PHI 1370 Study Guide - Final Guide: Homeopathy, Osteopathy, Moral Agency
6 Jun 2018
School
Department
Course
Professor
Philosophical Issues in Health Care
Notes: Midterm Review
Prof: K. Ferguson
1) Describe briefly, but clearly, three objections that critics have raised against Bill C-14, Caadas
assisted suicide law.
There are several serious objections against legalizing physician assisted suicide and/or voluntary
euthanasia. The first would be that active euthanasia is actively killing another individual. This is very
convincing because harming another individual is intrinsically wrong and there is no valid reason to kill
someone. However, the wrongness of killing must still be weighed against other wrongs or evils,
sometimes killing a person is actually a benefit to that person, and in such cases it may not be wrong.
Secondly, is that it is incompatible with the mission of the health care system which is to preserve life.
B atiel takig soeoe else’s life, the health ae poide ould go agaist the alues of the
health care system. The basis of the health care system is to help people in order to preserve their
lives. However, medicine has more than one goal or purpose – to prolong life, to relieve suffering, to
poote the edial elleig of patiets, ad so o. “oeties death ight e i a patiet’s est
interest. Finally, the last objection would be that it would put too much power in the hands of the
medical profession. This could cause issues because people may believe that physicians could kill
hoee the at due to the poe that the ould possess. The ould e atig like a god i
deciding who lives and who dies. The response to this objection is that careful regulation of the
practice of active euthanasia can prevent abuse.
2) Explain leal the dotie ko as liial euipoise
When a physician has no belief about whether a new therapy is more effective, or less effective, than
the current best therapies, then there is no ethical problem confronting physicians. However, if the
physician believes either that the current treatment is better than the new treatment or that the new
treatment is better than any current treatment, then there may be a problem. If the patient
participates in the trial in this situation, they may not receive what their physician considers to be the
best treatment. Regardless of what the physician does, they will violate one of her obligations, either
to patients or to research. Clinical equipoise makes it permissible for a physician to advise a patient to
patiipate ol if the epet edial ouit is uetai hih teatet is ette, ee if the
physician happens to believe that one treatment is better.
3) Explain clearly the desert theory, the utilitarian and the libertarian theories of justice
The desert theory of justice is that a distribution is only just if each person gets what he or she
deserves. Some of the criteria for this theory include talent, effort, contribution, danger, difficulty and
need. Objections to this theory would be that the criteria are somewhat arbitrary and unfair. As well,
some critics may argue that rewarding or punishing people on the basis of their talent, effort,
otiutio… is ufai. The utilitaia theo of justie is that a distiutio of eefits ad udes is
just if and only if it maximizes overall happiness. There are different ways of dividing things up which
produce different amounts of happiness. Objections to this theory would be that the interests of a
small minority would be sacrificed for the interested of the majority, as well, people may not get what
they deserve and utilitarianism seems to ignore just and fairness altogether for the sake of generating
the most amount of happiness. Finally, the libertarian theory of justice is that a distribution is fair and
just as log as o oe’s ights ae iolated i aiig at that distiutio. As log as a idiidual
acquied thei ealth, status, poe… fai ad suae ieualit is just. Ojetios to lietaiais
would be that the basic rules of the economic system are unfair and because of this, inequalities
deelop oe tie. It is’t alas fai that people iheit more wealth than others and some have
ette aess to eduatio that othes ad so o…
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4) “uaize as auatel as ou a Joh ‘als theory of justice. (You should take a look at the
section on Rawls in Reading 1)
Joh Ral’s theo of justice is egalitarianism and it helps to determine what distribution would be
just or fair in a given situation. The procedure Rawl proposes is to imagine that you are behind a veil
of igoae. You hae to iagie that ou do’t ko a of ou o pesoal haateistics such
as eig ale o feale, ih o poo, stog o eak… Ad the to ask hat tpe of distiutio o
what way of dividing things up in society you would prefer. Rational people are not risk takers and like
to play things safe so they would try to guard themselves against the worst situation. So when it
comes to dividing things up in society, most people favour equality because everyone is getting the
sae. This eas that a idiidual a ot ed up eig supe ih ut also o’t ed up eig ery
poor which is the most important thing. Therefore, the only inequalities that would be morally
acceptable and compatible with justice would be those that make everyone better off.
5) Describe clearly what the rule Worst first, first come, and hopeless seod eas i the tiage
case, Reading 47
When deciding the order for patients to see a health care professional there are two types of criteria
that come into play. On one hand you have non-medical criteria that may be important when ordering
patients, things such as age, number of dependents, contribution to society and friends and
relatives. O the othe had, ou hae hat’s ko as edial iteia suh as the atue ad
seriousness of the injuries as well as the possibility of benefiting from treatment. When one is
odeig patiets edial oditio a asi ule that is ofte poposed is ko as ost fist, fist
oe, ad hopeless seod. I othe ods, ou teat those ith the ost seious ijuies fist ad
after that, it is first come first served. The basic rule of first come first served as two types of
exception: that more seriously injured people go first and that for those who cannot be saved are
treated after those who can be saved. However, there are some issues with this rule as it is’t uite
lea hat ost eas i this situatio. Fo eaple, does it ea those ho ill die ithout
immediate treatment, those who are suffering the most, those with the most to lose if they die, or
something else altogether? The hopeless second rule is when you order patient by level (1 - 5/ critical
- non-urgent) and, within each level, use the first-come rule. But make an exception for some patients
who cannot be saved in which they are put at the end. However, it is unclear whether it means o put
them at the end within their level or at the end of all patients in need of care. In reality, it may be a
matter of one patent having a better chance of being saved that another which makes the criterion
relevant. Suppose that John is closer to death than Ethan but there is a better chance of saving Ethan
as he is a young, athletic male as compared to John a middle-aged out of shape office worker. Who
would have the priority here? There are other medical criteria that are relevant such as giving priority
to patient who are suffering more, can be treated more quickly, can benefit the most from treatment,
and who will have a better quality of life if saved.
6) Give a precise description of the Sympathy Rule presented in connection with the triage case
in Reading 47?
. In the case study in reading 47, Alice, a nurse of twenty years in a small town, made the decision to
put Lena, her aunt and a pillar of the community, ahead of Terrance, the town drunk who caused an
accident by walking onto the highway which caused the death of a person. Both Terrance and Lena
were classified as level 1 patients and Lena was helped first despite Terrance being brought in before
her. This raises the issue of whether or it is permissible for health care workers to get special
treatment for relatives or friends. It is unethical and unfair for doctors and health care providers to
allow their relatives to skip to the top of the waiting list because health care professionals should be
impartial when helping patients. However, it may be argued that the rules used must be appropriate
for people with ordinary human sympathies and feelings and therefore the rules should allow for
some bias which is where the sympathy rule comes into play. The sympathy rule does not permit
health care providers to help their relatives or friends in any way they like but instead permits them to
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give priority to their relatives in extreme life or death situations. Society believe that this rule is okay
because it values both impartiality and close ties between relatives and friends, it is a compromise
between the two.
7) Describe four non-medical criteria that some people feel are relevant to how health care
resources should be distributed.
Four non-medical criteria that some people feel are relevant to how health care resources should
be distributed are as follows: age, number dependents, contribution of the patient to society,
and relatives. Age is deemed to be relevant as if you have two patients with the similar injuries
the younger will be treated first as an 80-year-old has had their chance to live more than the 20-
year-old. In regard to the number of dependents a single woman with 4 kids may be seen as
more important to save than a single man with no children. Thirdly, the contribution of the
patient to society can be a factor as the president of the united states will get treatment over a
simple civilian as their life is more valuable to the most people. Finally, relatives can be a factor
because if someone has a relative that is a health care provider they would have the advantage
of getting treatment first because they have the connections.
8) Explain as clearly as you can the problem, or issue, discussed in the lectures of how health care
resources should be divided up at a macro-level.
Macro-allocation of resources is the large scale allocation of resources. The problem of how health
care resources should be divided up at this level is how much money should be spent on one illness as
opposed to another? One approach to this problem is the utilitarian way which would be that our goal
should e to u as a good ualit life-years as possible for the money we spend. This approach
ould e gie the sae alue to eeoe’s elleig o atte hat thei illess. I a situatio
where we could use 1 million dollars to provide dialysis machines for 100 people or use 1 million
dollars to provide a drug that lowers the risk of death which we estimate can save 1000 people. In this
situation we would choose the first option because the second option is only statistical and we can
never truly know how many lives would be saved. The issue raised here is relevant to whether more
funds should be spent on prevention as opposed to treating and curing illness and disease. Evidence
shows that prevention tends to be cheaper that treatment in the sense that more lives can be saved
fo ee dolla spet o peetio tha fo ee dolla spet o teatig the illess. It’s had to tu
people away because treating them is too costly even though their lives could be saved. One might
object to using the utilitarian way of maximizing the number of good quality life-years because it does
not give enough weight to the value of solidarity which is the idea of trying to take care of everyone
and not leaving anyone behind. Using the utilitarian principle means that we have to tell some
patiets that e hae the ailit to sae thei lies ut e’e ot goig to eause it ould e too
costly since spending money is a different way would do more good whereas solidarity might require
us to save all patients.
9) What is eat the te alteatie ediie? (Try to be as precise as you can.)
Alternative medicine are remedies, treatments or practices used for medical purposed that are not
recognized or accepted as being effective by the medical community or establishment. It is often
based on folk knowledge. It emphasizes the importance of natural substances as opposed to the
human-made drugs of modern medicine as well, it emphasizes a holistic approach to health. It often
also involves a spiritual or religious component and focuses on the relation between the body and the
mind. Alternative medicine is associated with theories of the body and health accepted in the past, an
example of this would be the hot and cold balance in the body. Examples of alternative medicine
ilude hoeopath, healis, atuopath, osteopath… as ell auputue, assage theap
and other more borderline cases of alternative medicine cause some doctors to deny that they have
any genuine therapeutic value. A substance that was once part of alternative medicine and become
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Document Summary
Prof: k. ferguson: describe briefly, but clearly, three objections that critics have raised against bill c-14, ca(cid:374)ada(cid:859)s assisted suicide law. There are several serious objections against legalizing physician assisted suicide and/or voluntary euthanasia. The first would be that active euthanasia is actively killing another individual. This is very convincing because harming another individual is intrinsically wrong and there is no valid reason to kill someone. However, the wrongness of killing must still be weighed against other wrongs or evils, sometimes killing a person is actually a benefit to that person, and in such cases it may not be wrong. Secondly, is that it is incompatible with the mission of the health care system which is to preserve life. B(cid:455) a(cid:272)ti(cid:448)el(cid:455) taki(cid:374)g so(cid:373)eo(cid:374)e else"s life, the health (cid:272)a(cid:396)e p(cid:396)o(cid:448)ide(cid:396) (cid:449)ould go agai(cid:374)st the (cid:448)alues of the health care system. The basis of the health care system is to help people in order to preserve their lives.
