Aristotle + Feminism
Explain Aristotle’s notion of seeking the “median and the best course” regarding things like “fear, confidence, desire, [and] anger”
The median refers to seeking a middle ground between emotional excess and emotional deficiency. With emotions like fear, confidence etc. finding the median is about feeling the appropriate level of emotion at the appropriate time.
Explain the three conditions of the authors’ “uncomplicated account” of autonomy
Intentionality: person must conceive something, think about consequences, and act on it.
Understanding: person needs to fully understand consequences of their actions and be fully informed.
Noncontrol: needs to be free of outside controls and be self-directed.
Explain the distinction between beneficence and nonmaleficence
Nonmaleficence has to do with not inflicting any harm. Beneficence has to do with preventing harm, removing harm, and promoting good. (positive vs negative)
Explain the idea the beneficence demands more than nonmaleficence and is “at the heart of medicine’s goal, rationale, and justification”
Non maleficence is just a lack of harm, but beneficence needs you to do more than that by taking positive steps. For medicine, it is about helping the patient, not just avoiding harm.
Explain one of the factors that Dr. Murthy blames for driving many health care workers “to the brink,” i.e., resulting in burnout
Doctors are being stretched too thin, they have to manage resources, administrative roles, and be knowledgeable on policy all while providing care for patients.
Explain Aristotle’s examples of people learning to “become builders by building houses and harpists by playing the harp” how this applies to learning to be virtuous
The way to learn is through repeated practice of an action or behaviour until it becomes habitual. So you have to practice being virtuous un order to be virtuous.
Explain what is meant by having both a “negative” and a “positive” obligation to respect autonomy
The negative obligation is to avoid controlling the decisions of others while the positive obligation is to provide information that would allow for others to make an autonomous decision.They each emphasize what doctors are obligated to avoid and obligated to provide, respectfully.
Explain what is meant by a “double effect” of an action in the “rule of double effect”
Rule of double effect has to do with actions that have one or more positive outcomes as well as one or more negative outcomes. It is an ethical principle that says that bringing about some negative action while performing/aiming at an ethically permissible action. If the action is performed only to bring about the positive outcome and a negative outcome also happened to trnapsire, it is permissible, but if it was also performed with negative outcomes in mind it is not longer justifiable.
List the five conditions that have to be met for a beneficent “duty of rescue”
1. Someone has to be at risk of significant loss or damage to a basic interest
2. the action that I must take is necessary to prevent loss or damage
3. The action will most likely prevent the loss or damage
4. The action does not present significant risks or burdens towards me
5. The benefit that someone will get outweighs any burdens or cost towards me
Explain Robert Nozick’s libertarian argument for why welfare programs involving the redistribution of wealth through taxation are unjust
Because they tax the wealthy at a progressively higher rate than those who are less wealthy, and then use those for welfare and support for unemployment. the same as "forced" or "slave labor"
Explain the feminist critique of detachment and impartiality in moral thinking and the view that an “impartial observer is disqualified rather than legitimated as a competent moral judge”
Impartial or detached thinking is problematic because it requires abstraction from peoples’ identities and relationships. This takes away the ability to see from someone else's pov and understand their individual needs - thereby inhibiting moral decision making. The care orientation claims that being attentive to identities and relationships is a feature of morals. Therefore it is needed to make a moral choice
Explain the distinction between an autonomous person and an autonomous choice (P, 100).
An autonomous person possesses the ability to self-govern and choose independently through their own reasoning. Autonomous choice is when a decision is made with all of the information of the decision present to the individual making the choice. An autonomous person sometimes makes non-autonomous choices
Explain the two conditions under which “letting die” is usually acceptable
1) medical technology is useless (in terms of being futile)
2) patients or authorized surrogates have validly refused a medical technology
Explain Nellie Bly’s conclusion that the insane asylum she visited was a “human rat-trap”
Once you enter the insane asylum, you are trapped within a system in which if you are truly insane, you are evaluated as such and will not escape, but the more rational you act the more insane you are taken to be as doctors and nurses already assume you to be insane and that you are masking it. Additionally, with the lack of listening and evaluation from practitioners to ascertain one’s sanity, it almost becomes impossible to lose the label of “insane” and become “sound” within their eyes, which would allow for your escape.
Explain how disparities in pain care in the United States as a case of “implicit bias”
Disparities in pain care for African Americans vs Caucasians in the United States demonstrate a case of “implicit bias” because previously held beliefs and discriminatory practices influenced people to believe that African Americans had a higher tolerance for pain and therefore could be given less pain care as opposed to Caucasians.
How could a “right action” nonetheless not be a “virtuous action”? What are the three criteria for a virtuous action according to Aristotle
Any action can be correct without being virtuous (aka if the person doing the deed doesn’t have virtuous motives). The three criteria are: must know he is performing a virtuous act, must choose to behave virtuously purely for the sake of being virtuous, their behavior manifests itself through habitual virtuous action and a fixed virtuous disposition
Explain one criticism of the “reasonable person standard” of disclosure
A criticism of the reasonable person standard is that it assumes there is a “reasonable person” who can be generalized. However, each individual may have different concerns. Unclear what qualifies as a reasonable person and how this abstract understanding should be implemented
Explain the case of Dr. Jack Kevorkian and Janet Atkins as a case of unjustified physician assisted dying. Explain two reasons why even advocates of physician assisted death condemn Kevorkian’s actions in this case
When she came to him asking for help in assisted suicide it was because she was in the early stages of Alzheimer’s. This was unjustified because he was not trained properly, did not conduct a mental evaluation of her, she could have still had a few more productive and happy years, and because her diagnosis could have been wrong
Explain the (supposed) distinction between “hard paternalism” and “soft paternalism”
Hard paternalism is the action of intervening to prevent or reduce harm or for beneficence through prevention of voluntary and autonomous choices (overides autonomy) while soft paternalism is intervening for similar reasons but in preventing nonvoluntary conduct or ill-informed choices (example, banning cigarettes vs putting a tax on cigarettes)
Explain the worry that pushing for greater “work-life balance” can jeopardize the approach to medicine in which ‘the patient comes first’
Though having work-life balance can help a physician recover and not get burnt out (therefore providing better care), the risk that it runs is that patients need to come first. If you prioritize physicians over the patients you will have issues with outcomes
Explain the critique that an ethics that presupposes relationships between equals will emphasize “mutual non-interference” that can “threaten us with neglect and isolation especially if we are dependent or relatively powerless, like the very young, the very old, or the sick”
Considering everyone equal turns a blind eye to power and material inequality. Only valuing autonomy normalizes never interfering and ignores that some people need extra care - extra care, that at some point everyone will need.
Explained the notion of “informed refusal” and the point that “it is sometimes necessary for clinicians to vigorously challenge patients’ choices that appear to be legally binding”
If the patient holds a false belief that is interfering with being fully informed on the situation, then they cannot make an informed refusal. It is important to challenge those false beliefs because it helps improve their outcomes, especially when that choice is legally binding.
Explain the four qualifications proposed for a competent surrogate decision maker
1. ability to make reasoned judgments (competence)
2. adequate knowledge and information
3. emotional stability
4. a commitment to the patients interests – cannot have conflicts or controlling interests
List the conditions necessary to justify hard paternalism in a health professional’s intervention
1. A patient is at risk of significant, preventable harm or failure to receive a benefit
2. The paternalistic action will probably prevent the harm or secure the benefit.
3. The intervention to prevent harm to or to secure a benefit for the patient probably outweighs the risks to the patient of the action taken.
4. There is no morally better alternative to the limitation of autonomy that will occur.
5. The least autonomy-restrictive alternative that will prevent the harm or secure the benefit is adopted
Name and briefly explain the four traditional theories of justice
1) utilitarian theories → emphasize many criteria that increases/maximizes welfare and utility
2) libertarian theories → emphasize individual rights to social and economic liberty
3) communitarian theories → emphasize principles of justice from conceptions of the good developed in moral communities
4) egalitarian theories → emphasize equal access to the goods in life that every rational person values