EXAM STUDY DOC

FORMAT 20 Multiple Choice - Choose the most correct answer to each Multiple Choice or True/False question. - You are not able to go backwards in the exam. Save each answer. - There are some “choose all that apply” questions which require a multiselect response (2-4 correct answers for each question). Choose all options you feel are correct. - All other multiple choice questions are single response answers. - Practice questions at the bottom of the following module: https://courses.ryerson.ca/d2l/le/content/492608/viewContent/3614855/View 5 Short Answer - Write your response to the short answer questions directly in the space provided for each short answer. You will choose a total of 5 concepts from a list of 20. - Identify which concept you will be writing about in each short answer space provided. Do not include all 5 written responses in one short answer space. - Each short answer is valued at 3 marks for a total of 15 marks for the short answers. - Describe and Explain each selected concept/term AND explain the meaning and significance for each of the FIVE terms/concepts relative to the Health Care Context that you have selected in the space provided. - Copy and paste each of your 5 concepts into one word document and upload that word document to the Final Exam folder found in the assignments section by 3:15 PM. DELEGATION OF NOTES Name Module Textbook Section Topics/Terms of Importance Anisha 1 xi–xix - Ethics vs Morality - Ethical vs Practical Dilemmas Anisha 3 Ethical Resources for Decision-Making - Rossian Deontology (pluralism, prima facie duties) - Feminist Ethics (ethics of care, naturalized feminist bioethics) - Virtue Ethics (disposition, habit, mean) - Rossian Deontology vs Virtue Ethics vs Feminist Ethics Anisha 5 The Physician as the Therapist - Human Research Subjects - Concerns (infants, elderly) - Rationale for Restrictions Anisha 7 The Moral Significance of Birth Abortion Through a Feminist Ethics Lens Moral Obligations to the Not-Yet-Born - Views on the Moral Status of the Fetus - Challenges Presented to Traditional Ethical Theories - Issues Concerning Abortion - Parents’ Obligation to Unborn Children Anisha 9 N/A - Ethics of Mental Health Care (autonomy,

paternalism, oppression) - Ethical Judgements About Mental Health vs Ethical Judgements About Autonomy - Mental Health Through Utilitarianiam and Feminist Bioethics Lens Anisha 11 Chaoulli v. The Attorney General of Quebec and the Attorney General of Canada Supreme Court Slaps For- Sale Sign on Medicare Equality and Efficiency as Basic Social Values Privatizing Health Care Is Not the Answer - Healthcare in a Canadian Context - Libertarianism and Rawls’ Political Philosophy - Macro Allocation of Resources (equality, efficiency) - Main Features of Supreme Court of Canada ruling in Chaoulli vs The Attorney General of Quebec and the Attorney General of Canada - Funding Healthcare in Canada (Kantian Deontology, Utilitarianism, Feminist Bioethics, Libertarianism, and Rawls’ Political Philosophy) Jayna 2 Moral Theories - Utilitarianism (consequentialism, utility, greatest happiness principle) - Deontology (categorical, imperative, autonomy) - Means vs Ends - Utilitarianism vs Kantian Deontology Jayna 4 Four Models of the Physician-Patient Relationship A Moral Theory of Informed Consent A Relational Approach to Autonomy in Health Care - 4 Models of Client-Provider Relationships (strengths, weaknesses using deontology, utilitatrianism, virtue ethics, feminist ethics) - Informed Consent - Relational Autonomy (feminist concerns, application to models) Jayna 6 Voluntary Euthanasia: A Utilitarian Perspective Gender, Feminism and Death - Assisted Death (for, against) - Euthanasia (voluntary, non-voluntary, involuntary) - New Technologies to Prolong Life - Utilitarianism and Kantian Deontology - Legalization Jayna 8 The Ethics of Genetic Research on Sexual Orientation - Germ-line Gene Therapy (for, against) - Genetic Screening, Testing, and Enhancement (social, political) - Available Information, Limitations,

- No emotion involved in judgement; no moral worth if acting from desire and not duty - Good = goodwill - Character depends on one’s intentions, not the result of their actions - An action done from duty has moral worth, not in the consequences to be attained by it, but in the maxim on which it decided upon Maxim - A general rule/principle which specifies what it is I will do and my reason for doing it - Must be applicable in all circumstances by all people to maintain logical consistency Categorical Imperative First Formation: Logical Consistency - Act on that maxim which you will to become a universal law - Treat oneself and all others as everyone ought to be treated - What is right for one is right for all - Universalized Second Formation: Do Not Just Use People - If I act on maxims that serve as universal laws, I will never treat a person as a means to my end - Value the intrinsic worth and dignity of rational human beings - Respect for the freedom to self-determine/choose, decide/judge for myself - Plays a role in therapeutic relationships, informed consent, valid consent to research, requests for PAD Third Formulation: Autonomous Agents - We treat others as autonomous agents, capable of self-directed action - Act freely on the basis of reason 3 Questions to Satisfy the CI - Could my personal maxim be a universal law? (must be yes) - Would my action degrade other rational agents by treating them as a means to an end? (must be no) - Would my action violate the autonomy of some rational agent, possibly myself? (must be no) Deontological Theory of Obligation, Kant (first means of argument) - Denies that we must only maximize the good and minimize the bad of our actions - Good and bad consequences do not determine whether or not the act is morally right or wrong - Obligation does not involve the maximization of the good - We must never withhold the truth from our patients - Lying is not justified in terms of consequences unless it meets the Categorical Imperative (ignores consequences all together) Deontological Theory of Obligation, Kant (second means of argument) - Additional ultimate obligations to maximizing the good/minimizing the bad: beneficence (do good for others), fairness, gratitude - A pluralistic theory - The duty to be fair is just as ultimate as the duty to maximize the good

Utilitarianism Formula - Project consequences of each action - Include direct, indirect, immediate, and long-term consequences - Calculate the balance of utility over disutility - Select the action the will produce the greatest happiness for the greatest number of people AU - Greatest good for the greatest number (GGGN) - All persons will be considered equally - All possible actions must be defined Weaknesses - Special duties, relationships, obligations; a monistic theory; may violate individual rights; time consuming to accurately calculate the action which maximizes good Strengths - Includes consideration of indirect consequences; equitable and impartial; levels power imbalances; objective assessment RU, Rawls - Construct moral rules to promote GGGN - An act is morally right only if it conforms with a set of rules whose general observance maximizes utility - Promotes general welfare - Do not lie, do not steal, do not kill Beneficence - Do good towards others, the individual, or society; above all, do good - One ought to not inflict harm (prevent), one ought to remove evil or harm (remove), one ought to do or promote good (promote) Nonmaleficence - Intentionally refrain from actions that would cause harm - Do not murder, lie, steal, ridicule, insult, belittle - Harm: kill, pain, suffering, offend, deprive others of life’s goods Autonomy - Self-governance, liberty, rights, privacy, individual choice, freedom of will - Acknowledge a person’s right to hold views - Take actions based on personal values/beliefs - Respectful action and attitude Limits in Healthcare - Cases of communicable diseases - Endangering the health of others - Prevent the harming of others - Prevent harm to self (paternalism) - Prevent the offending of others - Requires a resource that does have available funding - To benefit that person (paternalism) - To benefit others (social welfare) Justice - Equality of fairness - Refers to distributive justice/fair allocation of resources

works to level the power dynamic Informed Consent - The patient must be deemed competent/rational - Makes a reasonable choice from a set of options - Has adequate information and understanding about the available choices and consequences of the decision at hand - Free from explicit coercion toward/away from any on of the options Competency Requirements - Possession of a set of values - Ability to communicate/understand information - Ability to reason/deliberate Feminist Lens - Believe the forces of systematic domination/oppression has limited the autonomy of women/other oppressed groups - Sensitive to the ways in which gender, race, class, age, ability, sexual orientation, and marital status can undermine a patient’s autonomy/authority/credibility - Suggest an open consent process/providing an opportunity to ask questions; those who are marginalized may feel intimidated/not know which questions to ask - Women/other marginalized groups are considered irrational, thus deeming them incompatible with the informed consent criteria - Autonomy is granted to those who are self-interested/sufficient; this is exclusionary for those who are financially dependent or differently abled MODULE 5: RESEARCH ON HUMAN SUBJECTS Subtopic Main Points Research - Has many definitions, can be non-invasive as well as invasive - Research can be intermixed with various kinds of health care practice in ways that can be hard to discern - Can infringe upon the relationship between patient and practitioner if too invasive - Can harm the patient, by breaching CONFIDENTIALITY Utilitarian Concern - One major concern about medical research, particularly experimentation, is that the results are unknown - Medical treatment has the utilitarian aim of avoiding harmful consequences and/or bringing about good ones for the patient, medical experimentation is undertaken with the intention of finding out how to do this, for the patient and for many others Deontological - Suggests that medical research only be undertaken when it offers some hope of benefit to the subjects as well as to others. This helps to limit the unfairness in the risks taken by the subjects on behalf of others - Kantian deontology offers to address the concern that risks and benefits are not fairly distributed in medical research by requiring that we appeal to potential subjects as autonomous individuals.

Feminist - Health care clients are generally more vulnerable than the general population. - When they are also disadvantaged populations it is worse - Women are more vulnerable to exploitation - Concerns with autonomy and using people as a means to an end MODULE 6: END OF LIFE DECISIONS Subtopic Main Points MODULE 7: MORAL STATUS OF THE FETUS Subtopic Main Points MODULE 8: GENETICS Subtopic Main Points MODULE 9: MENTAL HEALTH Subtopic Main Points

Chaoulli v. The Attorney General of Quebec and the Attorney General of Canada most from it. Thus, it is argued, not only is the Canadian system the one which promotes the greatest health for the greatest number of people, but one that is more socially just. - A decision made by the Supreme Court of Canada where the majority ruled against the prohibition on private health insurance in the public healthcare system’s lack thereof. George Zellotis, along with his doctor Jacques Chaoulli appealed the Supreme Court of Canada to permit access to private health care in the absence of a reasonable wait time within the public healthcare system. Three out of four of the justices found that the right to life, as outlined in section 7 of the Canadian Charter of Rights and Freedoms is affected by the long waiting times.