Biomedical Ethics -Essay

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GENERAL INSTRUCTIONS

As one of the �applied� ethics, Biomedical Ethics is neither simply a theory to be learned in philosophy books nor a set of codes to be learned in a technical training course � it is a discipline that moves between theory and practice. Thus, one of the key methodologies in Biomedical Ethics is the method of �Case Studies,� which presents an analysis of the ethical questions arising from real-world situations as they are faced by healthcare professionals, patients, and families. This approach requires a careful foundation in ethical theories and concepts, and a careful
exploration of the ethically relevant facts of the case at hand. Indeed, theories often arise from the attempt to systematize our intuitions of what is right and wrong in particular cases, and reciprocally new cases require that we re-evaluate our theories! Your first written assignment will thus be an analysis of a case.

In this assignment, you are required to include 4 sections corresponding to the following list:
A) Introduction: Identify the main topic of concern using the terminology, concepts, and arguments learned from our course videos, readings, podcasts, and website. Also, clearly identify the �morally relevant
facts� of the case, and any key concepts or facts that are important.
B) Argument(s) for side #1: Identify the strongest argument(s) you can think of for ONE side of the debate.
Be sure to include the reasons supporting the argument(s).
C) Argument(s) for side #2: Identify the strongest argument(s) you can think of for the OTHER side of the
debate, or the best objections to side #1. Again, give reasons and go beyond simply repeating the story.
D) Recommendation/Conclusion: In your opinion and based on your reasoning and arguments, what
ought to happen in this particular case, and what general policy should be supported? Be �objective� and find the best way between the two sides, or give a reason to choose one over the other. This is your �considered� or �critical� opinion, not just your unreflective beliefs.

Choice of Topics:
� Please choose ONE of the following case studies. Make sure to discuss the issues clearly and critically. Cite all sources as you proceed (by a number referring to an endnote or footnote) and do not ignore points made in the textbook, course notes and video presentations, etc. related to this course.

� REMEMBER: This is a biomedical ethics course. Be sure to include the relevant ethical content for your paper from an ethical perspective, which goes beyond legal considerations, is more �objective� than �subjective,� and is critically aware of the bias or assumptions in unreflective discussions of these topics.

1) Freedom of Medical Information? McInerney v. Macdonald

In the case from the early 1990s between Margaret McDonald of New Brunswick and her physician Dr. Elizabeth McInerney, the patient requested a copy of her medical file. Dr. McInerney promptly provided Mrs. MacDonald with all of the contents related to her own reports and practice, but withheld any documents that had been issued or inserted by other health care professionals. Her thought was that each physician had an ownership over the documents, and would each have to be contacted for consent for their release. This burden is one she placed on the patient to find and request this release. Mrs. MacDonald filed a lawsuit for the immediate release of all the documents, and was granted the request because the initial judge believed the contents to be subject to the patient�s property interests. On appeal, it was asserted by the courts that the physician-patient relationship is a contractual one, and the Supreme Court upheld this reasoning. However, they suggested that if a physician deems it �not in the patient�s best interest� to disclose the information, then they may invoke a necessity to deny access. Explore the reasoning in this case about the doctor-patient relationship and the rights of the patient, as well as in relation to our course materials related to �truth-telling.�

2) The Case of Scott Starson

In 1999, Scott Starson was involuntarily committed to a psychiatric hospital in Ontario after he had been found �not criminally responsible� for two counts of uttering death threats. Starson had a history of psychiatric disorders, and had recently been diagnosed with bipolar disorder. Starson recognized his disorder and voluntarily underwent psychotherapy, but he refused any medication for the condition. Starson, a gifted theoretical physicist, believed the medications would destroy his ability to pursue his research, which in his opinion was the only thing
that gave his life meaning. Physicians and officials believed Mr. Starson was unable to genuinely appreciate the value of treatment, so they petitioned to have his treatment decisions transferred to a surrogate. The petition was granted, but Mr. Starson appealed in a case that made its way up to the Supreme Court of Canada, which overturned the decision and asserted that Mr. Starson was not incompetent to make medical decisions. A patient, they argued, is not required to make a decision that is in their �best interests� as determined by the physician, and therefore they are allowed to disagree with a treatment recommendation. Mentally ill patients, then, must also be allowed to make medical decisions that disagree with doctors unless a clear inability has been demonstrated. Explore this case and the consequences it represents for the concept of informed consent and the notion of competence in Canada. Should
doctors be allowed to impose treatments in such cases?

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