PHI 3633 St Thomas University

  1. Cure / care: compare and contrast.
  2. Basic care: Nutrition, hydration, shelter, human interaction.
    • Are we morally obliged to this? Why? Example
  3. Swallow test, describe; when is it indicated?
  4. When is medically assisted N/H indicated?
    • Briefly describe Enteral Nutrition (EN), including:
      • NJ tube
      • NG tube
      • PEG
    • Briefly describe Parenteral Nutrition (PN), including:
      • a. Total parenteral nutrition
      • b. Partial parenteral nutrition
  5. Bioethical analysis of N/H; state the basic principle and briefly describe the two exceptions.
  6. Case Study: Terry Schiavo. Provide a bioethical analysis of her case; should we continue with the PEG or not? Why yes or why not? (it is in the documents sent)
  7. Read and summarize ERD paragraphs #: 32, 33, 34, 56, 57, 58:
  8. 32. While every person is obliged to use ordinary means to preserve his or her health, no
    person should be obliged to submit to a health care procedure that the person has judged,
    with a free and informed conscience, not to provide a reasonable hope of benefit without
    imposing excessive risks and burdens on the patient or excessive expense to family or
    community. 33. The well-being of the whole person must be taken into account in deciding about any
    therapeutic intervention or use of technology. Therapeutic procedures that are likely to
    cause harm or undesirable side-effects can be justified only by a proportionate benefit to
    the patient. 34. Health care providers are to respect each person’s privacy and confidentiality regarding
    information related to the person’s diagnosis, treatment, and care. 56. A person has a moral obligation to use ordinary or proportionate means of preserving his
    or her life. Proportionate means are those that in the judgment of the patient offer a
    reasonable hope of benefit and do not entail an excessive burden or impose excessive
    expense on the family or the community. 57. A person may forgo extraordinary or disproportionate means of preserving life.
    Disproportionate means are those that in the patient’s judgment do not offer a reasonable
    hope of benefit or entail an excessive burden, or impose excessive expense on the family
    or the community. 58. In principle, there is an obligation to provide patients with food and water, including
    medically assisted nutrition and hydration for those who cannot take food orally. This
    obligation extends to patients in chronic and presumably irreversible conditions (e.g., the
    “persistent vegetative state”) who can reasonably be expected to live indefinitely if given
    such care. Medically assisted nutrition and hydration become morally optional when
    they cannot reasonably be expected to prolong life or when they would be “excessively
    burdensome for the patient or [would] cause significant physical discomfort, for example
    resulting from complications in the use of the means employed.” For instance, as a
    patient draws close to inevitable death from an underlying progressive and fatal condition,
    certain measures to provide nutrition and hydration may become excessively burdensome
    and therefore not obligatory in light of their very limited ability to prolong life or provide
    comfort.

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PHI 3633 St Thomas University

  1. Name and explain the levels of human sexual intercourse.
  2. Difference between reproduction and procreation.
  3. What are the two dimensions of intimacy?
  4. Contraception:
    • What is it?
    • What is the intention of contraception?
    • Describe the three types of artificial contraception.
    • Risks / Side effects
    • Bioethical analysis and unfair dynamics of artificial contraception.
  5. Non-Therapeutic sterilization; bioethical analysis
  6. Principle of double effect; explain
  7. Bioethical analysis of:
    • Ectopic pregnancy
    • Cancerous reproductive system with pregnancy
  8. In Vitro Fertilization(IVF):
    • Process
    • Bioethical analysis of IVF
  9. Bioethical analysis of “to have a child”
  10. Read and summarize ERD paragraphs #: 40, 41, 42, 48, 52, 53.

ERD paragraphs:

40. Heterologous fertilization (that is, any technique used to achieve conception by the use of
gametes coming from at least one donor other than the spouses) is prohibited because it is
contrary to the covenant of marriage, the unity of the spouses, and the dignity proper to
parents and the child.

41. Homologous artificial fertilization (that is, any technique used to achieve conception using
the gametes of the two spouses joined in marriage) is prohibited when it separates
procreation from the marital act in its unitive significance (e.g., any technique used to
achieve extracorporeal conception).

48. In case of extrauterine pregnancy, no intervention is morally licit which constitutes a direct
abortion.

42. Because of the dignity of the child and of marriage, and because of the uniqueness of the
mother-child relationship, participation in contracts or arrangements for surrogate
motherhood is not permitted. Moreover, the commercialization of such surrogacy
denigrates the dignity of women, especially the poor.

52. Catholic health institutions may not promote or condone contraceptive practices but
should provide, for married couples and the medical staff who counsel them, instruction
both about the Church’s teaching on responsible parenthood and in methods of natural
family planning.

53. Direct sterilization of either men or women, whether permanent or temporary, is not
permitted in a Catholic health care institution. Procedures that induce sterility are
permitted when their direct effect is the cure or alleviation of a present and serious
pathology and a simpler treatment is not available

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PHI 3633 St Thomas University

  1. Name some very important organs that are not vital organs.
  2. List the functional description of all the normal vital organs, including today’s exceptions.
  3. Is it possible to live without a vital organ? Why? Example?
  4. Distinction between assisting or substituting vital organs. Bioethical analysis.
  5. Do the following practices assist or substitute the vital organ? Why?
    • Dialysis
    • Respirator
    • Ventilator
    • Tracheotomy
    • CPR
  6. Read and summarize ERD PART FIVE Introduction: (Introduction
    Christ’s redemption and saving grace embrace the whole person, especially in his or her
    illness, suffering, and death. The Catholic health care ministry faces the reality of death with
    the confidence of faith. In the face of death—for many, a time when hope seems lost—the
    Church witnesses to her belief that God has created each person for eternal life. Above all, as a witness to its faith, a Catholic health care institution will be a community
    of respect, love, and support to patients or residents and their families as they face the reality
    of death. What is hardest to face is the process of dying itself, especially the dependency, the
    helplessness, and the pain that so often accompany terminal illness. One of the primary
    purposes of medicine in caring for the dying is the relief of pain and the suffering caused by it.
    Effective management of pain in all its forms is critical in the appropriate care of the dying.
    The truth that life is a precious gift from God has profound implications for the question
    of stewardship over human life. We are not the owners of our lives and, hence, do not have
    absolute power over life. We have a duty to preserve our life and to use it for the glory of
    God, but the duty to preserve life is not absolute, for we may reject life-prolonging procedures
    that are insufficiently beneficial or excessively burdensome. Suicide and euthanasia are never
    morally acceptable options.
    The task of medicine is to care even when it cannot cure. Physicians and their patients
    must evaluate the use of the technology at their disposal. Reflection on the innate dignity of
    human life in all its dimensions and on the purpose of medical care is indispensable for
    formulating a true moral judgment about the use of technology to maintain life. The use of
    life-sustaining technology is judged in light of the Christian meaning of life, suffering, and
    death. In this way two extremes are avoided: on the one hand, an insistence on useless or
    burdensome technology even when a patient may legitimately wish to forgo it and, on the
    other hand, the withdrawal of technology with the intention of causing death. The Church’s teaching authority has addressed the moral issues concerning medically
    assisted nutrition and hydration. We are guided on this issue by Catholic teaching against
    euthanasia, which is “an action or an omission which of itself or by intention causes death, in
    order that all suffering may in this way be eliminated.” While medically assisted nutrition
    and hydration are not morally obligatory in certain cases, these forms of basic care should in
    principle be provided to all patients who need them, including patients diagnosed as being in a
    “persistent vegetative state” (PVS), because even the most severely debilitated and helpless
    patient retains the full dignity of a human person and must receive ordinary and proportionate
    care.
  7. Unconscious state: Definition.
  8. Clinical definitions of different states of unconsciousness: Compare and contrast
  9. Benefit vs Burden: bioethical analysis

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PHI 3633 ST Thomas University

  1. Description and bioethical analysis of:
    • Pre-implantation Genetic Diagnosis PGD
    • Surrogate motherhood
    • “Snowflake babies”
    • Artificial insemination
  2. What is Natural Family Planning (NFP)?
  3. Describe the 3 Primary ovulation symptoms.
  4. Describe the 7 Secondary ovulation symptoms.
  5. Describe various protocols and methods available today.
  6. Describe some ways in which NFP is healthier than contraception.
  7. Bioethical evaluation of NFP as a means and as an end.
  8. Read and summarize ERD paragraphs #: 38, 39, 42, 43, 44, 52:
  9. 38. When the marital act of sexual intercourse is not able to attain its procreative purpose, assistance that does not separate the unitive and procreative ends of the act, and does not substitute for the marital act itself, may be used to help married couples conceive.
  10. 39. Those techniques of assisted conception that respect the unitive and procreative meanings of sexual intercourse and do not involve the destruction of human embryos, or their deliberate generation in such numbers that it is clearly envisaged that all cannot implant and some are simply being used to maximize the chances of others implanting, may be used as therapies for infertility.
  11. 42. Because of the dignity of the child and of marriage, and because of the uniqueness of the mother-child relationship, participation in contracts or arrangements for surrogate motherhood is not permitted. Moreover, the commercialization of such surrogacy denigrates the dignity of women, especially the poor.
  12. 43. A Catholic health care institution that provides treatment for infertility should offer not only technical assistance to infertile couples but also should help couples pursue other solutions (e.g., counseling, adoption). 
  13. 44. A Catholic health care institution should provide prenatal, obstetric, and postnatal services for mothers and their children in a manner consonant with its mission
  14. 52. Catholic health institutions may not promote or condone contraceptive practices but should provide, for married couples and the medical staff who counsel them, instruction both about the Church’s teaching on responsible parenthood and in methods of natural family planning. 

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