Exam 1 PHI 220
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Northern Kentucky University *
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220
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Philosophy
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Feb 20, 2024
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1.Examine the case study titled, “Ventilator shortages: Who Should Live,” on page 67 of our textbook, The Ethics of Pandemic. Based on the discussions in chapter 4, what moral values ought to govern decisions around resource allocation in the situation that Dr. Achebe faces in the case study? Describe the priorities that you would give to each of the moral values? Are there any people who would be more
disadvantaged by the values and priority you have chosen? (350 words)
In retrospect the decision should be made by who would have the best quality of life after recovery. The decision should also be based on if the person is expected to make a full recovery or not. I find it hard to feel like any of these options are of moral value. The case study titled, “Who Should Live”, paints a disturbing picture of reality doctors are being faced with during this pandemic. In this situation, giving priority to the worst off, as stated in chapter 4 of The Ethics of Pandemic states to give priority to the sickest patients first. It also goes on to say that priority care is a major aspect when dealing with these circumstances. Dr.Acheba is faced with numerous patients all needing vent care. Patients that all have families and could live a prominent life with successful care. The decision to take one person off the vent to care for another is not an easy decision. Dr. Acheba is faced with the decision to potentially give a patient up to die so another could live. Each patient has their own unique life and reason for living or for Dr. Acheba to want the patient to continue to live. If we take out the non-medical aspect of each case study, we will have a better flow of what needs to be priority. Forty-four-year-old Janet Greene with COVID-19 symptoms that needs a vent that is relatively good health before contracting COVID. Seventy-year-old male excellent condition before he came down with COVID-19 remains on ventilator with a high probability of dying if removed. Twenty-two-year-old woman in a serious medical state before being put on the ventilator. She has type 1 diabetes, liver disease, and an autoimmune disorder, but Dr. Acheba feels she could have many years ahead of her if she survives. Then there’s disabled man who has no COVID symptoms, but has a ventilator attached to his wheelchair. This patient can not survive without the ventilator. My top priority would be the patients that would benefit the most from the ventilator that would have a chance at a many years after
overcoming their illnesses. Priority one would be the 44-year-old, followed by the 70-year-old, then the disabled male, finally the 22-year-old female. I chose to prioritize in this manner because morally I feel it is right. The 22-year-old at least has a chance of survival without being on the vent as the others do not currently. She has pre-existing conditions that could or could not be affected by COVID. Now, she is not being affected by those pre-existing conditions allowing for her to be extubated and another source of oxygen applied. 2.In the readings for chapter 4, Ballantyne and Scully criticize some of the proposed standards for resource allocation on the grounds that they may disadvantage certain groups, such as disabled people, ethnic minorities, and people of lower socio-economic status. Do you find their arguments convincing? Why or why not? Could the criteria proposed by Emmanuel at al. be adjusted in response to Ballantyne’s
and Scully’s arguments? Is Fin’s response to the disability criticism successful? (350 words)
I do find their arguments convincing as I have a hard time prioritizing disabled individual or those that are already at a disadvantage either from being an ethnic minority or having a lower socio-economic status. I believe that an individual’s care should not be based on either of those factors and entirely on the health of the patient. Understandably with the COVID outbreak certain countries are faced with the
decision of triaging patients in a way that ensures those who have a possibility of life after successful treatment. We as healthcare professionals are having to decide which individuals get access to life saving care and who does not.
Scully goes on to say that the three-overlapping distinct disablist assumptions that critically endanger people with disabilities in a situation with clinical triage are first, there are assumptions about the overall health status of disabled people. Second, assumptions about disabled people’s quality of life, and
finally assumptions about disabled people’s social utility. He goes on to say that the social utility only becomes relevant if there is confusion about the role it plays (or should not play) in critical care decision making. As background its important to recognize that most triage protocols use probable clinical outcomes. As the primary decision-making criterion. This comes down to if the treatment will save the persons life who would otherwise not recover. Being able to recover without it or being certain to die with it are both reasons for refusal of treatment for this patient. Fin assisted in writing the guidelines on allocations of ventilators during a public health emergency in 2015 for the New York State task force. This is centered around the Sequential Organ Failure Assessment
(SOFA). This would allow for patients to be triaged into four codes, blue, green, red, and yellow. This score is based on several different factors already built into the system. It also avoids discriminating against individuals with disabilities.
Fin’s response to the disability criticism was successful in that Fin was in a heated debate with the task force with the which report discrimination against disability. He goes to say they debated about the allocation of ventilators. The late Adrienne Asch, a disability scholar and bioethicist who was a member of the task force helped to distinguish a ventilator in chronic use to maintain the health of someone with
pre-existing lung condition form a ventilator which was used in response to acute pandemic. Distinguishing between the two helped to do away with discrimination due to a disability. 3.In order to satisfy domestic obligations of justice, must we have publicly funded, universal health care?
Answer the question based on what you have studied from chapter five of our textbook, The Ethics of Pandemic. (300 words)
The social economic factor that influences a person or groups health in a positive or negative way. For example, people living in poverty or in polluted areas will often experience health problems as a result. The social determents of health include income and income distribution, social status, education and literacy, unemployment and job security, physical environment, employment and working conditions, childhood experiences, food insecurity, housing, social exclusions, social safety networks, access to health services, sexism, racism, ableism, and access to land. (The Ethics of Pandemics, chapter 5, page 72).
Publicly funded healthcare is a must in the U.S. We are faced with many oppressions that cannot be overcome by one’s self when faced with the list of social economic factors stated above. Other countries
have publicly funded universal healthcare. Why can’t we? In our society we are challenged to get privately offered insurance that cost as much as a house payment depending on the professional position a person holds. Personally, I am affected by the high prices that have me questioning if I can
afford the type of insurance my facility offers. With publicly offered health insurance I suspect that this would eliminate a lot of the “price gauging”. In our area we have a lot of individuals that do not have insurance. In Kentucky we have several ways to insurance one’s self. Since the pandemic in our area the state has mandated WellCare insurance for everyone in the state of Kentucky despite their social or economic status. This has been beneficial for those who would not otherwise have insurance. I assume as much beneficial as it would be to have national publicly funded healthcare. Our book states that national publicly funded healthcare would allow for the government to mandate the care taking the action away from the physician. I can see this being an issue as government funded Medicaid is very much ran by the government and several procedures and tests ordered are being declined and replaced with what is covered under the policy. This could be a major issue for people facing procedures that could be life saving that are being declined. 4.Are there global obligations of justice, or do nations have obligations of justice only to their own citizens? Do these obligations shift when during a pandemic? What argument would any of the authors in chapter five (of our textbook, The Ethics of Pandemic) offer to support the view that nations have obligations of justice only to their own citizens and which of the authors, if any, would disagree? Where do you stand on the debate? Defend your view. (300 words)
The global obligations of justice should be only to their citizens. As with many other laws governing our nation, this should be no different. I concur that nations should discuss actions that could be taken during a pandemic and strategies in an effective manner to control the pandemic spread. However, I feel
that each nation has their own obligations with their citizens to set forth a plan to control and minimize the spread of the pandemic. This pandemic COVID-19 spread quickly through our nation as it did with other nations. We found quickly by working with other nations protocols to use to help combat the spread and the medications being used. It was merely a suggestion not an action of another nation to govern our citizens. I like what author, Shaun Ossei-Owusu stated in his passage. He speaks about a book titled, “Faces at the
Bottom of the Well”. In this passage it talks about the environment being in shambles and how the poor choices made had the country in shambles and how the elderly and sick had to wear masks when venturing outside. He goes on to say that the world of coronavirus is not simply black and white. He states, its white and non-white, poor and non-poor. He writes that entire populations are considered disposable. He states that the responsibility of death due to COVID-19 is not only the responsibility of the governed but of private sectors as well. He goes on to say that there will be a tell of tales about who mattered and who was sacrificed once this pandemic ends. Is there something our government is not telling us? Is there something other nations know that could benefit our people? I stand with one nation governing one nation to combat this pandemic. I stand with our nation seeking assistance for reputable knowledge to control this pandemic. I stand with rules and regulations being put into place by our government. I however do not stand with other nations who offer control over this nations people.
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