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BBH 301 Week 1-3 Notes

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by: T Notetaker

BBH 301 Week 1-3 Notes BBH 301

T Notetaker
Penn State

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Notes for quiz 1
BBH 301
Ms. Sell
Class Notes
BBH, BBH 301, Biobehavioral Health
25 ?




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"Killer notes! I'm stoked I can finally just pay attention in class!!!"
Skylar Wiegand

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This 9 page Class Notes was uploaded by T Notetaker on Saturday January 30, 2016. The Class Notes belongs to BBH 301 at Pennsylvania State University taught by Ms. Sell in Spring 2016. Since its upload, it has received 43 views. For similar materials see BBH 301 in Behavioral Sciences at Pennsylvania State University.

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Reviews for BBH 301 Week 1-3 Notes

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Killer notes! I'm stoked I can finally just pay attention in class!!!

-Skylar Wiegand


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Date Created: 01/30/16
Morality System of rules that dictate socially acceptable behavior "What you ought to do" Often learned vicariosly Ethics Study of morality Normative analysis = Is an act in and itself right or wrong? Bioethics Healthcare ethics Study of morality in the context of Clinical care Research Historic Cases Development in Medical Technology Heart Transplantation Dr. Christiaan Barnard (1967) Used a heart from a 25 year old women who was brain dead from a car accident but her heart was still healthy. It was transplanted into a 55 year old man dying of chf. He only lived 18 days after transplant. Artificial respiration Karen Ann Quinlan (1975) Suffered severe brain damages because of alcohol consumption and became brain dead. Parents were going to pull the plug but the hospital did not want to give them that authority and wanted to work on saving her longer. They wen to court and parents won. Lived 10 years on machine. Use of people in research Medical experiments of Nazi scientists Numberg Trials Use of animals in research Pepper, the Dalmatian (1966) Silver Spring Monkeys (1981) Importance of studying bioethics Ethical dilemmas are not going away Decision-making environment is constantly changing Ability to recognize and address bioethical dilemmas is essential for success Common Condemnations Only immoral persons face moral dilemmas Morality is just following what one's religion prescribes Morality is just following the law By the time you are an adult, your morality is set Every case is unique, so moral guidelines are impossible to create Dilemma Situation in which reasons for alternative response seem equally good Moral Agent Person/institution making the decision Stakeholder Person/institution who has something to gain/lose from the decision Step 1: Assessment 1. List who is involved in the dilemma 1. Moral agent, stakeholders 2. Describe at least one stake each has in the decision 1. Stake = That which may be gained or lost 2. Stake (not equal) possible consequence Step 2: Ethical Conflict 1. Consider why the moral agent is conflicted 2. Briefly state ETHICAL reasoning for choosing "yes" vs. ETHICAL reasoning for choosing "no" Step 3: Decision 1. Def: Definitive statement of how the moral agent will act in response to the dilemma 2. Includes no caveats Step 4: Justification 1. Def: Brief persuasive argument of why the moral agent should act in the way that you propose Step 5: Consequences 1. Def: Statements regarding what will happen to each of the stakeholders, assuming your decision is followed Step 6: Re-evaluation 1. Think about what should be done to prevent the dilemma from happening again 2. Write out concrete suggestions Ethical Theory Account that explains Why an action is right or wrong or Why a persons character is good/bad Falible Do not provide formulas Framework for workable solutions Reductionistic Not mutually exclusive Awareness of what you are already doing Increase your ability to identify difficulties inherent to moral arguments,judgements Deontology Deon=duty or obligation Premise An act is morally acceptable if it is done in accordance with one's duties and obligations Decide which duties/obligations are relevant Make decision that best fulfills these duties/obligations Imperatives Hypothetical Imperative A command to do something if a particular aim is desired Categorical Imperative A command to do something that applies without exception and without regard for particular needs or purposes Version 1 Act only on the maxim through which you can at the same time will that it should become universal law. Act in a way any rational person would be willing to endorse Version 2 Act in such way that you always tray humanity, whether in your own person to in the person of another, never simply as a means but always at the same time an end Main Maxims It is not so important what happens in the end, but rather how you get there Utilitaranism Consequental theory Aims to maximize utility Utility=the state of being useful, profitable or beneficial Premise An act is morally acceptable if it leas to the greatest balance of good (in comparison to alternative actions) for everyone considered Survey courses of action Predict consequences Calculate the course that will lead to the greatest good in the circumstance for everyone considered Premise Act in accordance to predetermined rules that will promote th greatest amount of good, if everyone follows them Determine the rule that applies Act on the rule Feminist Ethics Group of theories that "attempt to revise, reformulate, or rethink those aspects of traditional … Goal: gender-neutral theory Focus on consequences Downplay doctrinal moral principles Emphasize context Embrace partiality and intuition Traditional focus: "private sphere" Carol Gilligan Student of Kohlberg Reseach on process of moral development Overemphasize self-interest overemphasize others' interests consider interests of self and others as a relational unit Premise Act in such a way to meet ones responsibility to care for persons in relationships Tasks Identify relationships affected by decision Choose action that causes the least amount of "hurt" to each person who has a stake in dilemma Principlism Premise An act is ethically acceptable if it can be supported by balancing and counterbalancing four principles Tasks Review the principles and how they apply in case/direct decision-making Weigh arguments in light of principles NO single principle is innately more important (weighty) than another Principle 1: Autonomy Self-rule or governance Autonomous persons should be allowed to exercise their capacity for self-determination Two views Negative Dont interfere Positive Obligation to "create"/support/augment Choose decision that supports self determination Common problem: Autonomy of stakeholders is in conflict! Principle 2: Beneficence/ Nonmalfience Beneficence Doing good to others Nonmalfience Avoiding doing unnecessary harm or injury to others. Fiduciary relationship Especially important when power differential exists Choose decision that supports well-being and causes least harm (prevents harm) Common problem: Difficult to apply beneficence completely to all stakeholders Principle 3: Justice Consistency between decisions Equals should be treated equally we do good by giving people their fair share Choose decisions that is most fair for all involved and may be consistently applied Common problem Justice conflicts with other principles Paternalism Overriding a person's actions or decision-making for his/her own good Prior to the 400s BCE, medical providers treated patients indiscriminately Starting with Hippocrates ( 400 BCE), medical tx (treatment) began to be Based on reason and understanding of body Considered an art/practice Hippocratic Oath (1964) Clinician's main responsibility: welfare of patient Competence Caring Commitment Traditional Health care Practice Paternalistic Providers Gatekeepers of medical knowledge Made decision for pts (patients) Modern Health Care Patients want Control over care decisions Info about alternatives Healthcare team Varying levels of expertise Varying expectations of relationships Patient provider Provider-provider Paternalism in current medical practice Paternalism directed toward people who cannot act autonomously Genrally, morally acceptable Focus: Protection from harm Strong paternalism Paternalism directed toward people who can act autonomously Generally, morally unacceptable Elizabeth Bouvia (1986) 26 years old Intelligent Had severe pain from cerebral palsy Wanted to die Riverside General hospital Patient request: refuse treatment to commit suicide Dr. Response: Force fed by nasal gastric tube Bouvia sued hospital and LOST Judgement: May have right to die but does not have right to compel others o help her do it High desert Hospital in LA County Patient re uest: Refuse treatment to commit suicide Dr. Response: Force fed by nasal gastric tube because treatment would allow life >15yrs Judgement Quality of life is just as (if not more) important as quality of life Competent persons have right to reject treatment needed to keep them alive Epilogue Bouvia elected to continue living with aggressive pain management


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