MEDRADSC 3Y03 - Bioethics

What is the definition of 'Ethics' as provided in the source material?

An area of study that deals with ideas about what is good and bad behaviour.

How is 'Medical ethics' defined in the source material?

An area of study that deals with the ethics of the physician/patient relationship.

Bioethics is described as a broad and general category of ethics dealing with _ ethics.

life

Medical bioethics is described as a combination of which three fields?

Medicine, law, and philosophy.

What typically brings about controversial ethical matters in medical bioethics?

Advances in biology, technology, and medicine.

What is the primary role of a bioethicist in the 'demi-discipline' of bioethics?

To collect facts, listen, take recommendations, and move through issues using debates towards a resolution.

What must follow the work of a bioethicist to inform decisions and changes?

Public discourse using reports, publications, laws, legislations, policies, and professional societies.

What controversial life-saving medical technology was introduced in the Seattle Artificial Kidney Program in 1962?

The world's first outpatient safe dialysis.

What was the main ethical problem with the Seattle Artificial Kidney Program?

The rationing of life-saving technologies.

Who was used to select patients for dialysis in the Seattle program, laying the foundations for triaging?

An anonymous lay committee.

Which two institutions collaborated on the Tuskegee Syphilis Study?

The Tuskegee Institute and the Public Health Service.

What was the stated purpose of the Tuskegee Syphilis Study?

To study and record the natural history of syphilis to justify treatment programs for African Americans.

The Tuskegee Syphilis Study, projected to last 6 months, actually continued for how many years?

40 years (from 1932 to 1972).

What deceptive local term were the men in the Tuskegee study told they were being treated for?

'Bad blood'.

What did the men in the Tuskegee study receive in exchange for their participation?

Free medical exams, meals, and burial insurance.

By what year did Penicillin become the standard treatment for syphilis, yet was still withheld from Tuskegee participants?

1947

What event in July 1972 led to a public outcry about the Tuskegee Syphilis Study?

An Associated Press story was published about the study.

What was the primary finding of the advisory panel regarding the informed consent of the Tuskegee study participants?

The men were misled and not given all the facts required to provide informed consent.

The advisory panel that reviewed the Tuskegee study concluded it was ' '.

ethically unjustified

In what year did the Assistant Secretary for Health and Scientific Affairs announce the end of the Tuskegee Study?

1972

By the end of the Tuskegee study, how many men died directly of syphilis?

28

Besides the participants, who else was negatively impacted by the Tuskegee study through infection?

40 wives were infected and 19 children were born with congenital syphilis.

What was the result of the 1973 class-action lawsuit filed on behalf of the Tuskegee participants and their families?

A $10 million out-of-court settlement was reached in 1974.

What was the name of the program established to provide lifetime medical benefits to living Tuskegee participants?

The Tuskegee Health Benefit Program (THBP).

In what year were wives, widows, and children added to the Tuskegee Health Benefit Program?

1975

Which U.S. President formally apologized for the Tuskegee Study in 1997?

President William J. Clinton.

What was the source of controversy in the Fetal Tissue Debate of 1973?

The usage of not yet dead fetuses and/or fetal tissue in experimentation.

The public outcry from the Fetal Tissue Debate resulted in a call for what?

A call for experts to come together to make public policy recommendations.

In Roe vs. Wade (1973), the Supreme Court decision was based on the idea that laws against abortion violated which amendment?

The Fourteenth Amendment.

What is considered the 'strongest candidate for the birth of bioethics' as a formal discipline?

The National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research (1975).

The principles of the National Commission for the Protection of Human Subjects were outlined in what legendary 1979 report?

The Belmont Report.

Aboriginal people make up approximately what percentage of the current population of Canada?

4%.

Of Canada's Aboriginal population, what percentage are First Nations?

60%.

What was the primary cause of the catastrophic 90% decline in the Indigenous population of North America by the mid-1850s?

The introduction of infectious diseases.

What 1876 legislation formalized the reserve system and made 'status' Indians wards of the state?

The Indian Act.

According to an 1876 Department of Indian Affairs report, the explicit purpose of Canadian legislation was to prepare 'the Red man' for a ' '.

higher civilization

What system, operating from 1883 until the mid-1980s, was used to inculcate Euro-Christian values in Aboriginal children?

The Indian residential school system.

Who was the head of the Department of Indian Affairs who, in 1920, made school attendance mandatory for Indian children?

Duncan Campbell Scott.

What did Duncan Campbell Scott state was the 'whole object' of his policy regarding Indigenous peoples?

To continue until there is not a single Indian in Canada that has not been absorbed into the body politic.

What were common conditions in the underfunded Indian residential schools?

Overcrowding, poorly trained staff, poor sanitation, inadequate nutrition, and physical, psychological, and sexual abuse.

The final report of the Truth and Reconciliation Commission (TRC) concluded that Canada had committed what against its Aboriginal peoples?

Cultural genocide.

What term describes the ongoing psychological effects on subsequent generations of those who attended Indian residential schools?

Intergenerational effects (or intergenerational trauma).

Adults with a parent or grandparent who attended an Indian residential school in Canada are termed _.

IRS offspring

Compared to other Aboriginal adults, what do IRS offspring report at higher rates?

Depressive symptoms, suicidal thoughts and attempts, and childhood abuse and neglect.

Besides historical trauma, what social determinants of health play a role in the mental health challenges faced by Aboriginal peoples?

Poverty, unemployment, housing and food insecurity, social exclusion, and discrimination.

The study of 80 First Nations bands in British Columbia found that rates of suicide correlated strongly with an index of ' '.

cultural continuity

What community factors were included in the index of 'cultural continuity' that correlated with lower suicide rates?

Self-government, involvement in land claims, and band control of education, health services, cultural facilities, and police/fire services.

What term is defined as 'the degree to which Aboriginal peoples identify with, feel a sense of pride for, and integrate the values and norms of their Aboriginal heritage culture'?

Enculturation.

What effect was enculturation found to have among urban Aboriginal adults in Edmonton?

It was associated with reduced illicit and prescription drug problems.

What framework, developed by First Nations, the Inuit Health Branch, and others, highlights culture as a cornerstone to achieving mental wellness?

The First Nations Mental Wellness Continuum Framework.

What is a major challenge to achieving mental wellness for many Aboriginal people regarding health services?

A general lack of appropriate and engaging mental health services.

What is a significant barrier to accessing mental health services for Aboriginal peoples, particularly in non-Aboriginal settings?

Stigma and discrimination.

What approach to mental health care is recommended by the 2015 First Nations Mental Wellness Continuum Framework, given the history of trauma?

A 'trauma-informed approach'.

What is one recommendation for mental health professionals to learn about the diverse perspectives of Aboriginal peoples?

Take opportunities to talk with people of Aboriginal origin.

What does the 'Mental wellness in Canada's Aboriginal communities' editorial suggest professionals do regarding the facts of history?

Bear witness to them and acknowledge that their effects are still deeply felt today.

Rather than assuming a single pan-Aboriginal identity, what should professionals be open to learning?

The large diversity of Aboriginal communities and individuals with their own personal stories.

To provide culturally responsive mental health services, professionals should consider engaging in respectful collaborations with whom?

Traditional healers and knowledge holders.

What tool in the DSM-5 is designed to help clinicians consider cultural topics in patient assessment, diagnosis, and treatment?

The Cultural Formulation Interview.

One suggestion for action is to support and lobby for cooperation among governments to provide what for Aboriginal communities?

Sustainable, dedicated funding for clinical mental health services.