got pregnant?

NO, she did not give the right to use her body

Thompson’s view: Do we have to give up our life to keep another alive?

No, we can not force anyones hand

Abortions that are not unjust killings?

1. Abortions with the patient being a rape victim

2. If the patient will lose their life

3. An abortion where precautions were taken

The good Samaritan

Someone who does more than morally required

Minimally decent Samaritan

Someone who does what is morally decent but not more than required

Thompson’s thought on good Samaritans

We should all be good smaritans

Morally indecent Abortions

1. Abortions of Convience

2. Late-term Abortions

What qualification does something need to be considered a person and a serious right to life?

Self Consciousness

Thompson thinks that keeping the baby under any circumstance would be morally decent? T or F

T

Where does Finnis believe a person starts?

Conception

What is a direct Abortion and are they wrong?

An abortion directly trying to kill the baby and always yes

What are Finnis’ two ethical points?

Justice and non-maleficence

Would Finnis support a rape abortion?

No, because after conception that fetus is a person

Would finnis support a mother-fetal conflict abortion?

Yes, becuase you have the right to self defense

Who is involved with Abortion?

Anyone that made the decision or opinion to have one

What is the double effect?

When it is sometimes permissible to cause harm as a side effect of bringing about a good result, but not if you mean to cause harm as a means to bring the same good end.

Ex: falling into grenade vs. suicide

Self defense vs murder