PHIL 235 BIOMEDICAL ETHICS EVALUATION
EXAM REVIEW QUESTIONS AND ANSWERS SURE
A+
✔✔a duty that is morally obligatory unless it conflicts with another moral duty, in which
case the more pressing duty takes precedence.
- fidelity - keeping both explicit and implicit promises;
- reparation - righting previous wrongs one has committed;
- gratitude - acknowledging services rendered by others;
- justice - rewarding acts of merit and thwarting those that aren't meritorious;
- beneficence - bettering the condition of others in the world;
- self-improvement - improving one's own virtue or intelligence; and
- nonmaleficence - refraining from injuring others - ✔✔prima facie duty
✔✔Aristotle
How you ought to be and how you ought to live
- Not a situation but rather your traits
- You become virtuous by performing the act
- Golden middle ground between two extreme behaviors that are virtuous.
limitation: tells us how to be, not what to do in a particular situation - ✔✔Virtue Ethics
✔✔Carol Gilligan
,a two-pronged theory of moral development widely used to guide actions and resolve
conflicts by (1) minimizing and avoiding harm, and (2) maintaining, protecting, and
creating positive relationships.
- Not looking at moral situations in terms of rights and justice
- Looking at it in terms of care and relationships.
- Instead of "Respect my rights" Its "I wish they could see things my way"
limitation: can't apply to strangers - ✔✔Ethics of Care
✔✔the medical principle of doing no long-term harm to a patient or worsening his
condition. - ✔✔non-maleficience
✔✔utilitarianism allows unjust behaviours to be done to a few individuals in order to
create a greater good for a larger number of individuals
- Modern utilitarians use a two-level strategy to deal with justice objection criticism
o First level: rule utility: we use general rules that benefit all people and acknowledge
and protect individual rights
o Second level: act utility - ✔✔the justice objection (utilitarianism)
✔✔- Above all, do no harm
- He was not the author
- Updated version written by Louis Lasagna "Above all I must not play at god" -
✔✔Hippocratic Oath
✔✔1. respect for autonomy
2. beneficence (doing good for or helping the patient)
3. nonmaleficence (not inflicting unnecessary pain, suffering, and/or harm on patients),
4. justice - ✔✔4 principles of biomedical ethics
✔✔a group of moral persons or moral agents, individuals who agree to voluntarily limit
their behaviour in order to achieve personal and social benefits through promoting the
goals of morality: practical action guidance and conflict resolution. - ✔✔moral
community
✔✔the policy or practice on the part of people in positions of authority of restricting the
freedom and responsibilities of those dependent on them in their supposed interest.
advantages: doctor has more training, doctor must make decisions with patients under
distress, unconscious...
disadvantages: suspends autonomy, things might have to be hidden - ✔✔paternalism
✔✔the belief that it is permissible to interfere with the autonomy of a competent
individual only when he is acting in an apparently irrational fashion that could lead to
harm to himself or to others. - ✔✔weak paternalism
, ✔✔the belief that it is permissible to override the autonomy of a competent individual in
order to promote beneficence and nonmaleficence. - ✔✔strong paternalism
✔✔a more accurate characteristic by which to measure an individual's ability to
understand and respond to a medical situation
3 diff standards of competence:
a) Minimal standard of competence (focuses on autonomy, more subjective)
o involves respecting every explicitly expressed choice a patient articulates.
o Disregards that not every choice will be competent
b) Outcome standard of competence (focuses on beneficience, more objective)
o the standard of "reasonable or rational choice" is assumed to be objective and the
patient must live up to this standard in order to be deemed competent.
o fails to protect the autonomy of the patient at all since it denies that non-standard
choices are ever competent, and pins everything onto beneficence.
c) Process standard of decision making competence (balancing autonomy and
beneficience)
o Process more important than the content - ✔✔Brock and Buchanan definition of
competence
✔✔an individual's ability to perform a particular task; competence to make medical
decisions requires the rational, mentally mature decision-maker to (1) be free from any
internal or external constraints that might impede his ability to understand the medical
situation, prognosis, and treatment options and the risks of treatment and non-
treatment, and (2) be able to make a decision that reflects his long-term, settled values.
- Competence is met when one has the abilities, skills, and knowledge necessary to
make a particular decision in a particular context.
- competence can vary with the time of day, the situation, the presence of drugs or
alcohol, the effects of head injury
- when patient not competent, need a surrogate - usually parents - ✔✔competence
✔✔1. Patient is at risk of a significant, preventable harm
2. Paternalistic action will probably prevent the harm
3. Projected benefits to the patient of the paternalistic action outweigh the risks
4. There is no reasonable alternative to limiting autonomy
5. The least autonomy restrictive alternative that will secure the benefits and reduce the
risks is adopted
6. Paternalistic action would not damage substantial autonomy interests -
✔✔Beauchamp & Childress requirements for hard paternalism
✔✔1. The Paternalistic model: Physician holds final decision-making power
2. The agency model: Physician acts as technical consultant where patient has
decision-making power.
3. Contractual model: Explicit or implicit contract entered by both parties. Care limited to
mentioned items
EXAM REVIEW QUESTIONS AND ANSWERS SURE
A+
✔✔a duty that is morally obligatory unless it conflicts with another moral duty, in which
case the more pressing duty takes precedence.
- fidelity - keeping both explicit and implicit promises;
- reparation - righting previous wrongs one has committed;
- gratitude - acknowledging services rendered by others;
- justice - rewarding acts of merit and thwarting those that aren't meritorious;
- beneficence - bettering the condition of others in the world;
- self-improvement - improving one's own virtue or intelligence; and
- nonmaleficence - refraining from injuring others - ✔✔prima facie duty
✔✔Aristotle
How you ought to be and how you ought to live
- Not a situation but rather your traits
- You become virtuous by performing the act
- Golden middle ground between two extreme behaviors that are virtuous.
limitation: tells us how to be, not what to do in a particular situation - ✔✔Virtue Ethics
✔✔Carol Gilligan
,a two-pronged theory of moral development widely used to guide actions and resolve
conflicts by (1) minimizing and avoiding harm, and (2) maintaining, protecting, and
creating positive relationships.
- Not looking at moral situations in terms of rights and justice
- Looking at it in terms of care and relationships.
- Instead of "Respect my rights" Its "I wish they could see things my way"
limitation: can't apply to strangers - ✔✔Ethics of Care
✔✔the medical principle of doing no long-term harm to a patient or worsening his
condition. - ✔✔non-maleficience
✔✔utilitarianism allows unjust behaviours to be done to a few individuals in order to
create a greater good for a larger number of individuals
- Modern utilitarians use a two-level strategy to deal with justice objection criticism
o First level: rule utility: we use general rules that benefit all people and acknowledge
and protect individual rights
o Second level: act utility - ✔✔the justice objection (utilitarianism)
✔✔- Above all, do no harm
- He was not the author
- Updated version written by Louis Lasagna "Above all I must not play at god" -
✔✔Hippocratic Oath
✔✔1. respect for autonomy
2. beneficence (doing good for or helping the patient)
3. nonmaleficence (not inflicting unnecessary pain, suffering, and/or harm on patients),
4. justice - ✔✔4 principles of biomedical ethics
✔✔a group of moral persons or moral agents, individuals who agree to voluntarily limit
their behaviour in order to achieve personal and social benefits through promoting the
goals of morality: practical action guidance and conflict resolution. - ✔✔moral
community
✔✔the policy or practice on the part of people in positions of authority of restricting the
freedom and responsibilities of those dependent on them in their supposed interest.
advantages: doctor has more training, doctor must make decisions with patients under
distress, unconscious...
disadvantages: suspends autonomy, things might have to be hidden - ✔✔paternalism
✔✔the belief that it is permissible to interfere with the autonomy of a competent
individual only when he is acting in an apparently irrational fashion that could lead to
harm to himself or to others. - ✔✔weak paternalism
, ✔✔the belief that it is permissible to override the autonomy of a competent individual in
order to promote beneficence and nonmaleficence. - ✔✔strong paternalism
✔✔a more accurate characteristic by which to measure an individual's ability to
understand and respond to a medical situation
3 diff standards of competence:
a) Minimal standard of competence (focuses on autonomy, more subjective)
o involves respecting every explicitly expressed choice a patient articulates.
o Disregards that not every choice will be competent
b) Outcome standard of competence (focuses on beneficience, more objective)
o the standard of "reasonable or rational choice" is assumed to be objective and the
patient must live up to this standard in order to be deemed competent.
o fails to protect the autonomy of the patient at all since it denies that non-standard
choices are ever competent, and pins everything onto beneficence.
c) Process standard of decision making competence (balancing autonomy and
beneficience)
o Process more important than the content - ✔✔Brock and Buchanan definition of
competence
✔✔an individual's ability to perform a particular task; competence to make medical
decisions requires the rational, mentally mature decision-maker to (1) be free from any
internal or external constraints that might impede his ability to understand the medical
situation, prognosis, and treatment options and the risks of treatment and non-
treatment, and (2) be able to make a decision that reflects his long-term, settled values.
- Competence is met when one has the abilities, skills, and knowledge necessary to
make a particular decision in a particular context.
- competence can vary with the time of day, the situation, the presence of drugs or
alcohol, the effects of head injury
- when patient not competent, need a surrogate - usually parents - ✔✔competence
✔✔1. Patient is at risk of a significant, preventable harm
2. Paternalistic action will probably prevent the harm
3. Projected benefits to the patient of the paternalistic action outweigh the risks
4. There is no reasonable alternative to limiting autonomy
5. The least autonomy restrictive alternative that will secure the benefits and reduce the
risks is adopted
6. Paternalistic action would not damage substantial autonomy interests -
✔✔Beauchamp & Childress requirements for hard paternalism
✔✔1. The Paternalistic model: Physician holds final decision-making power
2. The agency model: Physician acts as technical consultant where patient has
decision-making power.
3. Contractual model: Explicit or implicit contract entered by both parties. Care limited to
mentioned items
