Examination IV
This is a brief overview of our first examination which includes some example questions. I will provide any paper you need. You are allowed to bring one hand-written two-sided 4-inch by 6-inch note-card to help you keep all the material we have covered straight. Please don't hesitate to email or text should you have any questions. Note that per our syllabus, the exam is worth 400 points. I expect it to take longer than an hour, although how much longer we'll have to see. The essay questions below are drawn verbatim from the exam.
Examination IV Outline
A. Abortion
5 MC Questions
5 MC Questions
5 MC Questions
1 Essay Question
Consider this case: Annette Haroldson, independently wealthy due to a large family inheritance, has long lived the life of a carefree world traveler and debutante. Now thirty, however, she finds that she has largely given up on meeting "that special person"; yet she also discovers an intense desire to have children. Contracting with a fertility clinic, she selects a sperm donor and becomes pregnant on the third round of in-vitro fertilization. As it happens, Annette falls madly in love with Gaston after meeting him at a party. Three months after they begin dating, she musters the courage to tell him she's pregnant. At first, Gaston is overjoyed, inferring that her pregnancy is the happy result of their passionate time together. Tearfully, Annette explains about pursuing IVF at a time when she could not have imagined having someone in her life like Gaston. He puts his foot down and insists that he's always wanted children, but his children. He couldn't be with Annette if the child were not his. "The choice," he says, "is clear. It's either me or the baby!" Annette tells him she'll need time to think it over. A month later, she flies to France and has an abortion at the country's top women's clinic, returning to give Gaston the good news--she'll be able to start trying to have his baby!
In the space provided on this and the following two pages, i) explain what Thompson would likely conclude about the moral permissibility of Annette’s abortion given her arguments, ii) explain what Marquis would likely conclude about the moral permissibility of Annette's abortion given his arguments, and iii) explain what Warren would likely conclude about the moral permissibility of Annette's abortion given her arguments. Be sure that you clearly explain their arguments in your answers so as to justify your answers.
B. Reproduction
5 MC Questions
1 Essay
In the space provided on this and the following page, use carefully chosen examples to explain the distinction between selection and modification. Briefly explain at least two morally problematic of features of selection and explain at least two morally problematic features of modification.
C. Euthanasia
5 MC Questions
5 MC Questions
1 Essay
Consider the following case.
On April 8, 1984, Mr. William Bartling was admitted to the Glendale Adventist Medical Center in Los Angeles. He was seventy years old and suffered from five ordinarily fatal diseases: emphysema, diffuse arteriosclerosis, coronary arteriosclerosis, an abdominal aneurysm, and inoperable lung cancer. During the performance of a biopsy to diagnose the lung cancer, Mr. Bartling's left lung collapsed. He was placed in the ICU, and a chest tube and mechanical respirator were used to assist his breathing.
Mr. Bartling complained about the pain the respirator caused him, and he repeatedly asked to have it removed. When his physician refused, he pulled out the chest tube himself. This happened so often that eventually Mr. Bartling's hands were tied to the bed to keep him from doing it. He had signed a living will in an attempt to avoid just such a situation.
Although after discussions with Richard S. Scott, Mr. Bartling's attorney, Mr. Bartling's physician and the hospital administration agreed to disconnect the respirator, the hospital's attorney refused to permit it. He argued that, since Mr. Bartling was not terminally ill, brain-dead, or in a persistent vegetative state, the hospital might be open to legal action.
Mr. Scott took the case to Los Angeles Superior Court. He argued that Mr. Bartling was legally competent to make a decision about his welfare and that, although he did not want to die, he understood that disconnecting the respirator might lead to his death. The hospital's attorney took the position that Mr. Bartling was ambivalent on the question of his death. His statements "I don't want to die" and "I don't want to live on the respirator" were taken as inconsistent and so as evidence of ambivalence. Removing the respirator, the attorney argued, would be tantamount to aiding suicide or even committing homicide.
The court refused either to allow the respirator to be removed or to order that Mr. Bartling's hands be freed. To do so, the court ruled, would be to take a positive step to end treatment, and the only precedents for doing so were in cases in which the patients were comatose, brain-dead, or in a chronic vegetative state.
The case was then taken to the California Court of Appeal, which ruled: "If the right of a patient to self-determination as to his own medical treatment is to have any meaning at all, it must be paramount to the interests of the patient's hospitals and doctors. The right of a competent adult patient to refuse medical treatment is a constitutionally guaranteed right which must not be abridged."
The rule came too late for Mr. Bartling. He died twenty-three hours before the court heard his appeal.
In responding to the argument that VAE is contrary to the aim of medicine, which is healing, Brock argues that the aim of medicine is contrariwise to promote the welfare of the patient and to respect the patient’s autonomy. In concluding that "If the right of a patient to self-determination as to his own medical treatment is to have any meaning at all, it must be paramount to the interests of the patient's hospitals and doctors. The right of a competent adult patient to refuse medical treatment is a constitutionally guaranteed right which must not be abridged.", the State Supreme Court of California seems to agree, at least up to refusing treatment. In the space provided on this and the following two pages, give at least two arguments to justify the claim that the sole aim of medicine is healing, and give at least two arguments to justify the claim that the aim of medicine is both the promotion of patient welfare and respect for the patient’s autonomy. Which do you think are the better arguments, and why? Finally, it seems that the case of Mr. Bartling is an example—or could be understood as an example—where welfare and autonomy come into conflict. Mr. Bartling doesn’t want to be on the respirator, but his health depends on it. In such cases, should the health care profession privilege autonomy over welfare or welfare over autonomy? Justify your answer.
D. Impaired Infants
5 T/F Questions
5 T/F Questions
1 Essay
In the space provided on this and the following page, i) explain why Robertson's claim that the disutility of allowing defective infants to live can be minimized is dubious at best, ii) explain how Engelhardt argues that it is sometimes morally permissible to end the lives of severely defective infants, and iii) give at least one criticism of Engelhardt's argument.