Ethical Issues In Healthcare

Main Topics:

  • Paternalistic deception

  • Euthanasia

  • Genetic enhancement

  • Health care rights and systems

  • Human challenge trials

  • Rationing scarce resources

  • Abortion

  • Racism in health care

  • Medical malpractice



Week 3 Notes

VD1: Paternalistic deception

Bob’s Case - has a malignant brain tumor

  • option 1 - tell him truth

  • option 2 - lie completely

  • option 3 - withhold and tell him half the truth


VD2: Paternalistic deception

  • Autonomy- personal capacity for self determination and self governance, our ability to make choice in our life.

  • Paternalism (like being a parent): Overriding your actions and decision making for your own good, governing yourself for your benefit.


2 types of deception with physicians deceiving patients

  • Selfish deception: physician deceiving patients for physicians benefit, like so doctor can make more money.

  • Paternalistic deception: physician deceives a patient for the patients benefit, so patient doesnt have to get sad news about health.

- - - - Way 1: Lie

- - - - Way 2: withhold truth


VD3: Paternalistic deception (Collins and lipkin) support should view

Lipkin

  • short and nice, not sure what he’s saying

Collins

  • interesting story and idea but long read


Their reason for why physicians should use paternalistically deceive

  • telling whole truth : shouldn’t tell the whole truth because patients don’t understand and they might misunderstand the whole truth.

  • what patients want: patients often don’t wanna know the truth , LIPKINS: several patients indicated they didn’t want to know if it is a fatal illness. COLLINS: easy count the number of ppl who actually like hella actually wanna know.

  • harming patients: telling the whole truth can be harmful and deceiving can be beneficial. Telling the truth makes the patients hopeless, depressed and worst recoveries and bad final days( Lawyer Patient). Deceiving beneficial - didn’t tell the whole truth, power of placebos, enjoy days until they realize final day, have fun and succeed and does not become depressed (entrepreneur patient).

  • autonomy: Deceiving patients violates their autonomy,

- Response 1: Deceiving promotes autonomy, patients don’t wanna know whole truth and they get better and so deceiving is beneficial.

- Response 2: Deceiving limits autonomy:




Week 4 Notes

VD1: Euthanasia

  • Sandy: request for lethal injection to end her life because she would life a happier life dead than suffer through the treatments and what know when she is gonna die.


VD2: Euthanasia

When you directly or indirectly bringing about another’s death for their sake, so they are wanting to pass away for their sake, their interest as they are terminally ill and in a lot of pain.

  • Active Euthanasia: euthanizing a patient directly (mercy killing), You kill the patient, By: performing some action

  • Passive Euthanasia: euthanizing a patient indirectly: You allow the patient to die By: not doing something to prolong their life and

  • The distinction: killing versus letting die



Week 5 Notes

VD 1: Genetic Enhancement

  • List of genetic modification are things such as color, hair, eye and body type such as weight and then physical beauty and cognitive ability.

  • what genetic modifications should society even alow and what modifications should be legal and illegal to give and receive?

  • Who should have access to these modifications everyone or only some ppl or cases?


VD 2:

Less health - - - Normal Health - - - More Health

  • Treatment is getting u to 100 from low or keeping you at normal health of a 100. Manipulating genetic material for the purpose of treatment.

  • Enhancement is bringing you beyond normal health, for the purpose of enhancement.


VD 3: Glannon Perspective

Worry 1: gives competitive advantages to those who got more intelligent, sociable and beautiful and gives a real advantage over others in careers, income and social status and not everyone can afford it so only rich can afford and that’s unfair.

  • solution is to make genetic enhancement accessible to everyone


Worry 2: Getting career, income and social status is competitive and everyone gets genetic enhancements and then your competitive advantages are the same.

Worry 3: Valuing equality, we often think equality is valuable but then imagine what would happen if some people had genetic enhancements, it would cause us vs them and still there is no equality. More problem.

Worry 4: Agency, we value generosity, it should come from us and be our own not implanted in us from outside source.

Glannon’s argument overall - genetic enhancements would be unfair for ppl who cant afford, make us worse off if everyone could afford, threaten the importance of equality and threaten our agency. so if all this is true then no genetic enhancement in our society.


VD 3: Savulescu Perspective: at least some genetic enhancement

Argument 1: choosing not to enhance is wrong

  • child has stunning intelligence, but parents neglect because lazy, genetic enhancement is easy to get and give but parents neglect and that its wrong not to genetically enhance


Argument 2: consistency

  • we accept environmental interventions to improve our children and same thing with genetic enhancement.


Argument 3: No Difference to treating disease

  • Health matters enables us to live well and we should treat disease because it enables us to live well. Genetic enhancement enables us to live well and we should use genetic enhancements.