Biomedical Ethics 19929865

Test Instructions: 

1. Please answer both of the questions below.  Answer each sub-question as well.

2. Each answer should be approximately 600-900 words per answer.  Your total test should be roughly between 1200-1800 words. 

3. Only use course materials for this test. Cite the sources for any quotes in your test or in any instances where it is not clear which author you are paraphrasing. In-text citations, including the last name of the author and page number (Asch, 1653), are ideal for this purpose. No separate reference sheet is needed. 

4. You alone should answer your test questions. You may review any class readings with class member, but carefully avoid discussing your response to the test questions. If I find too many similarities between any two persons’ answers, I retain the right to test them further. 

5. Remember to explain yourself. Think carefully about your answers and explain them clearly and thoroughly (though keep the word count in mind). You may quote class texts to strengthen or clarify your answers. I recommend a separate paragraph for each major point.

6. Please submit a copy of your test using the link under Tests on Blackboard.  

Test Questions:

1. Read the following case and answer the questions below: 

Case: 

Susan, a 75 year old retired accountant, wife, mother of two and grandmother of three, has Alzheimer’s disease. Now six years into the diagnosis, her family finds that Susan can have a relatively comfortable life by attending an adult day center during the day while they work, and then they care for her in the evenings and weekends.  Susan has mood swings and sometimes angry outbursts, but usually, she enjoys singing and dancing at the day center. She cannot make new short or long-term memories, and she does not recognize friends and family.  She cannot be left alone.  Further, certain aspects of her health are beginning to fail.  Most importantly, the muscles she uses to swallow are beginning to atrophy.  Doctors tell her family that Susan will lose the ability to swallow in the new few months.  Her physician has offered to insert a feeding tube into her abdomen. Such a tube would, he believes, allow her to live several more years. The family is not sure whether to have the tube inserted. 

Questions: 

a. Susan’s family consults a family friend about whether to insert the tube who is a nurse with significant experience in end of life care.  The nurse advises the family that, in his experience, inserting such a tube for a patient like Susan would be futile. Using Wicclair’s categories of futility, what might the nurse mean by this statement?  In what sense(s) might the treatment be reasonably considered futile?  Please explain.

 b. What might the U.S. Bishop’s Committee say as to whether it would be ethical for Susan’s family to not insert a feeding tube for Susan?  Please briefly explain your answer, and refer to their text to support your answer. 

c. After Susan had kids in her early 30s, she and her husband filled out living wills, gave them to one another, and filled them with their providers. In Susan’s living will, she explained that she did not want to be kept alive through life-sustaining medicaltreatment if she is terminally ill and the treatment would provide little benefit other than keeping her alive.  What might be good reasons to not use this living will to make the family’s current decision regarding Susan’s care? 

d. Which of the ethical factors above do you find most compelling for the family in making this treatment choice as Susan’s surrogates?  Please briefly explain.  Is there one or two other ethical issues that you think are important for the family to consider in making this choice

2. PGD, Reproduction and Ethics   

Please read the case below and answer the questions at the end.  There are two questions: a and b.  

Case:

John and Martha have been married for three years.  They have always wanted to have children, and now they are ready to try to have their first child. Martha has a rare genetic condition that would pose a great risk of suffering and a shortened lifespan to any child of theirs.  A genetic counselor has suggested that the couple could use Preimplantation Genetic Diagnosis (PGD) as a way to avoid passing this genetic condition on to a child.  To use PGD, the couple would undergo IVF (in vitro fertilization) to reproduce like many parents, and doctors would select an embryo to implant that did not have the genetic condition they hoped to avoid.  

John and Martha are also both deaf, and they are active in communities that support deaf culture. They speak sign language and hold professional jobs they enjoy.  They believe that they live uniquely rich lives because they are deaf, and they want to share their unique culture with a child.  When they discuss PGD with the medical professionals at the clinic overseeing PGD procedures, they ask them, while they are selecting an embryo, to also select for an embryo that has the gene for deafness.  The parent’s first priority is to avoid the harmful disease, but if possible, they would like to select for deafness.  Is it ethical in this case to select for deafness?   

Questions: 

a. Describe two ethical issues from class that will help you analyze the ethics of this case (e.g. professional ethical duties, etc.).  Explain how these issues apply to the case and what the issues reveal about what is right or wrong in this case, specifically regarding selecting for deafness. (Please quote from class text in describing the ethical issues you’ve chosen to apply to this case.)

b. Last, but not least, what do you think Adrienne Asch would say about the ethics of this case?  Here, please address ethical issues that you did not discuss in part (a). 

c. Lastly, do you think it is ethically acceptable to use PGD to make such a choice?  Please explain.

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