Up@dawn 2.0

Friday, February 3, 2017

Quiz Feb 7

We wrap up our reading and discussion of Bioethics: The Basics with ch.6 on justice. Anticipating Eula Biss's On Immunity next month, we might pay particular attention to this chapter's discussion of vaccination/immunization. If you're interested, also see Seth Mnookin discussing his book Panic Virus:
  1. But first, to follow up on last time's discussion of "enhancement" and to anticipate the upcoming report on Michael Sandel's Case Against Perfection: awhile back I saw a chilling fictional representation of how future mental/cognitive enhancements might lead to dystopia. It was episode three of the British series "Black Mirror," in which everyone is equipped with an implant called a "grain" - it's kind of a subcutaneous Google Glass, with instant access to one's entire archival memory (and with f/forward and rewind). The late David Carr on Black Mirror, MicroSoft's HoloLens, and our dwindling experience of "actual unencumbered reality"...
    And if that's not chilling enough, check out "The World of Tomorrow"...
    1. What are the two major spheres of justice discussed by Campbell? 
    2. (T/F) Vaccination/immunization and restricted mobility are two of the measures used by preventive medicine to counter the spread of disease. 
    3. Another name for the micro-allocation of health care, concerned with prioritizing access to given treatments, is what? (HINT: This was hotly debated and widely misrepresented ("death panels" etc.) in the early months of the Obama administration.)   
    4. What "perverse incentive" to health care practitioners and institutions do reimbursement systems foster, as illustrated by excessive use of MRIs?
    5. What is the inverse care law?   
    6. What is meant by the term "heartsick patients"?
    7. How are Quality Adjusted Life Years (QALYs) supposed to address and solve the problem of who should receive (for instance) a transplant?   
    8. Who propounded a theory of justice that invokes a "veil of ignorance," and what are its two fundamental principles?   
      9. Under what accounts of health might we describe a sick or dying person as healthy?
    10. Name two of the "capabilities" Martha Nussbaum proposes as necessary to ensure respect for human dignity?

    1. Do you agree that health care providers are ethically obliged to promote a fair balance between the rights of the individual and the welfare of society as a whole, and a fair distribution of benefits and burdens in society? Would you say that ethos is widely shared among physicians?

    2. Reflecting on the present measles outbreak and the ebola quarantines of last summer, how would you rate the current strength and effectiveness of vaccination and restricted mobility as tools of preventive medicine? How might they be improved? Do you agree that most anti-vaccers lack a degree of social conscience?

    3. Are you aware of examples of unjust "queue jumping"? 150 (Does the name Mickey Mantle ring a bell?) 
    4. Are there better alternative payment systems than reimbursement? Is it possible to reign in excessive tests and costs while retaining a reimbursement system? 
    5. How would you resolve the Lifeboat Scenario? 153f.

    6. Do you agree that justice requires us to remove the social disadvantages caused by ill health and disability, and support a universal right to those health care interventions that will allow everyone to pursue their "normal opportunity range"? Would you be more or less likely to agree, if you found yourself behind the "veil"? 159

    7. Are there any "attainable human capabilities" on Martha Nussbaum's normative list you'd not include on yours? 163

    8. Elaborate on how bioethics overlaps with environmental ethics. 165
    Mother Jones (@MotherJones)
    We are this close to "designer babies" mojo.ly/1W5QtTe pic.twitter.com/KTO0VDpNHl

    New Republic (@NewRepublic)
    What’s wrong with Craig Venter? bit.ly/1UWRU65 pic.twitter.com/F3b8scr06N

    The USDA abruptly removes animal welfare information from its website

    Measuring the wonders of an empathetic ear in the doctor’s office

    Turning the Tide Against Cholera
    Two centuries ago, a global pandemic rose from the swamps of Bangladesh. Now researchers there may have found the tools to stop it.
    CreditJenn Ackerman for The New York Times

Trump’s Travel Ban, Aimed at Terrorists, Has Blocked Doctors

Across the United States, over 15,000 physicians are from the seven affected countries. Many work in small towns, poor urban neighborhoods and V.A. hospitals.


  1. Discussion Question:
    Is the rise in medial schools that accept students that show interest working/living in poverty areas enough to show signs of better health in those areas? Example: ETSU likes to accept students from the Appalachian area in hopes of providing future care for that area.

  2. Here is a link to Australia's grim reaper campaign

  3. Attached is a link to an educational video that visually explains the ideas and provides examples of both distributive justice and social justice.


  4. Quiz question: What two fundamental principles of justice does John Rawls argue is rational to ensuring that society is fair to everyone? (pp. 158)

  5. Quiz Question:
    Who stated "all shall count as one and none as more than one"?
    (pp. 156)

  6. This article is an interesting find that deals with social justice. It is about the more prominent appearance of DNA testing and the discrimination that is starting to come along with it. I think that this will definitely begin testing our society and its boundaries of what is socially just when it comes to genetics.


  7. Discussion Question:
    Do you think the aid of posting on social media websites (i.e. Facebook, Instagram, Twitter, etc.) to gain the attention of the public and celebrities to help with or pay for medical expenditures is socially just? Do you think it is considered "queue jumping"?
    EX: Ellen DeGeneres was somehow able to use her influence and TV show to get a boy (who was denied for a heart transplant twice) a new heart.

    1. The boy would make a strong argument that it is acceptable, but I believe the fact is that some people get help and some people die. It is a hard fact of life, and if someone has the influence to help another and does, then it was meant to be. Does that mean someone did not recieve a hear and died in his place? Who knows, but at least one life was saved. This seems to be a slippery slope with the answer to one question asking several more.

  8. DQ: How would you resolve the Lifeboat Scenario?

    If I were placed in the lifeboat scenario, I would first double-check to make sure that the amount of rations available could in fact ensure survival for a few people. I would then explain the situation to each of the members. Hopefully, the crew will understand the situation, and a few members may offer their rations to the primary rowers. Asides from those few steps, I would not change the lifeboat scenario too much as explained within the text. However, I might have designated a few rations to the woman with child in the case that another ship or plane notices our lifeboat and rescues the crew earlier than the anticipated 10 days. As depressing as this situation appears, I feel this is the way that I would handle the situation.

  9. QQ:

    What does Lennart Nordenfeldt refer to as a set of goals which are necessary and together sufficient for minimal happiness?

    (pg. 159)

  10. DQ: How would you resolve the Lifeboat Scenario?

    Desperate times call for desperate measures. It takes about five days for people to die from dehydration. Since the food/water will last five people for four days, then there is twenty days worth of food/water.
    If they were heading to civilization, I would divide the resources so that the two young men and the middle aged man got about seven days's worth of food/water each. If they were not heading to civilization, I would divide the resources so that the two young men and the young woman got about seven days's worth of food/water each. All of the outcomes are harsh.

  11. Quiz Question: Describe the six people in the Lifeboat Scenario.

  12. This is an informative video that explains the contribution of John Rawls in defining justice and its components.


  13. 3. Are you aware of examples of unjust "queue jumping"? 150 (Does the name Mickey Mantle ring a bell?)

    I'm not aware that it is seen very often, but I do hope that it doesn't occur at all. It reminds me of the movie 2012. This movie set up the apocalypse and (spoilers) at the end there were multiple ships that could withstand the end of the world. They were supposedly filled with people that would make the correct genetic makeup, but they were rather filled with the richest people in the world who funded the project. I just hope the world never gets to that point.

  14. Quiz Question:

    Who stated that 'Everyone has the right to a standard of living adequate for the health and well-being of himself and his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.'

  15. DQ: Are you aware of examples of unjust "queue jumping"? (Does the name Mickey Mantle ring a bell?)

    Answer: I am aware of the concept of unjust "queue jumping. However, the name, Mickey Mantle does not ring a bell. I do not find it fair that a patient can take priority over another patient next in line for a transplant due to the fact that the former can afford it sooner. This idea may be fair for patients that can afford it right away, but this is not the case for patients that come next in line.

  16. This is an article about Steve Jobs and his organ transplant. Apparently, Steve Jobs lived in Northern California. He received an organ transplant in four months, because the waiting list in Tennessee was shorter than that in California.


  17. Quiz question: What method of preventive medicine should be used optionally due to inaccuracy?

  18. Where does the U.S rank among other countries in life expectancy? pg145

  19. 1. Do you agree that health care providers are ethically obliged to promote a fair balance between the rights of the individual and the welfare of society as a whole, and a fair distribution of benefits and burdens in society? Would you say that ethos is widely shared among physicians?

    It must be a cooperative effort amongst us all. Instead of encouraging the competitive nature which ensures we exploit the weak and ignore the unintelligent, health care providers, branches of government, charities, and individuals belonging to both categories have a moral imperative to make a health a priority.

  20. Darcy Tabotabo, Lee Gish, Phillip Shackelford
    Talk and discussed immunization.

  21. Alternative questions:

    1. What is the difference between equitable treatment and equal treatment? (143)
    2. Who is the highest spender on health care across the world? (145)
    3. What is another name for the inverse care law? (148)
    4. Name two possible principles for how to allocate fairly. (155)
    5. Who said "all shall count as one and none as more than one?" (156)
    6. What three areas does WHO urge action in all the countries with poor health outcomes? (161)