Discussion: Health Care Ethics

Discussion: Health Care Ethics

Discussion: Health Care Ethics

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Reading Assignment: Chapter 10 Page 283

Assignment 1: Review Question B

Assignment 2: Review Question F

Assignment 3: Case Study – Page 260

Assignment 4: In the News – Page 267

Assignment 5: Please read the New York Times article, ”Ethical Questions arise as

Genetic Testing of Embryos Increases” by Gina Kolata, February 3, 2014.

Assignment 6: Please read the New York Times article,” A New Form of Stem-Cell Engineering Raises Ethical Questions”, by Carl Zimmer, March 21, 2017.

Genetic Counseling and Testing

· The science of genetics, discovered by Austrian botanist and priest Gregor Mendel, is the study of heredity and its variations.

· Genetics describes the biological influence that patients have on their offspring

· Genetic counseling is performed by geneticists.

· Genetic counselors meet with the couple usually before the pregnancy occurs to discuss the potential for passing on a defective gene.

· There are over 6,000 genetic disorders that have been identified as having a genetic factor, including: Tay – Sachs disease, Sickle-Cell Anemia and Cystic Fibrosis.

· Other common genetic diseases include:

· Down ’s syndrome, Phenylketonuria (PKU), Hemophilia, Huntington’s Chorea, Muscular Dystrophy, Fanconi’s Anemia, Neimann-Pick Disease, Gaucher Disease, Maple Sugar Urine Disease, Glycogen Storage Disease, and Cooley’s or Mediterranean Anemia.

· www.geneticdiseasefoundation.org

· Prenatal Screening

· In the future, physicians will be able to test parents to see if it is possible that they will give birth to a genetically impaired infant – BUT what is to be done with this information?

· Depending how paternalistic we are we may choose to:

· Not allow them to have children

· Suggest strongly that they do not have children

· Refuse to pay medical expenses

· Leave it up to the parents to take the risk.

· Ethically should we test for genetic diseases in the fetus for conditions that may show up late in life such as Huntington’s chorea?

· Patient’s feel they have the right to be informed of their medical conditions.

· Methods for genetic testing during pregnancy include:

· Chronic Villi Sampling

· Amniocentesis

· Genetic Testing of Newborns

· 3-5% of newborns have a hereditary or congenital disorder and one-fourth if all hospitalizations and deaths among babies are due to these disorders.

· Almost all states have passed laws requiring PKU testing in infant’s immediately after birth and before discharge from the hospitals.

· PKU is an amino acid defect that is treatable with dietary restrictions that must be started immediately to prevent mental retardation.

· Ethical questions regarding Genetic Testing

· Do parents have the right to be informed of all the results of a genetic test?

· What if there is the case of “misidentified paternity?” in which the testing indicates that the biological father us someone other than the man who believes he is the father?

· The mother is often told “quietly” about the misidentified paternity

· 1-10% of all people may have misidentified paternity.

· Does the person have the right to have children who are likely to be impaired?

· If a woman is carrying a child with severe neural tube defect –spinal bifida?

· Is society ever justified in requiring people to submit to genetic screening and counseling?

· Does the small number of people with the potential for a genetic disease it genetic condition justifies the expense of testing all babies?

· Should the public funds be used to pay for genetic testing when the parents are unable to pay?

· Genetic science has allowed us to think in terms of a post humanism society, a world of cyborgs, and new creations

· What are the ethical concerns that would forbid the movement toward a post human society (if any)?

· The promise

· Genetic screening

· Cloning

· Xenotransplantation without rejection (transplantation of non human organs

· Eugenics

· Gene therapy

· Somatic gene therapy

· Germ line therapy

· Cloning

· Genetic pharmacy

· Growth hormone has been used to treat conditions such as dwarfism

· Stem cells – develop into the body’s specialized tissues known as embryonic stem cells. “regenerative medicine”

· The promise

· Immortality

· Re-engineering humans

Eugenics

· Historical framework

· Eugenics is the practice of altering or controlling genetic makeup of offspring or the purpose of improving a population or matching the natural endowment of a group to certain social functions.

· Eugenics can be done in two ways:

· One can stop the reproduction of certain diseases and dispositions

· Or intervene directly in the genetic material of an individual after birth

· There is the possibility of catastrophic mistakes for both the individual and society.

· Eugenics also raises the problem of chance.

· How much chance can we morally and safely eliminate?

· Positive eugenics

· Improve the genetic pool of humanity by selecting positive attributes

· Negative eugenics

· We could eliminate genetic diseases

· Potential

· If one could create a society of happy, healthy, productive, handsome/beautiful, creative citizens