Response Histograms

These histograms represent responses from 34 randomly-selected optometry students and faculty members. All responses were recorded anonymously.

1). Is killing another person who is trying to kill you ethical?

2). Is killing another person who has food and will not share if you or your family is starving ethical?

3). Is killing another person preemptively because you believe that the person might be a threat to you in the future ethical?

As the human genome project progresses, it will soon be possible to determine the probability that a person will develop specific diseases or conditions, e.g., cancer, diabetes, alcoholism, obesity, mental illness.

4). Is it ethical to require genetic testing of each newborn to determine the probability that the newborn will develop certain diseases or conditions during his or her lifetime?

5). Is it ethical to tell a person (and the parents in the case of in infant) about these probabilities?

6). Assuming that the patient does not provide the information, is it ethical for a patient's health care providers to know these probabilities?

7). Assuming that the patient does not provide the information, is it ethical for a patient's spouse to know these probabilities?

8). Assuming that the patient does not provide the information, is it ethical for a potential spouse, i.e., a person considering marriage, to know these probabilities?

9). Assuming that the patient does not provide the information, is it ethical for a patient's health care insurance provider to know these probabilities?

10). Assuming that the patient does not provide the information, is it ethical for the government to know these probabilities?

11). Assuming that the patient does not provide the information, is it ethical for a patient's employer to know these probabilities?

12). Assuming that the patient does not provide the information, is it ethical for an optometry or medical school to know these probabilities and thus deny admission to a person who has a high probability of developing a condition that might be dangerous to patients, e.g., mental illness, alcoholism, or pedophilia?

13). Assuming that the patient does not provide the information, is it ethical for everyone to know these probabilities from the time the person is an infant?

14). Assume that the genes for antisocial behavior, i.e., criminal behavior, have been found, and it is possible to prevent the conception of individuals who are likely to demonstrate criminal behavior. Is it ethical to prohibit conception of such individuals?

15). Assume that the gene for criminal behavior is present in strong association with a particular race (which race is irrelevant to the issue), and that it is possible to prevent the conception of individuals who are likely to demonstrate criminal behavior. But it will also mean preventing the conception of many members of a particular race. Is it ethical to prohibit conception of these individuals?

16). Assume that the gene for Best's disease, which leads to early blindness, has been discovered, and it is possible to prevent the conception of individuals who will have Best's disease. Is it ethical to prohibit conception of these individuals?

17). Assume that the gene for myopia has been discovered, and it is possible to prevent the conception of individuals who will be 6 diopters or more myopic. Is it ethical to prohibit conception of these individuals?

18). A recently televised football game featured the University of Utah playing the United States Air Force Academy. On the uniforms of the Utah and Air Force players there was a rather large Nike Swoosh logo. There was also a large Swoosh logo on the football. Is it ethical for state university and Air Force teams to wear advertising logos?

19). Recently, an ophthalmic corporation donated white clinic coats to all third year students at a school of optometry. Each of the coats had a small company logo on the sleeve cuff. Is it ethical for optometry students to wear coats with company advertising logos?

20). Many medical and ophthalmic companies provide lunches or dinners to doctors in exchange for listening to a product/sales presentation. Is it ethical for doctors to accept these free meals?

21). Some medical and ophthalmic companies provide cash, equipment, rebates, and other significantly expensive perks to doctors who use or prescribe their products. Is it ethical to accept these perks assuming that the doctor passes the perks along to the patients in the form of reduced fees?

22). Now consider the perk issue above but assume that the doctor does not pass along the perks to patients. Instead, he or she uses the perk for personal benefit. In addition he or she does not let patients know that there are perks associated with certain products or prescriptions. Is this ethical?

23). An ophthalmic corporation invites optometry faculty members to its headquarters all expenses paid to learn how to give presentations about their products. It then pays them to give these presentations, which are based on scripts or PowerPoint slides furnished by the company. The faculty member speakers do not reveal that they are company trained or paid. Is this ethical?

24). Consider the issue above regarding company training and pay for faculty member speakers, but now assume that the speakers declare at the beginning of the presentation that they are company trained and paid. Is this now ethical?

25). Assume that your spouse has a simple but very painful corneal abrasion. OTC pain relief products have not helped. Oregon law prohibits the prescribing of category III drugs to family members but you use a category III pharmaceutical sample from your office for pain relief. Is this ethical?

26). Physicians do not typically sell the drugs they prescribe. However, it has been suggested that they should begin selling drugs at a profit. Would it be ethical?

27). Optometrists typically sell lenses at a profit. Is this ethical?

28). Is it ethical to deny medical school admission to individuals with disabilities such as poor color vision that would potentially reduce the ability to make diagnoses?

29). Is it ethical to deny optometry school admission to individuals with disabilities such as poor color vision or reduced binocularity if they would potentially reduce the ability to make diagnoses?

30). A health plan has been developed that essentially rations care for patients with limited incomes. Diseases and conditions, including those related to the eyes, are ranked in order of expense to treat, probable outcome, etc., and a line is drawn on the list below which treatment will not be paid for by the state. Is this ethical?

31). A health plan has been developed that essentially rations care for all patients regardless of income or ability to pay. Diseases and conditions are ranked in order of expense to treat, probable outcome, etc., and a line is drawn on the list below which treatment will not be provided even if the patient can pay. Is this ethical?

32). You have contracted a contagious disease, e.g., AIDS or TB. You observe all required precautions with your patients to prevent transmission, but is it ethical not to tell your patients about your disease?

33). Your patient has contracted a contagious disease, e.g., AIDS or TB. You observe all required precautions with your patient to prevent transmission, but is it ethical for the patient not to tell you about their disease?

34). Some believe that optometrists must be held to a higher code of conduct in their daily affairs than the average person. Is it ethical for an optometrist to use marijuana recreationally on a vacation out of the US where use of the drug is legal?

35). You are romantically attracted to a patient who seems to return your feelings. Neither of you are involved in another serious relationship. Is it ethical to date a person and have him/her still remain your patient?

36). You are romantically attracted to a member of your staff who seems to return your feelings. Neither of you are involved in another serious relationship. Is it ethical to date a person and have him/her still remain on your staff?

37). A senior colleague has grown out-of-date in his treatment and diagnostic skills. The colleague is not dangerous to his patients because he has years of experience and makes referrals when he is unsure. Yet he is not practicing up to the current standard of optometric care in the community. Is it ethical to contact the state board with your concerns?

38). You have hired an office assistant who turns out to be incompetent. When you try to dismiss her, she threatens action against you for racial discrimination, age discrimination, sexual harassment, or whatever. However, she agrees to leave quietly if you will give her a good letter of recommendation. Is it ethical for you to do this?

39). You have hired an office assistant who you believe is stealing from you but you have no hard evidence. When you try to dismiss her, she threatens action against you for racial discrimination, age discrimination, sexual harassment, or whatever. However, she agrees to leave quietly if you will give her a good letter of recommendation. Is it ethical for you to do this?

40). You have hired an office assistant who is stealing from you and you have hard evidence of this. You decide to avoid calling the police because of all the scandal, but when you try to dismiss her, she threatens action against you for racial discrimination, age discrimination, sexual harassment, or whatever. However, she agrees to leave quietly if you will give her a letter of recommendation. Is it ethical for you to do this?

41). Touching your patient or performing an "invasive test" without informed consent can be considered assault. You feel a strong need to perform a test for the benefit of the patient, but he/she is resisting out of fear, e.g., fear of having the Goldmann probe touch the eye. You tell a "little white lie" and explain to the patient that the probe will not touch the eye. (Do not avoid the intent of the example by arguing that you could use another test.) Is it ever ethical to lie to a patient?

42). In parts of Canada, "Sight Testers" provide refractions and glasses (no health testing is done) to adults who meet certain criteria and who specifically request this service. Notwithstanding any laws or regulations to the contrary, would it be ethical for optometrists to provide only refractions and glasses to adults who specifically request that no other testing be done?

43). Notwithstanding any laws or regulations to the contrary, would it be ethical for opticians who have been adequately trained by optometrists to provide only refractions and glasses to adults who specifically request that no other testing be done?

44). A laboratory with which an optometrist does business sends a holiday gift with a certain value. At what value, if any, does it become unethical to accept the gift. Let the scores of 2 through 9 represent gift values in $100 increments, e.g., 3 would be $300, etc.

45). A doctor or practice group with which an optometrist does business (i.e., sends or receives referrals sends a holiday gift with a certain value. At what value, if any, does it become unethical to accept the gift. Let the scores of 2 through 9 represent gift values in $100 increments, e.g., 3 would be $300, etc.

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