Ethics week 3
Rights are, at least partially, meant to permit individuals control over their own futures. Which of the following are reasons that Goldman offers as to why these decisions should normally be left to the individuals themselves?
-The presumption that the individual is the best judge of their own interest, which may depend on personal value orderings known only to them-Self determination, at least in regard to important decisions (which might include, in medical contexts, decisions that may involve life and dealth alternatives, affect the completion of major life projects, or affect bodily integrity) has an independent value.-Individuals may come to resent even the well-meaning decision of another moreso than they would should the harm come as a result of their own decision.
Please select the situations in which, traditionally speaking, a doctor's duty not to harm his patient's health or shorten his life might appear to override otherwise obtaining rights of the patients to full truth according to Goldman.
-where the truth will cause direct harm such as depression or loss of continued will to live -Where informing may be instrumentally harmful in leading to the choice of the wrong treatment or none at all.
This law gave teh Florida governor the prerogative of reinserting a patient's feeding tube and required the appointment of a special guardian ad litem to review the case - A. B. C. D. The ruling that held Congress had not authorized federal agencies to regulate nontreatment decisions in hospitals and newborn nurseries. - A. B. C. D. A New York law that allows the duly appointed surrogate of a person with mental retardation to terminate life-sustaining treatment under the very narrow circumstances that Sheila Pouliot faced. - A. B. C. D. A federal set of standards that permitted legal intervention to override the parental authrity to withhold treatment from handicapped or disabled newborns.
1. Terris Law 2. Bown V. American Hospital 3. health care decisions act 4. child abuse amendments
In which year did the Baby Doe case occur?
1981
In how many states of the United States is some form of physician-assisted suicide or active euthanasia (not merely allowing to die) legal (as of the publication of Battin's article)?
3
Hardwig reports that which percentage of people who participated in the SUPPORT study lost all of their savings?
33.3%
Brody's claim that "death is a fuzzy set" refers to which of the following of crucial assumption?
Acceptance of the fundamental insights of fuzzy logic
Which of the following is the ethical standard the President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research set forth?
Access for all to an adequate level of care without the imposition of excessive burdens.
According to Ken Baum, when does the criminally condemned patient most need the care of a physician?
At the end of the criminal process
Which of the following reasons does Marquis offer for believing that abortion (a kind of killing) is wrong?
Because it takes away the potential child's future-like-ours
Which of the following is the closest to an accurate definition of "moral triangulation" as John D. Arras uses the term?
Examining categories of patients on either side of the patient in question on the continuum of incompetency, categories that do yeild fairly firm moral intuitions, and then attempt to locate a proper response to the case in this context.
David B. Allen suggests which of the following conceptual guidelines toward the goal of achieving both controlled but fair access to growth hormone (GH)?
GH be viewed as a treatment for the disability of Short Stature (SS) and not for the diagnosis of Growth Hormone Deficiency (GHD).
Circumstance: Continuing to live will impose significant burdens- emotional burdens, extensive caregiving, destruction of life plans, financial hardship- on your family and loved ones. Circumstance: One grows significantly olderCircumstance: One has lived a full and rich life Circumstance: One's loved ones have already made great contributions/sacrifices to make your life a good one. Circumstance: You can make a good adjustment to your illness or handicapping condition. Circumstance: One's loved ones' lives have already been difficult/impoverished or if they have already had only a small share of the good things that life has to offer. Circumstance: One can still make significant contributions to the lives of others, especially your family. Circumstance: The part of the person that is loved will soon be gone or seriously compromised. Circumstance: One has lived a relatively lavish lifestyle instead of saving for illness or old age
INCREASE INCREASE INCREASE INCREASE DECREASE INCREASE DECREASE INCREASE INCREASE
What is "the first order of business in deciding for incompetent patients" according to John D. Arras?
Inquire what the patient would want were she presently able to communicate.
There are three common arguments that Joralemon and Cox point out are often leveled at the current altruism-based approach to organ procurement. Which of the following is NOT one of those three critiques?
It is coercive to permit sales since any financial reparations will put impoverished donors at risk of facing hunger or donation
Which condition was the "catalyst" in the case of Miller v. HCA?
Low birth weight
Which of the following are arguments in favor of a pharmacist's right to object that Cantor and Baum discuss?
Pharmacists can and should exercise independent judgement as a matter of commitment to their obligation to a duty of care.
Which of the following premises in the argument for medical paternalism does Goldman reject?
Premise Three: Health and prolonged life can be assumed to have priority among preferences for patients who place themselves under physicians' care.
Which legal decision was referred to regularly in the case of Claire Conroy because it dealt with a special category of patients: those in chronic, persistent vegetative or comatose state?
Quinlan
Which of the following changes would result in the virtual elimination of the duty to die, according to Hardwig?
Society paid for facilities that provide excellent long-term care for all chronically ill, debilitated, mentally ill or demented people in this country.
While liability is defined as "a duty to use ordinary care and skill to avoid danger" with regard to another such "that if [the defendant] did not use ordinary care and skill in his own conduct he would cause danger or injury to the person or property of the [plaintiff]" (102), which of the following is the consideration the assenting judges found to be most important consideration in their finding against UC Berkeley et al.?
The foreseeability of harm to the paintiff
Which of the following is true about the therapist's obligation to reveal threats of violence as established by the Tarasoff ruling?
The therapist ought to reveal such information discreetly, and in a fashion that would preserve the privacy of the patient to the fullest extent compatible with the prevention of threatened danger.
Which of the following is the best definition of "commodification" with regard to the organ donation debate?
The treatment of human bodies and therefore human beings as if they are merely objects rather than embodied subjects
Which of the following are true about Emergency Contraception? Select all that apply.
There is a narrow window of efficacy. They may inhibit ovulation or create an unfavorable environment for the implantation of a blastocyst. Repeated use of these medications can impair long-term reproductive health. they have no effect on an established pregnancy
Only 6% of the nation allows "causing to die" as a legally protected alternative to maximal treatment. - A. B. C. D. E. F. 3% of the nation's deaths are attributable to a physician ending a patient's life at the patient's request. It is a choice and it is widely understood. - A. B. C. D. E. F. A conspicuous private organization supports citizens' choice to assisted suicide in limited situations. It is available and not illegal. - A. B. C. D. E. F. Significant stress is placed on palliative care but also rejects physician-assisted suicide and active euthanasia. - A. B. C. D. E. F. Active Euthanasia is legal but physician-assisted suicide is not. - A. B. C. D. E. F. The nation has four right-to-die organizations that provide information, counseling, and other support to terminally ill patients who choose suicide.
United States the Netherlands Germany United Kingdom Belgium Switzerland
The President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research asserts that leaving health care solely to market forces is not viewed as acceptable when which of the following occurs?
When a significant portion of the population lacks access to health services
Which of the following is the "key point of contention, in courts of law as well as that at the bedside of patients," according to Joralemon and Cox?
Whether death immediately ends the body-as-self connection and opens the door to application of property concerns and the logic of commodities.
Which of the following are steps that Baylis suggests should be taken by the medical profession to encourage honest disclosure of medical errors?
a,b,c,e
Which of the following is NOT one of the properties of health care that makes it especially important, according to the President's Commission?
adequacy
Fill in the blank: Ackerman argues that we need to reconceptualize the problems associated with end-of-life decisions based on our duty to ________.
aid
Physician participation in executions commonly refers to only those actions taken as part of the actual execution process. However, Ken Baum argues that which of the following are also actions that physicians take which participate in capital punishment? Select all that apply.
all but facilitation of gathering of evidence or testify in criminal trials and capital sentencing hearings
Which of the following aresome of the alternatives to the current "opt in altruism" system of organ donation that Joralemon and Cox mention? Please select all that apply.
all of the above
Which of the following are typical motivations for a physician's nondisclosure to their patient, according to Francoise Baylis?
all of these
Which of the following groups of people, according to Cantor and Baum, are made disproportionately vulnerable by a pharmacist's refusal to fill a prescription?
all of these
According to Baylis, medical errors are which of the following?
avoidable
Don Marquis makes a distinction regarding which category the term 'human being' belongs to. Which categories does he discuss?
biological and moral
Ackerman provides which of the following counter-examples to show that Hardwig's conception of what constitutes an unacceptable family burden is weak?
college bound teenagers
Which of the following is NOT an argument against a pharmacist's right to object explored by Cantor and Baum?
conscientious objection is integral to democracy
Which of the following is NOT a behavior that can characterize a PVS state?
consistent non random eye blinking
the aim of the physician patient interaction is to help the patient determine and choose the best health-related values that can be realized in the clinical situation
deliberative model
the conception of patient autonomy is moral self-development; the patient is empowered not simply to follow unexamined preferences or examined values
deliberative model
the physician acts as a teacher or friend, engaging the patient in dialogue on what course of action would be best
deliberative model
Which of the following is NOT a burden that may influence an individual's health status considered in "An Ethical Framework for Access to Health Care"?
economic
True or False: A patient who superficially appears to be coherent and communicative but lacks short-term memory and shows confusion about her medical diagnosis is considered "minimally functional" on the scale discussed by John D. Arras?
false
True or False: According to a 1999 study, 97% of doctors are aware of the guidelines governing their participation in executions?
false
True or False: Ackerman argues that the discussion of how physicians can best respect persons who are patients can ignore the psychological and social dimensions of illness?
false
True or False: Bernat believes that the classical formulation of whole-brain death is without flaw as a theoretical and practical definition of death?
false
True or False: Blackhall et. all claim that advanced care directives and the concern about too much care at the end of life are the most important concerns for all segments of the population?
false
True or False: Blackhall et. all found that the most important factor contributing to physician attitudes toward truth-telling was religion.
false
True or False: Brock and Arras agree about the correct stance with regards to physician-assisted suicide and euthanasia?
false
True or False: Claire Conroy was a never competent patient?
false
True or False: Dax (nee Donald) Cowart was deemed mentally competent and was thus given decisional capacity regarding his medical care?
false
True or False: Don Marquis defines abortion as "the voluntary or involuntary termination or allowing another person to terminate a pregnancy"?
false
True or False: Dr. Brody believes that harvesting organs from still-breathing anencephalics is immoral, unreasonable and should be banned by the AMA?
false
True or False: Goldman asserts that we may always override a person's autonomy when in our opinion the potential harm to him from allowing autonomous decision outweighs the value of his freedom.
false
True or False: Hardiwg argues that even those who have never had competency (who have never been able to understand moral obligation at all) have moral duties commensurate with our own?
false
True or False: Hardwig argues that "a duty to die" reflects "our society's bias against systematic devaluation of the old and ill, a devaluation some old people accept uncritically, just as many women used to accept the idea that women should be subordinate to men"?
false
True or False: Ken Baum argues that the preservation of life is the paramount maxim for medical practitioners and is always in the best interest of the patient.
false
True or False: Marquis believes that individual sperm and some ovum are candidates for a subject of harm by abortion?
false
True or False: Mary Anne Warren and Margaret Thomson both argue that abortion is always permissible?
false
True or False: Mary Anne Warren believes we ought to argue that the right to obtain an abortion is derived from the right of a woman to own and regulate property?
false
True or False: Mary C. Northern forcibly underwent double amputation of her lower appendages.
false
True or False: Norman Daniels argues that fair equality of opportunity requires opportunity to be equal for all persons and a leveling of individual differences?
false
True or False: Norman Daniels argues that the medical adequacy of health care for a given society is the array of life plans reasonable persons in it are likely to construct for themselves.?
false
True or False: Radcliffe-Richards et all. argue for the positive conflusion that organ sales must always be acceptable and that there should be an unfettered market in this regard?
false
True or False: Sheila Pouliot was competent at one point in her life?
false
True or False: The "body-as-self" view holds that post-humous organ donation may be conscripted because the person is no longer in posession of their body after death.
false
True or False: The President's Commission interprets equity as access according to benefit or need alone?
false
True or False: The President's Commission view health care as equal to or on par with most other good and services?
false
True or False: The President's Commission views equitable access as an impossible ideal?
false
True or False: The Supreme Court has found a constitutional right to health and health care?
false
True or False: The Tarasoff case upheld that proof, aided by hindsight, that a healthcare professional judged wrongly regarding their patient's intention to do violence to another is sufficient to establish negligence
false
True or False: The physician who discloses an error perpetuates the myth of the infallible physician?
false
True or False: The word "superogatory" is best defined as being a legal, moral or professional requirement or duty; compulsory?
false
true or false: the Hippocratic oath does not require physicians to guard the privacy of their patients
false
true or false: the principles of medical ethics of the American medical association requires physicians to inform eh patient of his own condition in order to serve the protection of patient autonomy and well being
false
Fill in th blank: The belief that our lives are separate and unconnected from other persons is called the _________________ fantasy, according to Hardwig.
individualistic
sometimes called the scientific, engineering or consumer model, this model's objective for physician patient interaction is for the physician to provide the patient with all relevant information
informative model
the conception o patient autonomy is patient control over medical decision making
informative model
the physician is a purveyor of technical expertise, providing the patient with the means to exercise control
informative model
According to Eric Cassell, the loss of ______________ is the hallmark of suffering. Please fill in the blank with the best option below.
integrity
The "reasoned ideal" argument is also known as support for what form of organ donation?
inter vivos sales
the aim of the physician patient interaction in this model is to elucidate the patients values and what he or she actually wants
interpretive model
the conception of patient autonomy is self-understand; the patient comes to know more clearly who he or she is
interpretive model
the physician is a counselor, and advisor, supplying relevant information, helping to elucidate values, and suggesting what medical interventions realize these values
interpretive model
Which of the following is true about the Halvey-Brody response?
it rejects the definition of death as unitary
Which of the following groups were most likely, according to Blackhall et. all, to hold that it is cruelt to tell a patient the truth about a fatal prognosis?
korean and Mexican Americans
Which of the following subject groups studied by Blackhall et. all was more likely to see truth-telling as cruel and potentially harmful?
korean and Mexican Americans
Hardwig uses which of the following terms to refer to cases where there are very unusual circumstances, accommodation of which may make for "bad ethics"?
life boat cases
"When, due to a physicician's lack of knowledge, failure to execute a requisite skill, or failure to exercise good judgment, a planned act or omission fails to achieve its intended outcome and this failure has nothing to do with chance or inherent risk ."
medical error
When a certain set of circumstances, a sequence or cluster of actions and decisions by different people combine in unfortunate ways that result in unintentional harm, a medical mishap is considered which of the following?
multifactorial
Pope John Paul II calls the deliberate and direct killing, by whatever means it is carried out, of a human being in the initial phase of his or her existence, extending from conception to birth by which of the following terms?
murder
Norman Daniels aregues that health-care institutions should be among those governed by a principle of fair equality of opportunity, provided which of the following conditions obtain:
neither a or b
which of the following is the best definition of the right to self determination?
ones right to control over decisions vital to the course of one's life
What percentage of Donald (Dax) Cowart's body was burned in the fire on July 23,1973?
over 65%
sometimes called the parental or priestly model, this model ensures that patients receive the interventions that best promos their health and well being
paternalistic model
the conception of patient autonomy is patient assent, either at the time or later
paternalistic model
the physician acts as the patient's guardian articulating and implementing what is best for the patient
paternalistic model
Fill in the blank: Mary Anne Warren argues that a __________________'s right to life outweighs the _________________ right to life of a fetus.
person/potential
Judith Jarvis Thomson starts her argument by assuming that the fetus is/has which of the following moral categories?
personhood
According to Baylis, which of the following are NOT aspects of the element of subjectivity in naming misadventures as errors and in determining levels of culpability?
physical contexts
Which of the following is the name of the test which requires the net burdens of the patient's life with the treatment should clearly and markedly outweight the benefits that the patient derives from life, and further, the recurring, unavoidable, and severe pain of the patient's life with the treatment should be such that the effect of administering life-sustaining treatment would be inhumane?
pure-objective
Ackerman identifies four major constraints on autonomous behavior. Identify them
social, cognitive, physical, and psychological
Which of the following has a moral obligation to ensure that everyone has access to adequate care without being subject to excessive burdens?
society
which of the following is an example of what Goldman refers to as justified paternalism?
state control over physician licensing and the requirement that prescriptions be obtained for many kinds of drugs
Which German phrase translates roughly to "the capability of exercising control over his or her actions"?
tatherrschaftsfähig
which of the following is the best definition of paternalism?
the overriding or restriction of rights or freedoms of individuals for their own good, including in instances where competent adults can be assumed to act otherwise against their own interest, values, or true preferences
The Dutch regulation for euthanasia and assisted suicide at the time of the Chabot case required which of the following?
the patients suffering is unbearable and without prospect of improvement
Which of the following are reasons cited by the dissenting judge in the Tarasoff case for maintaining doctor-patient confidentiality in the face of threats of violence to third parties? Select as many as apply.
the ruling will cripple the use and effectiveness of psychiatry the ruling will increase anxiety among non-patients, thereby increasing social stigma against the mentally ill the ruling will prevent patients from seeking treatment the ruling will prevent patients from fully disclosing their actual mental and behavioral health needs
Pope John Paul II believes that a human being is to be respected and treated as a person from which of the following moments?
the time the ovum is fertilized
According to Finkelstein and colleagues, patientes of a right to _________ and physicians have a corresponding obligation to _________. Fill in the blanks.
the truth; be truthful
To "catabolize" most closely means which of the following?
to utilize energy by breaking down the bodies own tissue
Which test does Bernat argue is one of the definitive tests of death for contested diagnoses or inexperienced examiners?
transcranial doppler ultrasonography
Goldman further asserts that choice unhindered by others is nevertheless not truly free when determined by internal factors
true
True or False: "Capacity to Consent" is defined as the mental ability to make a rational decision, which includes the ability to perceive, to appreciate all relevant facts, and to reach a rational judgment upon such facts?
true
True or False: A person may have "capacity" as to some matters and may lack "capacity" as to others?
true
True or False: According to Baylis, one of the reasons for silence on the part of physicians, as regards not only their own 'errors' but those of their colleauges, is genuine uncertainty about whether a particular adverse outcome is the result of an error?
true
True or False: According to one study seven to eight times as many patients suffered negligent injuries as filed malpractice claims?
true
True or False: All members of Sheila Pouliot's medical team believed her condition to be terminal and that palliative care alone was the most appropriate treatment?
true
True or False: Blackhall et. all link the desire to complete a will prior to death and the desire 'to settle one's affairs' to the attempts to reach one's control into situations in which we otherwise have no ability to exert to control.
true
True or False: Brock argues that in both physician-assisted suicide and voluntary active euthanasia the choice rests fully with the patient?
true
True or False: Brock argues that in both physician-assisted suicide and voluntary active euthanasia the physician plays an active and necessary causal role?
true
True or False: Brody argues that there are incongruities in the normal clinical tests and the whole-brain criterion of death in light of the definition that justifies it.
true
True or False: Cowart argues that the right to choose includes the right to choose wrongly?
true
True or False: Distributing goods and services through markets leads to large differences in their consumption, according to the President's Commission?
true
True or False: Erin and Harris argue that it is hypocritical to ask that the donor alone be the only unpaid party in an organ transplant operation given that the surgeons, medical team, etc., are all paid?
true
True or False: In a high-context culture, such as that of Korea, Japan, or Mexico, one is expected to infer from the social context many things without being told explicitly?
true
True or False: In the Tarasoff case, the court found that the health care provider (the defendant) did in fact predict that Poddar would kill, but were negligent in failing to warn.
true
True or False: John Hardwig argues that we have a duty to die that may include a duty to suicide?
true
True or False: Ken Baum argues that the condemned death row inmate is, for all practical purposes, terminally ill and deserves to be treated as such.
true
True or False: Ken Baum argues that the condemned should be free to request or refuse physician oversight, and the individual physician should be free to choose to participate in executions or not to do so.
true
True or False: Mary Anne Warren argues that there may be situations in which the killing of innocent human beings is justified?
true
True or False: Medical testimony prior to her death could not be conclusive as to whether Claire Conroy was capable of experiencing pain?
true
True or False: Not all harms that result from medical interventions(for example, sepsis, prolonged pain, prolonged hospitalization, additional therapy, permanent disability, death) are due to medical errors.
true
True or False: One of the characteristics of adequacy of health care is its ability to reflect a reasoned judgment not only about the impact of the condition on the welfare and opportunity of the individual but also about the efficacy and the cost of the care itself in relation to other conditions and the efficacy and cost of the care that is available for them?
true
True or False: Radliffe-Richards et all. argue that permitting kidney sales would necessarily increase the number of kidneys available to those in need?
true
True or False: The Court ultimately found that the doctor's initial resucitation in Miller was justified because the situation was an emergency and there was not enough time necessary to get consent from the patients or a court?
true
True or False: The Hippocratic oath forbids doctors from operating on patients?
true
True or False: The President's Commission believes that prohibiting people from purchasing more care than everyone else gets would probably result in a black market for health care?
true
True or False: The Tarasoff case hinges on the question of whether their is a duty to warn and whether that duty outweighs the patient's right to doctor-patient confidentiality in treatment.
true
True or False: The case of Vitaly Tarasoff et al. V. The Regents of the University of California et al. is a case that debates whether or not the University of California et al. owed a duty of care to Tatiana Tarasoff and her family despite the fact that the Tarasoff's were not the patient in the case in question.
true
True or False: The court found that the Chancellor had made an error in attempting to effectuate his action in spite of the appeal in the case of Mary C. Northern?
true
True or False: The court in the Tarasoff case asserted that the risk that unnecessary warnings may be given to potential victims of patients in treatment is a reasonable price to pay for the lives of possible victims that may be saved.
true
True or False: The most influential formulation of the "best-interests test" requires not merely that the burdens of life clearly outweight the benefits, but also that further treatment would be inhumane due to the presence of severe and uncontrollable pain?
true
True or False: The word "obligatory" is best defined as being a legal, moral or professional requirement or duty; compulsory?
true
True or False: To protect physicians who participate in state mandated executions from license challenges for violating ethics codes, states commonly provide legal immunity and promise anonymity?
true
True or False: Well-meaning physicians may be loathe to disclose medical errors to patients because they believe that full disclosure serves no useful purpose.
true
True or False: While some states require that a physician personally supervise the execution of criminals convicted of capital crimes, the American Medical Association and other licensing organizations prohibit physician participation in executions.
true
True or False: the "body-as-property" view holds that one's body is owned by one's self and, accordingly, one's organs may be sold, acquired, inherited or otherwise transferred after the owner has died?
true
True or false: One limitation to the "Best-Interests Standard" is that focus upon the narrow issue of pain can tend to reduce the patient from a full-fledged person to the status of a mere physical repository of pleasures and pains?
true
true or false: Ackerman argues that doctors higher social status and educational attainment can prevent patients form acting upon their considered choices
true
true or false: the hippocratic oat requires that medical education should be free
true
What is the best definition of "inter vivos" donation?
use of live donors for live recipients
Respiratory and cardio-vascular functioning. - A. B. C. D. E. F. G. H. Irreversible and total loss of brain function as a definition of death. - A. B. C. D. E. F. G. H. A psychosocial construct that can be lost but cannot die. - A. B. C. D. E. F. G. H. The total and irreversible loss of that which is considered to be essentially significant to the nature of man as a definition of death. - A. B. C. D. E. F. G. H. A property of a whole that is not possessed by any of its component parts, and that cannot be reduced to one or more of its component parts. - A. B. C. D. E. F. G. H. The loss of consciousness and the capacity for independent breathing; destruction of the ascending reticular activating system and the medullary breathing center as a definition of death. - A. B. C. D. E. F. G. H. Patients reportedly diagnosed as brain dead but whose circulation and visceral organ functioning are successfully physiologically maintained. - A. B. C. D. E. F. G. H. The spontaneous cessation of breathing and heartbeat as a definition of death.
vital functions whole brain death personhood higher brain death emergent functioins brain stem formulation chronic brain death cardiorespiratory criterion
Which metaphor seems to encapsulate the disagreement between Cowart and Burt, according to both men?
when it is "the end of the day"
