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Bioethics Final Exam Review Questions and answers | Latest updated | Rated A+
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Bioethics Final Exam Review Questions and answers | Latest updated | Rated A+
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Bioethics Final Exam Review Questions and answers |Latest updated | Rated A+
What are some of the problems Gwande identifies with end-of-life care in the United States
and how is this addressed through hospice care? - ✔✔The US spends an enormous amount of
time on this and it is sometimes more burdensome than beneficial; patients simply don't want
to prolong life. Hospitals aim to extend life while hospices aim to ENHANCE life. Gwande
wants people to plan end of life care for a more peaceful death
Define advanced directives - ✔✔They are living wills which enable people to make autonomous
decisions about treatment options in the future when they no longer posses autonomy
What are some problems associated with advanced directives, relate them specifically to the
Margo case? - ✔✔The past decision can conflict with the current surrogate's assessment;
with full health it is difficult to decide what you'd want in a state of diminished health
Margo- wanted to die if she had dementia in future; however even with dementia, she was the
same happy person and it'd seem weird to let her die since she still had desires and needs
What are two alternatives to living wills/advanced directives? - ✔✔1. Proxies
2. Advance care planning (make a simple list of things you'd like to do when you get old)
Whole brain death (President's Commission) - ✔✔one is dead when breathing and
circulation lack neurologic integration; critique: life consists of various bodily systems, brain
plays a role but shouldn't be determinative
,Higher Brain Death (President's Commission) - ✔✔If consciousness, thought and feeling are
essential to personhood or identity, then death occurs when these functions are no longer
possible; critiques: opinions about what is central to personhood vary greatly
Bodily fluids/ Non Brain Formulations (President's Commission) - ✔✔Traditional
cardiopulmonary criteria requires cessation of the flow of bodily fluids
What is Oregon's Death with Dignity Act (DWDA)? - ✔✔Allows terminally ill adult Oregonians
to use prescriptions from their physicians for self administered, lethal doses of medication.
What are some of the key findings in Oregon's DWDA? - ✔✔-1327 people had prescription,
859 died from taking medication
-67.6% were 65+, 95.2% white, 47.6% had bachelors degree
-90% enrolled in hospice
-no patient that ingested meds regained consciousness
-number of prescriptions written per year has risen since 1998
What were the main end of life concerns for those who had PAS? - ✔✔1. Loss of autonomy
2. Decreasing ability to participate in enjoyable activities
3. Loss of dignity
What are the flaws that Katva sees with DWDA? - ✔✔-There is a lack of transparency
and accountability bc physicians self report.
-Low referral rate for psych consultations (depression is often missed)
-Doctor shopping
-inattention to moral formation
, What does inattention to moral formation mean? - ✔✔Desensitization of doctors to death. PAS
is a slippery slope situations bc doctors will be more likely to write prescriptions for death
instead of finding other solutions.
Brittany Maynard - ✔✔29 year old woman with brain cancer who had PAS bc of pain. She
was younger, more educated, and had strong family connections which is uncommon for
most participants of PAS. She is a compelling figure of popular media.
Katva critique of Brittany Maynard - ✔✔Maynard doesn't represent those who use PAS
(isolated, self reliant, lack trusting relationships) and the policy of PAS is formed around pain so
Maynard's story supports this misconception (PAS being associated w/ pain)
How does Quill approach PAS? - ✔✔He uses the narrative approach, offers several stories
with simple solutions rather than dying
What other solutions does Quill give rather than PAS? - ✔✔Fully treat physical symptoms,
psychosocial problems (like feeling like a burden on family, financial situations), spiritual
crisis, and pain
What are Quill's proposed clinical criteria for PAS? - ✔✔1. Clear and repeated request to
die (autonomous decision)
2. Judgement of pt. isn't distorted
3. Condition is incurable (Severe, unrelenting suffering)
4. Adequate Comfort Care
5. Meaningful doctor-patient relationship
6. Consultation with another physician
7. Documentation supporting each condition above
What are the ethics of care and compassion according to Quill? - ✔✔-Listen and learn
(doctors are action oriented, they need to see what patient wants)
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