Bioethics: Justice, Rights, Healthcare Allocation, Abortion, and Ageism

Comprehensive vocabulary flashcards covering distributive justice, personhood theories of abortion, scarcity dilemmas in organ transplantation, and ageist versus fair-innings allocation models.

Justice as Fairness (Rawls)

The principle that justice requires a fair distribution of resources, such that some members of a society do not disproportionately benefit without a net benefit for all members.

Original Position

John Rawls' thought experiment where individuals make societal rules behind a "veil of ignorance" without knowing their future, ensuring morality and equal access under those circumstances.

Healthcare as a Privilege

The view that healthcare is not a right and no right exists to use another person's resources to pay for someone else's care; failing to work for the common good may be selfish or cruel, but it is not unjust.

Positive Rights

Entitlements to perform certain actions or to be in certain states (for example, the First Amendment right of free speech or silence).

Negative Rights

Entitlements that others not perform certain actions or enforce certain states upon an individual (for example, the right to not allow soldiers in your home).

Justice as Protecting Entitlements (Libertarian View)

The view associated with Robert Nozick and John Locke asserting that no person or government can seize property held by another, meaning using tax revenue to fund another person's healthcare is taking their labor away.

Deprivation of a Future Like Ours (FLO)

Don Marquis' explanation of why killing is wrong: killing deprives the victim of their valuable future experiences, activities, and enjoyments; because abortion deprives a fetus of a "future like ours," it is morally impermissible.

Marquis' Basic Syllogism on Abortion

The argument stating: 1. Depriving someone of a future like ours is morally impermissible; 2. Abortion deprives someone of a future like ours; 3. Therefore, abortion is morally impermissible.

Contraception under Marquis' Account

A practice considered morally permissible because prior to conception, there is no identifiable subject that has been deprived of a future like ours.

Active Euthanasia under Marquis' Account

A practice permitted under Don Marquis' framework in cases where a person faces only intractable suffering and pain, because they are not being deprived of a valuable future.

Exotic Life Saving Therapy (ELT)

Advanced medical technologies (such as heart transplants) whose potential candidate pool far outnumbers the available supply, creating Nicholas Rescher's scarcity dilemma.

Criteria of Eligibility (Rescher)

The initial general criteria used to establish the candidate pool for scarce therapy: constituency (geographic boundaries), progress of science (research needs to advance knowledge), and prospect of success (excluding groups where therapy has proven ineffective).

Case-by-Case Selection Factors (Rescher)

The individualized criteria for allocating scarce therapy: biomedical probability of effectiveness, life expectancy after treatment, and social/familial factors (family dependency, societal contribution based on age/skills, and services rendered in the past).

Ordinary View of Personhood (Finnis)

John Finnis's view holding that persons are nothing more than living human individuals, which should remain the default view until a superior one is established.

Human Person (Finnis)

Defined by John Finnis as: "any entity which, remaining the same individual, will develop into a paradigmatic instance of a substantial kind already is an instance of that kind"; thus, the one-cell organism formed at conception is already a human person.

Doctrine of Double Effect

The moral principle that it is sometimes permissible to cause serious harm as an unintended side effect of bringing about a good result, even though causing that harm directly as a means to achieve the good result is impermissible (e.g., performing a hysterectomy that results in fetal death).

Finnis's Ethical Principles for Healthcare Providers

The two primary rules guiding clinical decisions: 1. Do no harm; 2. Treat cases alike (justice).

Finnis on Rape and Prevention

The stance that a rape victim may use medical precautions to prevent conception as self-defense against the attacker's invading sperm, but once conception occurs, an abortion is impermissible.

Participation in Immorality (Finnis)

The principle that anyone who commands, directs, advises, encourages, prescribes, approves, or defends an immoral act actively participates in its immorality.

Self-Consciousness Requirement (Tooley)

Michael Tooley's condition establishing that an organism possesses a serious right to life only if it possesses the concept of a self as a continuing subject of experiences and other mental states, and believes that it is a continuing entity.

Right to Life (Tooley)

Defined not merely as a right to biological existence, but specifically as a right to continue existing as a subject of experiences.

Biological Cut-Off Points (Tooley's Critique)

Developmental benchmarks—such as conception, acquiring human form, spontaneous movement, viability, or birth outside the womb—that Tooley rejects because none are grounded in a basic moral principle of personhood.

Good Samaritan Standard (Thomson)

The moral notion that while one is not morally required to sacrifice bodily autonomy to save another, one may choose to carry a pregnancy if one possesses the necessary health and financial resources, or wishes to adhere to their personal moral convictions.

Violinist Thought Experiment (Thomson)

Judith Jarvis Thomson's analogy demonstrating that a person's classical liberal right to control what happens in and to their body overrides another person's (e.g., an ailing violinist's) right to use that body for life support.

Right to Life (Thomson)

The negative entitlement not to be killed unjustly, which does not grant an individual the right to use another person's body or force someone to provide the bare minimum necessary to keep them alive.

Thomson on Fetal Body Rights and Contraception

The distinction where a fetus has no right to the mother's body if pregnancy is caused by rape or if contraceptives were used, whereas if voluntary sex occurred and precautions were taken, the fetus is considered to have a right.

Ageism

Prejudice or discrimination directed against individuals based strictly upon their chronological age.

Anti-Ageist Argument

The view that life possesses absolute value to all who have it ($20\text{ years} = 3\text{ years} = 4\text{ weeks}$ from the patient's perspective) and is just as precious to those with little time remaining, making age an unjust factor in allocating medical resources.

Fair Innings Argument

The resource allocation theory proposing that there is a standard reasonable lifespan (typically $70\text{ years}$); individuals are entitled to reach this threshold, but once surpassed, they are living on "bonus time" and can fairly be denied scarce resources in favor of younger patients.

Harris's Threshold Equivalence

The rule under the fair innings argument that all individuals below the threshold (e.g., a $20\text{ year old}$ and a $65\text{ year old}$) are considered equal candidates; prioritizing the $65\text{ year old}$ over the $20\text{ year old}$ simply because they are closer to the threshold is unjust.

Misfortune vs. Tragedy (Harris)

John Harris's justification for fair innings: it is always a misfortune to die, but it is never a tragedy to die of old age.

ARESLD

Alcohol-Related End-Stage Liver Disease, which is caused directly by sustained alcohol use (such as alcoholic cirrhosis).

ESLD

End-Stage Liver Disease arising from various non-alcoholic causes (such as biliary sclerosis).

HCFA Recommendation vs. Secretary Sullivan Decision

The Health Care Financing Administration ($\text{HCFA}$) recommended Medicare cover liver transplants for alcoholic cirrhosis only if patients maintained sobriety, whereas Secretary Sullivan ruled that no required period of sobriety would be mandated.

Moss and Siegler's Proposal

The policy proposal that patients with ARESLD should not compete equally with other candidates for donor livers because developing ARESLD requires $10\text{ to }20\text{ years}$ of heavy drinking, making it a chronic, treatable illness for which the patient is responsible.

Chemical Dependency Critique (against Moss and Siegler)

The argument against penalizing ARESLD patients: while initial drinking may stem from free choice, advanced alcoholism produces chemical dependency and a biological need, meaning subsequent drinking is an unfree action for which the patient cannot be held morally responsible.