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H E Test 2
n/a
150
Dance
Undergraduate 3
04/02/2011
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Term
Virtually all theories of autonomy view two conditions as essential for autonomy. Name them:
 Definition
Information and voluntariness
Term
Name the three main standards of surrogate decision-making
 Definition
pure autonomy, substituted judgement, and best interests
Term
A person acts ______________ if he or she wills the actions without being under the control of another’s influence.
 Definition
voluntary
Term
4. Utilitarian Mill gives little weight to respect for autonomy in his moral theory of weighing happiness/value and unhappiness/lack of value produced by an action. (T/F)
 Definition
false
Term
5. The principle of respect for autonomy can be stated as either a negative obligation or as a _______________ obligation.
 Definition
positive
Term
6. In the study cited by BC6 Korean Americans and Mexican Americans tended to believe that the family should make decisions about the use of life support. (T/F)
 Definition
true
Term
7. Autonomous choice is a duty of patients. (T/F)
 Definition
false
Term
8. The difference between and opt-in and opt-out approach to public policy is that opt out assumes _______________ while opt in does not assume _____________.
 Definition
consent for both
Term
9. Technically, health care workers assess capacity and not competence. (T/F)
 Definition
true
Term
10. The substituted judgment standard of surrogate decision-making determines whether or not the life lived and to be lived by the patient has adequate quality. (T/F)
 Definition
false
Term
11. The single core meaning of “competence” applicable in all contexts:
 Definition
ability to perform a task
Term
12. Competence is a threshold concept. (T/F)
 Definition
true
Term
13. The competence to decide is always relative to the particular ____________ to be made.
 Definition
decision
Term
14. The main standard of disclosure to use in determining what material facts should be disclosed to a patient is the professional practice standard. (T/F)
 Definition
false
Term
15. One specific moral rule specified under the principle of autonomy:
 Definition
tell the truth
Term
16. Name the three types of cases that provide legal exceptions to informed consent:
 Definition
emergency, incompetence, waiver
Term
17. Persuasion is a form of coercion. (T/F)
 Definition
false
Term
18. A ___________ is a substance or intervention that the clinician believes to be pharmacologically or biomedically inert for the conditions being treated.
 Definition
placebo
Term
19. Subjects in research sometimes commit the ______________________, whereby the fail to distinguish the aims of clinical care from those of research.
 Definition
therapeutic misconception
Term
20. Patients in mental institutions who cannot care for themselves and have been declared legally incompetent cannot make any autonomous choices. (T/F)
 Definition
false
Term
21. Actions are autonomous by degrees. (T/F)
 Definition
true
Term
22. To respect autonomous agents is to acknowledge their right to hold views, to make choices, and to take actions based on their personal beliefs and values. (T/F)
 Definition
true
Term
23. According to BC6, disrespect for autonomy involves attitudes and actions that do what to others’ rights of autonomous action?
 Definition
ignore, insult, inattentive to the other's right of autonomous action
Term
24. The principle of respect for autonomy has a correlative right and mandatory duty to choose. (T/F)
 Definition
false
Term
25. A fundamental obligation exists to ensure that patients have the right to decline information. (T/F)
 Definition
true
Term
26. Forced information and forced choice are consistent with the obligation to disclose material information so as to ensure an informed decision on the part of a patient. (T/F)
 Definition
false
Term
27. Consent should refer to presumptions about the choices the individual would or should make and not merely an individual’s actual choices. (T/F)
 Definition
false
Term
28. AIDS exceptionalism refers to a criticism of policies that refrained from applying conventional public health measures to HIV infection and AIDS. (T/F)
 Definition
true
Term
29. Acting in character does not necessarily show autonomy. (T/F)
 Definition
true
Term
30. BC6 cite several recent reviews of instruments to measure competence and they find that these instruments produce variable results. (T/F)
 Definition
true
Term
31. The level of evidence for determining competence should vary according to _____________.
 Definition
risk involved
Term
32. Informed consents, when legally effective authorizations, are autonomous acts. (T/F)
 Definition
false
Term
33. Legal, regulatory, philosophical, medical, and psychological literatures tend to favor the following 5 elements of informed consent:
 Definition
competence, disclosure, understanding, voluntariness, consent
Term
34. Two competing standards of disclosure have emerged:
 Definition
reasonable person, professional practice
Term
35. The information to be disclosed should be determined by reference to a hypothetical reasonable person when using the professional practice standard of disclosure. (T/F)
 Definition
false
Term
36. Subjects in research sometimes commit the ______________________, whereby the fail to distinguish the aims of clinical care from those of research.
 Definition
therapeutic misconception
Term
37. Data indicate that patients generally make their decisions prior to and independent of the process of receiving information. (T/F)
 Definition
true
Term
38. Therapeutic privilege states that a physician may legitimately withhold information, based on a sound medical judgment that divulging the information would potentially harm a depressed or unstable patient. (T/F)
 Definition
true
Term
39. It is usually appropriate to recognize waivers of rights because we enjoy discretion over whether to exercise our rights. (T/F)
 Definition
true
Term
40. The manner in which a health care professional presents information---by tone of voice, by forceful gesture, and by framing information---can manipulate a patient’s perception and response, thereby affecting understanding and voluntariness. (T/F)
 Definition
true
Term
41. The substituted judgment standard is a weak standard of autonomy and holds that the surrogate should make the decision the incompetent person would have made if competent. (T/F)
 Definition
true
Term
42. Obligations not to harm others are the same as obligations to help others. (T/F)
 Definition
false
Term
43. A beneficial action necessarily takes second place to an act of not causing harm. (T/F)
 Definition
false
Term
44. Rules in ethics favor avoiding harm over providing benefit in all circumstances. (T/F)
 Definition
false, not in all
Term
45. Rules of nonmaleficence take the form, __________________.
 Definition
do not do "x"
Term
46. Obligations of nonmaleficence include not only obligations not to inflict harms, but also obligations not to impose risks of harm. (T/F)
 Definition
true
Term
47. A standard of due care is a specification of the principle of ______________________.
 Definition
nonmaleficence
Term
48. In some cases agents are causally responsible for a harm that they did not intend or know about. (T/F)
 Definition
true
Term
49. ______________ means taking sufficient and appropriate care to avoid causing harm, as the circumstances demand of a reasonable and prudent person.
 Definition
due care
Term
50. _________________ is the absence of due care.
 Definition
negligence
Term
51. The four essential elements in a professional model of due care:
 Definition
duty, breach of duty, harm, harm caused by the breach
Term
52. The distinction between withdrawing and withholding treatments is morally irrelevant. (T/F)
 Definition
true
Term
53. Giving priority to withholding over withdrawing treatment can lead to overtreatment and undertreatment. (T/F)
 Definition
true
Term
54. The distinction between ordinary and extraordinary means of treatment is unacceptably vague and morally misleading. (T/F)
 Definition
true
Term
55. Courts have increasingly maintained that medical nutrition and hydration are medical procedures subject to the same standards of evaluation as other medical procedures and thus sometimes unjustifiably burdensome. (T/F)
 Definition
true
Term
56. There is no reason to believe that medical nutrition and hydration is always an essential part of palliative care or that it necessarily constitutes a beneficial medical treatment. (T/F)
 Definition
true
Term
57. Evidence indicates that patients who are allowed to die without artificial hydration sometimes die more comfortably than patients who receive hydration. (T/F)
 Definition
true
Term
58. One of the few widely shared views in the literature on the rule of double effect is that intentional actions require that an agent have a _____________ —a blueprint, map, or representation of the means and ends proposed -- for the execution of the action.
 Definition
plan
Term
59. A person who knowingly and voluntarily acts to bring about an effect acts in an _____way.
 Definition
intentional
Term
60. The term “______” means a treatment provides no physiological benefit or is hopeless and becomes optional.
 Definition
futile
Term
61. A judgment about whether to use life-prolonging treatment rests unavoidably on the anticipated quality of life of the patient, not merely on a standard of what is medically indicated. (T/F)
 Definition
true
Term
62. Mental retardation is quite relevant in determining whether treatment is in the patient’s best interest. (T/F)
 Definition
false
Term
63. Criteria focused on the incompetent patient’s best interests should be decisive for a proxy unless the patient’s interests conflict with familial or societal interests in avoiding burdens or costs. (T/F)
 Definition
false
Term
64. When a patient has such a low quality of life that aggressive intervention or intensive care produces more harm than benefit, physicians justifiably may withhold or withdraw treatment from near-term fetuses, newborns, or infants, just as they do with persons of older ages. (T/F)
 Definition
true
Term
65. The meanings of “killing” and “letting die” clearly are vague and inherently contestable. (T/F)
 Definition
true
Term
66. “Letting die” is (prima facie) acceptable in medicine under one of two conditions:
 Definition
treatment is futile, patient makes autonomous rejection of life-sustaining treatment
Term
67. Standard justifications of killing prevent us from prejudging an action as wrong merely because it is a killing. (T/F)
 Definition
true
Term
68. Forgoing treatment to allow patients to die can be both as intentional and as immoral as actions that in some more direct manner take their lives, and both can be forms of killing. (T/F)
 Definition
true
Term
69. Rightness and wrongness depend on the merit of the justification underlying the action, not on whether it is an instance of killing or of letting die. (T/F)
 Definition
true
Term
70. Two types of advance directive aim at governing future decision making:
 Definition
health care power of attorney and living will
Term
71. The family’s role as surrogate decision-makers for incompetent patients should be primary for the following three main reasons:
 Definition
depth of concern about the patient, intimate knowledge about patients wishes, traditional role in society
Term
72. _________________________ is the name of the principle BC6 use to describe all forms of action intended to benefit other persons.
 Definition
beneficence
Term
73. This chapter presents two principles of beneficence:_________________ and _________________.
 Definition
positive beneficence and utility
Term
74. Some forms of beneficence are morally obligatory. (T/F)
 Definition
true
Term
75. Principles of beneficence are broad enough to justify all other principles. (T/F)
 Definition
false
Term
76. The New Testament parable of the Good Samaritan suggests positive beneficence is an obligation. (T/F)
 Definition
false
Term
77. We are morally required to benefit persons on all occasions. (T/F)
 Definition
false
Term
78. One rule specified under the principle of beneficence:
 Definition
rescue persons in danger
Term
79. Rules of nonmaleficence need not always be followed impartially. (T/F)
 Definition
false
Term
80. Rules of beneficence are negative prohibitions of action. (T/F)
 Definition
false
Term
81. Rules of nonmaleficence provide moral reasons for legal prohibitions of certain conduct. (T/F)
 Definition
true
Term
82. Failing to act beneficently toward a party is prima facie immoral. (T/F)
 Definition
false
Term
83. Failing to act nonmaleficently toward a party is prima facie immoral. (T/F)
 Definition
true
Term
84. The more widely we generalize obligations of beneficence, the less likely we will be to meet our primary responsibilities. (T/F)
 Definition
true
Term
85. Peter Singer argues that even if it is in our power to prevent something bad from happening, without thereby sacrificing anything of comparable moral importance, we have no moral obligation to do it. (T/F)
 Definition
false
Term
86. Health care worker X has an obligation of beneficence toward patient Y if five conditions are met. Name them:
 Definition
y sig. risk, x acts nec., x acts high probability of success, x not a big risk, benefit to y outweighs cost to x
Term
87. The morally relevant difference between rescuing specific individuals and alleviating global poverty and increasing public health is what?
 Definition
well placed at that moment to help victim
Term
88. Ethical theory and practical deliberation can set precise, determinate conditions of obligations of beneficence. (T/F)
 Definition
false
Term
89. There is an implicit assumption of beneficence in all medical and health care professions. (T/F)
 Definition
true
Term
90. ___________________ is the act or practice of making an appropriate and often proportional return.
 Definition
reciprocity
Term
91. Paternalism typically involves a conflict between two moral principles. Name them:
 Definition
respect for autonomy, beneficence
Term
92. The analogy between professional paternalism and paternalism of a father for a child presupposes two features of the paternal role. Name them:
 Definition
makes most decisions, does so in a way to further child's best interests
Term
93. The definition of paternalism used by BC6:
 Definition
intentional overriding of one person's preferences, justify by benefit to person
Term
94. The main difference between soft paternalism and hard paternalism is the existence of what in hard that is absent from soft?
 Definition
voluntariness
Term
95. Refraining from soft paternalism is an example of respect for autonomy. (T/F)
 Definition
false
Term
96. Refraining from hard paternalism is an example of respect for autonomy. (T/F)
 Definition
true
Term
97. Soft paternalistic actions are morally complicated because of the difficulty of determining whether a person’s actions are substantially nonautonomous. (T/F)
 Definition
true
Term
98. “Sin taxes” are an example of a hard paternalist policy. (T/F)
 Definition
true
Term
99. What an informed and competent person actually chooses to do is the best evidence we have of what his or her values are. (T/F)
 Definition
true
Term
100. BC6 warn against routinely using soft paternalism, giving two major reasons. Name them:
 Definition
comes with negative psychosocial costs, runs the risk of preparing way for hard paternalistic interventions
Term
101. Three general positions dominate the literature on the justification of paternalism. Name them:
 Definition
antipaternalism, paternalism justified by beneficence, paternalism justified by respect for autonomy
Term
BC6 argue the main justification for paternalistic interventions is respect for autonomy. (T/F)
 Definition
false
Term
103. BC6 argue that beneficence alone justifies paternalistic actions. (T/F)
 Definition
true
Term
104. As the benefits for a person increase and that person’s autonomy decreases, the justification for paternalistic action becomes less plausible. (T/F)
 Definition
false
Term
105. In general, as the risk to a patient’s welfare increases or the likelihood of an irreversible harm increases, the likelihood of a justified paternalist intervention correspondingly increases. (T/F)
 Definition
true
Term
106. There exist cases of justified hard paternalism. (T/F)
 Definition
true
Term
107. The antipaternalistic stance resisting suicide intervention is vulnerable to criticism on two grounds. Name them:
 Definition
fails to convey community concern for individual, individual may be depressed
Term
108. A suicide attempt, irrespective of motive, almost universally provides a legal basis for public officers to intervene, as well as grounds for involuntary hospitalization. (T/F)
 Definition
true
Term
109. _________________ include the resources required to bring about a benefit, as well as the negative effects of pursuing and realizing that benefit.
 Definition
costs
Term
110. IRB stands for ____________________________________.
 Definition
institutional review board
Term
111. An IRB proposal should essentially include what about the research being proposed?
 Definition
statement of risks, benefits, and clear that benefit outweighs risk
Term
112. CEAs are typically put in monetary terms. (T/F)
 Definition
false
Term
113. CEA and CBA are appear precise and helpful because they __________________________.
 Definition
put things in qualified terms
Term
114. _____________ refers to a possible future harm.
 Definition
risk
Term
115. Unlike risk, benefit is a probabilistic term. (T/F)
 Definition
false
Term
116. __________ is the set of individual, institutional, or policy responses to the analysis and assessment of risk, including decisions to reduce or control risks.
 Definition
risk management
Term
117. Societal perceptions of clinical research shifted significantly in the 1970s and early 1980s, from increasing access to clinical trials to protecting individuals from risks and burdens associated with research. (T/F)
 Definition
false
Term
118. BC6 draw two general conclusions from their consideration of the RBA of silicone-gel breast implants. Name them:
 Definition
need FDA and public safety protection, RBA's are not value-free
Term
119. Measures commonly associated with the _______________________ principle include transparency, involvement of the public, and consultation with experts about possible responses to threats marked by uncertainty or ignorance about probabilities and magnitudes.
 Definition
precautionary
Term
1. One method used to determine the value of a human life by policy makers is _______________.
 Definition
WTP
Term
121. QALYs bring _______ of life and ___ of life into a single framework for evaluation.
 Definition
quality, quantity
Term
122. __________ justice refers to fair and equitable distribution determined by justified norms of society.
 Definition
distributive
Term
123. The formal principle of justice:
 Definition
equals should be treated equally, unequals unequally
Term
124. A material principle of justice identifies relevant _________________ for distribution.
 Definition
properties
Term
125. In Philosophy 221, the two maternal principles most used for grading:
 Definition
merit, effort
Term
126. In the Auto Workers v. Johnson Controls, Inc., the course found that the workplace policy involved was based on the irrelevant (unjust) property of ______________.
 Definition
gender
Term
127. In order to specify and balance principles a general _________ of justice can provide assistance.
 Definition
theory
Term
128. __________ theories of justice focus on principles that evolve through traditions and practices.
 Definition
communitarian
Term
129. The right to health care is on a weak foundation when based on overall utility. (T/F)
 Definition
true
Term
130. _________theories of justice hold that health care is not a right, and the ideal health care system is privatized.
 Definition
libertarian
Term
131. John Rawls’ theory of justice holds that each person is entitled to the maximum amount of ______________ compatible with a similar measure of liberty for others.
 Definition
liberty
Term
132. The theory of _________________ holds that there is a social obligation to reduce or eliminate barriers that prevent fair equality of opportunity.
 Definition
egalitarianism
Term
133. The fair opportunity rule is specified under the principle of _________________.
 Definition
justice
Term
134. The fair opportunity rule says that no person should receive social benefits on the basis of _________________. It also hold that no person should be denied social benefits on the basis of ___________________ .
 Definition
undeserved advantageous properties, undeserved disadvantageous properties
Term
135. The genetic lottery refers to distribution of advantages and disadvantages of ticket numbers for a hypothetical health care insurance drawing. (T/F)
 Definition
false
Term
136. Many studies in the US indicate blacks and women have greater access to various forms of health care in comparison to white men. (T/F)
 Definition
false
Term
137. ______________ refers to a person’s susceptibility to coercion or harm.
 Definition
vulnerability
Term
138. A ______________________ situation is one where a person feels controlled by the situation, such as severe illness or lack of food and shelter.
 Definition
constraining
Term
139. Undue inducements are sometimes referred to as undue profits. (T/F)
 Definition
false
Term
140. Inducements are not undue unless they are both excessive in _______ and excessive in ________.
 Definition
risk; profit
Term
141. Two main arguments support a moral right to government funded health care: an argument based on _____________________ and an argument from ______________________.
 Definition
collective social protection, fair opportunity
Term
142. The decent minimum approach entails acceptance of a __________________ system.
 Definition
two-tiered
Term
143. The concept of decent minimum represents one place of agreement among different theories of justice. (T/F)
 Definition
true
Term
144. Public preferences should play a role in setting the decent minimum. (T/F)
 Definition
true
Term
145. Ethical and political theories that explicitly address questions of global justice are referred to as ______________________ theories.
 Definition
cosmopolitan
Term
146. Approximately 20 million people in the developing world die each year from malnutrition and diseases that can be inexpensively prevented or treated by cheap and available means. (T/F)
 Definition
true
Term
147. CUA stands for ________________________.
 Definition
cost utility
Term
148. Good evidence exists to show that public health expenditures targeted at poorer communities for ________________________ (such as prenatal care) save many times that amount in future care.
 Definition
preventative care
Term
149. BC6 present several basic “target goals” for a new health care policy:
a. Some form of _____________________________.
b. Acceptable incentives for ___________________ and for __________________.
c. A fair system of rationing that does not violate the ____________________.
d. Put new system into effect ____________________.
 Definition
universal insurance coverage, physicians and patients/customers, decent minimums, incrementally
Term
150. ___________ is a French term meaning sorting, picking, or choosing.
 Definition
triage
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