Principles of Bioethics. Biomedical Ethics Case Studies.

Principles of Bioethics. Biomedical Ethics Case Studies.
Response Papers Instructions
General Instructions for Response Papers
The idea behind each Response Paper is for you to reflect on the case or article and to write a thoughtful, well-reasoned response to the situation or issue presented, incorporating any arguments or conclusions you may make in light of the other readings and presentations in the course. Your evaluation of the case should be based on the following questions: Do you agree with the ultimate outcome of the case or conclusion to the article? What would you have done differently? Are there any red flags that are raised in your mind? As a Christian, how should you respond to situations or arguments like these? The prompt for each Response Paper will present additional, specific questions for you to consider as you read the case. Each prompt will identify which questions you must address and which ones you may consider and optionally address in your response.
One thing to avoid is an emotional response. You may passionately disagree with the outcome or the views of the author(s) or judge(s); however, you must not turn your Response Paper into an emotional rant. Each paper must be a reflective, intellectual, academic response to the merits of the case or article. Also, be respectful of those involved. Do not insult them by calling them names or using other derogatory language. This will lose you points. You can disagree and be respectful about it.
You must write at least 500 words (about 2 pages) for each Response Paper. Your grade will be reduced if you go below the minimum. Each Response Paper must follow current Turabian format. You must submit each Response Paper as a Microsoft Word document using the submission link in Blackboard. Do not cut and paste your paper. Instead, attach it as a separate file.
Response Paper 1: Case Study on Principles of Bioethics
Patient Choice vs. Patient Good
Mrs. Wright, a fifty-five year old woman with advanced multiple sclerosis, was admitted to the chronic care unit of a hospital. As part of the admission routine, a full diet was ordered. At lunch time, Nurse Klein observed that Mrs. Wright was eating very slowly and appeared to have difficulty swallowing some of the foods on her dinner tray. Mrs. Wright explained that she needed to chew the food well in order to avoid choking. After staying with her until she finished her meal, Nurse Klein told Mrs. Wright that she was going to fill out a special diet requisition for a soft diet.
At dinner time when her food tray was presented, Mrs. Wright became very angry and upset. “I won’t eat this slop!” she asserted. “Bring me some real food that I can get my teeth into.” Nurse Klein patiently explained to her why it was best that she eat a soft diet and informed her about the risks of choking and aspiration. She also pointed out that the nursing staff would have limited time to spend assisting her with meals. Even so, Mrs. Wright was adamant. “It’s my life and I will live it the way I want!” she insisted.
The next day arrangements were made for nursing staff to meet with Mrs. Wright and her husband. During the discussion, it became clear that Mr. Wright supported his wife, and that the couple had thoroughly explored the options and were prepared to accept the consequences of their decision. They had also discussed the implications their decision would have on family members. Having realized that the Wrights were not going to change their decision, the nursing staff approached Mrs. Wright’s physician and convinced him that it would be in her best interest to order her a soft diet. This only further angered Mrs. Wright.
(Michael Yeo, Concepts and Cases in Nursing Ethics [Lewistown, NY: Broadview Press, 1991], 68–69.)
Address the following questions:

1. Which 2 of the 4 principles do you think are in conflict in this case? Support your answer.
2. Which principle do you think should take precedence in this case? Support your answer.

Other questions to consider:

1. In light of the couple’s statement that they had “thoroughly explored the options and were prepared to accept the consequences of their decision,” do you think that should have ended the discussion?
2. Do you think the nursing staff were justified in approaching the physician and convincing him to write an order for a soft diet?
3. Can you think of a creative alternative that might resolve the conflict between the couple and the staff?

Response Paper 2: “Active and Passive Euthanasia” by James Rachels (New England Journal of Medicine 292 [January 1975]: 78–80)
In this article, philosopher James Rachels attempts to erase the distinction between active euthanasia (AE) and passive euthanasia (PE) and suggest that if one is ethically permissible, the other should be also be permissible in similar, morally relevant situations. Read the article and address the following questions:
 

1. Rachels’s first argument is that AE is often preferable to PE because AE is more merciful towards those who are suffering extreme pain. Do you agree? While one can recognize a strong emotional appeal here, is this morally relevant to the issue of intentionally ending a life? Do you think his use of the Down’s syndrome child is effective?
2. Rachels’ s second argument is critical of decisions based on “irrelevant grounds.” What are the irrelevant ground he mentions? Do you think he makes a good argument here? Do you think that the fact he uses a downs syndrome child muddies the water with this point?
3. Rachels claims that the analogy of the boy in the bathtub contains 2 cases “that are exactly alike except that one involves killing whereas the other involves letting someone die.” Are they exactly alike? What are some differences between the “boy in the bathtub illustration” and the active/passive distinction?
4. According to the Reading & Study material, are AE and PE “exactly alike except that one involves killing whereas the other involves letting someone die”?
5. In his fourth argument, Rachels seems to believe that the only difference between AE and PE is that AE involves action and PE involves inaction. Is that true? Is that what makes the moral difference?

Response Paper 3: Davis v. Davis (842 S.W.2d 588 Tenn. 1992)
Read the case and address the following questions:

1. What do you see as the main problem in this case? Can you foresee a way it could have been resolved earlier than coming to court? What could the couple have done to avoid the problem?
2. Explain how the court resolved the case. Do you agree with the majority opinion of the Tennessee Supreme Court on this resolution? Why or why not?
3. In what ways does this case affect the way you view in vitro fertilization (IVF)?
4. What ethical principles come into play with IVF as it is normally practiced? Which 2 principles can you see coming into conflict, and what would be a way to resolve them?

Other questions to consider:

1. The court depended for much of its testimony—both scientifically and ethically, and especially with regard to the status of the pre-embryo—on the standards set by the American Fertility Society, an organization funded and supported primarily by fertility clinics. In light of the statement that the decision to declare these frozen pre-embryos as persons “would doubtless have had the effect of outlawing IVF programs in the state of Tennessee,” do you think this raises a question of a conflict of interest, since these clinics have a vested financial interest in the outcome of this case? Why or why not?
2. The curt depended heavily on the distinction between embryo and pre-embryo, claiming that at the “8-cell stage, the developmental singleness of one person has not been established.” Do you think the designation of “pre-embryo” should have an effect on how we judge the moral status of these zygotes? Or is this just another stage of development, similar to childhood and adolescence?

Response Paper 4: “Buck v. Bell (1927)” by Nathalie Antonios and Christina Raup (Embryo Project Encyclopedia)
Read the case summary and address the following questions:

1. What 2 principles are in conflict in this case? Support your answer.
2. What are some red flags you see in how the trial came about and the persons involved?
3. Do you think forced sterilization of those deemed genetically inferior is an appropriate way to deal with the disease?

Questions to consider:

1. How much do you think the decision to treat Carrie as “feebleminded” was based on a moral evaluation of her unwed pregnancy (and her mother’s moral background)? Do you think this raises questions about the other 60,000 institutionalized patients who were sterilized between 1927 and 1974?
2. The court argued that forced sterilization as necessary for the public good was similar to forced vaccination. Do you think that argument is successful? In what ways are forced sterilization and forced vaccination analogous and disanalogous?