Write a short essay (one or two paragraphs are more than enough) in response to 3 of the following 6 questions (worth 10 points each for a total of 30 points). This exam is open book/open note. Make sure to answer the questions you pick in individual responses because they are separate answers and not a single paper! 

Question 1

Consider the following case (Case developed by Dr Constance Perry and adapted from the Heinz Dilemma used by Lawrence Kohlberg and Carol Gilligan):

John Smith is a single father of a young infant, Lizbeth. Lizbeth was just diagnosed with an extremely rare condition called Pompe’s Disease.

Pompe’s Disease is a rare genetic glycogen storage disease that leads to progressive muscle weakness and an enlarged heart. People with the disease fail to make sufficient amounts of glycogen-degrading lysosomal enzyme acid alpha–glucosidase (GAA). This leads to a build up of glycogen in the body’s cells, leading to gradual paralysis, ventilator dependence and heart failure. Cognitive development is not usually affected. The infantile form creates little or no GAA and is the most severe, usually leading to death within the first year of life if untreated.
The only available treatment for this disease is enzyme replacement therapy (ERT). ERT has been shown to prolong survival and decrease the symptoms of the disease process in some individuals. The annual cost of ERT for Pompe’s Disease is expensive, averaging $300,000 per year.(Genzyme)

Lizbeth’s health insurance is through the state CHIP program. But it does not cover this medication. It has a yearly prescription limit of $1,000. John tries to get Genzyme, the company that makes the drug, to give him the drug for a reduced cost. But the company responds that it cannot afford to do this since it provides the drug for free to individuals in poor countries. So few people have this condition and the process for making the drug is so expensive that it would go out of business if it gave the drug away for free to all who ask.

John works at the hospital pharmacy. He sees the ERT drug on the shelf and decides to steal it.

Did he do the right thing? Apply one of the theories from normative ethics that we discussed in class to develop an explanation of why he did or did not do the right thing by stealing the drug.

Resource: Genzyme, (2009) Genzyme: Our Commitment – The Cost of Enzyme Replacement Therapy. http://www.genzyme.com/commitment/patients/costof_treatment.asp (Links to an external site.) (accessed 8/20/09).

Question 2

Explain what Vaughn means when he says that one of the key features of ethics is that they have “normative dominance” and give at least one concrete example of ethics being normatively dominant

Question 3

Explain the difference between a valid argument and a sound argument, and give an example of each.

Question 4

When deciding whether to accept or refuse a medical treatment on behalf of an infant, which standard should a parent use? Give an argument that explains and justifies your answer. 

Question 5 

Give an example of a situation in which a person is assenting but not consenting to an experience (medical or otherwise). Give an argument that explains and justifies your answer. 

Question 6 

Give an example of letting die that is in alignment with the distinction made by Callahan and explain why it is NOT an act of killing.