Ethics

Question 1

Name the four key ethical principles related to medicine

Answer 1

Autonomy

Non-maleficience

Beneficiene

Justice

Question 2

Describe the ethical principle ‘autonomy’

Answer 2

self:rule - the capacity to make reasoned decsisions and act on them

Question 3

Describe the ethical principle ‘non-malificence’

Answer 3

First do no harm

Question 4

Descibe the ethical principle ‘beneficience’

Answer 4

Make the care of your patient your first concern

Question 5

Describe the ethical principle ‘justice’

Answer 5

Fairness - respect for rights

Question 6

Name the 3 principle ethical theories

Answer 6

Virtue ethics

Duty (deotology) ethics

Consequentialism (ethics)

Question 7

a) Describe virute ethics
b) who created it?

Answer 7

a) An action is right if, and only if, it is what a virtuous agent would do in the circumstance

Balance between two extremes

b) Aristotle

Question 8

a) Describe duty (deontological) ethics
b) Who created it?

Answer 8

a) An action is right if, and only if, it is in accord with a moral rule or principle

Morality is a matter of adhering to fixed standards, of performing duties

b) Immanuel Kant

Question 9

a) Describe consequentialism (utiltarianism)
b) Who created it?

Answer 9

a) An action is right if, and only if, it promotes the best consequnce

Ends justify means

Outcomes are what matter

Promote ‘greatest happiness for the greatest number’

b) John Stuart Mill

Question 10

Discuss the origin of values

Answer 10

• Bernard Williams (1929-2003)
• Thick concepts: descriptive + normative e.g., rude, kind, sympathetic, violent
• Thin concepts: moral judgement over facts e.g., good, bad, right, wrong

Question 11

Discuss the role of doctor’s decisions over patient’s

Answer 11

Greater knowledge of medical facts

• But not invariably: sometimes a doctor can be wrong
• Sometimes the patient will know more than the doctor

Greater accuracy of hypotheses

• Familiar with the date and how to apply it
• Greater aptitude for interpretation

Doctors can participate in their patients’ value judgements and will invariably have their own values - developed throughout time

Ensure you base your decision on your medical judgement (facts) + the patient’s values primarily

Question 12

a) When is an argument valid?
b) Does a valid argument need to have a true conclusion?
c) What is the technical term for validity

Answer 12

a) An argument is valid when if the premises are true then the conclusion MUST be true
b) No
c) Truth perservation

Question 13

Int terms of facts and values, what should your care/decisions involve?

Answer 13

Involve both facts and values - the patient’s as well as your own

Question 14

What do clinicians tend to significantly underestimate about patient’s?

Answer 14

• Patient’s willingness to undergo toxic treatments to improve length/QoL
• Desire of patients to have full information even if they dont act on it or believe it

Question 15

Why are animals used?

Answer 15

• Creation and breeding of genetically modified animals (mainly mice)
• Basic research (how it works)
• Regulatory testing
• Research that translates animal-human
• Protection of natural environment
• Preservation of animal species

Question 16

Is the use of animal research still necessary? Provide a reason for both sides including the necessity argument and compartive moral value argument

Answer 16

No

• Not virtuous and morally acceptable

Yes

• Potential benefits to humans justifies it
• Necessity argument: In-vitro or in-silico investiagtions cannot replicate the function of complex living systems
• The comparative moral value argument: Human wellbeing is paramount, and it is even less morally acceptable to experiment on human

Question 17

What are issues with paying and using human subjects

Answer 17

• Paying research subjects risks selecting for the neediest, vulnerable groups (economic coercion)
• Many do regard people as having more moral worth than other animals

Question 18

Describe the 3 principles of replacement, reduction and refinement of the animal welfare ethical reviews boards (AWERBS) of using animals for animl research

Answer 18

1. Ensure that, wherever possible, a scientifically satisfactory method or testing strategy, not involving the use of live animals is used instead
2. Use a minimum amount of animals without compromising the objectives of the project.
3. Ensure breeding, accommodation, and care, methods of prcedures procedures and eliminating are reduced to the minimum of any possible pain, suffering, distress or lasting harm to the animals.

Question 19

Describe factors of consideration in animal research

Answer 19

• How important is the possible result?
• How likely are there to be benefits?
• Possible benefit vs certain harm
• Act certainty v omission possibility: animals will surely suffer by the act, humans might suffer without research
• 92% of drugs shown safe and effective in animals fail in human trials

Question 20

In the past there has been problems when it comes to experimenting on humans. Describe 3 situations in history where humans have been use

Answer 20

1. Tuskegee syphilis experimennt

• 1932-1972, US
• 399 African americans with untreated syphilis monitored for 40 years
• Told that they would be getting free medical care
• Not told of their diagnosis - given placebos rather than experiment

2. HeLa cell line

• African american woman’s cancer cell growth culture after she had died
• Conset from her or her family never sought
• Total mass of HeLa cells > 50 million tonnes
• Still in use today

3. Nazi experiments on prisoners

• Nazis claimed not to see some people as fully human but still used for medical research
• Denial of humanity
• Indifference to suffering
• Some experimental results still in use today

Question 21

List the five “rules” of ethical (human) research

Answer 21

1. Obtain informed conset
2. Minimise risk of harm of partcipants’
3. Protect anonymity and confidentiality
4. Be transparent to subjects (avoid deception)
5. Respect participants’ right to withdraw

Question 22

What are the reasons for con compulsion (compulsive) vaccinations?

Answer 22

• Autonomy - individuals right to choose or parents’ right to make treatment decisions for their children
• Fear of “other kinds of hrm” - Blood-clot paranoia around Oxford-AstraZeneca Covid vaccine,Wakefield MMR scandal
• Distrust of medical profession
• Distrust of ‘big pharma’
• Vehemence (sometime violent) of some ant-vaxxers

Question 23

What are the reasons for pro compulsion (compulsive) vaccinations?

Answer 23

• Beneficience- good for the individual
• Consequentialism (Ulitarian) - “herd immunity” leads to general reduction in suffering
• Non-malificence - unvaccinated individuals are at risk of harm
• Justice - compromising herd immunity by refusing to bevaccinated or vaccinate one’s child is not fair to others

Question 24

What are some hard problems for parents when it comes to vaccinating their child?

Answer 24

• Harm vs benefit - will the vaccine harm/benefit my child?
• Knowledge vs belief - “do you know that the vaccine is safe?”
• Individual vs population vs patient autonomy - “why should I put my child at risk for the sake of this ‘herd immunity’”

Question 25

a) What are vaccine passports? b) What issues can this lead to?

Answer 25

a) Certificate to permit access to some venues or transport etc b) * Alienation from health services and professions * Discrimination against groups or those refusing vaccination * Some might feel compelled to get vaccinated