Ethical Dilemmas in Medical Research and Euthanasia: A Historical Analysis, Quizzes of Bioethics

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TERM 1 Wit DEFINITION 1 Dr. Kelikain - doctorDr. Vivian Bearing - patient TERM 2 Problems with Dr. Kelikian's and Dr. Bearing's interaction DEFINITION 2 -doubt about whether the patient understood all info-lack of time to process info-form not read-not adialogue/lacking compassion-glossed over research/experimental nature of "treatment"-no alternatives mentioned or discussed-doctor appeared to focus primarily on the research and not the patient-vague regarding risks and benefits TERM 3 Voluntary informed consent DEFINITION 3 1) patient must be informed of diagnoses, prognosis, risks and benefits, and alternative available2) patient orparticipantin research must be uncoerced3) patient or participant must be capable of understanding the info given TERM 4 Willowbrook hepatitis study DEFINITION 4 -researchers wanted to improve gamma globulininoculation- gamma globulin was given tomentallyhandicapped children TERM 5 Justification for the Willowbrook hep. Study DEFINITION 5 -children were likely to catch virus anyways-this version of hepatitis was 'mild'-children generally have milder reactions to hepatitis than adults TERM 6 Problems w/ Willowbrook hep. study DEFINITION 6 -parents were not told of the 'experimental' nature of research- parents were told children would be 'exposed' to the virus, but not given the virus-there was a long waiting list for entry into the non- research section of the hospital (source of coercion)-staff was not included in the study despite being exposed to the same environmental risks as the children TERM 7 Tuskegee syphillis study DEFINITION 7 -population was poor black males form the south-200 controls, 100 w/ syphillis-study ran for 40 years from 1932- 1972-goal of the study was to bring subjects to necropsy so that the researchers could do post-mortem autopsies on them TERM 8 Justifications for Tuskegee syph. study DEFINITION 8 -researchers claim this was a "study in nature"-claimed that their subjects would not seek treatment anyways TERM 9 Problems w/ Tuskegee syph. study DEFINITION 9 -researchers did not provide treatment (Olso study was already done and using arsenic to treat syphillis)-actively prevented subjects from getting treatment (wrote letters to different organizations, health services, and military prohibiting treatment of the participants)-lied to the subjects and told them they were being treated-"special treatment" was a spinal tap which is generally a diagnostic procedure TERM 10 Legacy from the Tuskegee study (by King) DEFINITION 10 -socialimplicationsconcerning racism-problems withunder- inclusionor exclusion in current studies-either too much focus on differences vs. ignoring differences-overcoming the problem: start with the assumption that human are biologically the same TERM 21 Cafe study DEFINITION 21 -done by researchers from U. of Minnesota-used Astra- Zeneca (Seroquel)-Dan Markingson put on the drug then committed suicide-mother tried to get him out of the study- researcher had financial incentive to enroll participants into the study (U of M had a low enrollment rate) TERM 22 Institutional Review Boards DEFINITION 22 -supposedto assess the ethics of studies before they are implemented-today, companies can submit their proposals to for-profit IRBs TERM 23 Florida Study DEFINITION 23 -conducted by SBCE in a Florida hotel on illegal immigrants- the study was approved by a relative of one of the researchers who ran an IRB-illegal immigrants were threatened deportation for leaving the study early- participants were pack 8-10 in a room, conditions were unsanitary TERM 24 Eli Lilly study DEFINITION 24 -recruited homeless alcoholics from around the country to comeparticipatein the a study inIndianapolis-possible coercion due to the fact the men were homeless and the study offered a place to stay TERM 25 undue inducement DEFINITION 25 is the compensation in some sense coercive (are they takingadvantageof a person's situation)? TERM 26 Duck, Death, & the Tulip DEFINITION 26 -death is always close by-should not fear death-can't be stopped-death "gives signs"-acceptance of death-death gives meaning to life-if we could live forever, would we want to?- fear of death will prevent genuine living of life-unclear of what happens after death-what is death? generates uncertainty/curiosity TERM 27 euthanasia DEFINITION 27 -"good death" or "good dying"-distinction between active and passive TERM 28 active euthanasia DEFINITION 28 -meaning "mercy killing" and "lethal injections"-the act is both necessary and sufficient to bring about patient's death TERM 29 passive euthanasia DEFINITION 29 meaning "letting die" and "letting nature take its course"- withholding intervention or refusal of treatment TERM 30 coma vs. PVS vs. locked-in DEFINITION 30 coma = neither awake nor awarePVS (persistant vegetative state) = awake but not awarelocked-in = aware and awake, but the mind-body connection is severed TERM 31 Rachel's article on euthanasia DEFINITION 31 -makes active vs. passive distinction-there is a bare difference, but no morallyrelevantdifference-Smith v. Jones example-A/P distinction is made on "irrelevantgrounds" (allows people to make serious decisions on irrelevant grounds)-in some cases, active euthanasia may be more humane than passive euthanasia-letting does DOES NOT equal doing nothing TERM 32 Why does letting die not equal doing nothing? DEFINITION 32 -a state still arises out of inaction-inaction is the opposite decision of action-the end result is the same (letting die, helping die, still means dying)-doing nothing still causes death in the same way the a lethal injection causes death TERM 33 Velleman's Against the Right to Die DEFINITION 33 -should there be a law/rule/policy that requires caregivers to honor requests for assistance in dying? Velleman says no-"right to die" is a problematic concept- what does it mean?-positive right entails obligations on the part of others to help one secure his/her right(s)assuming death is a benefit in some cases, it does not follow that it is the sort of benefit that should be secured by an institutional right- having the choice to VAE or PAS changes things because it makes us need to justify our choices-in some instances we are required to take the initiative in withholding certain options-offering someone the option of death removes the possibility of remaining alive by default TERM 34 Proponents of VAE or PAS DEFINITION 34 base their defense of these practices on the right of autonomy or self-determination (versus non-Kantian concept of autonomy which is thevaluingof opportunities) TERM 35 Physician assisted suicide DEFINITION 35 -suicide or self killing-physician's act is necessary, but not sufficient to bring about the patient's death