Sample multiple choice, case studies PDF

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Sample Case Study # 1 (answer all of the questions at the end of the case study) Case study excerpted from Bioethics, Lewis Vaughn, Oxford UP – p. 302 “On December 13, 1988, 32 year old Nancy Klein, wife and mother of a young daughter, was in an auto accident that damaged her brain and put her in a coma. At the time, she was 10 weeks pregnant. After 6 weeks, she was still in a coma and still pregnant. Her doctors doubted that she had any chance of recovering, unless she had an abortion, which would increase the chances of recovery. So, her husband, Martin, asked a New York State court to appoint him as power of attorney so that he could give permission for the abortion. But abortion opponents went to court to block the abortion, one of them petitioning to be Nancy’s guardian while another asked to be guardian of her unborn fetus. Martin argued that these people were interfering with family concerns. For two weeks, legal battles ensued, but ultimately, Martin Klein won, becoming Nancy’s power of attorney. The opponents took the case to the Supreme Court, although they lost. Finally, at 18 weeks of pregnancy, the abortion was performed. Martin Klein and his wife’s parents were relieved and said they expected that after the abortion, Nancy would recover from her coma. Several weeks later she did. For the next two years, she struggled in rehabilitation hospitals to regain her memory and her ability to speak and walk. She eventually recovered much of what she had lost, though her speech and walking remained impaired. She condemned the actions of the abortion opponents: “I feel very strongly that it was my problem, not theirs, and that they had no right to interfere.” Answer each of the following questions (no more than 1 or 2 paragraphs per question): 1. Would Don Marquis side with Martin Klein or with the abortion opponents? 2. What about J. J. Thomson – would she side with Martin Klein or with the abortion opponents? 3. Was it unethical that the unborn fetus was not assigned a power of attorney? Marquis would thinks, But Thomson said, 4. Suppose that the doctors handling Nancy Klein’s case had advised her husband that she had little chance of recovering from her coma, regardless of whether the pregnancy was terminated. What would Marquis and Thomson say in such a case?

Sample Case Study # 2 (answer all of the questions at the end of the case study) Case study excerpted from http://virtualmentor.ama-assn.org/2003/07/ccas2-0307.html

“Dr. Hoover, a family physician practicing in the United States, reckons that, given the good relationship he has with his patients, and by offering them the opportunity to do their part for medical science, he could persuade many of his depressed male patients to participate in a randomized clinical trial testing an experimental drug for depression. As the decision time draws close, however, Dr. Hoover begins to

2 have second thoughts. The pharmaceutical company will pay him $3,000 for each patient he enrolls in the study. He will follow the participating patients for 2 years. These visits will be free to the participants. “The study is double-blind, so Dr. Hoover will not know which patients are receiving the trial drug and which are not. Dr. Hoover has no financial interest in the company that is conducting the trials, and believes that a good anti-depressant with limited side effects would be a therapeutic advantage over what is currently available.”

Answer each of the following questions (no more than 1 or 2 paragraphs per question): 1. Does the offer of free visits to Dr. Hoover’s depressed male patients constitute coercion and does it jeopardize their giving informed consent? 2. Is the offer to pay Dr. Hoover 3,000$ per patient an incentive for him to persuade his patients to enter the study, and does it interfere with his duty to look out for the best interests of his patients? 3. Suppose that Dr. Hoover sees improvement in some of his patients and he suspects that they are receiving the experimental drug. Does he have a duty to tell the patients who are not improving that they are likely on a placebo? 4. In the Tuskegee study, only male subjects were used. Is there a possible spectre of genderism involved in this study given that only male subjects are being used? What about Dr. Hoover’s female patients who are suffering from depression – is Dr. Hoover violating his duties to them as their physician?

Sample Multiple Choice Questions 1. What does Rawls mean by the "initial situation?” A) B) C) D)

A hypothetical situation where principles of criminal justice are chosen. A hypothetical situation where economic and political institutions are chosen. A hypothetical situation where principles of distributive justice are chosen. A hypothetical situation where principles of retributive justice are chosen.

2. Which one of the following ethical theories is NOT a consequentialist theory? A) ethical egoism B) psychological egoism C) utilitarianism 3. According to Kant, which one of the following actions would most likely have moral worth? A) giving to charity in order to be loved and admired B) going to the doctor because of the inclination towards self-preservation C) giving to charity even though you’re not inclined to do so, and with no benefit to yourself

3 D) keeping promises to friends because they will be loyal in return and help you when you are in need 4. The incompleteness problem in virtue ethics is which of the following? A) B) C) D)

Virtue ethics is unable to provide an adequate account of what virtue is. Virtue ethics requires external theories to justify why we should be virtuous. Virtue ethics ignores actions and instead focuses on moral character. B, C

5. According to Aristotle, which one of the following would be furthest from being a virtuous act? A) B) C) D)

a poor swimmer risking their life to save a drowning victim being loyal to your best friend when they are feeling depressed donating 5% of your pay to charity and declaring it on your income tax buying an economical car and putting the rest in your savings for your child’s college fund

6. Which one of the following is a NOT a postulate of practical reason in Kant’s ethics? A) People are free B) God exists C) God makes moral law. D) People are immortal. 7. In Rawls’ initial situation, representatives are ignorant of their: A) B) C) D)

position in society educational background conception of the good all of the above

8. Rawls’ material principle of justice says that: A) People who are relevantly similar should be treated similarly. B) People who are relevantly similar should be treated dissimilarly. C) People who are relevantly dissimilar should be treated dissimilarly. D) A and C 9. Each of the following is a problem with the utilitarian thesis that only consequences matter in evaluating actions EXCEPT: A) in some cases, it would be permissible to punish the innocent B) in some cases, it would be permissible to break one’s promises C) in some cases, it would be permissible to violate human rights D) each of the above is a problem with the thesis that only consequences matter.

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10. According the to the rule utilitarian, an act is morally right provided that: A) the rule that governs the action can be willed to be a universal moral law B) the rule that governs the action is beneficial for the person performing the action C) the rule that governs the action treats persons as ends and not as means D) none of the above 11. A randomized clinical trial where neither the subjects nor the physicians conducting the study know who is getting the experimental drug is called a A) single blind study B) double blind study C) triple blind study 12. If a physician helping in an RCT has a hunch that the experimental drug is effective, then this supposedly violates A) clinical equipoise B) the Hippocratic oath C) individual equipoise 13. The Tuskegee study that generated a lot of negative publicity due to racism was an experimental study. A) True B) False => it is an observation study 14. According to Capron, psychiatrists – in desperation to find cures for their mentally ill patients – argued that: A) there should be no limit to how risky an RCT is, provided it has promise of benefits B) there should be a maximum level of degree of risk set in RCTs C) there should be an allowable minimum increase of risk in minimal risk RCTs D) there should be no risk in any RCT unless it shows high promise of benefits to patients 15. According to Ramsey (as discussed in Ross’s article), it is wrong to experiment on children because: A) children are unable to freely give their assent to taking part in an experiment B) children are unable to freely voice dissent from taking part in an experiment C) children are unable to give informed consent for taking part in an experiment D) parents are unable to give informed consent for their child taking part in an experiment 16. In Thomson’s coat analogy where Jones steals the coat from Smith, the police officer is analogous to: A) the fetus

5 B) the mother C) the body of the mother D) none of the above 17. Which of the following does Warren consider to be the most important characteristics of personhood? A) being able to reason B) being conscious C) being able to communicate D) A and B 18. Don Marquis argues that trying to resolve the abortion debate using the concepts of personhood and being human is fruitless because: A) it is not clear what distinguishes persons from non-persons B) such debates always end in an argumentative stand-off C) it is not clear what distinguishes humans from non-humans 19. Which one of the following analogies is used by Thomson to refute the ‘less extreme’ view that abortion is impermissible unless the mother’s life is in jeopardy? A) B) C) D)

burglar analogy coat analogy Fonda analogy violinist analogy = very extreme

20. According to Capron, the therapeutic misconception involves which one of the following? A) Assuming that randomized clinical trials have a therapeutic dimension B) Assuming that the sole goal of practicing medicine is medical therapy. C) Assuming that the drug being tested in a clinical trial holds more promise than it actually does. D) Assuming that medical therapy is more important than medical research. 21. According to Brody and Miller, the therapeutic misconception involves which one of the following? A) Assuming that randomized clinical trials have a therapeutic dimension B) Assuming that the sole goal of practicing medicine is medical therapy. C) Assuming that the drug being tested in a clinical trial holds more promise than it actually does. D) Assuming that medical therapy is more important than medical research. 22. According to Brody and Miller, the concept that promotes the therapeutic misconception is which one of the following? A) minimal risk B) minimum increase C) individual equipoise D) clinical equipoise

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23. Which one of the following clinical studies involving children would Laine Ross agree with? A) research on the smallpox vaccine B) research on the polio vaccine C) research on the MMR vaccine D) none of the above

A) Overview of Ethics 1) What is applied ethics? a. Includes bioethics, business ethics and environmental ethics b. deal with specific realms of human action and to craft criteria for discussing issues that might arise within those realms. c. is an attempt to apply normative ethical theories to contemporary moral problems such as: d. Abortion e. World hunger f. Death penalty g. Euthanasia h. Biotechnology such as genetic engineering i. Biowarfare 2) What are the main branches of pure ethics? a. consists of normative ethics (attempts to find a justification of moral values) & metaethics (an investigation of the objectivity of moral values plus the meaning of moral terms such as “good”, “right,” “duty,” etc. 3) What is the difference between normative ethics vs. metaethics? a. Normative ethics: attempts to find a justification of moral values i. Involves consequentialist, deontological and virtue ethics ii. interested in determining the content of our moral behavior. Normative ethical theories seek to provide action-guides guidelines for determining a specific course of moral action. b. Metaethics: attempt to determine whether ethical values - the value of life, the value that it is wrong to steal, etc. - have an objective basis. i. talks about the nature of ethics and moral reasoning. Discussions about whether ethics is relative and whether we always act from self-interest 4) What is the difference between consequentialist theories, deontological theories & virtue ethics? a. Consequentialist theories - attempt to determine the moral rightness of actions by focusing on their results (utilitarianism, ethical egoism) b. Deontological theories - attempt to determine the moral rightness of actions by focusing on agents’ motives of duty (Kantianism, Rawlsian ethics) c. Virtue ethics - focuses on developing a theory of moral character in terms of virtues

7 B) Utilitarian Ethics 1. What is Mill’s theory of the good and how does he derive his theory of the right (principle of utility) from it? a. The highest good for humanity is happiness defined as pleasure (given that it is the highest good for each person). b. From the theory of the good, we derive the theory of right action. c. Principle of Utility: An action is morally right if it promotes the general happiness. d. Since the highest good for humanity is happiness, so it is right to make human happy e. The principle of utility does not assess actions based on whether they make everyone happy, but only based on whether they make most people happy. f. What is important is not everyone but rather “society as a whole” or the “social aggregate” 2. According to Mill, what are the sanctions of the principle of utility? a. Mill argues that moral principles - such as the principle of utility - are worthless if they have no binding force on people. b. So there are sanctions - penalties - that ensue if one disobeys the principle of utility, thereby giving it its binding force. i. External sanctions - such as disapproval from peers. ii. Internal sanctions - feelings of guilt that follow when one disobeys a moral principle => Another name is conscience which is a necessary condition for morality because without it, there is point in being moral. 1. Thus, the actions of a person who lacks a developed conscience are neither moral nor immoral - they are amoral. 2. Such people today are said to suffer from a sociopathic personality disorder. 3. What is Mill’s proof of the principle of utility? a. If Mill can prove his theory of the good, then given that this theory of the good entails the principle of utility, then he has proven the principle of utility. b. G --> R c. G d. Thus, R 4. What is a major criticism of Mill’s approach to ethics? a. 5. What is the Ford Pinto case, and how does it serve as a criticism of a formulation of utilitarian ethics in terms of social costs and benefits? a. 6. What are criticisms made against the thesis that only consequences matter in evaluating actions? (Rachel view, punishing people, violate people right, etc) a. If only consequence matter in evaluating actions, then when the social benefits outweigh the costs, it is acceptable to break promises, violate human rights, and to punish the guilty. b. But any theory of ethics that condones violating rights, punishing the innocent, and breaking promises does not qualify as a proper theory of ethics. c. That is, utilitarian ethics is a bad moral theory since it violates our pre-existing moral intuitions. d. Therefore, the theory should be abandoned. 7. What are J.J.C. Smart’s 2 replies to the 3 criticisms of the thesis that only consequences matter in evaluating actions?

8 a. If our intuitions disagree with a new theory, sometimes it is reasonable to abandon the intuitions rather than the theory. i. E.g., The Copernican Revolution, the theory of general relativity, quantum mechanics. b. Plain old “act utilitarianism” that assess actions according to their consequences is too short-sighted, since it ignores longer-term consequences. i. E.g., if we punish an innocent person to appease society, this may have good short-term consequences. But if we did this routinely, it would not be a happy society. ii. Thus, it would be wrong to punish an innocent person even if in this case, it benefits society, since in the long-run it will lead to an unhappy society where the innocent are routinely used as scape-goats. iii. Versus focusing on consequences of actions, we should focus on the consequences of the rules governing these actions. 8. Distinguish act utilitarianism (AU) from rule utilitarianism (RU) a. RU: An act is morally right if the rule that it falls under has more favorable long-term consequences than rules governing alternative courses of action. i. Prefer long term consequences b. AU: that assess actions according to their consequences i. Short term consequences

C) Kantian Ethics Know the following terms from Kant’s ethics 1) will, good will a. the will is what enables us to deduce duty from moral law. b. A good will is a will that is not influenced by selfish motives and emotions. i. the highest good for humanity since it enables us to deduce duty from moral law. ii. Whereas for Mill, the highest good is happiness. 2) duty vs. imperative a. A duty is a specific command or imperative with respect to a particular type of action i. duty serves as a corrective for a weak will influenced by emotion. b. Imperative: 3) 3 motives of action a. 1) self-interest (honest grocer example) b. 2) inclination (e.g., self-preservation) c. 3) duty (Wealthy miser example). 4) means, end a. Means: In Kant's view, acts that are done on maxims that require deception or coercion of others, and so cannot have the consent of those others (for consent precludes both deception and coercion), are wrong. When we act on such maxims, we treat others as mere means, as things rather than as ends in themselves. If we act on such maxims, our acts are not only wrong but unjust: such acts wrong the particular others who are deceived or coerced. b. End: Act in such a way that you always treat humanity, whether in your own person or in the person of any other, never simply as a means but always at the same time as an end. 5) categorical (universal) vs. hypothetical imperative (problematic)

9 a. hypothetical imperatives that are based on antecedent desires. They have the form “If you want X, do Y.” i. E.g., if you want friends, don’t lie. ii. According to Kant, hypothetical imperatives cannot serve as the basis of morality since they are not binding on everyone. iii. Not everyone may want friends, so the above imperative does not apply to them. b. Categorical imperative: have the logical form which are based on reason alone “do Y.” i. E.g., Don’t lie. ii. This imperative is universal. 6) kingdom of ends- no longer subject to their goal and morality a. Thus, to ensure that morality is truly universal, moral rules need to be derived in an ideal moral kingdom where emotions and subjective goals are factored out. b. A kingdom of ends is a systematic union of rational individuals abstracted from their subjective goals and purposes and united under the categorical imperative. 7) dignity 8) 3 postulates of practical reason: a. Postulate 1: God exists as the perfect moral agent - as an ideal to aspire towards. b. Postulate 2: We are immortal since this gives us an infinite amount of time to develop into perfect moral agents. c. Postulate 3: We are autonomous (free) since if we are not free then we can neither be praised nor blamed for our actions. 9) According to Kant, what makes an act morally right? a. Motivated by the duty 10) Why, according to Kant, are most (if not all) actions amoral or immoral? 11) Why does Kant maintain that we can never prove that anyone ever acts from duty? a. Kant admits that it is not possible to prove that anyone ever acts from duty, since one can always speculate that they really acted from self-interest or inclination. b. The wealthy miser who is not inclined to give to the po...