BIO 603 3 24 18

1. Cure/ care: compare and contrast.
2. Basiccare: Nutrition, hydration, shelter, human interaction. Are wemorally obliged to this? Why? Example
3. Swallowtest, describe; when is it indicated?
4. Whenis medically assisted N/H indicated?
   • Brieflydescribe Enteral Nutrition (EN), including:
     • NJtube
     • NGtube
     • PEG
   • Brieflydescribe Parenteral Nutrition (PN), including:
     • Totalparenteral nutrition
     • Partialparenteral nutrition
5. Bioethicalanalysis of N/H; state the basic principle and briefly describe thetwo exceptions.
6. Case Study: TerrySchiavo (EXCEL FILE IN CANVAS). Provide a brief bioethical analysisof her case; should we continue with the PEG or not? Why yes or whynot?TERRISCHIAVO CASE TIMELINE.xlsx

read: 32, 33, 34, 56, 57, 58

32.While every person is obliged to use ordinary means to preserve hisor her health, no person should be obliged to submit to a health careprocedure that the person has judged, with a free and informedconscience, not to provide a reasonable hope of benefit withoutimposing excessive risks and burdens on the patient or excessiveexpense to family or community.18

33.The well-being of the whole person must be taken into account indeciding about any therapeutic intervention or use of technology.Therapeutic procedures that are likely to cause harm or undesirableside-effects can be justified only by a proportionate benefit to thepatient.

34.Health care providers are to respect each person’s privacy andconfidentiality regarding information related to the person’sdiagnosis, treatment, and care.

56.A person has a moral obligation to use ordinary or proportionatemeans of preserving his or her life. Proportionate means are thosethat in the judgment of the patient offer a reasonable hope ofbenefit and do not entail an excessive burden or impose excessiveexpense on the family or the community.39

57.A person may forgo extraordinary or disproportionate means ofpreserving life. Disproportionate means are those that in thepatient’s judgment do not offer a reasonable hope of benefit orentail an excessive burden, or impose excessive expense on the familyor the community.

58.In principle, there is an obligation to provide patients with foodand water, including medically assisted nutrition and hydration forthose who cannot take food orally. This obligation extends topatients in chronic and presumably irreversible conditions (e.g., the“persistent vegetative state”) who can reasonably be expected tolive indefinitely if given such care.40 Medically assisted nutritionand hydration become morally optional when they cannot reasonably beexpected to prolong life or when they would be “excessivelyburdensome for the patient or [would] cause significant physicaldiscomfort, for example resulting from complications in the use ofthe means employed.” 41 For instance, as a patient draws close toinevitable death from an underlying progressive and fatal condition,certain measures to provide nutrition and hydration may becomeexcessively burdensome and therefore not obligatory in light of theirvery limited ability to prolong life or provide comfort.