PHI 237 1st EditionFinal Exam Study Guide Velleman- Difference between dignity and interestso “Disease is an affront (offense) to ones dignity”- Interpretations of the quote:o 1. Because patient is aware of the condition and suffers…because he realizes that he cannot act fully rational  Suffering because trying to act rational and fails to do so because of your conditiono Hershenovs objection- dignified for the mentally impaired at their limitations impaired for what they can and cant do  mentally impairedo 2. Because the patient is aware that the disease might further erode his value Awareness causes suffering  leads to affront to societyo Hershenovs objection – this awareness cant take with Vellemans twilight of autonomy  have rationality to come down the road  have to much to care in the future Listened euthanasia to earlyo 3. Once you have disease you have less dignity than before Disease takes away some dignity you had  remove ito Hershenovs objection  If less dignity doesn’t mean less dignity you offend  Less value or dignity there  what are you offendingo 4. Because the disease prevents you from being who you ought to be Compassion shows that there is an offense to dignity - The way that the disease prevents you is an offense to dignityo Hershenovs objection  if this was the mentally impaired undignified too? No offense to their dingily that they are mentally impairedo 5. Because it is an offense to the way the person used to be  How he used to be in persono Hershenovs objection  cant work because then it would okay to euthanize comatose patients  If you are awake you can exercise rationally  step down how they were rationally Ronald Dworkin (R. Dworkin)  dying and living life puts reason  Margo- Topic  Advance directive  Make decision ahead of time- What does one do about an advanced directive (AD)?- Does Margo have the right to decide what happens to herself?o Dworkin views that doctor should go with AD 1. Dr. should promote a patients autonomous interests and experimental well being 2. If a patients experimental interests conflicts with the patients autonomously produced critical interests, then Drs. Should promote the autonomously chosen critical interests- Prefer critical over experimental if com in contact 3. Margo at T2 has a experimental interest in the well being produced from further life 4. Demented Margo has an autonomous choses critical interest in death hastened 5. Dr. should go with and promote critical interestso Choose critical over experimental  Drs. Do that Experimental interest (E.I.)  things that give us pleasure like sports, cooking, eating well Critical Interest (C.I)  goals you have in life that lend genuine meaning and coherence to your life  more centrally important and more important - RD claim that you basically should go with AD because AD is about critical interest and Margo’s happiness is and E.I o Has no E.I to live but she has an CI to dieo Have EI day to day o CI trumps EIo Gist  I can go to conflict … go with C.I. conflict of interest … C.I take precedent because found in AD- Hershenovs  C.I don’t survive post dementia… don’t extend by the wake of dementia o E.I don’t apply with  set in o Margo1 shouldn’t affect Margo2 because they are 2 different peopleVeatch and Pitt  Presumed Consent- Main q in article  The ethics of organ procurement (more about consent) o Should we have an opt-in/opt-out of organ donations  opt in to donate like USA or opt out of donating like European Countries  Doctrine of presumed consent- More about fairness. Organ distribution  supply of organs is much less than demand. Once youget an organ that do you decide to give it to?o Should you give a recovering alcoholic a new liver or are they disqualified? o Should we give preference to people who decided to donate?o Some religions don’t believe in donating organs … should they receive if not willing to give?- Strategies for increasing organ supply  supply is less than demand o 1. Mandated Choice (required response) : everyone has decision to make if they want to be an organ donor Let them chooseo 2. Routine Salvage: its okay to take organs unless told otherwise … if someone died it would be okay now that they are dead so lets take their organs  mourn for a little thencarry out their organso 3. Financial Incentives: receive money for donating organs Those in need of money will sell organs just to sello 4. Preferred Status: thought that organ donors will be high up on the list if need a transplant VIPo 5. Xenographs: Can successfully accomplish inter-species organ donations Not much success but do it scientifically can helpo 6. Redefine death: Ambiguous if someone was dying  Body function normally but persons in ambiguous states- Is person still there?  Rid as permanent loss of consciousnesso If brain dead  permanent loss of consciousness  brain dead is that you are deado 7. *Controversial*- Use organs from prisoners on death row Might incline judges to give out death sentences more frequently - Presumed consent (“opt out” model) definition –o If opt out otherwise presume that people automatically donate organs o Presume that your are in unless you said specifically no- P&V argue that presumed consent is not real and that they are doing routine salvage in European countrieso No consent going on – just harvesting organs without consento Euphemism  put it in nice termso Presumed Consent collapses into routine salvage- Use of consent and donor are euphemistic o Scenario that no one has agreed to donate organs  no consent given  to call them donor is misleading in other cases not just this Presumed consent (PC) is real in other cases not just this PC happens only if someone consents if asked Don’t know if you would ask them if they would say yes Need something more explicit  either by knowing them - Doesn’t need to be personal relationship Cant assume person would agree if we say yes  Can’t know if they would opt-out unless said Survey says we would be wrong 30% of the time - If you didn’t opt out would be okay if people took organs  Need to ask to know for sure if they consent Depending on poll – 7 – 38% of Europeans like system of opt out Majority like the opt out policy  VIP Argument – make a lot of