2601 - Week 10: Practice Exam Guide Questions Fully Solved.

1972 repeal of criminal code prohibiting suicide - correct answer Took out suicide being illegal but kept that if you help someone do it you can go to jail 2015 Supreme Court - correct answer Took the time to figure out a way to allow medical assisted suicide if they are mentally competent and suffering intolerably active euthanasia - correct answer You kill the patient (roughly), did an action that killed someone (Euthanasia - death brought consensually) passive euthanasia - correct answer roughly, involves letting a patient die Example: Not reviving a patient with a DNR order Not offering assistance for the cause of death you did not introduce Types of passive euthanasia - correct answer 1. Witholding of treatment: -Not performing a needed surgering or not admeinistering a needed drug (might not want it or might be too far gone) 2. Cessation of treatment: -Treatment isn't working so you withdraw it (turning off a respirator) Voluntary vs Non-voluntary Euthanasia - correct answer 1. Voluntary: Capable person has given permission (usually sustained over a long period of time)- "this is what i want" 2. Non-Voluntary: Person can't give concent, so the caregiver does it for them 3. Involuntary: not possible - saying no no no and they still do it (murder) Is Assisted Suicide Euthanasia - correct answer No, since the patient is making the big decision at the end. Example: Merticon - Set it up for the patient and they can flip the switch. (if disabled the doctor does it) •Voluntary active euthanasia, legal or not? - correct answer legal prior to 2015 due to "the doctrine of double effect" •Restricted because it takes a long-term process of reassurance that this is what the patient really wants à moral decision, time to reflect Assited suicide, legal or not? - correct answer legal Non voluntary active euthanasia, legal or not? - correct answer illegal although again" doctrine of double effect" •No, patient or someone must give consent before you introduce death Non voluntary passive euthanasia, legal or not? - correct answer legal under appropriate proxy decision •Depends on scenario and province •Law tells us who is next in line in decision making if the patient themselves can't give consent Voluntary passive euthanasia, legal or not? - correct answer legal (in fact, required) •Listening to the patient, don't question it •Required because consent problems Coma - correct answer Brain activity, but no consciousness or wakefulness (they can hear you) Persistent Vegetative State (PVS) - correct answer Wakefulness, but no awareness. Eyes open, no reaction to anything Little intellectual activity Minimally conscious state (MCS) - correct answer Wakefulness and minimal awareness Locked-in syndrome - correct answer Full conciousness, but extreme paralysus (trapped inside) The Doctrine of double effect (DDE) - correct answer If you want to do the good thing and don't intend for the bad side effect to happen do it (as long as your intention is the good thing and you know something bad will also happen - taking a risk with the good in mind like the grampa example. Kinda an excuse to do something that has risk if you have good intentions What euthanasia occurs under the Doctrine of double effect? - correct answer (non-voluntary active euthanasia and voluntary occur under this doctrine) -When the doctor is doing the killing Fundemental Issue of Assisted Suicide (Four p's 1 c) - correct answer p1: The competent patient has autonomy over his or her body, and authority over treatment choice. p2: Doctors currently stop treatment in terminal cases under orders from patients or proxies. p3: Killing is morally equivalent to letting someone die p4: Killing in terminal cases would be more merciful than allowing them to die c1: Therefore, patients should be able to authorize physicians to perform assisted suicide p1: The competent patient has autonomy over his or her body, and authority over treatment choice. - correct answer -When you turn 18 you have autonomy of your body unless your using it to violate the right of others Daniel Callahan - correct answer Was worried that the rule of autonomy would run amok in the hospital environment - would cause coercion and people wouldn't want to give their life away to the doctors because of "futility" - could be lying p2: Doctors currently stop treatment in terminal cases under orders from patients or proxies. - correct answer If a terminal case says stop, physicians have to respect it p3: Killing is morally equivalent to letting someone die - correct answer Idea brought by James Charles - consequentialist -if you wanted the person to feel pain because you were mad so you let it happen it is equal to killing them. In the cause of a dying passient he said if we are doing it to end their suffering why not do it in the fastest way possible (assisted suicide) Callaghans view (causation) - correct answer "causation" We can work with timing the death, but we know it will happen. A physician is allowed to adjust the timing, but to not cause it (DDE applies) p4: Killing in terminal cases would be more merciful than allowing them to die - correct answer - intuitively, this has some appeal - but mercy is a loaded term, mercy suggests what you do is good 'under the circumstances' (I'm making the best of a very bad situation) - but mercy isn't justified if I'm making a situation worse. Sue Rodriguez - correct answer • the most famous case of "assisted suicide" in Canada •She had amyotrophic lateral sclerosis (ALS) •The Supreme Court rejected her argument, ruling 5-4 that society's obligation to preserve life and protect the vulnerable outweighed her rights. Is there a possibility that issues other than the patient's best interests will come into play (3) - correct answer - freeing scarce medical resources - family acting greedily - quality of life is subjective What would be the benefit of Advanced Request for assisted suicide - correct answer allows MAIDS candidates to maximize remaining quality time without the fear and anxiety of losing the capacity of giving consent could also keep them away from long-suffering What illness makes ARM questionable? - correct answer Dementia 2 Important aspect that make us question ARM? - correct answer 1. The criteria necessary to establish consent (capacity, disclosure and voluntariness ) 2. Recognition that capable patients have the right to refuse or withdraw any form of medical interventions Negative Request - correct answer Stopping, limiting or refusing a treatment Positive Request - correct answer Requesting for some sort of treatment (ventilation) Two Steps needed for providing positive request - correct answer 1. The three necessary criteria of consent 2. Pass the test of medical justifiability The three necessary criteria patients must meet in order to give consent - correct answer 1. Patient must have the capacity to make the decision 2. Physicians must disclose the nature of the patient's condition, proposed treatment and harm that comes with refusing or accepting 3. Patient must be free to make a decision Pass the test of medical justifiability - correct answer Treatment must be therapeutically beneficial and not harmful to a patient