Read the introduction in your text (pp. 1-40) and review my notes (under "notes & links"). Then, discuss the prompts below. After you make your original post (by Mon 1 Feb), followup on 2 of your classmates' posts (by Fri 5 Feb). If you can't make an original post without completely repeating what someone else has already posted, then just comment on someone else's. Use an example to help.
- Give an example of something that doesn't fit cleanly into all of these categories: morality, legality, etiquette/custom, religion. Explain your categorization. For example, take using pot. I could say that it is moral for medical uses; legal in some states; some circles approve, others don't; religion X is neutral about its use but religion Y condemns it. When you comment on another's example (your follow-up), gently challenge each other's categorizations. So you might challenge me by saying, if it is ok for medical use, why not for mental health (stress relief)? And so forth.
- What are the conditions that excuse or mitigate moral responsibility? Followup: Do you agree? Why or why not?
Something that doesn't fit cleanly into all of these categories is physician-assisted suicide or active human euthanasia:
ReplyDeleteMorality: It is considered morally acceptable in some cases where a person is suffering greatly and has no chance of recovery. In these cases it is often considered by supporters to be the kind, humane thing to do and they believe refusal to do so is immoral.
Legality: It is legal/ illegal in different contexts in different states. The line between active euthanization and passive (allowing to die/ withdrawal of care often) is very blurred. Some examples of laws in various states include:
• Washington: In 2008, the legislators voted in favor of Initiative 1000 which made assisted suicide legal in the state through the Washington Death and Dignity Act.
• Montana: In a 2009 case, the court ruled there was "nothing in Montana Supreme Court precedent or Montana statutes indicating that physician aid in dying is against public policy," however prosecutions under the state's assisted suicide statute are still possible.
• California: legislature passed a bill legalizing physician-assisted suicide September/October 2015. This law went into effect on January 1, 2016.
• Vermont: in May 2013, the governor signed a legislative bill making PAD legal in Vermont.
Etiquette/custom: This varies greatly amongst supporters/ oppostion as to whether it’s more polite to help someone die or fight for them to live despite the circumstances.
Religion: Most religions, traditionally, are against euthanasia, including: Catholicism, Islam, Hinduism, and other less known religions. Although many, like Buddhism, may teach compassion, they still consider it immoral to “embark on any course of action whose aim is to destroy human life, irrespective of the quality of the individual’s motive”. Protestantism and Judaism take a mixed approach within their own religions as to their support for/ against euthanasia. There are religious leaders/ icons these days who do find different ways to justify euthanasia. Within the protestant church, there are even those who argue for active euthanasia/ physician-assisted suicide. Whereas, in the Jewish church, the support leans toward passive euthanasia/ end of life care with dignity and compassion.
I agree. Definitely does not fit. Just like having the right to do what you will with your body you should be allowed to die if you want. Cant say I as a provider want to be a part of ending your life but do see how helping someone die peacefully is the human thing to do.
DeleteAn example of an issue that I found does not fit cleanly in these categories is abortion. Morally, the arguments are related to the fetus being considered a human being or not. Some consider the fetus a human with rights and others do not. Therefore, if a fetus is not a human, then abortion can be justified in the same way as a woman choosing to have her gallbladder removed. On the flip side, if the fetus is considered a human being with rights, then an abortion can be considered murder.
ReplyDeleteLegally, the same argument of whether or not the fetus has human rights applies. Is it murder, which is obviously illegal, or is it a women choosing to remove something from her body which is legal?
Etiquette and customary, the issue of abortion has been and continues to be an ongoing ethical debate with opposing views split nearly down the middle. The topic is extremely sensitive and both sides have very strong opinions and views of the issue and circumstances surrounding it which can make discussions very tense and heated at time.
From a religious standpoint, to my knowledge, there is not a religion that approves of abortion. I would assume that most if not all are strongly against it and consider it immorally wrong. However, there may be some that approve it under certain circumstances or situations such as rape, or a fetus that is incompatible with life, etc.
I can't help but wonder everyone's take on medically suggested abortion. I had a friend who did amniocentesis and was advised her child had a 98% likelihood of being born with Down's (that was when people aborted Down's babies more than now when they help nurture them to have full, productive lives, she was given the option of aborting with medical clearance. She elected to have her baby, who was born without any genetic issues, completely healthy. She had basically been given the option to abort a healthy baby.
DeleteI've closely followed a couple cases this past year of anencephaly. The first was the story of Baby Shane, where his parents elected to carry him to term. They celebrated every holiday/ occasion during the pregnancy. When he was born, his anencephaly was severe, he lived only a very brief period of time, those mere hours complicated by seizures, etc. Should medicine dictate to these parents they should abort and rob them of those brief moments? On the other hand, should the cost of healthcare and the risk to the mother be increased for a non-viable fetus?
The other case of anencephaly I've been following is that of Baby Jaxon, who just celebrated his first birthday, and whose parents insist he does communicate in his own way. There is also Baby Morales, who celebrated her first birthday as well. Had they followed the recommendations, their babies would have never had the opportunity to reach this milestone and still be functioning, growing daily.
I agree Erin, the topic is always a struggle. Where do you draw the line on what is an acceptable reason for an abortion and what is not? I hold my belief that life begins at conception until natural death. However, I do think there are many situations that could warrant an examination of the circumstances to terminate the pregnancy. It is a moral dilemma.
DeleteAn example of a situation that doesn't fit cleanly into the above categories is when a patient is a Jehovah's Witness, and is in dire need of a blood transfusion. This particular religious denomination is opposed to the receiving of blood products on the basis of a biblical standard or proclamation they believe in. Some cases present the facet that the patient could die if a transfusion is not received. The patient and his family must face this predicament; a struggle between choosing to stick to their belief versus taking the transfusion and living. The medical personnel as well, must abide by the patient's wishes, but may face an extremely difficult time watching someone die when they know they could save them with a transfusion.
ReplyDeleteWhat I would say to this is although it seems so petty it's just a little blood and it will save your life but to that person it is a big deal. I view this is as the same as someone having a DNR they are basically saying let me die even if we can say them they are saying don't. In the same respects I have seen some Jehovah's witness change there mind and choose transfusion which is interesting once faced with death how important or unimportant religion is.
DeleteAs well I agree with you this is a sticky subject, Gloria. I also with Alex have seen patients that in a life or death matter go against their religion and they will accept the transfusion.
DeleteI do disagree with the Alex however with the DNR comment, DNR does not mean do not treat, to we will do everything to help them and treat what is going on unless they go into cardiac arrest or respiratory failure. Until we reach life sustaining measures such as intubation, cpr or shocking we still do everything we can to prevent them to making it at that state. Being a DNR could be a very controversial issue as well but with that being said I will stop there since this is more to do with blood transfusions. That is a definite tricky subject and we need to respect but that is why we are taught not to let our own beliefs effect others, and only educate as much as we can and let them come to the decision on their own.
This is definitely a category that does not fit cleanly into the listed categories. It's a difficult one ethically, and legally. I have always been annoyed they expect treatment without allowing the full treatment they need to heal properly and respond best to their medical treatment. My focus has always been the legality in assuring they sign all refusals necessary and documenting so we are covered legally in the event the patient did deteriorate and the family then wanted to hold us responsible.
DeleteI was curious at to their reasoning, and I found the scriptures quoted in the article I read interesting. The following scriptures are what they cite as holding to this belief of theirs.
“Every moving thing that liveth shall be meat for you; even as the green herb have I given you all things. But flesh with the life thereof, which is the blood thereof, shall ye not eat” (Genesis 9, 3–4). “And whatsoever man there be of the House of Israel, or of the strangers that sojourn among you that eateth any manner of blood; I will even set my face against that soul that eateth blood, and will cut him off from among his people” (Leviticus 17, 10). “Therefore I said unto the children of Israel, No soul of you shall eat blood, neither shall any stranger that sojourneth among you eat blood” (Leviticus 17, 12). “For it is the life of all flesh; the blood of it is for the life thereof: therefore I said unto the children of Israel, Ye shall eat the blood of no manner of flesh; for the life of all flesh is the blood thereof: whosoever eateth it shall be cut off” (Leviticus 17, 14). “Only thou shalt not eat the blood thereof; thou shalt pour it upon the ground as water” (Deuteronomy 15, 23). “For it seemed good to the Holy Ghost and to us to lay upon you no greater burden than these necessary things; that ye abstain from meats offered to idols, and from things strangled, and from fornication: from which if ye keep yourselves ye shall do well (Acts 15, 28–29). (Petrini, 2012)
National Center for Biotechnology Information. Petrini, Carlo(2014). Ethical and legal aspects of refusal of blood transfusions by Jehovah’s Witnesses, with particular reference to Italy. Retrieved from the website http://rnbiomedicalethics2016.blogspot.com/2016/01/getting-started-in-ethics-1-5-feb.html
Gloria, this exact situation unfolded in front of my eyes when I was a new nurse. I had a patient the was a Jehovah's Witness and had a severe GI bleed. She was a full code but refused a blood transfusion. There were many people who talked with her about the risks of her losing blood and not taking the transfusion. Her Hgb was dropping everyday. She was on the floor for a few days and she arrested. CPR was performed but she did not make it.
DeleteI have always wondered the same thing Shelly, what their reasoning behind the decision to not accept blood products was. Thank you for doing the research, very enlightening. I may not agree with their decision especially in a situation that may save their life, however I recognize that it is their right to refuse and will continue to honor that.
DeleteAfter thinking about what I should write about I thought about discussing the age limits for drinking in America. There are really 2 sides of the coin.
ReplyDelete1. Minus that small heart health benefit that you can get from Alcohol (only if used in moderation) there really no positives to drinking alcohol Other than to make you feel good. I don't even need to list all of the negative things that happen when you drink. 2. The other side of the coin is lots of other countries have lower age limits to drink and the argument to that side is you are decriminalizing Alcohol and maybe making it less tempting to minors instead of dangling that carrot in front of them. If it was legal at lower age limit it could decrease drinking and driving related fatalities because minors wouldn't have to sneak around and drink somewhere else and then maybe need to get behind the wheel to get home or to a friends house.
Morally I think some religious groups would have a hard time accepting this as well as a lot of parents. It's easy to say as a 17 year old I think they should lower the age but when you are a parent and it's you child you start to think differently. I feel that your customs and your countries culture is a big part of why the age limits are what they are for example Germany's legal drinking age is 16 but they have a very large culture of alcohol and beer being apart of their heritage.
I think that there are a lot of sides to this story when you look at it from other age limits for things. Such as the argument " If you can fight for our country at the age of 18, why can you not have a beer?" Which I feel is like a legitimate concern. How can we dictate that at the age of 18 you are okay to go across the world and risk losing your life but can't have a drink. I think that also tobacco is just as if not worse for you as alcohol. So how can we have one thing be able to be bought and used by 18 year olds and the other 21 year olds.
DeleteI think that if there was something that ever came into place that it should be a set age for these three things for sure. That across the board make it 20, or 18 whatever we could vote on and come to terms with. I feet that there are pros and cons though. I don't know that it really has to do with it being legal everywhere else at an earlier age. I think the issue really with how other things such as the the tobacco issue and going to fight for our country is a lower age and they are not able to drink at the same age.
This is a tricky subject. This has to do with adults teaching their children to respect alcohol like they would respect a gun. Used incorrectly they both can be deadly. I am on the side that they should wait until they are 21 years old. We don't have to look far to see adults well beyond that age are still unable to act responsible with alcohol. Ever been to a Bengals game? The age of 18 was set for the draft because you needed young able men you could train and send to war without question. Back in those eras 18 year old boys were more mature. They usually by that time had jobs and started to have families. The population was much less too. I notice when I was a kid you could ride your bike on the roads. Today there are too many cars and people are much more impatient.
DeleteWow, this is a tricky subject, my thoughts are ambiguous even as I write about it! I feel that drinking is something that in some families is so 'normal'; possibly due to the Irish/Catholic heritage or maybe because you were raised around it always. Other families may not have alcohol in the home ever, yet a child can grow up to drink because it is legal and socially acceptable. Either case, I agree with Chris that adults must be the teachers to their children to respect alcohol, as it can be deadly. I also can relate to the statement that Kourtney brings up that a young man can go to war, but cannot have a beer. So many sides to this coin. But another point that I tend to believe in, is the point that Alex brought up about decriminalizing it makes it less tempting to sneak around and abuse it. My daughter, when she was in high school went to France as a foreign exchange student. She stayed with another high school girl and her family. In France there is no age limit to drinking, and nightly the family had wine with their dinner; including the high schoolers. It was not an issue, so the kids there, didn't make it an issue. But the American kids that were visiting there, were very excited about being able to drink, and talked about it a lot.
DeleteThat being said, I feel that where we are today, that the age limit is ok right where it is. I don't believe at this point, lowering it would change the attitudes of drinking much. Alcohol can be a big problem as it is, so deal with the problems where they are, without adding another issue.
Wow, this is a tricky subject, my thoughts are ambiguous even as I write about it! I feel that drinking is something that in some families is so 'normal'; possibly due to the Irish/Catholic heritage or maybe because you were raised around it always. Other families may not have alcohol in the home ever, yet a child can grow up to drink because it is legal and socially acceptable. Either case, I agree with Chris that adults must be the teachers to their children to respect alcohol, as it can be deadly. I also can relate to the statement that Kourtney brings up that a young man can go to war, but cannot have a beer. So many sides to this coin. But another point that I tend to believe in, is the point that Alex brought up about decriminalizing it makes it less tempting to sneak around and abuse it. My daughter, when she was in high school went to France as a foreign exchange student. She stayed with another high school girl and her family. In France there is no age limit to drinking, and nightly the family had wine with their dinner; including the high schoolers. It was not an issue, so the kids there, didn't make it an issue. But the American kids that were visiting there, were very excited about being able to drink, and talked about it a lot.
DeleteThat being said, I feel that where we are today, that the age limit is ok right where it is. I don't believe at this point, lowering it would change the attitudes of drinking much. Alcohol can be a big problem as it is, so deal with the problems where they are, without adding another issue.
An issue that I believe that is coming more to surface and that does not really fit into the above categories easily is homosexuality. It definitely is still a grey topic.
ReplyDeleteMorally it is still not accepted by all people throughout the US. Even though from a legal standpoint it has been passed that same sex marriage is acceptable. Just because it is legalized does not meant that everyone is "okay" with it.
The US was the 21st country to legalize same sex marriage. Which obviously says that customarily other countries have had same sex marriage legalized for quite sometimes. They adapted to this much more naturally than the US. Which is not surprising to me.
I think that coming from the religious standpoint, there are a lot of religions that still are skeptics to this subject. Coming from at devout catholic family I was raised that this was unacceptable and that man loves a woman, however, I strayed away from this and became more open minded to the idea that love is love no matter what.
Even though it is not my cup of tea, that doesn't mean that I have the right to take that cup of tea away from someone else or judge the cup of tea they might drink from.
Following the new Pope Benedict he is starting to really open the world on the catholic side of things to new thinking. I am not sure that he will ever come out and say that it is "okay" but I do think that he is encouraging catholics and other people that respect his views on controversial topics, to be more open minded and to not judge others for who they love and want to spend the rest of their lives with.
Kourtney I disagree a little with you on this even though I personally disagree with homosexuality is right. I believe it is morally accepted in the secular world only the religious world is it still viewed as taboo. I believe the morals this country is founded on are changing, It can be argued if that is a good or a bad thing. The reason I feel that it is morally accepted in today's culture is because if I were to log on to facebook and make a anti homosexual post the comments would come raining in. I have seen it happen to others.
DeleteI can see your point of view for sure. I just feel that its still such a controversial issue. I agree it is taboo in religion but still I don't think that from knowing some people that when we discuss it they feel that it is morally acceptable. Given what you say about the post on Facebook actually there are still people that have their different viewpoints on it being acceptable. I don't know maybe I have the wording mixed up but I definitely see your view point for sure.
DeleteI chose birth control as a controversial subject that really doesn't fit.
ReplyDeleteI believe that birth control is a choice and a right of all people to choose when they want to have children. With that being said, I do not advocate abortion or the day after pill as a viable choice for birth control. There are many religions that practice natural family planning and birth control is considered denying the gift of a child.
I have a hard time knowing that our government tries to force religious institutions to supply birth control even when it goes against their beliefs and values. Also, it's a hard pill to swallow (no pun intended) that some of our hard earned tax dollars are earmarked to pay for abortions and the day after pill.
Regardless of what I believe, I think we should be allowed to have a moral say in where our tax dollars are spent and the religious institutions should have the right to stand for their beliefs and not be forced to go against them because of government regulations.
I agree that abortion and the day after pill are not forms of birth control and should not be used as such. Is the day after pill paid for by taxpayers? I was under the impression that the pill is over the counter and paid for out of pocket.
DeleteAn issue that has been brought to my attention from a friend of my daughters is the moral issue if two homosexuals should be allowed to adopt a child. There is a strong feeling that there it is morally wrong to place children in an environment that does not them to either have a father figure or a mother figure. The religious outlook is it not only wrong for same sex marriages but also for those to raise children. Some of society that are not religious feel that this is not fair to the child and takes the idea of a nuclear family out of their norm.
ReplyDeleteKnowing that they can legally marry in the US, will the society look at this issue and makes laws. How do we know what is best for the children since this is new to our society with little known about the affects on the children? Does it matter as long as they are in a loving home? Is media over time with all they put in the news and on TV desensitizing us to homosexuality. I do believe this is happening to the younger generations who are taught it is okay.
I believe this issue is not addressed in the categories in the book. It does spark controversy when people or groups talk about it. It also contains different equations. How do you deal with two women that have their own baby and restrict men? Men that were married that left their wives for men but have children. Do they no longer have the right to raise their own children?
Yes, this is definitely one of those gray areas. Now it is more socially accepted for homosexuality and homosexual marriage. Just like anything else some with always see it as wrong for various reasons. However, if legally accepted to have a marriage between the two is it morally acceptable to tell the couple they do not have the right to have children or are not as fit to raise children just because of sexual preference?
DeleteWorking in labor and delivery I have seen it all. Every combination of couples possible have come in and had a baby. I have had the pleasure of taking care of a few same sex couples. I will say that a lot has gone into their decision, especially if it is two men. Usually the child is much better off in the home environment with this couple than in the biological parents home. I have seen numerous couples come in and have a baby and I cant help thinking that the poor baby doesn't have a shot in life with parents like that. I feel like a loving, stable home is what is most important for children to thrive. They will grow up knowing love and hopefully these same sex parents will always be open with them and explain the variety of family set ups there are.
DeleteAn issue that I do not believe fits cleanly in the above categories would be withholding patient information. When a family member asks you to withhold information regarding patient's health from the patient.
ReplyDeleteThis is an ethical dilemma that I've seen occur. Not too frequently thankfully, but one that I have seen a handful of times in my department. A situation where the patient who is oriented or may be confused, is diagnosed with a terminal illness, and the family or loved one asks that you not tell the patient. Or even on that is coming into the hospital and the family states that their loved one has been diagnosed with a brain tumor but they do not know. The information they may want to be held is information usually regarding the terminal illness or even the prognosis. The family's request is usually followed by their reasoning which is usually because they believe that disclosure of this painful information regarding serious illness or terminal diagnosis/prognosis will be too difficult and painful for their loved ones to hear. They may be in fear that their loved one will lose hope, fall into sever depression, or even live out the rest of their life with anger.
Morally we are taught as nurses and physicians to communicate with patients and to be honest. This is essential for the patient-provider relationship. The patient has a right to know information regarding their health. I do believe that withholding information is violating those rights. However, I do understand the family's perspective and why they may have these wishes. I do not believe that their wishes are malicious but are genuine in wanting to protect their family from devastating news.
Ashley, I agree this is a very tough situation to handle. I was faced with it many times while working on TCU. I too understand where the family is coming from but feel obligated to my patient to be honest. I know if I was in that predicament, I would want to know the status of my condition and would hope my family would support me by being 100% honest. If the patient ever found out about the withholding of information, they would have a really hard time trusting nurses and caregivers ever again.
DeleteWhile going back through these posts to read some of the responses that I may have missed, I realized that my initial post is not here. Not sure what happened to it, but I figured I would respond again, even if it is late. So I will take on your example of using pot. It is now legal in multiple states and is legally sold for medical uses as well as recreational uses now in those states. Many people claim that marijuana has many medicinal uses that are all natural and don’t have the side effects that many synthetic medicines have. It is also used to combat the side effects of some of those medicines. Children that suffered from hundreds of seizures a day are now down to just a few. The quality of life for that child has improved 10 fold all from one little plant that nature provided. Folks that have been diagnosed with glaucoma and need to decrease the pressure in their eyes or risk going blind smoke pot to bring the pressure down to the same level that synthetic eye drops can do without the side effects of those medications. In labor and delivery, the social worker is called for any positive drug screen on mothers. If it is marijuana, they let the baby go home with mother and nothing else is done. If it is for anything else, then they run the risk of the cabinet getting involved or losing custody of that child. So if it is ok for medical reasons, then why not for mental health (stress relief)? I say why not? If alcohol is legal and is used as a stress relief for some people, then there should be no reason why marijuana cannot be used also. Since the days of history man has been not only imbibing in alcohol but my ancestors have been smoking tobacco and marijuana. I have never understood why one was made legal and the other was outlawed. I believe that times are changing and laws will soon be passed that will legalize marijuana all across our country. Just like alcohol, it needs to be monitored. We still have the moral obligation to protect our citizens. It should still be against the law to drive under the influence or go to work under the influence. The regulation of its sales may cut down on the amount of time and money our country wastes on law enforcement and other expenditures related to marijuana. Tax on sales could be used in a positive manner to help fund other things.
ReplyDelete