Biomedical Ethics Final Exam Review

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13 May 2011
Biomedical Ethics Exam Review
(1) The reason “medical futility” should not be used as a reason to deny treatment
-futile refers to uselessness of medical intervention
-Wicclair defends the idea that medical futility” should not be used as a justification for physicians
refusing life-sustaining treatment because it involves evaluative standards
-although there is a general consensus that patients and their surrogates can accept or refuse life-
sustaining treatment, there is increasing support for the idea that physicians are not required to offer
medically futile treatments
(2) What are reasons that bearing a child with the gene for HD is immoral?
-the fetus has a moral status if we have to have some reason for destroying it
-it is ironic that we have acquired the ability to detect and eliminate the medically unequal at a time in
history when we have finally succeeded in removing much of the stigma associated with certain illnesses
-the way we speak has allowed many to believe that one is the disease than actually has the reason
-the parents of such child are likely to treat them differently and resent them especially if the mother
wished for but did not get amniocentesis because of ignorance, poverty, or distance from the testing
-life will become even more unbearable for those defectives that escape detection
-abortion after prenatal screening may look like killing imperfect humans without their consent
-all human beings are seen are moral equals, so all human beings are equally entitled to a high quality of
-it is morally wrong to reproduce when we know that there is a high risk of transmitting HD
-Purdy says that is it one thing to take risks for oneself, but another to subject someone else to suffering
without their consent
-optimists claim that a child born with the HD gene has a reasonable chance of living a satisfactory life
-pessimists believe that 50% chance for HD is too high
-children born into a HD family will have to spend years wondering if they will develop the disease
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-Purdy says that is essential that we try to provide a child with a minimally satisfying life
-this idea can be derived from either utilitarian or contractarian theories of justice
-the judgment is that we ought to try to prevent unhappiness where we can
-some think that this is in conflict with the right to reproduce
-it might seem like a huge sacrifice to require not to have genetically related children because the main
reasons that people have children is so that they can enjoy family life: love, companionship, watching the
children grow, to feel like adults, and to cement a marriage
-however there are alternative ways of satisfying these desires
-some people think they have the right not to know
-Purdy says this can only be defended if it does not place others at serious risk
(3) The five forms of euthanasia and their legality
Voluntary active: The patient requests a lethal injection because of suffering and poor prognosis (legal
only in the Netherlands)
Involuntary active (illegal everywhere): murder
Voluntary passive: the patient requests that treatment be discontinued so that the disease takes its course
Involuntary passive: when there a permanently comatose or vegetative patient and treatment is
discontinued without the patients consent (because the patient cannot give consent and is likely not to
Physician Assisted Suicide: not technically euthanasia. A physician prescribes a lethal dose of
medication or sets up a contraption which allows the patient to trigger intravenous lethal fluid. The
proximate cause is the patient himself. Legal only in Washington and Oregon in North America.
(4) The relationships between genotypes and phenotypes
A genotype describes the actual set (complement) of genes carried by an organism, whereas a phenotype
refers to the observable expression of characters and traits coded for by those genes.
(5) SCNT (Somatic Cell Nucleus Transfer)
-SCNT is partially continuous with previously existing technologies, but it is also something new
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-combined with the technology for genetic enhancement, it has foreseeable consequences
-the technology for SCNT is well-defined and it requires significant skill and know-how
-the demand for SCNT is low and most people are against it
-nothing would be lost by banning it
(6) The implications for reproductive liberty of Kass right to life position
-the defenders of cloning see themselves as defenders of freedom, the freedom to make progress in genetic
knowledge, the freedom of entrepreneurs to profit on the market
-they argue that cloning is similar to practices that are now commonly accepted
-this is the logic of the slippery slope—it foes all the way to determining the entire genetic make-up of the
-proponents of SCNT urge us to forget about the wrong reasons for cloning and focus only on the infertile
couple who wants to reproduce
(7) The legality of various reproductive technologies in Canada
To be done.
(8) The arguments against cloning for biomedical research given by Kass
-anyone can be cloned, an infant, and adult, or even the dead because stored cells can outlive their source
-we have to decide whether children are to be made or begotten
-the success rate is not very high, so it is unlikely to be very popular, but fertility clinics have already has
inquiries from people eager to clone
-cloning is a violation of our human nature and kinship relations that are based on a natural ground
-cloning is a radical form of child abuse
-it constitutes unethical experimentation, threatens identity and individuality, turns reproduction into
manufacture, and is a perversion (parody) of parenthood
-these objections do not concern the cloning of embryos for research
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