APPLIED ETHICS NOW THE REAL WORK STARTS APPLIED

APPLIED ETHICS NOW THE REAL WORK STARTS

APPLIED ETHICS • Personal benefit: acknowledge the extent to which an action produces beneficial consequences for the individual in question. • Social benefit: acknowledge the extent to which an action produces beneficial consequences for society. • Principle of benevolence: help those in need. • Principle of paternalism: assist others in pursuing their best interests when they cannot do so themselves. • Principle of harm: do not harm others. • Principle of honesty: do not deceive others. • Principle of lawfulness: do not violate the law. • Principle of autonomy: acknowledge a person's freedom over his/her actions or physical body. • Principle of justice: acknowledge a person's right to due process, fair compensation for harm done, and fair distribution of benefits. • Rights: acknowledge a person's rights to life, information, privacy, free expression, and safety

BIOMEDICAL ETHICS • Patient Rights/Informed Consent • Abortion • Stem Cell Research/Cloning • Euthanasia

PATIENT RIGHTS (INFORMED CONSENT) • Informed Consent – fully understanding the situations, options, and possible consequences of the treatment. • Essential to maintaining the autonomy of a patient. • Beneficence – trying to help people • Non-maleficence - try to avoid harming people • Hippocratic Oath – core principle is “first, do no harm”

HIPPOCRATIC OATH • Hippocratic Oath: One of the oldest binding documents in history, the Oath written by Hippocrates is still held sacred by physicians: to treat the ill to the best of one's ability, to preserve a patient's privacy, to teach the secrets of medicine to the next generation, and so on. • https: //www. medicinenet. com/script/main/art. asp? articlekey=20909

ABORTION • Reminder – we are discussing this as a MORAL issue, not a LEGAL issue. The Supreme Court has already decided that. (Insulting your mama is immoral, but shouldn’t be illegal) • Reminder – Required, Forbidden, or Permitted • Let’s start with some basic information (definitions and laws) and go from there • We will then work from some basic statements… • READY? ? ? • Btw… we aren’t going to solve this today, but hopefully, you will have some tools to help you sort out your own thoughts on it.

https: //www. businessinsider. com/latest-point-in-pregnancy -you-can-get-abortion-in-50 -states-2019 -5

ABORTION • Devise statement(s) that work for YOUR stance. • Devise a working definition for the class’s use • Examine exceptions/inclusions • Base them on permitted, required, forbidden • Examine Applied Ethics Theories to form statements

ABORTION • All actions that kill a human being are wrong. • All abortions are actions that kill a fetus. • All abortions are wrong. • Conclusion – ? ? ? ? • This is clearly WAAAYYY too simple a way to frame anything, especially an argument as complex as abortion. I think we can all agree that NONE of these statements are functional for us.

ABORTION- DEFINITIONS • The spontaneous or induced termination of pregnancy before the fetus reaches a viable age. The legal definition of viability (usually 20 to 24 weeks’ gestation) differs from state to state. Some premature neonates of less than 24 weeks’ gestation or 500 g are viable. * *Venes, Donald, editor. "Abortion. " Taber's Medical Dictionary, 23 rd ed. , F. A. Davis Company, 2017. Taber's Online, www. tabers. com/tabersonline/view/Tabers-Dictionary/766365/all/abortion. • Medical abortion is a procedure that uses medication to end a pregnancy. A medical abortion doesn't require surgery or anesthesia and can be started either in a medical office or at home with follow-up visits to your doctor. It's safer and most effective during the first trimester of pregnancy. Having a medical abortion is a major decision with emotional and psychological consequences. If you're considering this procedure, make sure you understand what it entails, side effects, possible risks, complications and alternatives. ** ** “Medical Abortion. ” Mayo Clinic, Mayo Foundation for Medical Education and Research, 2019, https: //www. mayoclinic. org/tests-procedures/medical-abortion/about/pac-20394687.

ABORTION • Working Definition for THIS CLASS!! • The induced termination of a pregnancy before the fetus reaches a viable age. * • **based on Taber’s Medical Dictionary’s definition • This eliminates spontaneous miscarriages and the morning after pill as forms of abortion in our discussions.

ROE VS WADE • Established that laws against abortion violate patient privacy rights • Prompted two sides of the debate (pro-life and pro-choice) • Major unanswered question – “When does life begin? ” Still no answer… • Court said that states cannot restrict a woman’s right to an abortion during the first trimester; they can regulate it during the second trimester; and they can restrict or forbid it in the third. • Extremists on both sides of debate, which is dangerous to logical thought and argument. • Killing abortion doctors saves babies and #Shout. Your. Abortion hashtags make it seem like it’s an everyday thing without fallout.

STEM CELL RESEARCH • Stem cells are undifferentiated cells that can turn into any kind of cell as the body needs them; sort of a blank canvas cell. • Two primary sources • Adult stem cells - (tissue specific or somatic)- non-specific state, but more specialized than embryonic. Remain dormant until called on to regenerate damaged cells (skin, liver, brain, bone marrow, etc. ) Still researching to find out how these work EXACTLY. • Embryonic stem cells – come from a blastocyst (embryo 3 -5 days old). These have the potential to develop into any cell in the body. Most are from IVF embryos not implanted and donated. • Induced Pluripotent Stem Cells • Laboratory grown cells from an adult skin cell or an embryo **Source - https: //www. medicalnewstoday. com/articles/323343. php

CLONING • Three Types of Cloning • Gene cloning – creates copies of genes or segments of DNA • Very technical, and used to isolate and reproduce DNA molecules • Useful in producing things like copies of human growth hormones or human insulin • Reproductive cloning – creates copies of whole animals • The DNA is planted into a “blank” egg and then implanted into a female – voila – a genetic copy of the donor animal. • Therapeutic cloning – creates embryonic stem cells (designed to grow healthy tissue to replace injured or diseased tissues in the human body) • A cell is taken from an animal’s skin and is inserted into the outer membrane of a donor egg cell, creating a “stem cell”

MEDICAL BENEFITS OF STEM CELL RESEARCH • Tissue Regeneration (new organs for transplant) • Cardiovascular Treatment (creation of new, healthy blood vessels) • Brain Disease Treatment (Parkinson’s, Alzheimer's) • Cell Deficiency Treatment (Type I diabetes, heart repair) • Blood Disease Treament (lukemia, sickle cell anemia) **Source - https: //www. medicalnewstoday. com/articles/323343. php (Oct. 2018)

POTENTIAL BENEFITS OF CLONING • Infertility – infertile or same-sex couples could conceive children from cloned cells* • Organ replacement – a clone could be produced to harvest tissues (obviously this might be problematic)* • Genetic Research – gene editing (the correction of potentially faulty genes (cystic fibrosis)* • Selective Human Traits – the editing or removing of bad genes could lead to engineering human beings for specific traits* • Prevents the extinction of species – reviving already extinct populations and expanding the diversity of gene pools of endangered populations** • Increased food production – in plant life (genetic jackpot instead of laying lottery), scientists can create super organisms** *Source - https: //sciencing. com/pros-cons-cloning-5453902. html**https: //www. bioexplorer. net/pros-and-cons-ofcloning. html/

STEM CELL/CLONING – ETHICAL ISSUES • Use of embryos for research… destroying a human blastocyst stops the potential development of an embryo into a person • Mixing humans and animals – much of the research involves inserting human cells into animals… Hello, Dr. Moreau. The concern is that science could create some sort of organism that is part human. • Legality – it is illegal in many countries to produce embryonic stem cell lines (reproduce stem cells from an embryo). In the US, it is illegal to work with stem cell lines created after Aug. 2001. • Regulations – some people are offering “anti-aging” stem-cell therapies. These are not approved, may be illegal, and are certainly dangerous. **Source - https: //www. medicalnewstoday. com/articles/323343. php (Oct. 2018)

STEM CELL/CLONING – ETHICAL ISSUES • Designer Babies – choosing your baby’s sex, height, weight, eye color, etc…* • Human cloning – a violation of human rights? * • Embryonic Cloning – cellular degradation occurs when too many copies are made from embryos – think the movie Duplicity* • Exclusive Identity – moral/human right to a unique identity – who’s the real John Smith? * • Not safe or accurate and still not fully developed– things are still WWWAAAYY unsure. (277 attempts to clone Doll the sheep)** • Dangers of reviving extinct animals – the wooly mammoth? Jurassic Park? *https: //sciencing. com/pros-cons-cloning-5453902. html ** https: //www. bioexplorer. net/pros-and-cons-ofcloning. html/

APPLIED ETHICS • Personal benefit: acknowledge the extent to which an action produces beneficial consequences for the individual in question. • Social benefit: acknowledge the extent to which an action produces beneficial consequences for society. • Principle of benevolence: help those in need. • Principle of paternalism: assist others in pursuing their best interests when they cannot do so themselves. • Principle of harm: do not harm others. • Principle of honesty: do not deceive others. • Principle of lawfulness: do not violate the law. • Principle of autonomy: acknowledge a person's freedom over his/her actions or physical body. • Principle of justice: acknowledge a person's right to due process, fair compensation for harm done, and fair distribution of benefits. • Rights: acknowledge a person's rights to life, information, privacy, free expression, and safety

HIPPOCRATIC OATH • I swear to fulfill, to the best of my ability and judgment, this covenant: • I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow. • I will apply, for the benefit of the sick, all measures which are required, avoiding those twin traps of overtreatment and therapeutic nihilism. • I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug. • I will not be ashamed to say "I know not, " nor will I fail to call in my colleagues when the skills of another are needed for a patient's recovery. • I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God. • I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick. • I will prevent disease whenever I can, for prevention is preferable to cure. • I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm. • If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.

EUTHANASIA - DEFINITION 1. An easy, quiet, and painless death. 2. The deliberate ending of the life of people (or in veterinary practice, animals) with incurable or terminal illnesses or unbearable suffering. The ethical ramifications are actively debated and unresolved: Should patients have the right to choose death? When is death imminent, or suffering intolerable? Does participation by a health care provider, e. g. , a doctor, nurse, or pharmacist, violate personal, professional, religious, or social mores? - [Gr. eus, good, + thanatos, death] **Venes, Donald, editor. "Euthanasia. " Taber's Medical Dictionary, 23 rd ed. , F. A. Davis Company, 2017. Taber's Online, www. tabers. com/tabersonline/view/Tabers-Dictionary/758345/all/euthanasia.

EUTHANASIA – PATIENT CARE “Active euthanasia (sometimes called “mercy killing”) occurs when a person, usually a physician or nurse, performs an act, e. g. , administering a lethal injection, to end a patient’s life. Additional descriptors for euthanasia include “voluntary, ” i. e. , the patient requests euthanasia, “involuntary, ” i. e. , the patient specifically refuses euthanasia, and “nonvoluntary, ” i. e. , the patient is not able to inform others of his wishes concerning euthanasia. Currently euthanasia is illegal in most countries except for the Netherlands, which allows limited, voluntary euthanasia. The general terms “assisted death” and “aid in dying” apply to actions intended to hasten death and include both assisted suicide (AS) and active euthanasia. “Withdrawing or withholding life-sustaining therapy” (WWLST) is the discontinuance or foregoing of therapies that may keep someone alive, e. g. , cardiopulmonary resuscitation (CPR), mechanical ventilation, artificially provided nutrition and hydration, and antibiotics or other drug therapies. Most patients who die in acute care settings, particularly in intensive care units, do so after the withholding or withdrawing of CPR or other life-prolonging therapies. The U. S. Supreme Court has consistently upheld the right of patients to refuse such therapies via living wills or advanced medical directives. Euthanasia, however, is illegal and may be treated by the courts as an act of murder. ” **Venes, Donald, editor. "Euthanasia. " Taber's Medical Dictionary, 23 rd ed. , F. A. Davis Company, 2017. Taber's Online, www. tabers. com/tabersonline/view/Tabers-Dictionary/758345/all/euthanasia.

EUTHANASIA – WORKING DEFINITIONS • Euthanasia – a doctor is allowed by law to end a person’s life by a painless means as long as the patient and their family agree • Assisted Suicide – A doctor assists a patient to commit suicide if they request it. • “intentionally helping a person commit suicide by providing drugs for self-administration, at that person’s voluntary and competent request. ” • Some definitions include the words “in order to relieve intractable (persistent, unstoppable) suffering. ” **https: //www. medicalnewstoday. com/articles/182951. php#euthanasia-and-assisted-suicide- ( Dec.

WORKING DEFINITION • Euthanasia – “the practice of intentionally ending the life of someone who’s suffering from an incurable illness or is an irreversible coma. ” • ** Panza, Christopher, and Adam Potthast. Ethics for Dummies. Hoboken, NJ: Wiley Publishing, Inc, 2010. Print.

EUTHANASIA • Active – a person physically helps a person end his/her life (maybe prescribing a lethal dose of morphine in pain management, knowing it will be fatal). • Passive – a person has no active role in ending life (for example, when life-sustaining treatments are ended or withheld). • Voluntary – euthanasia is conducted with the consent of patient, family, and all involved parties • Non-voluntary – euthanasia is conducted without knowledge of his or her wishes; likely because the patient’s condition makes it impossible to ascertain • Involuntary – euthanasia is performed on a person who would be able to consent, but does not; when a terminally ill patient’s life is ended against that person’s wishes (murder) **https: //www. medicalnewstoday. com/articles/182951. php#euthanasia-and-assisted-suicide- ( Dec. 2018) ** Panza, Christopher, and Adam Potthast. Ethics for Dummies. Hoboken, NJ: Wiley Publishing, Inc, 2010. Print.

EUTHANASIA

EUTHANASIA – STATE LAWS • https: //euthanasia. procon. org/view. resource. php? resource. ID= 000132 • 9 states and DC have legalized physician-assisted suicide • 41 states consider assisted suicide illegal • 0 Federal laws on Euthanasia and Assisted Suicide** **1990 the US Supreme Court did approve the use of non-active Euthanasia; 1997 the US Supreme Court adopted Death with Dignity laws

EUTHANASIA – CONTROVERSY (IN FAVOR) • Freedom of Choice • Quality of life • Dignity • Witnessing the slow/horrible death of loved ones • Best Use of Resources • Burden on loved ones • If we do it for pets and see it as an act of love…

APPLIED ETHICAL THEORIES IN FAVOR OF EUTHANASIA

EUTHANASIA – CONTROVERSY (OPPOSITION) • Health care professionals’ roles • Faith based argument that ALL life is sacred and suicide is forbidden for ANY reason • Patient competence (ability to express wishes) • Patient motivation (guilt) • Mental illness (depression, bi-polar, schizophrenia) • Drawing a line (start with terminally ill – what about terminally old? ) • Miracle recoveries • Palliative Care (is euthanasia necessary) • Regulation/legality – can it be regulated?

APPLIED ETHICAL THEORIES IN FAVOR OF EUTHANASIA

BY THE NUMBERS • In the countries where euthanasia/assisted suicide is legal, they result in only 0. 3 -4. 6% of deaths, more than 70% of which are related to cancer. • In Washington and Oregon (two of the states where physicianassisted suicide is legal), fewer than 1% of physicians write prescriptions that will assist suicide each year. **https: //www. medicalnewstoday. com/articles/182951. php#euthanasia-and-assistedsuicide- ( Dec. 2018)

ENVIRONMENTAL ETHICS • Field of ethical enquiry concerned with the value of ecosystems, the natural environment, and the distribution of benefits and harms in relation to the environment. • Basically how do we balance the needs of mankind with the preservation the environment and practicing good stewardship of our natural resources • This school of ethics has largely begun to rely on our idea of prima facia and actual duties (remember where actual sometimes overcomes prima facia)

ENVIRONMENTAL ETHICS • Moral Approaches to Ethics • Non-Anthropocentrism – biocentric of ecocentric focus of deep ecology ( non-human entities have value on their own and cannot be measured by human interests) – focus on wilderness preservation • Anthropocentrism – Environmental issues should be addressed and solved in terms of human interests (human health, happiness, and profit and a primary focus; denies the value of non-human beings for their existence outside of their benefit to humanity • Moderate or Mixed View – Balancing human and non-human interests (recognizes the value of nonhuman beings/things; sustainable development and environmental justice balance human needs with respect for nature

BUSINESS ETHICS • Examines moral controversies relating to the social responsibilities of business practices including issues such as the moral status of corporate entities, employee rights and responsibilities, deceptive advertising, consumer rights and responsibilities, insider trading, job discrimination/affirmative action, drug testing, and whistle blowing. • Business Ethics isn’t complicated – doing the right thing in the way people run their companies… When customers and employees trust a company to do the right thing, the business is more productive inside and out.

WHAT MAKES A BUSINESS ETHICAL? • Transparency • Respect • Loyalty • Concern • Customer Focus • Commitment • Passion What other traits/Virtue Ethics might we add to this list?

BUSINESS ETHICS • Think of examples as a customer, employee, or manager that you have faced… how were they handled? Ethically or not?