B09: Tutorial 6 – Summary

  • Administrative reminders:
    • Participation reflections #2 due end of day
    • Will hold office hours once the midterms are returned (to be scheduled) to discuss grades and any issues etc
    • Will hold office hours (to be scheduled) to talk about the essay when it’s released. If you want to talk about the essay in tutorials, you should email me questions so I can prepare responses
    • There is a philosophy essay clinic (link under news on main tutorial page) which you may want to sign up for, for free help with your essay drafts, outlines, etc
    • C will post some lectures they’ve given elsewhere for those who have asked about other questions around bioethics we’re not covering in this course
  • Gave summary of the last lecture (over two weeks ago!)
  • C brought two handouts as choices, but each tutorial only covered one (Abby) copied below. The other (Henri) may come up in other tutorials and is not copied here as we didn’t cover it.
    • Abby is a 64 year-old married woman, with a nine-year history of Multiple Sclerosis (MS). She was hospitalized two years ago following multiple falls caused by balance issues, onset with the progression of MS and lesions to her pons and cerebrum. She has also seen some decline in memory, and she has better days and worse days, but seems not to have any further cognitive impairments or history of depression. In the past year, she has developed difficulties with a number of motor functions, and her caretaking team feels that she may need to be placed on a feeding tube soon to assure adequate nourishment.  They ask Abby about this—explaining the nature of the procedure and its consequences—and in the morning she agrees to the procedure. However, in the evening (before the tube has been placed), Abby seems confused about her decision to have the feeding tube placed. She tells the team she doesn’t want it in. They revisit the question in the morning after, when the patient seems more lucid again. Unable to recall her state of mind from the previous evening, the patient again agrees to the procedure. What would Buchanon and Brock, Freedman, and Misak say about this case? Should we, all things considered, move forward with the procedure and insert the feeding tube? Would your argument differ if Abby was 24 years-old?  
    • What are some barriers to granting or obtaining informed consent? What roles does informed consent play in settings like critical care medicine or emergency departments? Should the standards of informed consent be different when the person consenting is not the current patient (such as a surrogate decision maker or an advance care plan or directive)? Do the standards and expectations for informed consent in medicine match the standards of informed consent we use in other parts of our lives? How, why, or why not?

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