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Philosophy 1370.docx

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Philosophy 1370Philosophical Issues in Health CareA wide range of issues in health care will be discussed in this courseA few of these are not directly about ethics example What is health What does it mean to be autonomousBut most of the issues we will be concerned with will be ethical in nature issues about right and wrong So the question arises why study ethics Why should you study health care ethicsThe short answerIt is just a fact nowadays that ethics is an important part of the health care professions So if you want to be a fully competent complete HC professional you have to know something about ethics Why is ethics important in health care The nature of illness makes patients highly vulnerable which creates the possibility for abuseHippocratic OathAbove all do no harmThree revolutionary changes in HCNew attitudes toward patientspatient rightsScientific medicine development of new medical technologiesEmergence of large health care organizations and bureaucracies New attitudes toward patientsIn traditional medicine the treatment of patients was paternalisticDoctor knows bestPaternalism has been replaced by the practice of informed consent Ultimately it is the patient who should decideThis is a good change but it raises many new issues Some issues involving patient consentConditions of valid consentHow do we know if a patient is competent Is informed consent really possible in HCShould health care workers always tell patients the truthWhen if ever can a patients wishes be overruledAre placebos acceptable Issues related to science and technologyShould physician assisted suicide be legalized Who should decide when it is time to pull the plug Should the sale of human organs be legalized When is it permissible to experiment on humans Is genetic therapyacceptableEthics of prenatal screening Issues related to health care bureaucraciesHow should HC resources be distributed First come Worst off Most deservingShould alternative medicines be publicly funded Which onesMay HC providers dofavours for familyfriendsIs there a human right to HC But theyll tell us what to doWherever you work there will be rules and procedures involving ethicsBut following these rules wont be enough Reasons why the rules wont be enoughNo set of rules can anticipate all the contingencies that might ariseyou must have your own skills to fall back onThe rules may presuppose that youre already familiar with HC ethicsYou might be the one in charge of making the rulesUltimately youre responsible for your own actionsit will be no excuse to say you were just following rules or orders We dont need a course to tell us right from wrongThis misunderstands the purpose of this course It is not moral instructionI will not tell you whats right and whats wrong in health careTogether we will explore a wide range of issues in health care Hopefully this will help you improve your ability to discuss ethical issues in an intelligent reasonable way But ethics is subjectiveIt is clear that medicine and the field of health care assume that ethics is NOT subjectiveIn the real world its hard to accept that anything at all is morally acceptableReason and reflection can provide a reliable guide in trying to decide whats right and wrong MORAL THEORIES IN HEALTH CAREMoral theories discussed in Reading 1UtilitarianismKantian EthicsRosssEthicsRawls theory of justice Natural Law theoryVirtue Ethics Care Ethics Feminist Ethics What is a moral theoryA moral theory tries to give a complete answer to the following question What is it that determines whether an act is right we have a moral obligation to do it or wrong we have an obligation not to do itAnswering this question could help us resolve moral dilemmas and disagreements in health careTwo Types of Moral TheoryConsequentialism the rightness of an act depends only on its consequencesNonconsequentialism consequences are not the only thing that affects the morality of an act UtilitarianismThe most prominent form of consequentialismAccepted by many philosophers today
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