Medical Ethics Bing Final

Kantian Deontology

  1. Q: What is the Categorical Imperative, and what are its two formulations?
    A: The Categorical Imperative states that actions are moral if they follow universal laws. The two formulations are:

    • First: Act only on maxims that could be universal laws.

    • Second: Treat humanity as an end, never merely as a means.

  2. Q: Why would Kant argue against killing one person to save five in the Transplant Case?
    A: It violates the Categorical Imperative by treating the person as a means to an end, not respecting their autonomy.

  3. Q: How does Kant's Second Formula apply to moral decisions?
    A: It ensures that individuals are treated with inherent dignity and not merely as tools for achieving outcomes.

Utilitarianism (John Stuart Mill)

  1. Q: What is the difference between Act and Rule Utilitarianism?
    A: Act Utilitarianism evaluates individual actions by their outcomes, while Rule Utilitarianism focuses on following rules that maximize happiness over time.

  2. Q: Why might Rule Utilitarianism argue against killing one person to save five?
    A: Allowing such actions could erode trust in societal institutions, reducing overall happiness in the long term.

  3. Q: How does Mill reconcile justice with utility?
    A: Mill argues that respecting individual rights often leads to greater overall happiness, aligning justice with utility.

The Survival Lottery (John Harris)

  1. Q: What is the central question posed by the Survival Lottery?
    A: Is it justifiable to kill one healthy person to save two others who need organ transplants?

  2. Q: What distinction does Harris challenge between killing and letting die?
    A: He argues that the moral difference between actively killing and passively letting someone die is not always justified.

  3. Q: What are the objections to the Survival Lottery?
    A: Concerns include distress over doctors’ power to kill and treating individuals as interchangeable.

BLOCK 2: Abortion and Stem Cell Research

Moral Status of Embryos (Tooley and Marquis)

  1. Q: What is Tooley’s Self-Consciousness Requirement?
    A: It states that the right to life depends on the ability to desire continued existence, which requires self-consciousness.

  2. Q: According to Marquis, why is killing wrong?
    A: Killing is wrong because it deprives individuals of a valuable future filled with experiences and joy.

  3. Q: How does Marquis argue that killing embryos and infants deprives them of a valuable future?
    A: Both have futures that they would come to value, even if they cannot value them in the present.

Thomson's Defense of Abortion

  1. Q: What does the Violinist example demonstrate about abortion?
    A: It shows that even if the fetus has a right to life, the woman is not obligated to sustain it if she didn’t consent.

  2. Q: How does the People-Seed example address contraception failure?
    A: It argues that accidental pregnancy from failed contraception doesn’t impose an obligation to carry the fetus to term.

  3. Q: How does Thomson respond to the Responsibility Objection?
    A: She distinguishes between responsibility for causing existence and responsibility for providing ongoing support.

Stem Cell Research

  1. Q: Why is the destruction of embryos controversial in stem cell research?
    A: It raises ethical concerns about destroying potential human life for scientific purposes.

  2. Q: What is McMahan’s argument regarding the moral status of embryos?
    A: Embryos lack moral status until consciousness develops, which occurs weeks after conception.

  3. Q: How does McMahan justify the permissibility of stem cell research?
    A: Since embryos are not yet persons with consciousness, their destruction is not morally equivalent to killing.

BLOCK 3: Healthcare Justice

QALY and Resource Allocation

  1. Q: What is QALY, and how is it used in healthcare decisions?
    A: Quality-Adjusted Life Years (QALY) measure the quantity and quality of life gained from treatments, guiding resource allocation.

  2. Q: Why does QALY tend to favor younger and healthier patients?
    A: Younger and healthier patients are more likely to gain significant quality and quantity of life years from treatment.

  3. Q: How does Lockwood critique QALY in the context of justice?
    A: Lockwood argues that QALY neglects justice by favoring efficiency over the needs of the worst-off.

Should Age Count?

  1. Q: What are consequentialist arguments for age mattering?
    A: Younger patients provide greater societal benefits and more efficient use of resources.

  2. Q: What are justice-based arguments against age mattering?
    A: Justice requires equal respect for all individuals, regardless of age.

  3. Q: What is Veatch’s central claim about age?
    A: Veatch suggests using different principles for fairness: over-lifetime allocation for minor cases and slice-of-life allocation for severe cases.

Identified vs. Statistical Victims

  1. Q: What is the identified vs. statistical victim bias?
    A: People prioritize identified victims due to vividness and certainty of harm over statistical victims.

  2. Q: What is Daniels’ example of concentrated risk?
    A: A single patient needing five tablets is prioritized over five others with a 20% chance of contracting a disease.

BLOCK 4: Autonomy and Truth-Telling

Rational Desires and Autonomy

  1. Q: What conditions must be met for a choice to express a rational desire?
    A: The choice must involve knowledge of all options, logical reasoning, and vivid imagination of consequences.

  2. Q: How do obstructive desires challenge patient autonomy?
    A: Obstructive desires prevent patients from making rational, autonomous choices.

Must Doctors Tell the Truth?

  1. Q: What are the main arguments for lying to patients?
    A: Lying can protect patients from harm, avoid distress, and simplify complex explanations.

  2. Q: What are the main arguments against lying to patients?
    A: Truthfulness respects autonomy, builds trust, and enables informed decision-making.

BLOCK 5: Global and Special Topics

Brain Drain

  1. Q: What is medical brain drain, and why is it controversial?
    A: It refers to healthcare workers emigrating from poor to wealthy countries, worsening healthcare inequities in their home countries.

  2. Q: What are ethical arguments for brain drain?
    A: Workers’ autonomy and systemic issues, not migration, often cause healthcare deficits.

Complicity in Torture

  1. Q: What are the two factors that determine complicity?
    A: Assistance and shared intention with the wrongdoers.

  2. Q: When might complicity be excused in medical ethics?
    A: If refusing to act would harm the patient or lead to worse consequences.

Human Right to Health

  1. Q: What are the challenges of defining a human right to health?
    A: Vagueness, inefficient spending, and prioritization of specific diseases over systemic reform.

Q: How does recognizing health as a right drive systemic changes?
A: It highlights global inequities and demands structural reforms to ensure equitable access to healthcare.