Autonomy, truth-telling, and confidentiality

Some things that I learned about Autonomy, truth-telling, and confidentiality is firstly,
medical professionals can’t make you do anything against your own free will if you are
over the age of eighteen. The patient has autonomy which means they can make their
own informed choices if they are in the correct state of mind. You can’t force a heart
transplant on somebody, even if it means they will die without it. Second, medical
professionals have a duty to tell you when they discover something pertaining to your
health. Yet, there is a moral grey area with placebos. Placebos can only work if the
person taking them believes they will actually help them. Placebos are a “Medication”
that in reality, has little to no effect on the body. Placebos work though because the
patient believes that the medication is actually doing something. Placebos would not
work though, if the doctor were to inform the patient that what they are actually taking is
a sugar pill. So if the doctor were fully telling the truth, the patient would not be able to
experience the benefits of the placebo. Third, pertaining to confidentiality. Unless told
otherwise, your doctor or other healthcare provider should not be discussing your
personal healthcare needs with anybody not directly working with you or your case. If
somebody were to come in on their own and ask for a copy of your file, it would be
illegal for them to give it to that person without your consent.
When starting this class I believed that the doctor should always let the patient decide
what they want, no matter their age, doctors should always tell their patient the
complete truth, and that the spouse of the patient should be able to request a copy of
the patient’s file, even without consent. Now I realize though that autonomy has to
depend on many factors, like if the patient is in a safe state of mind to make these
decisions, and if they are old enough to fully understand their decisions. Truth-telling
should always be tried for, unless it would benefit the patient physically to not know that
what they are taking is a placebo. Placebos should never be used just because the
doctor isn’t sure what the illness is and they want to look smart. Lastly, confidentiality
can be important for the patient’s privacy, and in some cases their safety (Like in cases
of abuse.)
Talking about this topic in class, and learning about it through reading has helped me to
look at these issues from different perspectives. In turn I believe my ability to discuss
these topics has been improved greatly.

Research ethics and informed consent

Some things that I learned pertaining to research ethics, and informed consent are
firstly, for research purposes, sometimes things are done to people that can cause them
pain or discomfort. These things must be done though so we can continue to grow our
knowledge of the human body. Ethically though, you should not be doing these things to
somebody who doesn’t want to participate. For this reason, we have things called
“Clinical Trials,” where people volunteer to be guinea pigs testing new medications or
procedures. Sometimes people choose to participate in these studies because they are
offered money, some do it because they have run out of options. This however, is a
slippery slope because this preys on the poor. People with low incomes, who are
struggling financially are more likely to volunteer for these studies. Whether it be
because they just need more money, or because they are sick, and the normal
treatment costs too much so they decide to do a research study on a new treatment,
because it is free. Informed consent can also be an issue when dealing with research
studies. Many people might find themselves in a situation they didn’t expect when
signing up for a clinical trial, because they weren’t walked through it thoroughly enough.
Also, because low income families sometimes are less educated they may not
understand what they are truly signing up for.

Originally coming into this class I believed research studies were perfectly ethical, as
long as they payed the person, and told them what might happen, but now I see that
there are many flaws in this system. I still think that the patient should be paid for their
trouble, but they should be asked to repeat back to the person things that are going to
happen to them, and what might happen to them. To be sure that they truly understand.

I have actually talked with my mother about the possibility of me doing a clinical trial,
and before I didn’t know a lot about it. Now I believe my ability to discuss this with her
would be greatly improved, thanks to this class (I don’t plan on ever doing one now
though.)

Genetic control

When coming into this class, I thought I already knew what “Genetic Control” meant.
Yet, I have learned so much more than I ever thought I would. Firstly, I didn’t know that
genetic control was something that we already for the most part know how to do. I
thought that it was a far off science fiction idea. Instead, it is something that many soon
to be parents are already pondering. Although genetic control can be referring to the
physical features of a baby (If they want dad’s eyes, and mom’s nose.) This can also
refer to the genetic deformities parents wish to avoid. This is not just about getting a
perfect supermodel baby, but instead protecting them from having a disability that their
parents may have. Some see this as the parents “Playing God,” and some see it as
being good parents, who want to reduce suffering.

My opinion on this subject has changed slightly upon learning these new things.
Although I still believe it is slightly selfish to only want your child if they look a certain
way, It is not selfish however to take steps to ensure that your child is healthy. This is
what most parents wish for their child. It is perfectly normal to want your child to be as
healthy and happy as they can be. Although, I can still understand the parents that may
want their child to have a certain physical trait, because they may have lived with it and
know that the physical trait may cause it’s own form of suffering (Like an odd looking
nose, or a lazy eye.)

Because I am more well rounded on this subject now, I believe that if I were to enter into
a conversation with somebody about this I would be able to thoroughly explain my
beliefs in a way that the other person could understand. Maybe in turn I could make
them a bit more well- rounded on the subject as well.

Reproductive control

This chapter goes over many different aspects of genetic control, so I will be going over
just a few things that I learned that stuck out to me a lot. Firstly, egg donors. This, a lot
like the clinical trials, seems to heavily rely on people with low incomes to donate. The
process to donate eggs is not simple, quick, or easy. It is painful and in most cases
traumatizing. When you learn more about the process, it is odd to think how anybody
would volunteer to do this. Yet they still do. In comparison to sperm donation, women
get payed a lot more. Yet, men can create more sperm every day, and therefor donate a
lot more than women can. Without the invasive procedure. Second, I would like to talk
about test tube babies. This procedure gives women the chance to have children, when
they might have otherwise not been able to. Some people though, think that this is
another way of “Playing God.” and that it should be avoided. These people may also
feel this way about hiring surrogates. Which is a woman tasked with carrying somebody
else’s baby to term, and giving birth. Unlike adoption, this is not the surrogates baby. It
is the paying parents egg and sperm, which they then fertilize and place into the
surrogates body. This is usually used when the mother physically can't carry or birth the
baby without extreme risk, or in some cases when the mother simply doesn’t want to
carry the baby or give birth. People have many differing opinions on this subject. Some
people believe it’s God’s/fate’s will that they can’t have a baby and they shouldn’t do
anything to get around it. Others think that it is a great way for people to have children,
when they can’t do it themselves.

By being in this class, my opinion on reproductive control hasn’t actually changed much.
I still believe that any way of bringing a child into this world is amazing and beautiful. I
am very impressed how science has made it so accessible to so many people. Though,
learning more about egg donation has made me more aware of our exploitation of the
poor.
If I were entering into a conversation about reproductive control with somebody I believe
that now I have more knowledge on the subject, and therefore could defend my views
more in a more well rounded way.

Abortion

When coming into this class I thought that I already knew everything about abortion, but
that was very incorrect. I learned more than I ever thought I would want to know about
this procedure and In turn it has slightly changed my opinion on the subject. A few
things I learned about the subject of abortion were firstly, the state’s laws on abortion
and how they differ. When coming into this class I assumed that abortion was illegal in
every state. I realize now that many states allow abortion up to a certain point in the
pregnancy and very few states actually have no laws on when you can have an
abortion. You could have one at 8 months if you wanted. The laws also differ greatly on
who needs to be notified. If you have to tell the father of the baby or not. I always just
assumed that women made the decision and nobody else had to know, which I realize
now was a ridiculous assumption. The laws also differ on why you are choosing to
abort, some places allow it if the baby was conceived in rape or incest. Learning this
made me realize that not everybody gets abortions because they made a bad decision,
but because they got dealt a bad hand. Also during this class I discovered the different
methods used to kill the fetus during an abortion. The horrifyingly graphic details in
which they describe crushing the fetus’ head. I will admit, I felt a bit sick when listening
to that be described.

Due to this class my opinion has slightly changed on my view of abortion. I believed
before that although I would never get one personally, I can’t make the decision for
anybody else. Also I believed that legalizing it wouldn’t normalize abortion, but instead it
would save women from having to get dangerous back alley abortions. They would
instead get safe legal ones. Now I still believe that I would never personally get an
abortion and although I can’t make decisions for other women, I will always discourage
them from doing it. I also believe now that abortion should be legalized in some cases
but they should have to go through a process where they have to get approved before
doing the procedure. Some cases like rape and incest can be approved, but not in many
other cases. Cases like multiple babies, when you may have to abort one to save the
other three should be listed as an option, but not encouraged. The parents should get
the last say on that. Also with babies that might not live past birth, or who will live a
short painful life, abortion again should be listed as an option, but not at all encouraged.
I also think that there should be a more humane way to abort the child. They should
never be torn apart or feel pain.
My ability to discuss this topic has improved greatly during this class, due to the fact that
I have learned so much more, and heard so many differing opinions. Although, I don’t
like to get into discussions or arguments about this very tough topic, I am now confident
that I would be able to thoroughly defend my opinion if needs be.

Treating or terminating impaired infants

Learning about this topic was a little tough for me because when people are talking
about this they often refer to babies with downs syndrome, and spina bifida. I have a
cousin whom I love dearly, who has downs syndrome. The thought of not having her in
my life saddens me greatly. I also have a good friend who is bound to a wheelchair
because she was born with spina bifida. She has also added to my life immensely, and
whenever I thought about how some parents would think to abort her it angered me.
Now I have learned that “Terminating impaired infants” is not just referring to those
specific ailments. There are many other things that a fetus might be dealing with. In
some cases, people may think that saving the child from a life of pain, needles, and
surgery is actually sparing them, not killing them. Some cases this may be true.
Sometimes a baby can be disfigured, and they won’t survive outside of their mother for
more than a few hours. Those hours might be painful, or they might not be. The parents
though are forced to make the decision whether or not they carry the baby to term,
which is not as easy as some may think. Also during this chapter I learned that the
doctors can sometimes be wrong. They can tell the soon-to-be mother that her child
won’t survive birth and that it will be best to terminate, and then the baby ends up being
completely fine. This makes you wonder how many unnecessary abortions have been
performed, when the baby was actually okay. It is a terrifying realization for any new
parents, that they can’t completely trust their doctors.

Although my opinion has slightly changed knowing that not all cases are parents who
don’t want a special needs child because it would be “Too hard,” It still saddens me to
know that some parents would let that sway their opinion.

If entering into a conversation with somebody about this topic, I am confident in my

ability to state what I believe and defend it. I still however, would not be able to tell an
expecting mother what to do. I have never had children, but I have worked with children
with special needs for many years so I could share some insight on that side of things,
but I still can’t understand all of it because I haven’t been in that situation.

Euthanasia and physician-assisted suicide

Entering this class, I did not know the difference between euthanasia and physician-
assisted suicide. Now I have learned how the two differ. Euthanasia is when the doctor
themselves do something to end the patient’s life. Usually they inject them with
something that will first make them fall unconscious, then stop breathing, and eventually
their heart will stop. Physician assisted suicide however is not done personally by the
doctor. The doctor will give the patient a pill or drink that they will have to choose to take
themselves. This drug will do the same thing as the injection. It will make them fall
unconscious, stop their breathing, and then their heart will stop.

Many doctors will not ethically participate in these practices, because they believe their
job is to keep people alive and in good health. Some other doctors though believe that if
the patient is in the right state of mind though, and they understand what they are
choosing to do, they have the right to end their own lives, or have help ending their
lives.

This is a hard topic to form a distinct opinion on. Originally coming into this class I
thought that if the person didn’t want to live, they shouldn’t have to. I also believed that
the doctors should have the duty to end the patients suffering. Now I can see that the
death effects so many more people than just the patient. It affects their family and
friends. It also affects the doctor, who now has your blood on their hands. I also didn’t
originally take into account that the person wanting to die might not be in the right state
of mind to be making this kind of decision. Their age also is a factor in if they should be
allowed to end their own lives. At what time is a person mentally mature enough to
make such a decision? It’s really hard to say.

Discussing this topic, I believe I would have a lot of things to contribute, but I am not
sure if in the end I would have a definitive answer to fully support. Still though, I would
do better discussing this than before I took this class.

Organ transplants, scarce medical resources

In this class I learned how truly scarce our medical resources truly are. I did not know
how many people were really waiting on that transplant list, and how many good people
die waiting to get the help they so desperately need. I think that if more people knew
what I now know, we would have more people agreeing to be organ donors. I learned
that people are considering changing to an “Opt Out,” method. This means that instead
of having to specifically say “Yes, you have my permission to take my organs if I die.”
you are an organ donor unless you specifically say no. This would lead to a lot more
organ donation. Yet, it would also lead to many people being upset that you took their
loved ones organs. It would pose problems with people who didn’t fully understand that
you had to take steps to prevent organ donation. Some religions believe that the body
has to be whole after death, and no part can be taken out and given to somebody else,
or they can’t move on. This would understandably upset people to know you doomed
their loved one.

When I first learned about the “Opt Out,” method, I thought it was a great idea that
would lead to saving so many more lives. I did not think about how it would affect
people that didn’t understand it. Now I see that it would cause more problems than it
would fix. If somebody was misinformed and their loved one had their organs taken
without informed consent, that person could sue the hospital, and therefore take more
money out of the healthcare system. They would then in the long run have to charge
people more and make healthcare harder for people to recieve.

My ability to analyze and discuss this topic has improved greatly because of this class.
Now I can see from multiple viewpoints, and hopefully help other people to see other
views as well.

Distributing health care

When coming into this class, I thought that socialized healthcare was the best way to
go. I thought that everybody should get free healthcare because we are all human, and
we all deserve to be healthy. I soon realized though that it is not as easy as it sounds. In
this class we learned how socialized healthcare can be detrimental. We Learned about
a little boy from the UK. His parents wanted to keep giving him care, but because they
had socialized healthcare, they were not allowed to continue care after a certain amount
of time. Even though the parents were willing to pay, or even move to be able to get
their son care. There are other issues I learned about as well, like how our taxes will be
forced up if we don’t have money going into the system from healthcare. People who
hurt their bodies knowingly will be getting their care paid for by people who are healthy
and good to their bodies.

Based on what I have learned, I believe that socialized healthcare will end up doing
more harm than it does good. More suffering will come from it, and some people may
take this as an excuse to not care about their bodies as much, because if something
goes wrong they can get it fixed for free. This is a dangerous way of looking at things.
Also having the government so heavily involved in what care you can and can’t receive
seems dangerous. At least now, of you are willing to go bankrupt you can save your life
or the life of a loved one. With socialized healthcare you won’t go bankrupt but you can
be told “Nope, we can’t do any more for you.”

My ability to analyze and discuss this topic has improved greatly because I now
understand what might happen in both situations. I’m no longer looking at the situation
like “One way I have to pay a lot of money, the other way I don’t.”

Women and medicine

As a woman in medicine myself, I am a bit biased on the subject. I came into this class
thinking that there were no good reasons to not want a woman taking care of you. If
somebody didn’t want a woman, well then they are just sexist! They don’t get to choose!
Now though I have learned that many people aren’t trying to be sexist when they don’t
want women in medicine. In the past doctors, dentists, funeral directors, most of the
“Big,” jobs were done by men, while the nurses, dental assistants, and receptionist jobs
were usually done by females. If you are dealing with somebody who is older, or from a
different culture sometimes they don’t expect women to be doing the “Big,” job, and they
may wrongly assume the are not qualified. Although in many cases this is not true, and
the woman doctor is just as qualified as her male counterpart, it is not intentionally
sexist for the person to think this way. Sometimes it isn’t even that the patient doesn’t
think the woman is qualified, but instead they would prefer a man because they are
embarrassed in front of a woman. This would usually happen with men, but could
happen with other women as well. Some may sway the other way though, and only
want female healthcare workers. This may come from the fact that many people are
raised to believe that women are more nurturing and caring than men. They will take
better care of you. This can be true in some cases, but isn’t always.

My opinion on this subject has changed slightly, knowing what I know now. I don’t just
automatically assume that if somebody requests a male doctor, they are being sexist.

I believe that being in this class made me less biased on this subject and therefor I will
be able to discuss and analyze this better in the future due to my change in perspective.

Health care for minorities

Before reading this chapter, I was blissfully unaware of how truly horrible our healthcare
system is for minorities. I learned that it isn’t easy for people to just “Get out of their
current situation, get a good education, and get a job,” The family in which you are born
affects your life more than you can understand. It is so much harder for people born in
poverty to get a good education and be able to afford healthcare. Immigrants, illegal or
not, avoid getting the help that they need for fear of being treated differently or even
being deported. Transgender people are ridiculed and sometimes denied care. They
even took a poll to see if whites vs. blacks felt like they got adequate care, and the black
patient’s usually felt like they could have been helped more, as opposed to their white
counterparts. Prejudice and racism is still very prominent in our culture today, and many
people are like I was, Blissfully unaware. Learning all we can about our prejudices will
help us to become less prejudice in the future. Maybe one day we can eradicate it all
together. For now though, we have to take the small steps it takes us to get there. We
may need to start with our healthcare system, making it more accessible for everybody.
My opinion has changed greatly since learning what I have in this class. Originally i was
almost neutral on the subject. I knew in the back of my mind that things need to change
and there is probably still racism today, but I didn’t know how prominent it truly was until
now.

Thanks to this class, for making me analyze this issue further, I now know how to inform
others about this issue. I can now see how ethically our healthcare system still has a
long way to go before we are truly not prejudice towards anybody.

Those with AIDS/HIV

Some things that I learned about people suffering from HIV/ AIDS during this class was
firstly, how much they are discriminated against around the world. I had no idea how
much of an epidemic that it was. Now I know that most people even if they have not
experienced the difficulty of having HIV/AIDS in their own lives, they know somebody
else whether it be their family or friends, who has suffered due to HIV/AIDS. I also
learned that countries that take steps to prevent the spread of HIV/AIDS by providing
things like condoms and clean needles, have a lower number of people who get
infected. While countries that put all their efforts into punishing people infected with
HIV/AIDS or people who use drugs, have a higher rate of people infected with HIV/AIDS
from drug use.

Before taking this class, I did not know how big of an issue this actually was. I just
thought that it was an issue that gay men had to deal with. Looking at it now though I
understand that it is so much more than that and if we not only as a nation, but as a
world change the way we look at these people, we can eventually eradicate this illness
all together.

My ability to analyze and discuss this topic has improved greatly since taking this class
because now I have more knowledge on the subject. I am able to look at it as
somebody that may someday be affected by this, not somebody who Is looking from an
outsider's perspective. I can both see why somebody is in favor of putting in laws to
prevent the spreading of this disease, and why somebody believes the opposite. If I
enter into a conversation with somebody regarding this topic, I will surely be able to
defend my personal opinion, without disregarding theirs.