- 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
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