Full transcript
0:01okay so test one is in the books i hope
0:04that it did not give too many of you
0:07excuse me problems
0:09i warned you to work on it as we went
0:11through but inevitably some of you
0:13waited till the last minute and that
0:14didn't turn out
0:15as well for you as you might have hoped
0:17your test two
0:18is already up it's there please download
0:21it and work on it as you go
0:23because a lot of the test questions are
0:26going to
0:28repeat or be very very similar to blog
0:31posts
0:32a test question requires a great deal of
0:34thought
0:37and much more content than a simple blog
0:39post does but the blog post will get you
0:41started
0:42and then you can expand on what you
0:43write there as you move into
0:46your test questions one of the things
0:48we're going to talk about in the next
0:49video
0:50is the difference between an opinion and
0:53a stance
0:54and what i'm going to ask you to develop
0:55in this class is a stance
0:58because the stance can be supported um
1:00before we get into that though we're
1:02going to talk about the beginning of the
1:04next unit which is applied
1:06ethics now we talked about metaethics
1:08which which is kind of the
1:10excuse me commentator for football and
1:12then we talked about normative ethics
1:14normative ethics are
1:16the referees that sort of put everything
1:18in perspective and in line and gives us
1:20something we can really really work with
1:23and then we're to applied ethics this is
1:26the players
1:27on the field this is when we take
1:29everything we've learned about the rules
1:31and the opinions involved in ethics and
1:34now we're going to take
1:35all of that and apply it to the really
1:38tough issues things like abortion
1:40and euthanasia things like assisted
1:42suicide and environmental ethics
1:45so those things that really are going to
1:47um
1:48cause you to think and and i really want
1:50to express to you how important it is
1:54that you remain open-minded as we move
1:57through this
1:59we are not going to enter into religious
2:00debates or anything like that this is an
2:03ethics class and while we've seen ethics
2:06sometimes it's tied to religion
2:07it is not religion and allowing your
2:10religion to determine your ethics can
2:12sometimes be a very dangerous thing so
2:13keep that in mind as we move forward and
2:15i really want you to keep
2:17um conscious of the fact that i need you
2:20to be open-minded okay so
2:22let's talk about applied ethics um first
2:25of all and this is the single most
2:26important slide i'm going to give you
2:28in this entire unit because what this
2:31has done
2:32is it has taken all the principles of
2:35things like duty ethics and virtue
2:37ethics
2:38and um kantian ethics and prima facie
2:41duty and all of those things that we
2:43talked about
2:45and boiled it down to a list
2:48of applied ethics principles
2:51that we can take and ask ourselves the
2:54question
2:55about any issue based on this list
2:59so what you've got is personal benefit
3:01so
3:02does whatever you're looking at produce
3:04a beneficial consequence for an
3:06individual
3:08societal or social benefit does whatever
3:11issue we're looking at provide benefits
3:13to society
3:15benevolence does it help paternalism
3:19does it help people who cannot help
3:21themselves
3:23the principle of harm is really
3:25important because it's very simple
3:27don't hurt other people do not harm
3:30other people
3:31ethical behavior never involves harming
3:34someone else
3:35or someone else's stuff or someone
3:37else's livelihood or someone else's
3:39family relationships
3:41principle of honesty don't lie do not
3:44deceive
3:44others especially when you're dealing
3:46with an ethical question
3:47and this is one that has gotten lost in
3:49the 21st century because people are so
3:51desperate to be right they're so
3:55desperate to be
3:56accepted and they're so desperate to be
3:58thought of as woke which is the
4:00stupidest word on the planet bt dubs and
4:02we're going to talk about that as we go
4:05that they will lie or mislead or
4:08manipulate
4:10other people to get their way principle
4:13of lawfulness
4:14don't break the law do not break the law
4:16if the law says that this
4:18certain thing is is illegal you have to
4:21acknowledge that
4:23now we we know the other side just
4:26because something's legal doesn't mean
4:27it's ethical
4:29but if it's illegal you really have to
4:31stop and question it
4:34um principle autonomy now this is the
4:36one that most of you are going to
4:38recognize
4:38this is the question of a free person's
4:40freedom over his or her own
4:42body and of course abortion is the first
4:45thing that comes to your mind
4:46but there's also questions that involve
4:48principle of autonomy that are much more
4:50complicated for example
4:52jehovah's witnesses are not allowed to
4:54receive blood transfusions
4:57so if i'm an adult and i say
5:01i cannot receive a blood transfusion
5:02because of my religious beliefs
5:05then the hospital respects that what if
5:08it's a child
5:10does that child have the freedom over
5:14his or her actions or body
5:16should a nine-year-old be able to go get
5:18a medical procedure
5:19without parents permission because it's
5:22their own body
5:24should a six-year-old be able to get a
5:25tattoo
5:29all right so the principle of justice
5:30now this involves the
5:32due process this involves that if
5:34somebody has committed something a crime
5:36or done something wrong
5:38or even if someone has wronged others
5:42it acknowledges this person's right to
5:45um compensation or
5:49reparation or repayment or
5:52that concept of justice now you have a
5:55video that talks about what justice
5:57is and i'm looking forward to y'all's
5:59responses about that because it's really
6:01good
6:02and then the last one is a very sort of
6:05hodgepodge collection
6:06this is your basic rights your right to
6:09life
6:10information your right to privacy your
6:12right to safety your right to expression
6:15but remember rule number one is your
6:18rights
6:19stop where my rights start
6:22and my rights stop where your rights
6:26start you don't get to tear something up
6:30of mine because you're mad at somebody
6:31else you violated my rights
6:35okay so here's the application we're
6:39going to put to this this is a
6:41the case of a child called they called
6:43her baby doe it was 1982
6:46okay 1982 so it's 40 years ago
6:50um and you have to remember medical
6:53technology is not what it was 40 years
6:55ago
6:56i mean what it medical technology is not
6:59medical technology was not what it is
7:02today
7:0340 years ago that was harder to say than
7:05i should have been
7:07this child was born and you can read
7:09this explanation
7:10this child was born with a severe case
7:13of down syndrome
7:16now let me put a caveat here most of our
7:18impressions of down syndrome
7:20are the m are the television shows like
7:22born this way or peanut butter falcon
7:25and those are very high functioning um
7:27people with down syndrome
7:29okay down syndrome is a almost like a
7:32spectrum of different levels
7:34some people are able to do just fine
7:36live by themselves whatever and some
7:38people can never be left alone
7:39they have to have someone with them all
7:41the time this was a
7:42very severe case this child would likely
7:44have been non-verbal
7:46and would likely not have had a long
7:48life expectancy
7:49regardless of anything else but on top
7:52of this severe case of down syndrome
7:54this child also had an esophageal
7:56fistula basically the esophagus did not
7:59connect to the stomach
8:01so the child would never re receive
8:03nutrients
8:04now there is a surgery that fixes that
8:07esophageal fistula
8:10but the parents elected not to do it now
8:13your first thought is
8:14oh my god how could they not alright
8:16wait now
8:18look at your rights look at your list on
8:21one side we have the infant's right to
8:23life
8:24that baby had a right to live and it
8:27suggests the surgery should have been
8:29done
8:30you also have the principle of
8:31paternalism that says we should help
8:33others when they cannot help themselves
8:34that baby obviously could not make that
8:35choice for itself
8:37so on one side you have rights and and
8:39paternalism
8:41but in ethics there are always two sides
8:44don't ever
8:45think that your opinion is right or the
8:47only one because that's dangerous
8:50the other side you have to question the
8:52personal and social benefit
8:54of saving this baby the baby's quality
8:58of life
8:59on a personal level would have been
9:01deplorable
9:03it would likely never been able to feed
9:05itself or
9:06be potty trained its quality of life
9:09would have been
9:11bad the social benefit would also
9:15have created a financial burden for the
9:17parents
9:19huge financial burden because are you
9:22gonna stay at home
9:23at all you know your entire life and
9:24look after this adult child
9:26what happens when you die
9:30you will have spent all your resources
9:32and all your money caring for this baby
9:35while you were alive there will be
9:37nothing to care for it later
9:38and if this if society has to pick up
9:41the bill
9:43for a person with no quality of life
9:46that's a bad deal so our initial and
9:49this is what i really want you to pay
9:51attention to
9:52your initial response was horror that's
9:55your emotional response
9:58see it recognize it and then set it to
10:00the side
10:01and start asking those hard questions go
10:03back to that list
10:04go back to that list and apply all of
10:07those principles
10:08to a certain issue and come up with both
10:11sides
10:12and then you have to decide how you feel
10:15about that or what your stance is about
10:17that based on
10:18these principles not your emotional
10:20response
10:22okay so foregoing the surgery seemed
10:26like it was the best thing because of
10:27the
10:27the quality of life and
10:30the the infant's right to life was
10:32unclear because
10:34of the severity of the impairments
10:37mental and physical
10:38that it was facing because you got to
10:41remember your moral rights involve more
10:43than just your physical body
10:45because if i can keep your body alive on
10:47a machine indefinitely
10:49so that i can continue to collect your
10:50social security check
10:54is that the morally right thing to do
10:57the answer is
10:58no but it happens every day
11:02um when you talk about a person's right
11:06to life
11:07that implies cognitive function and
11:10moral personhood okay and this is the
11:14big question with abortion
11:16right to life cognitive function
11:19and moral personhood hold on to those
11:21two thoughts so
11:23this is our example what they wound up
11:25doing is they
11:26they elected not to have the surgery and
11:28the baby died
11:30which is terribly sad but at the end of
11:33the day
11:34it was very likely the best thing
11:37for the baby the parents society
11:40the hospital everybody
11:44from a very practical non-emotional
11:46stance now some of you are
11:47fuming mad with me right now stop it
11:50you cannot be fuming mad with me because
11:53fuming mad means you're responding how
11:57emotionally and you can't do that
11:59remember this was also 40 years ago
12:01okay so now that i've gotten everybody
12:04upset
12:05let's talk about our major um topics
12:08here all right so we're going to
12:11touch some things i could teach this
12:13class
12:14for years and never touch the moral
12:17ethical dilemmas
12:18that we face in the 21st century
12:21um but what we're going to do is you're
12:23going to learn to deal with any issue
12:26by dealing with the ones that we have
12:28chosen for
12:30this course and so we go into biomedical
12:33ethics and that's
12:34the largest portion of this class
12:36because i have so many students
12:38who are entering the healthcare field
12:41and so i really like to hit this one
12:42hard
12:43plus biomedical issues and biomedical
12:46ethics
12:47are the thing that appeals to our
12:49emotions
12:51the most so if you can learn to conquer
12:54your emotional response
12:55in these few topics you'll be able to
12:57manage that when you
12:58look at other things as well so we're
13:00going to look at informed consent
13:02the hippocratic oath what do those
13:03things mean and what does it mean for
13:05patients
13:07abortion obviously is the probably the
13:10hottest topic
13:12that you can possibly imagine we start
13:14with it
13:15because i want you to learn how to
13:18manage your emotional response before we
13:19go a
13:20step further i also want you to
13:22understand that just because you think
13:24you know about something doesn't mean
13:26you do there's
13:27always room to learn and always room to
13:30change your stances
13:31um i was reading a blog post by one of
13:34my students and he talked about how
13:35drastically his views have changed
13:38as he's gotten older he used to be very
13:40idealistic
13:41and used to vote a certain way and that
13:43everybody should have
13:44and then as he got older things started
13:46to change because he learned more and
13:48more
13:49as you learn your ideas should change
13:52euthanasia assisted suicide um
13:56this one is very emotional for people as
13:58well because a lot of us have watched a
14:00loved one
14:01suffer and wither away and we would
14:04never allow our pets
14:06to suffer the way we allow our family
14:08members to suffer
14:10part of that's because it's the law um
14:12stem cells and cloning this is also a
14:14super hot topic
14:16very complicated and what i did is i've
14:19broken it down as simplistically as i
14:21possibly can so that you have a working
14:23knowledge
14:24of what this is and can then formulate
14:27an opinion
14:29we also deal with environmental ethics
14:31now
14:32environmentalism has been part of your
14:34lives your entire existence you can't
14:36remember before it was a thing
14:39the problem is that
14:43environmentalism has become a huge
14:45money-making
14:47industry huge there's tons of money to
14:50be made
14:51in people's desire to save the
14:54environment
14:55there's a lot you don't know and there's
14:57a lot of guilt you feel
14:59that you shouldn't feel because it's not
15:02your fault it's not america's fault
15:05it's other countries who are committing
15:06a lot of the egregious environmental
15:09acts and terrorism and all those kinds
15:10of things that really are just
15:12destroying some things
15:13so we're going to talk about that too
15:15and we're also going to talk about the
15:16manipulation of statistics
15:20the forest fires in the amazon a couple
15:22years ago
15:25people used photographs from 2012
15:29in order to engage you emotionally so
15:31you would send what
15:33money it's all tied to money and the
15:36last thing we're going to talk about is
15:37business ethics
15:39most of us this is common sense for most
15:41of us
15:42but it becomes a challenge because
15:44businesses have to balance
15:45the needs of their customers the needs
15:47of their shareholders the needs of their
15:48employees the need you know
15:50and they have to run this sort of
15:52gauntlet
15:53of ethical um challenges because they're
15:56trying to satisfy so many different
15:58groups of people
15:59so we're going to talk about business
16:00ethics for a little bit
16:02and go over that
16:05with some specificity to help get you in
16:08line
16:08all right so if we look at our first
16:10we've talked about our our bio
16:12medical ethics this is our first sort of
16:14unit
16:17so let's start with patients rights and
16:20informed consent
16:22um most of us are blinded by the white
16:26coat
16:26when we can see the doctor we assume he
16:29knows what he's talking about we assume
16:31he knows what's best for us
16:32and he says we're going to do and we all
16:35say
16:36okay
16:40okay informed consent is much more
16:42complicated than
16:44okay informed consent means that you
16:47fully understand
16:48the situation the options and the
16:51possible consequences or side effects
16:53of the treatment i hate going to a
16:57doctor's office
16:58and even when they try to talk to me
17:00they use a fifteen dollar word
17:03i don't know what you just said i do not
17:05understand the words coming out of your
17:06mouth
17:09this informed consent is essential to
17:12your
17:12own authority over your body and choices
17:15that you can make
17:18um it goes way beyond you know the the
17:21signing of the piece of paper
17:22and how many forms do you get when you
17:24go to the doctor's office and sign in
17:27all the forms you don't read that
17:30privacy agreement
17:32you just sign it because nobody has time
17:34to read it
17:36we assume that our medical professionals
17:38have our best interests at heart
17:41um it this has two sides
17:45beneficence which is the goal of
17:47medicine to try to help people
17:49and something called non-malfeasance
17:51this is avoiding
17:52harming people and of course all of this
17:56is founded in the hippocratic oath which
17:59all doctors take
18:02and one of the core principles is first
18:05do no harm when you're trying to help
18:07people don't hurt
18:09this do no harm concept is going to run
18:11afoul
18:12of things like euthanasia assisted
18:15suicide
18:16abortion stem cells and cloney
18:20because here's the question
18:23where does that start and stop all right
18:26so here's the hippocratic oath
18:28it is one of the oldest binding
18:30documents in history
18:32it's written by hippocrates which is why
18:34it's called the hippocratic oath
18:36and this link in the powerpoint will
18:38take you
18:41to it and it'll take you to the modern
18:44version
18:44and the classic version so here's the
18:47classic version
18:49no i don't want to do whatever that is
18:51and then here's the modern version
18:54read that and then ask yourself the
18:57question
18:58is it still being respected in the 21st
19:01century
19:02is it still being respected in the 21st
19:05century and i think you'll be surprised
19:07a lot of doctors have great respect for
19:09it but a lot don't
19:11and so you discover how you're treated
19:14if you start measuring your treatment by
19:16the hippocratic oath
19:17you may be very pleased you may be very
19:20disappointed
19:21all right gang so that's it sort of for
19:23our introduction to applied ethics
19:26our first unit is biomedical ethics
19:28informed consent hypocritical we talked
19:30about that today
19:31and then the next video will cover
19:34abortion so
19:34get ready all right gang see you then