Bioethics Midterm

Moral Reasoning

The deliberative process of careful reflection on what “one ought to do”

4 parts of Moral Reasoning

-You are a competent moral reasoner

-to do the right thing

-discussion driven

-clarity of thought, communication, interpersonal justification

Normative Ethics

the branch of philosophy from which bioethics has emerged, asks “what are good reasons for making moral judgments?”

Normative ethical Models

-Utilitarianism

-Deontological Ethics

-Virtue Ethics

Utilitarianism

the most ethical choice is the one that will produce the greatest good for the greatest number

Deontological ethics

an ethical theory that uses universal rules to distinguish right from wrong

Virtue Ethics

guide to living life vs specific rules for resolving ethical dilemmas

In a moral argument, what do we call a statement used as evidence or reasoning to support a conclusion?

A premise which is a statement or proposition serving as a basis or evidence supporting the conclusion of an argument

Additional 3 normative ethical models

-Natural Law Theory

-Ethic of care

-Contractarianism

Natural Law Theory

holds that the moral act must inherently respect and preserve human life, regardless of potential benefits to others

Ethic of Care

focuses on cultural and emotional sensitivity, supportive communication, and proactive measures to ensure accessibility for vulnerable populations

Contractarianism

believes rights and duties arise from social contracts and agreements, meaning they can vary based on societal consensus. 

4 Principles of Bioethics

-Respect for Autonomy

-Nonmaleficence

-Beneficence

-Justice

Respect for Autonomy

principle requiring respect for the decision making capacities for autonomous persons

Nonmaleficence

principle requiring the avoidance of causing harm to others

Beneficence

a group of principles requiring both lessening of and prevention of harm as well as provision of benefits to others

Justice

group of principles requiring fair distribution of benefits, risks, and costs across all affected parties

Why was the U.S. Public Health Service (USPHS) Untreated Syphilis Study at Tuskegee ethically problematic?

-Researchers deliberately withheld effective treatment from participants even after it became available.

-The study disproportionately targeted a specific racial group without their informed consent

-Participants were misled about the nature of the study and believed they were receiving medical treatment when they were not.

What is considered a vulnerable population?

Children, prisoners, pregnant women, mentally disabled persons, and economically or educationally disadvantaged persons

What are the principles of ethics concerning experimentation with humans

-Voluntary informed consent

-Animal experimentation first

-Qualified investigators

True or False: The Belmont Report directly influenced U.S. laws and federal regulations on human subjects research, including the development of the Common Rule.

True

What is the Belmont Report?

The Belmont Report was published in 1979 and it outlined three core ethical principles—respect for persons, beneficence, and justice—that became the foundation for U.S. federal regulations on human subjects research. These principles were directly incorporated into the Common Rule.

What is informed consent?

a process by which a fully informed individual voluntarily agrees to participate in research, clinical treatment, or any other procedure after understanding the risks, benefits, alternatives, and implications of their decision.

What is broad consent?

a specific form of consent used primarily in research involving human subjects where the exact nature and scope of future research may not be clearly defined at the time of consent.

What is the story of the HeLa Cells?

Doctors took a sample of Henrietta Lacks's cancerous tissue without her knowledge or consent. A researcher distributed the cells to researchers around the world (without her knowledge or consent). The HeLa cell line soon became one of the most important tools in medical research.

Which statements are true regarding regulations in human subject research and the use of discarded tissue for scientific research, in the context of the creation of the HeLa cell line?

-There were no established practices for informing patients or obtaining their consent for the use of their cells or tissues in research.

-Patients lacked the right to access or keep copies of their medical records, and there were no legal restrictions on sharing medical information for research purposes.

What is Non-Western ethics?

Non-Western ethics has a broader consideration of family or community. Well being of community or family equal or more important than an individual.

What are some of the Non-Western ethical models?

-Deontological Ethics

-Confucian Ethics

-Ubuntu Ethics

-Tikanga Maori

Confucian Ethics

emphasize benevolence rooted in filial piety (respect for parents) and family roles.

Ubuntu Ethics

based on the African philosophical concept of interconnectedness and communal support. It promotes the idea that an individual’s well-being is inseparably connected to the well-being of others.

Tikanga Maori

described as behavioural guidelines for living and interacting with others.

Cultural Competence

focuses on acquiring knowledge and skills to interact effectively with patients from diverse backgrounds.

Cultural Humility

an approach that emphasizes ongoing self-reflection, recognition of power imbalances, and openness to learning from others

What are the Maori values?

• (Mana) Respect, authority, and status within the community.

• (Whakapapa) Everything that holds DNA is considered a culturally valuable object with a whakapapa that is key to Māori identity

• (Rangatiratanga) Leadership, control, authority and selfdetermination (incl. governance & sample/data jurisdiction).

What are the CARE principles?

are centered on ensuring the ethical handling of data, particularly emphasizing the rights and participation of Indigenous communities in managing and controlling their own data.

What are the FAIR principles?

are specifically designed to enhance scientific research by focusing on technical standards and practices that make data more accessible and useful to researchers.

What is Eugenics?

Deliberately crafting a society, or controlling human evolution to reach a perfect people through genetics and laws of inheritance. A defining idea of the 20th century.

What is the history of the eugenics movement in the United States?

-The United States became the first country to implement a widespread program of involuntary sterilizations, targeting those deemed "unfit."

-California led the nation in forced sterilizations, accounting for approximately 20,000 procedures under its eugenics laws.

-“Fitter Family” contests, which promoted hereditary fitness, were held at events like the Kansas State Fair.

True or False: Within the U.S. and European scientific communities concepts of Eugenics were not fringe, but widely held and taught in universities in the 1920s. 

True; Within the U.S. and European scientific communities, eugenics was not considered a fringe movement, but rather a mainstream idea in the early 20th century.

What was the historical significance of the Supreme Court's decision in the Buck v. Bell case of 1927?

This landmark decision effectively legitimized eugenic sterilization laws across the United States and had profound and lasting impacts on sterilization practices.

Feebleminded

a pseudoscientific classification used by physicians, psychologists, and eugenicists to describe people they believed had limited intellectual abilities.

True or False; Forced or involuntary sterilization practices took place in America for decades after the end of WWII.

True; Forced sterilization practices persisted in the United States into the 1960s and 1970s as many states continued to enforce eugenic sterilization laws.

How does reparative justice differ from restorative justice?

Reparative justice primarily seeks to compensate and make amends directly to victims, while restorative justice focuses on healing relationships and community involvement.

True or False; Modern genetic research has shown that race is a social construct, not a biological fact, and that humans are more than 99.9% genetically identical.

True; While humans show some genetic variation, it does not map neatly onto racial categories. Most variation is shared across all populations, and the concept of “race” reflects social and historical ideas, not biological ones.

What is Preimplantation Genetic Testing?

a technique used during in vitro fertilization (IVF) to screen embryos for genetic abnormalities before they are implanted in the uterus.

Why do some bioethicists argue that using Preimplantation Genetic Testing (PGT) to select embryos for traits like intelligence or physical appearance could be considered a modern form of eugenics?

Because selecting embryos based on "desirable" traits promotes the idea that some lives are more valuable than others, reinforcing social inequalities and echoing eugenic ideologies.

What is Public Health Ethics?

focuses on populations, often leading to policies that benefit the majority but may infringe on individual preferences and freedoms.

What is Medical Health Ethics?

centers on individual patient care, emphasizing personal consent and individual treatment preferences over broader community outcomes.

Anthropocentrism

places human interests at the center of moral concern

Biocentrism

all life-forms have inherent value, and all living things have “substantive” moral standing

Ecocentrism

the view that environmental decisions should take in the entire ecosystem rather than the health and well-being of any plant or animal.

Sentientism

ethical view that moral consideration should be extended to all sentient beings. That is, beings that can experience pleasure, pain, suffering, or joy

What are the Social Determinants of Health (SDOH) factors?

-Health is More Than Healthcare: social factors such as income, education, and environment impact health outcomes

-Health disparities are not random; they are patterned by social structures like racism, classism, and historical injustices

Monism

Mind and body are manifestations of a single substance.

Dualism

holds that the mind and the body are distinct and separate, famously argued by René Descartes

Materialism/Physicalism

a philosophical position that proposes that the mind, consciousness, and mental states are ultimately derived from or can be explained by physical processes in the brain

What are the ethical challenges related to the use of neurotechnology (e.g., PCI) at the bedside in clinical settings?

-The accuracy and reliability of neuroimaging data can be uncertain, leading to complex interpretations.

-Obtaining informed consent is difficult when patients have severe cognitive or communicative impairments.

-Misdiagnosis based on brain-based assessments may lead to inappropriate care decisions, including end-of-life choices.

What are mini brains/brain organoids?

lab-grown structures derived from human stem cells that replicate certain aspects of brain development and function but they are not fully developed brains and do not possess consciousness or cognitive abilities.

What are the following statements about the current policy landscape for brain organoid research?

-In the U.S., brain organoid research may fall under rules for human subjects, stem cells, or animal research, depending on how the study is designed.

-The ISSCR Guidelines (2022) classify most brain organoid studies as low risk and generally exempt from specialized ethical oversight.

-There is growing support for continued monitoring and ethical review, especially in studies involving transplantation or potential signs of consciousness.

Heritable Human Genome Editing

Alter DNA at the “germline” (sperm, egg, or early embryo), which will be passed on to future generations.

Germline Mutations

occur in the reproductive cells and can be passed on to offspring, making them heritable.

Somatic Mutations

occur in body cells other than reproductive cells and are not passed on to offspring.

CRISPR

(Clustered Regularly Interspaced Short Palindromic Repeats) A tool with “considerable potential” to edit the genome with ease.

What is true about the first public announcement of CRISPR-edited babies in China?

He Jiankui violated multiple ethical standards: he did not obtain valid informed consent, misled participants about risks, and acted without proper institutional or regulatory approval. His actions were widely criticized as premature and irresponsible.

A key concern raised by disability rights advocates about heritable human genome editing …

They argue that editing out disability-related traits suggests those lives are less desirable or less worthy, reinforcing social stigma.