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PHL 223

by: Paola Araque
Paola Araque
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About this Document

These notes cover the lecture from the first week of Medical Ethics
Medical Ethics
Stuart Rachels
Class Notes
medical ethics




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This 3 page Class Notes was uploaded by Paola Araque on Friday January 29, 2016. The Class Notes belongs to PHL 223 at University of Alabama - Tuscaloosa taught by Stuart Rachels in Summer 2015. Since its upload, it has received 26 views. For similar materials see Medical Ethics in PHIL-Philosophy at University of Alabama - Tuscaloosa.

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Date Created: 01/29/16
Medical Ethics Notes: Week 1  Lecture    ● The field of medical ethics began arount the 1970s. Why not before?  ● Trends in Philosophy  a) Philosophy had been dominated by the analysis of language  b) Then…  i) A Theory of Justice (John Rawls)  ii) Delayed impact of the 1960s (activism, protest on Vietnam War, Civil  Rights Movement, Sex, Drugs, Feminism  iii) Common sense  ● Technological advances created new ethical problems.  a) New life sustaining technologies (feeding tube, ventilator)  ● Active Euthnasia​ ­ taking an active role in ending life, also known as mercy killing.  ● Passive Euthnasia​ ­ letting someone die, you could have done something but didn’t.  ● Crisis: medical technology lets us sustain life longer than ever before.  ● In the U.S.:  a) Active euthnasia is murder, under the law.   b) Passive euthnasia is legal. Most deaths are passive euthnasia. Before, people  would die in their home. However, it is more common that people die in hospitals.   ● Karen Quinlan (1975)  a) Took drugs and stopped breathing, caused anoxia to the brain (no oxygen to the  brain).  b) Fell into a persistent vegetative state (PVS)  c) 35,000 patients in the U.S. are currently in PVS. 280,000 now in “minimally  conscious state”  d) Quinlan would sometimes open her eyes, writhe around, vomit and moan. These  actions are common when a patient is in PVS.  e) Quinlan was put on ventilator, but was eventually taken off by per the request of  her family.   f) Catholic hospital refused to “kill” Quinlan.       Assigned Reading  ● A nurse practices with…  ● Nature of health problems  i) Worth of the person isn’t affected by disease, disablity, functional status,  or proximity to death.   ii) Nurse extends supportive care to not only patients, but also  family/significant others.   iii) Nurse provides interventions to relieve pain and symptoms in a dying  patient.     ● Respect for human dignity  i) A principle in all nursing practice is repect for the inherent worth and rights  of every patient.   ii) takes into account the needs/ values of everyone.   ● Relationships to patients  i) Nurse establishes relationships and delivers nursing services while  respecting human needs/values without being prejudice.   ii) Patient’s lifestyle/beliefs should be taken into consideration when planning  health care.   ● Right to self determination  i) Patient has a right to self determination, autonomy (philosophical basis for  informed consent in health care).  ii) Patient has the moral and legal right to determine what will be done with  their own be given accurate, complete, and understandable  information in order to facilitate an informed judgement.   iii) Nurse is oblighed to know about the moral and legal rights of ALL patients.   iv) Surrogate makes decisions for patient how he/she would have wanted,  when the patient becomes incapable/ incompetent of making the decision  themself.   ● Euthnasia­ directly or indirectly bringing about the death of another person for that  person’s sake.   ● Active Euthnasia­ performing an action that directly causes someone to die, also  known mercy killing; illegal and is considered ALWAYS wrong. ex) giving a patient  a lethal injection to end suffering.   ● Passive Euthnasia­ allowing someone to die by not doing something to prolong  life; morally permissible, legal, and is officially endorsed by the medical  proffession. ex) removinga patient’s feeding tube and letting nature take its course.  ● Voluntary Euthnasia­ when a competent patient voluntarily request/ agrees to  euthnasia. They communicate their wishes while they’re still competent or give  instructions for when they become incompetent (living will).   ● Nonvoluntary Euthnasia­ when patients aren’t competent to choose death for  themselves and never dislosed their preferences. In this instance, the patient’s  family and physician decide for the patient.   ● Involuntary Euthnasia: bringing about someone’s death against his/her will or  without asking for consent while the patient is competent; illegal and morraly  impermissable.   ● 4 kinds of euthnasia:  i) Active Voluntary­ dircetly causing death (mercy killing) with​ the consent of  the patient.   ii) Active Nonvoluntary­ directly causing death (mercy killing) ​without​  the  consent of the patient.   iii) Passive Voluntary­ withdrawing life sustaining measure ​ with​ the consent  of the patient  iv) Passive Nonvoluntary­ withdrawing life sustaining measure ​ without​  the  consent of the patient.  ● Physician­Assisted Suicide: patient takes his/her own life with the help of a  physician. ex) Physician prescribes lethal doses of drugs or explains the method  of suicide, and the patient performs it.           


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