MEDICAL HUMANITIES EXAM II (MEDICAL
HUMANITIES STUDY GUIDES CH. 14-22) 121
QUESTIONS WITH ACTUAL SOLUTIONS!!
Note opening quote! CH.14 Answer - · "The Relief of suffering is the
fundamental goal of medicine"
The social constructionist approach versus the essentialist approach to describe
the purposes of medicine: Know the definition, description and features of
each Answer - · Social constructionist approach
o takes into account the diverse social factors and cultural values that shape
healing practices
o medicines ends and purposes are externally determined and thus culturally
variable
· Essentialism
o The goals of medicine are derived internally from values inherent in the
practice of medicine
o Considers such values as preventing and curing disease, relieving pain,
mitigating suffering to be invariant or unchanging
Hastings Center: purpose and conclusion of their report, bottom of page 226
Four broad notions to describe the goals of modern medicine concluded by the
Hastings report. What are these four "guideposts"? Answer - · "A medicine
that has no inner direction or core values will be too easily victimized and
misused by society if it lacks the resources to resist encroachment upon it... yet
it is also naïve to think that medical values can remain uninfluenced by society.
,Since doctors, health care personnel, and patients will be part of society, it will
never be possible to find a sharp line between the institution of medicine and
other social institutions."
· Four broad notions "guideposts"
o 1. Disease prevention and health maintenance and promotion
o 2. Relief of pain and mitigation of suffering caused by disease or injury
o 3. Care and cure of those with an ailment and care for those who cannot be
cured
o 4. Avoidance of premature death and pursuit of a peaceful death
Principles of Biomedical Ethics written by Beauchamp & Childress advocating
an approach to moral reasoning grounded in four principles. What are these
four principles? Know the definition of each and be able to recognize these
principles in a case study. THIS IS A VERY IMPORTANT BOOK AND YOU NEED TO
KNOW THE AUTHORS AND THESE FOUR PRINCIPLES. Answer - · Four
principles/Definitions
o Autonomy - the freedom to decide for oneself what course of action is most
consistent with ones values and beliefs
o Nonmaleficence - an obligation to refrain from causing harm
o Beneficence - forms of action intended to benefit others
o Justice - fair and equitable treatment in light of what is due
· Written in 1979 by Tom L. Beauchamp and James F. Childress
o Advocated an approach to moral reasoning
What does Callahan say on p 232 about the relationship of death to the self,
and about rethinking the image of ourselves as sovereign? Answer - · Instead
of fighting death on every front, he asks, might it be possible to pick our battles
with a view not to defeating death but to shaping it to our own ends
· "The relationship of death to the self, to the way we think about our individual
fate, is the most central issue."
,· "an image of the self that is more flexible, less manipulative, more
interdependent with others, more open to risk, a self-appropriate to a peaceful
death."
Know which country the hospice movement originated in, when did the
movement start in the US? Answer - · Originated in Britain, started in America
in the mid 1970's, gained momentum from 1982 when hospice services
became an entitlement under medicare and the joint commission on
accreditation of health care organizations initiated hospice accreditation
Note mention of Quinlan case, again. New interest in palliative care started in
the US when, and when was the subspecialty of palliative care created?
Answer - · 1990's witnessed a new professional interest in palliative care whose
purpose is that of providing effective control of symptoms, especially pain
management
· 1997 institute of medicine published a report calling for the creation of a new
subspecialty of palliative medicine
o American board of medical specialties approved the creation of hospice and
palliative care as a subspecialty in 2006 and was approved in 2008 by
accreditation council for graduate medical education
raison d'etre Answer - reason or justification for existing
therapeutic modesty Answer - · preoccupation with medically managing the
human body is of relatively recent origin. "Indeed, aside from vaccines and a
few antibiotics and hormones to control infections and metabolic
derangements like high blood sugar, the idea that anyone could control
desperate medical conditions has only arisen since World War II .... When
therapeutic modesty gave way to widespread new enthusiasm for technologies
of bodily control that began with the mid-1960s and took off in the 1970s, the
older way did not linger for long".
, Know WHO definition of health and its criticisms Answer - · Health is a state of
complete physical, mental, and social well-being, and not merely the absence
of disease or infirmity.
· Most critics consider it inflated and unrealistic
o Not only does the WHO's definition of health create an impossible ideal, they
argue, but it also creates disappointment among physicians and patients. There
is simply no way to measure "a state of complete ... well-being" or to know
when it has been achieved. In addition, the WHO definition also supports the
modern Western view that health is the highest good - a troubling implication
that the philosopher Daniel Callahan (1930-) has nicely captured with the
phrase "the tyranny of survival."
Examples of medicalization in this chapter Answer - alcoholism, homosexuality,
drug addiction, menopause, or even aging
Holistic Concepts of Health and Healing Answer - Health: means wholeness
To heal: to make whole
Greek: hygeia, sense of living well and caring rightly for one's body
· health is more than the absence of pathology or disease; that it involves
aspects of meaning and purpose that are essential to human flourishing
The Nature of Suffering and the Goals of Medicine article by Eric Cassell defines
healing as what? Answer - · defines healing as the restoration of wholeness in
a patient whose identity and social life have become fragmented.
THREE FALSE GOALS OF MEDICINE...what are they? Answer - · Leon Kass
attributes
o false goal of happiness to the open-ended character of some contemporary
notions of mental health, which consider frustration, anxiety, or unsatisfied
desires to be marks of ill health rather than part of the human condition.
HUMANITIES STUDY GUIDES CH. 14-22) 121
QUESTIONS WITH ACTUAL SOLUTIONS!!
Note opening quote! CH.14 Answer - · "The Relief of suffering is the
fundamental goal of medicine"
The social constructionist approach versus the essentialist approach to describe
the purposes of medicine: Know the definition, description and features of
each Answer - · Social constructionist approach
o takes into account the diverse social factors and cultural values that shape
healing practices
o medicines ends and purposes are externally determined and thus culturally
variable
· Essentialism
o The goals of medicine are derived internally from values inherent in the
practice of medicine
o Considers such values as preventing and curing disease, relieving pain,
mitigating suffering to be invariant or unchanging
Hastings Center: purpose and conclusion of their report, bottom of page 226
Four broad notions to describe the goals of modern medicine concluded by the
Hastings report. What are these four "guideposts"? Answer - · "A medicine
that has no inner direction or core values will be too easily victimized and
misused by society if it lacks the resources to resist encroachment upon it... yet
it is also naïve to think that medical values can remain uninfluenced by society.
,Since doctors, health care personnel, and patients will be part of society, it will
never be possible to find a sharp line between the institution of medicine and
other social institutions."
· Four broad notions "guideposts"
o 1. Disease prevention and health maintenance and promotion
o 2. Relief of pain and mitigation of suffering caused by disease or injury
o 3. Care and cure of those with an ailment and care for those who cannot be
cured
o 4. Avoidance of premature death and pursuit of a peaceful death
Principles of Biomedical Ethics written by Beauchamp & Childress advocating
an approach to moral reasoning grounded in four principles. What are these
four principles? Know the definition of each and be able to recognize these
principles in a case study. THIS IS A VERY IMPORTANT BOOK AND YOU NEED TO
KNOW THE AUTHORS AND THESE FOUR PRINCIPLES. Answer - · Four
principles/Definitions
o Autonomy - the freedom to decide for oneself what course of action is most
consistent with ones values and beliefs
o Nonmaleficence - an obligation to refrain from causing harm
o Beneficence - forms of action intended to benefit others
o Justice - fair and equitable treatment in light of what is due
· Written in 1979 by Tom L. Beauchamp and James F. Childress
o Advocated an approach to moral reasoning
What does Callahan say on p 232 about the relationship of death to the self,
and about rethinking the image of ourselves as sovereign? Answer - · Instead
of fighting death on every front, he asks, might it be possible to pick our battles
with a view not to defeating death but to shaping it to our own ends
· "The relationship of death to the self, to the way we think about our individual
fate, is the most central issue."
,· "an image of the self that is more flexible, less manipulative, more
interdependent with others, more open to risk, a self-appropriate to a peaceful
death."
Know which country the hospice movement originated in, when did the
movement start in the US? Answer - · Originated in Britain, started in America
in the mid 1970's, gained momentum from 1982 when hospice services
became an entitlement under medicare and the joint commission on
accreditation of health care organizations initiated hospice accreditation
Note mention of Quinlan case, again. New interest in palliative care started in
the US when, and when was the subspecialty of palliative care created?
Answer - · 1990's witnessed a new professional interest in palliative care whose
purpose is that of providing effective control of symptoms, especially pain
management
· 1997 institute of medicine published a report calling for the creation of a new
subspecialty of palliative medicine
o American board of medical specialties approved the creation of hospice and
palliative care as a subspecialty in 2006 and was approved in 2008 by
accreditation council for graduate medical education
raison d'etre Answer - reason or justification for existing
therapeutic modesty Answer - · preoccupation with medically managing the
human body is of relatively recent origin. "Indeed, aside from vaccines and a
few antibiotics and hormones to control infections and metabolic
derangements like high blood sugar, the idea that anyone could control
desperate medical conditions has only arisen since World War II .... When
therapeutic modesty gave way to widespread new enthusiasm for technologies
of bodily control that began with the mid-1960s and took off in the 1970s, the
older way did not linger for long".
, Know WHO definition of health and its criticisms Answer - · Health is a state of
complete physical, mental, and social well-being, and not merely the absence
of disease or infirmity.
· Most critics consider it inflated and unrealistic
o Not only does the WHO's definition of health create an impossible ideal, they
argue, but it also creates disappointment among physicians and patients. There
is simply no way to measure "a state of complete ... well-being" or to know
when it has been achieved. In addition, the WHO definition also supports the
modern Western view that health is the highest good - a troubling implication
that the philosopher Daniel Callahan (1930-) has nicely captured with the
phrase "the tyranny of survival."
Examples of medicalization in this chapter Answer - alcoholism, homosexuality,
drug addiction, menopause, or even aging
Holistic Concepts of Health and Healing Answer - Health: means wholeness
To heal: to make whole
Greek: hygeia, sense of living well and caring rightly for one's body
· health is more than the absence of pathology or disease; that it involves
aspects of meaning and purpose that are essential to human flourishing
The Nature of Suffering and the Goals of Medicine article by Eric Cassell defines
healing as what? Answer - · defines healing as the restoration of wholeness in
a patient whose identity and social life have become fragmented.
THREE FALSE GOALS OF MEDICINE...what are they? Answer - · Leon Kass
attributes
o false goal of happiness to the open-ended character of some contemporary
notions of mental health, which consider frustration, anxiety, or unsatisfied
desires to be marks of ill health rather than part of the human condition.
