PHIL 1030 HEWITT FINAL EXAM

PHIL 1030 HEWITT FINAL EXAM - November 5 2007*Two issues...

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November 5, 2007 *Two issues usually come up when talking about EXPERIMENTATION on humans. 1. Informed consent 2. Equipoise *Both of these are conditions of moral permissibility of experiment. *INFORMED CONSENT is letting patient know what is going to happen during the experiment and possible effects (both positive and negative). *EQUIPOISE requires that doctors and all medical professionals must give their patients the best treatment available. They must not harm you, and they cannot “short change” you (they cannot choose to give you a secondary medicine to see its effects if it is known that there is a better treatment.) *For an example of equipoise, suppose we have accepted treatment A and experimental treatment B. We must be UNCERTAIN about the merits of A over B for the experiment to be morally permissible. In other words, there must be a “balance of uncertainty”. *What is the problem with this? 1. Equipoise may be present at the beginning of an experiment, but the point of the experiment is to get information so equipoise is out of balance; it becomes apparent which treatment is superior making it morally impermissible to continue experiment. 2. Placebos ( an inert substance used mostly in controlled experiments testing the effectiveness of another substance) are not highly available so controlled experiments are not usually possible. *There are two types of equipoise: 1. THEORETICAL equipoise is individual experimenters that are uncertain of the best treatment. (Problems with this are the preliminary results throw off the balance of uncertainty and placebo trails are highly unavailable.) 2. CLINICAL equipoise is when there is a lack of consensus (which is better) among the clinical community (the experts) at large; only way to get some consensus is to run a trial to get a scientific answer. *Can we move to clinical equipoise if doctors are supposed to give patients the best treatment available?
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November 7, 2007 Clinical equipoise versus “patient centered care” *If we were to run a clinical trail on stage I breast cancer patients, here is how we might break down different experimental groups: size of tumors, relative health (and health history) of patient, and opinion of doctor (that is, the doctor may think one treatment is better than another). *Concerning the first two above (size of tumors and relative health), these groups could be broken down into small groups. However, these would be so small that they would not be helpful because the results would be very limited. No trail would prove good. *Concerning the third (that the doctor may think one treatment is better than another), if only one doctor thinks one treatment is better than another but the rest of the respectable doctors disagree, then that doctor’s opinion must be suspended. Therefore, this criteria does not matter.
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